Knud Kaaber

Changes in the pattern of sensitization to common contact allergens in Denmark between 1985–86 and 1997–98, with a special view to the effect of preventive strategies

The objective of the present study is to describe any changes in the prevalence of sensitization to common contact allergens in patch‐tested patients over a 12‐year period. Attention is given to possible effects of preventive strategies introduced in Denmark regarding nickel and chromate sensitization during that period, and particular areas of concern are identified. Members of the Danish Contact Dermatitis Group collected patch‐test results from consecutive eczema patients as well as information about exposures and demographic variables over a 6‐month period in 1985–86. The investigation was repeated in 1997–98 in the same clinics, at the same time of year, using identical methods and patch‐test substances, including nickel sulphate 5%, potassium dichromate 0·5% and fragrance mix 8%. Nickel was the most common contact allergen in both study periods, followed by the fragrance mix. In children 0–18 years of age, the frequency of nickel allergy decreased from 24·8% in the first study period to 9·2% in the second study period (P < 0·0008). Fragrance mix allergy doubled in frequency from 4·1% in 1985–86 to 9·9% in 1997–98, an increase that affected all age groups. Contact allergy to potassium dichromate decreased significantly from 3·0% in the first period to 1·2% in the second period (P = 0·001). The decrease was seen in both sexes and was most pronounced among those of working age. No other significant changes were found in the frequency of sensitization to common allergens over the 12‐year observation period.

Clinical patch test data evaluated by multivariate analysis

The aim of the present study was to evaluate the influence of individual explanatory factors, such is sex, age, atopy, test time and presence of diseased skin, on clinical patch lest results, by application of multivariate statistical analysis. The study population was 2l66 consecutive patients patch tested with the standard series of the International Contact Dermatitis Research Group (ICDRG) by members of the Danish Contact Dermatitis Group (DCDG) over a period of ft months. Fur the 8 test allergens most often found positive (nickel, fragrance‐mix, cobalt, chromate. balsam of Peru, carba‐mix, colophony, and formaldehyde). one or more individual factors were of significance for the risk of being sensitized, except for chromate and formaldehyde it is concluded that patch test results can be compared only after stratification of the material or by multivariate analysis.

Antabuse treatment of nickel dermatitis. Chelation-a new principle in the treatment of nickel dermatitis

Eleven nickel‐hypersensitive patients with chronic, dyshidrotic hand eczema aggravated by oral challenge with 0.6–2.5 mg nickel were treated with 100 mg tetraethylthiuramdisulfide (Antabuse®) two to four times daily for 4–10 weeks.

Decreasing trends in methyldibromo glutaronitrile contact allergy – following regulatory intervention

Background:  The preservative methyldibromo glutaronitrile (MDBGN) has been banned, first from stay‐on, and later from rinse‐off cosmetics, in the EU countries because of increasing rates of contact allergy.

Nickel, cobalt and chromium sensitivity in patients with pompholyx (dyshidrotic eczema).

Sixteen patients with negative routine patch tests were challenged orally in a controlled trial with 2.5 mg nickel, I nig cobalt, and 2.5 nig chromium given as salts of the respective metals. All of the patients had symmetrical, vesicular hand dermatitis and in some cases also foot involvement. The dermatitis of two patients flared after challenge with cobalt; in two patients flare occurred following chromate ingestion.

Treatment of nickel dermatitis with Antabuse® a double blind study

A double Wind, placebo‐controlled treatment with Antabuse® was carried out in 24 patients with hand eczema and nickel allergy. The amount of Antabuse® given was gradually increased from 50 to 200 mg daily. The maximum dose was given for ft weeks. During the treatment period, the dermatitis of 5 out of 11 patients in the group treated with Antabuse® healed, compared with 2 out of 13 in the group receiving the placebo. A statistical analysis was made of changes observed during the study, through the parameters: staling, frequency of flares, erythema, area involved and number of vesicles. Differences in results obtained with Antabuse® and the placebo were statistically significant only for the parameters scaling and frequency of flares (p < 0.05). The difference between the sums of parameters following the 2 forms of treatment was not statistically significant (p= 0.11). 2 patients treated with Antabuse® showed signs of hepatic toxicity; 1 of them had toxic hepatitis. No other significant side effects were seen.

Clinical severity and prognosis of hand eczema

Background  Hand eczema (HE) is a frequent, long‐lasting disease with both personal and societal repercussions. Consequently, more information is needed on factors that maintain symptoms.

Classification of hand eczema: clinical and aetiological types. Based on the guideline of the Danish Contact Dermatitis Group

Background. No generally accepted classification scheme for hand eczema exists. The Danish Contact Dermatitis Group recently developed a guideline defining common clinical types and providing criteria for aetiological types.

Occupational contact dermatitis in painters - an analysis of patch test data from the Danish Contact Dermatitis Group

Background. Painters are among the occupational groups that most commonly experience occupational contact dermatitis, but few investigations exist concerning this occupation.

Fragrance mix II in the baseline series contributes significantly to detection of fragrance allergy

Background: Fragrance mix II (FM II) is a relatively new screening marker for fragrance contact allergy. It was introduced in the patch test baseline series in Denmark in 2005 and contains six different fragrance chemicals commonly present in cosmetic products and which are known allergens.