Sari Suomela

Occupational contact dermatitis caused by D‐limonene

Limonene is widely used as a fragrance substance and solvent in cleansing products. Oxidized limonene is a frequent contact allergen among consumers of cosmetics, personal care products, and scented household cleaning products. Less is known about the sources of occupational exposure and occupational contact dermatitis caused by limonene.

Occupational contact allergy to methylchloroisothiazolinone/methylisothiazolinone and methylisothiazolinone.

Methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) and MI are common preservatives in industrial and household products and in cosmetics. Occupational contact allergy to MCI/MI or MI has been reported among painters and paint factory workers in particular.

Current knowledge on biomarkers for contact sensitization and allergic contact dermatitis

Contact sensitization is common and affects up to 20% of the general population. The clinical manifestation of contact sensitization is allergic contact dermatitis. This is a clinical expression that is sometimes difficult to distinguish from other types of dermatitis, for example irritant and atopic dermatitis. Several studies have examined the pathogenesis and severity of allergic contact dermatitis by measuring the absence or presence of various biomarkers. In this review, we provide a non‐systematic overview of biomarkers that have been studied in allergic contact dermatitis. These include genetic variations and mutations, inflammatory mediators, alarmins, proteases, immunoproteomics, lipids, natural moisturizing factors, tight junctions, and antimicrobial peptides. We conclude that, despite the enormous amount of data, convincing specific biomarkers for allergic contact dermatitis are yet to be described.

Contact allergy to capryldiethanolamine in metalworking fluids.

We patch tested the two machinists discussed here in 2012–2013, according to ICDRG recommendations. We read the tests on D2, D3, and D4, on D2, D3, and D6, or on D2 and D5, depending on the day of application. The tests included a modified baseline series, antimicrobials, oils and cutting fluids, ethanolamines, and coconut fatty acid derivatives, as well as MWFs, liquid soaps, and other cleansers from the workplace. When positive reactions to own substances were seen, we ordered the respective ingredients and tested them separately.

Occupational contact dermatitis caused by 1,3-benzenedimethanamine, N-(2-phenylethyl) derivatives in hardeners for epoxy paints and coatings.

Amines in epoxy hardeners are significant causes of occupational allergic contact dermatitis among workers who use epoxy resin systems.

Occupational contact allergy to sodium cocoamphopropionate in a hand cleanser

Keywords: n naminoethylethanolamine; namphoacetates; ndisodium cocoamphodipropionate; noccupational dermatitis; nsodium cocoamphoacetate; nsodium lauroamphoacetate; nsurfactant

Occupational contact dermatitis caused by hydrogenated formaldehyde–benzenamine polymer (FBAP) in epoxy hardeners

Patch Testing We patch tested a spray painter in 2016 in accordance with ESCD recommendations (1). We read the tests on day (D) 2, D3, and D6. The tests included a modified baseline series, antimicrobials, ethanolamines, epoxy chemicals, glues and plastics, isocyanates, acrylates, coconut fatty acid derivatives, hydroperoxides of limonene and linalool, and the patient’s own workplace materials including epoxy resins and hardeners. When the reaction to one of the patient’s own products was positive, without other relevant allergies, we ordered the respective ingredients and tested them separately. After the first case, we began testing epoxy-exposed patients with a 1% FBAP-containing ingredient in pet. The pipe relining worker reacted positively to this test substance. His tests did not include acrylates, but otherwise he was tested as the first case.

3-(Bromomethyl)-2-chloro-4-(methylsulfonyl)- benzoic acid: a new cause of sensitiser induced occupational asthma, rhinitis and urticaria

Objectives 3-(Bromomethyl)−2-chloro-4-(methylsulfonyl)-benzoic acid (BCMBA) has not previously been identified as a respiratory sensitiser. We detected two cases who presented respiratory and urticaria symptoms related to BCMBA and had positive skin prick tests to the agent. Subsequently, we conducted outbreak investigations at the BCMBA-producing factory and performed clinical examinations to confirm occupational diseases. Methods The outbreak investigations included observations of work processes, assessment of exposure, a medical survey with a questionnaire and skin prick tests with 0.5% BCMBA water solution on 85 exposed workers and 9 unexposed workers. We used specific inhalation or nasal challenge and open skin application test to investigate BCMBA-related occupational asthma, rhinitis and contact urticaria. Results We identified nine workers with respiratory and/or skin symptoms and positive skin prick tests to BCMBA in a chemical factory. A survey among chemical factory workers indicated a BCMBA-related sensitisation rate of 8% among all exposed workers; the rate was highest (25%) among production workers in the production hall. Sensitisation was detected only in workers with the estimated highest exposure levels. Six cases of occupational asthma, rhinitis and/or contact urticaria caused by BCMBA were confirmed with challenge tests. Asthma-provoking doses in specific inhalation challenges were very low (0.03% or 0.3% BCMBA in lactose). Conclusions We identified a new low molecular weight agent causing occupational asthma, rhinitis and contact urticaria. A typical clinical picture of allergic diseases and positive skin prick tests suggest underlying IgE-mediated disease mechanisms. Stringent exposure control measures are needed in order to prevent BCMBA-related diseases.

Occupational allergic contact dermatitis caused by colophonium

Colophonium is a common contact allergen that is present not only in household products but also in occupational settings.

Allergic reactions to lower concentrations of nickel sulfate and formaldehyde often appear later than reactions to higher concentrations

A late‐appearing patch test reaction may be a sign of active sensitization or represent a delayed elicitation reaction.