Mauro Grandolfo

Occupational sensitization to epoxy resin and reactive diluents in marble workers

10 out of 22 marble workers handling a bicomponent resin, based on epoxy resin and ortho‐cresyl glycidyl ether (CGE), developed Contact dermatitis and airborne contact dermatitis within 20 days to 2 months of exposure. All 22 subjects were patch tested with epoxy resin, bisphenol A, epichlorohydrin and a series of reactive diluents. The 10 symptomatic subjects were all positive to the reactive diluent CGE, and 4 of them also to epoxy resin. The other reactive diluents that gave positive reactions were phenyl glycidyl ether (7 cases), cyclohexanedimethanol glycidyl ether (2 cases), 1,6‐hexanediol diglycidyl ether (2 cases) and allyl glycidyl ether (1 case). The findings of our Study suggest that allergic potential is directly proportional to the electronic charge available, for all electron‐rich molecules (solvents, high and low polymers, reagents) that interact with the glycidyl ether group. Lesser, but still noticeable, effects are detected when activation of the glycidyl group is related to the possible formation of intramolecular hydrogen bonds. In practice, the occupational problem was partly solved by changing the type of glycidyl ether.

Contact allergy to impurities in surfactants : amount, chemical structure and carrier effect in reactions to 3-dimethylaminopropylamine

Since finding that all Subject with contact allergy to cocamidopropylbetaine give positive reactions to 3‐dimethylaminopropylamine (DMPA), we wished to verify whether sensitization to other industrially‐used tensioactives might also be due to contact of DMPA as an impurity. We also investigated the possible “carrier action” that tensioactives might exert on minimal quantities of DMPA. Finally, we analyzed the relationship between the structure of DMPA and other chemically‐correlated molecules and their sensitizing potential, with particular reference to the structure of alkylam‐idopropylbetaines. For this purpose, in 34 patients with contact allergy to DMPA, we tested: (i) DMPA in concentrations below the threshold limit in water and in different tensioactives: (ii) substances that employ DMPA as a reagent in their synthesis: (iii) substances similar to DMPA as regards chemically reactive groups. The study showed that: (i) DMPA remains as a quantitatively detectable impurity in all tensioactives employing it in their synthesis: (ii) some common anionic (SLES) and non‐ionic (polysorbate 20) tensioactives enhance the risk of sensitization from very low doses of DMPA, presumably due to a “carrier effect:” (iii) the sensitizing chemical structures in DMPA and related molecules are the primary amine and the tertiary (dimethyl‐substituted) amine groups, when separated by either 2 or 3 carbon atoms:(iv) no sensitizing action can be attributed to the functional groups present in alkylamidopropylbetaine molecules.

An evaluation of the allergic contact dermatitis potential of colloidal grain suspensions

BACKGROUND Colloidal grain suspensions have been used for decades as adjuncts in the treatment of atopic dermatitis, especially in the US. In Italy, many young children have been exposed to colloidal grains. Recently, it was suggested that these bath therapies may induce allergic contact dermatitis in some young atopic children. OBJECTIVE To evaluate the allergic skin reactions to topical oat and rice colloidal grain suspensions of normal and atopic children with and without previous exposure to colloidal grain suspensions. METHODS A double-blind, randomized patch study. Two concentrations of oat and rice colloidal grains (0.007% and 0.7%) were applied occlusively to the backs of 65 children living in Italy, ages 6 months to 2 years (43 were atopic and 22 were normal). RESULTS There were neither immediate urticarial nor allergic reactions in any of the 65 study subjects, atopic or nonatopic; 5 of 43 (12%) atopic subjects developed irritant reactions to the test materials. Radioallergosorbent tests (RAST) tests were performed on 55 subjects. The negative RAST test results found in the nonatopic group correlated well with nonatopic status, but positive RAST tests were found in only 8 of 35 (23%) atopic dermatitis subjects. None of the sera from positive RAST scores corresponded to subjects with irritant patch reactions. CONCLUSIONS The data indicate that topical colloidal grains can be used as an adjunct in the management of mild atopic dermatitis in children under 2 years of age. There was no evidence of sensitization to topical colloidal grains in the group studied.

Contact allergy to oleamidopropyl dimethylamine and related substances

Contact allergy to oleamidopropyl dimethylamine and related substances CATERINA FoTI , LuiGI RIGAN0, GrNo A. VENA , MAURO GRANDOLFo 1, GIOVANNI LIGuoRr 1 AND GIANNI ANGELINI 1 Department of Dermatology, University of Bari, Policlinico, 70124 Bari, Italy Institute of Skin and Product Evaluation (ISPE), 20150 Milano, Italy

Carrier and inhibitory effects of surfactants on allergic contact reactions to 3-dimethylaminopropylamine

The rôle of 3-dimethylaminopropylamine (DMPA) in non-occupational allergy to cosmetic surfactants containing alkylamidopropylbetaines (CAPB) has been demonstrated (1). CAPB purified by thin-layer chromatography does not elicit reactions in patients sensitized to cosmetic surfactants containing commercial CAPB (2). Allergic reactions induced by oleylamidopropyl dimethylamine (and possibly by similar amido-amines) have been attributed to the same ubiquitous impurity (3). It has also been demonstrated (4) that the activity of DMPA in the elicitation of allergic reactions is generally increased by the surfactants in which it has been dissolved (carrier effect). We have explored this relationship further.

Mometasone furoate versus betamethasone valerate in the treatment of allergic contact dermatitis

laminin 5 , most frequently to the a3 subunit [S]. Furthermore, cases of scarring epidermolysis bullosa acquisita in which the target epitopes are present within type VII collagen in anchoring fibrils, have clinically been identified as Brunsting-Perry CP [6] . Management of Brunsting-Perry CP is similar to other forms of CP, although oral dapsone in doses of SO-100 mg may be effective in producing a rapid therapeutic response [7]. In severe or resistant disease, other immunosuppressive agents, including oral corticosteroids, azathioprine and cyclophosphamide can be tried either as single agents, or in combination. In summary, we have described a case of Brunsting-Perry cicatricial pemphigoid where non-specific scalp crusting was the presenting feature. This case illustrates the need to consider this diagnosis in lesions on the head and neck, particularly where scaling, erosions and chronic inflammatory changes are a feature. A careful history and clinical examination, correlated with histological evaluation, may reveal the true pathology.

contact Allergy Associated With Airborne Contact Allergy From Phosphorus Sesquisulfide

Background:Contact dermatitis from phosphorus sesquisulfide, contained in some brands of matches, is quite well known. It can present with various different clinical pictures according to site, morphology, sex, and pathogenic mechanism. The most usual form is that of common allergic contact dermatit

Lichen myxoedematosus treated with cyclosporin A: a new therapeutic approach for a disabling dermatosis

Lichen myxoedematosus (papular mucinosis) is characterized by papular lesions (and sometimes by internal involvement) caused by a dermal infiltrate of acid mucopolysaccharides which induce extensive thickening and hardening of the skin. The aetiopathogenesis of the disease is unknown. The therapy is generally by immunosuppression. We report the case of a 63-year-old man with lichen myxoedematosus successfully treated with cyclosporin A.