D. Guimaraens

Type IV allergy to rubber additives: A 10-year study of 686 cases

BACKGROUND Rubber additives, mainly vulcanizers and antioxidants, are increasingly a cause of contact dermatitis. OBJECTIVE The aim of the present study was to determine the frequency of type IV allergy to rubber additives. METHODS Seven thousand patients seen during a 10-year period were evaluated. Of them, 4680 were patch tested with the standard series recommended by the Spanish Group for Research of Contact Dermatitis (GEIDC) and a series of individual rubber additives. RESULTS A total of 686 patients (14.7% of those patch tested) had one or more positive reactions to rubber additives. Of these, 582 (84.8%) were men and 104 (15.2%) were women. The incidence of rubber sensitization was especially high among construction workers (47.0%). CONCLUSION Rubber additives are a common cause of occupational contact dermatitis, particularly in construction workers. We postulate that rubber gloves and boots (utilized to avoid contact with sensitizing substances) themselves may be a common cause of contact dermatitis. The high incidence of allergy to some rubber additives, such as thiurams and carbas, indicates that their replacement by other less sensitizing vulcanizers is advisable.

Estudio epidemiológico de la dermatitis alérgica de contacto en España (2001)

Resumen Introduccion El estudio mediante pruebas de contacto estandar es fundamental para diagnosticar y tratar cualquier paciente en el que se sospeche una dermatitis de contacto. El primer estudio estadistico con pruebas epicutaneas estandar del Grupo Espanol de Investigacion de Dermatitis de Contacto (GEIDC) data de 1977. Veinticinco anos mas tarde, se realiza este estudio que tiene como objetivo valorar la prevalencia y la relevancia de las positividades a los alergenos de la serie estandar del GEIDC. Metodos Todos los pacientes fueron estudiados mediante la serie estandar del GEIDC (29 alergenos) en 13 centros dermatologicos. Se valoraron los siguientes parametros: sexo, edad, localizacion, diagnostico, causa del eccema, positividades y relevancia total, presente y pasada. Resultados El 55,11 % de los 3.832 pacientes estudiados (2.300 mujeres y 1.532 varones) tuvieron alguna positividad en la serie estandar. Los diagnosticos mas frecuentes fueron la dermatitis de contacto alergica en el 31,02 % e irritativa en el 15,88 %. El origen mas comun de la dermatitis fue profesional en el 16,66 % de los casos, y la metalurgia y la construccion fueron las ocupaciones mas prevalentes. Mas de la mitad de los pacientes sufrian eccema en manos (54,34%). El alergeno mas prevalente fue el niquel (26,64%) seguido de cobalto (9,89 %) y cromo (8,66 %). Conclusiones Comparando los datos de este estudio con el realizado por el GEIDC en 1977 comprobamos como ha aumentado la alergia a niquel mientras ha disminuido la debida a cromo y cobalto. Alergenos no incluidos anos atras como tiomersal, mezcla de perfumes y Kathon CG muestran actualmente una alta prevalencia. Es siempre fundamental establecer la relevancia de las pruebas positivas, que es alta en este estudio para las gomas y para el niquel.

Contact dermatitis in hairdressers: Patch test results in 379 hairdressers (1980–1993)

From 1980 to 1993, 379 hairdressers were studied in the outpatient clinic of our department. All were patch tested with a standard screening tray and specific hairdressing products. Most of the workers assessed were women (92.3%) with a mean age of 21.33 years. A positive patch test response to one or more of the allergens tested was presented by 58.8%. Allergic contact dermatitis was diagnosed in 48.8%. The mean frequencies of sensitization ranked as follows: p-phenylenediamine base, 45.9%; nickel, 41.4%; disperse orange 3, 32.7%; and 4-aminoazobenzene, 31.9%. Finally, the risk of contact dermatitis is indicated among these workers and their sensitization, while still young, after only a few years in the trade.

Occupational allergic contact dermatitis in construction workers

We report the patch test results of 449 con in met ion workers who came as patients to tine Occupational Dermatology Service of the Instituto National de Medicina y Seguridad del Trabajo in Madrid between 1989 and 1993. 90.8%. of them were patch tested, because they had cutaneous lesions or a clinical history suggestive of occupational dermatitis. 65.5% (268) of those patch tested showed one or more reactions connected with their work. Chromate at 411 was the main allergen. followed by cobalt, 20.5% nickel. 10%, and epoxy resin. 7.5%. 25.9% (106) of patients showed sensitization to rubber components, the majority at 20.7%, to thiuram mix, with TETD being the main allergen.

Contact urticaria caused by heat-sensitive raw fish allergens

Patients allergic to fish usually present with skin reactions after handling raw fish. Less frequently, these reactions are seen without symptoms after oral intake, often in chefs and food handlers. We have attempted to explain the skin selectivity of such reactions in a 36‐year‐old woman with contact urticaria after handling raw fish. We obtained aqueous extracts of raw and cooked fish (sole and hake) for in vivo (prick test) and in vitro (SDS‐PAGE, IgE Immunoblot) tests. Prick‐by‐prick test, 20‐min closed patch test, rub test with fresh and cooked fish (sole, hake and cod) and specific IgE (CAP‐system) to sole, cod and hake were performed. The strength of positive reaction to raw fish was greater than to cooked fish on both prick and prick‐by‐prick testing. Rub tests showed positive responses only to raw fish. Specific IgEs to sole (45 KU/l), hake (66.9 KU/l) and cod (18.7 KU/l) were obtained. IgE immunoblot recognized 3 antigens of 25, 48, 56 kDa in raw sole and 1 of 42 kDa in raw hake extracts. No IgE binding was observed with the cooked extracts or control sera. Our findings strongly suggest a Type‐I hypersensitivity to fish. Immunoblot analyses demonstrated a loss of specific IgE binding to cooked extracts. We have reported a case of contact urticaria caused by heat‐sensitive raw‐fish allergens in a patient who probably became sensitized via the cutaneous route.

Occupational allergic contact dermatitis from cyanoacrylate

Cyanoacrylates are widely used in adhesive techniques. Cyanoacrylate adhesives differ physically for the different needs of application, and chemically in function of the size of ester molecules. A 40-year-old man employed at the National Mint and Stamp factory presented with hyperkeratotic lesions on the fingers of the right hand. His job consisted of fixing microchips to plastic phone cards with Loctite Series 414. Patch testing confirmed sensitivity to cyanoacrylates. After the diagnosis of allergic contact dermatitis was established, the patient, to be cured of the dermatitis, changed his workplace 2 months later.

Fixed exanthema induced by ultraviolet radiation

An unusual cutaneous eruption of the feet and lower limbs induced by ultraviolet radiation in a 30-year-old caucasian man is presented. Previous reports in the literature and the present case indicate that sunlight and UV radiation may provoke fixed eruptions themselves without drug exposure.

Burns due to moxibustion.

Then, 569 patients, ranging from 20 to 70 years, consecutively referred to our allergological service with dermatitis suspected of being allergic in nature, underwent patch tests with the GIRDCA standard series (Trolab, Germany), a textile dye series (FIRMA, Italy) and with 17 textile dyes directly provided by the industry, as listed in Table I. The dyes in this new series were all patch tested at 2% pet. This concentration was chosen as non-irritant, after patch testing in 20 healthy volunteers. Patch tests were applied with Finn Chambers (Epitest, Finland) on Scanpor tape (Norgesplaster, Norway) to the healthy skin of the back, removed after 2 days and read 1 day later. Overall, we found 6 patients (approximately 1%) sensitized to the 8 textile dyes listed in Table 2. 3 of these subjects were atopies. Table 3 shows the SHORT COMMUNICATIONS

Occupational dermatitis from glass fiber

10 control subjects gave negative patch test results to the minoxidillotion. Application of minoxidil I % in alcohol 70° (without propylene glycol) on the scalp caused an outbreak of itching papules. Open tests on the forearm (application 3 times daily) caused a strong positive eczematous reaction in 2 days (Fig. 2). Up to the present, several dozen other patients have been treated with minoxidillotion without any apparent adverse affects.