Gunilla Färm

Isothiazolinones (MCI/MI): 200 ppm versus 100 ppm in the standard series

In an attempt to define the optimal test concentration for isothiazolinones. 200 and 100 ppm of 5‐chloro‐2‐methyl‐4 isothiazolin‐3‐one 2‐methyl‐4‐isothiazolin 3‐one (MCI/MI) in aq. Solution were tested simultaneously in 918 consecutive eczema patients. 3.4% were positive to 200 ppm and 1.7% to 100 ppm. Indicating that up to 50% of the cases might have been missed. Among the 33 cases with positive reactions, 21 showed stronger reactions to 200 than to 100 ppm, while 9 had reactions of the same strength. Use testes were carried out in 7 cases, of which 2 were positive. MCI/MI plus other allergens), the outcome of the use tests and the optimal test concentration. Our present strategy is to use 200 ppm as an indicator and then to carry out serial dilution and use tests in each “positive” case.

Interferon-γ secreted from peripheral blood mononuclear cells as a possible diagnostic marker for allergic contact dermatitis to gold

10% of patch‐tested patients have a positive reaction to gold. Most lack clinical symptoms, but allergic contact dermatitis (ACD) to gold is increasing. In this study, 77 dermatological outpatients were divided into 3 groups depending on epicutaneous patch test outcomes: a group positive to gold (EPI+), a group negative to gold (EPI−), and a group with irritant reactions to gold (EPI‐IR). Lymphocytes were stimulated in vitro with gold sodium thiosulfate. Proliferation was assessed using the lymphocyte transformation test (LTT), and cytokine secretion was assessed using a multibead array (Luminex®; Linco Research Inc., St. Charles, MO, USA), in order to evaluate whether an in vitro method with high diagnostic accuracy could be devised. The EPI+ group showed a significantly increased secretion of interferon (IFN)‐γ, interleukin (IL)‐2, and IL‐13 and also showed a significantly higher stimulation indexes for LTT, compared to the other 2 subject groups. Sensitivity and specificity were calculated for all methods individually and combined, but IFN‐γ assessment alone was the most accurate method for identifying ACD to gold, with sensitivity and specificity of 81.8% and 82.1%, respectively. This method also identified 87.5% of the EPI‐IR subjects as non‐allergic. Therefore, assessment of secretion of IFN‐γ should be a valuable complement to patch test for diagnosing gold allergy.

Can the reporting of adverse skin reactions to cosmetics be improved? A prospective clinical study using a structured protocol

Background:  The use of cosmetics is rising, and adverse reactions to these products are increasing. In Sweden, the Medical Products Agency (MPA) keeps a voluntary reporting system for such adverse reactions. However, the reporting is sparse, consisting almost only of cases with test‐proven allergic contact dermatitis, thus under‐reporting the more common irritant reactions.

Contact allergy to nicotine from a nicotine patch.

ment (Euceta-Gel®, Sanabo, Vienna) regularly on mosquito bites for more than 10 years. For 8 months, itchy dermatitis had been noted at the sites of application. He was patch tested with the European standard series, Euceta-Gel® ointment and its components (aluminium acetic tartrate 0.05%, camomile essence 0.01%, chloroacetamide 0.001% and sodium benzoate 0.00045%). Patch tests were prepared in white petrolatum at the same concentrations as used in the product, and applied to the upper back using Finn Chambers on Scanpor® tape. Readings were made after 3 days, reactions being scored as recommended by the ICDRG. There was a bullous + + + reaction to Euceta-Gel® ointment and a + + reaction to chloroacetamide 0.001%; the other substances did not react. 6 days after removing the patches, severe itching was still reported at the test sites of chloroacetamide and Euceta-Gel®.

Changing patterns in chromate allergy

To investigate whether the incidence and pattern of contact sensitivity lo chromate have changed in recent years, after a voluntary addition of iron sulphate to Swedish cement (11. the test results from the Department of Occupational Dermatology, Kurolinska Hospital in Stockholm, were analyzed. The figures for S years (1975, 19S0 and 19K5) were selected for further study.

Are opera-house artistes afflicted with contact allergy to colophony and cosmetics?

The frequencies of cosmetics intolerance and contact allergy to colophony were investigated among 116 singers and dancers and 16 make‐up artists. Participants were interviewed, examined and patch tested with a standard series and materials from the opera house. Common skin lesions were found in 1/3 of participants and more than 50% had a history of intolerance to cosmetics. Colophony gave positive patch test reactions in only 3 subjects. The prevalence of positive patch test reactions to fragrance mix and balsam of Peru was about the same as among dermatitis patients generally. Contact allergy to colophony did not seem to be a problem regarding cosmetics.

Rosin (colophony) and zinc oxide in adhesive bandages : an appropriate combination for rosin-sensitive patients ?

Adhesives and bandages containing zinc oxide (ZnO) and rosin are often used for treatment of ulcers. The aim of this work was to study a possible inhibitory effect of ZnO on the eliciting of allergic contact reactions to rosin und lo determine whether such an effect might be due to the formation of zinc resinates. Patch testing in rosin‐sensitive patients was performed with mixes of ZnO and rosin. The eliciting capacities of one mix in which zinc resinates might be formed and another mix in which the formation of zinc resinates was prevented, were compared to the eliciting capacity of rosin alone. If a reduction of the allergic response was observed for the mix in which zinc resinates might form and if no reduction was observed for the mix in which formation of zinc resinates was prevented, this would support the hypothesis that the reduction in eliciting capacity was due to formation of zinc resinates. However, we could not see any difference in eliciting capacity when comparing the 2 mixes with a lest preparation of rosin. Commercial adhesives (bandages) containing ZnO and rosin were patch tested in 7 rosin‐sensitive patients. The concentration of abietic acid in the adhesives was determined with HPLC. Abietic acid was detected in all but one of those declared to contain rosin. The patients reacted to the adhesives in which abietic acid was detected. For rosin‐sensitive persons, the addition of ZnO to rosin‐containing adhesives cannot be regarded as an appropriate measure to inhibit the elicitation of allergic reactions.

A clinical and patch test study in a tall-oil rosin factory

Rosin of different sources is commonly used in many technical products and is known to cause contact allergy. The aim of the present investigation was to study the frequency of occupational dermatoses and of contact allergy to rosin in a factory producing tall‐oil rosin. 163/180 present employees and 17/35 former employees participated in the study, which consisted of interview, clinical examination and patch testing with a standard series and additional rosins. 1/4 of those examined had some kind of current skin lesion. There were 10 cases of hand eczema. 7 subjects were patch‐test‐positive to gum rosin in the standard series. This frequency is about the same as among dermatitis patients at our clinic. Only 1 reaction to tall‐oil rosin and none to the modified rosins tested were found. No relation between a positive patch test reaction to rosin and current skin disease could be established. No case of ongoing occupational skin disease was proved.

Contact allergy to miripirium chloride in Depo-Medrol.

Keywords: contact allergy; Depo-Medrol; methylprednisolone; miripirium chloride; myristyl-γ-picolinium chloride; rheumatoid arthritis; medicaments; preservatives; biocides; antimicrobials