Sigfrid Fregert

Reduction of chromate in cement by iron sulfate.

Cement dermatitis is connected with chromate sensitivity. It can therefore be expected that “elimination” of chromate in cement would decrease the number of cases of cement dermatitis.

Patch testing with low molecular oligomers of epoxy resins in humans.

Thirty‐four patients sensitive to epoxy resin were patch tested with oligomers of epoxy resin. All reacted when tested with MW 340 oligomer. Twenty‐three were tested with MW624 and MW908 oligomers and seven with MW 1392 oligomer; none reacted. Eight patients tested with commercial mixtures of epoxy resins with an average MW 1280 and MW 1850 reacted to these resin mixtures which contained the MW 340 oligomer. The MW 340 oligomer seems to be the main ingredient responsible for contact allergy to epoxy resins in humans.

Simple methods for demonstration of epoxy resins of bisphenol A type.

Low molecular weight oligomers of epoxy resins of bisphenol A type are common sensitizers. For demonstrating the presence of sensitizing oligomers of these resins, two simple methods are described. The first one, a colour reaction, demonstrates the presence of the bisphenol A skeleton. If this test is positive, thin-layer chromatography is carried out to demonstrate the presence of low molecular weight oligomers of epoxy resins. Some practical applications are reported.

Contact allergy to lidocaine

Two cases of contact allergy to lidocaine are reported. They also reacted to chemically related anesthetics of the amide type: one to bupivacaine, mepivacaine and prilocaine and the other to mepivacaine only. The patients also reacted to the chemically nonrelated cincaine, an anesthetic of the ester type. The lidocaine metabolites o‐toluidine and m‐xylidine gave negative reactions.

Release of nickel from plated utensils in permanent wave liquids

Soluble cutting oil dermatitis is generally of an irritant type. An allergic type of contact dermatitis occurs but is rare. The allergens are additives such as preservatives and anti-rust agents or nickel, cobalt or chromate which have contaminated the fluid. Recently, one case of cutting oil dermatitis with colophony (rosin) allergy was seen. A man aged 50 had worked as a turner for many years. He had developed hand dermatitis 1 year before our examination. The dermatitis had relapsed several times after sick leave periods. After the last sick-leave period, he had used potassium soap water instead of cutting oil. Within 2 days the hand dermatitis relapsed more severely than before. Patch testing with the ICDRG series (Altest®, Imeco-Astra) showed a positive reaction to colophony. The cutting oil used for the last 2 years contained 10 % soap (as emulsifier) made of tall oil fatty acids and triethanolamine. The fatty acids contained 25 % colophony. The cutting oil was diluted with water to 5 %. The potassium soap was made from tall oil fatty acids, which contained 20 % colophony, mainly consisting of abietic acid and isomers. Patch testing with the tall oil (25 % in olive oil), tall fatty acids with 2 % colophony (50 % in olive oil), tall rosin (10 % in MEK), abietic acid (10 % in MEK) and soap (2 % in water) all gave positive reactions. These substances have been tested in seven other patients with colophony sensitivity. Reaction to all the compounds was positive. It is obvious that the patient had been sensitized to colophony in the cutting oil and that the severe relapse was caused by the colophony in the soap water. Owing to the high frequency of dermatitis from cutting oils in the metal industry, employees in Sweden at present demand that cutting oils should be replaced by soap water. There is a potential risk of allergic contact dermatitis from the soap because of the presence of colophony. At present cutting fluid based on vegetable oil soaps is under technical and dermatological investigation.

Allergic contact dermatitis from volatile epoxy hardeners and reactive diluents

A 22-year-old hairdresser developed eczema localized to the back of the second and third fingers of her right hand. She was patch tested (Leukotest, Beiersdorf) with the European Standard and hairdressing tray (Trolle-Lassen), and with several products she handled in her job. At 72 h there was a + + reaction to nickel. She told us that when doing permanent waving, she held clips with the first three fingers of her right hand in such a way that permanent wave liquid drained between the second and third fingers where eczema lesions were seen. Irritant contact dermatitis by permanent wave liquid could be a possibility. However, with a little modification of the dimethylglyoxime (DMG) stick test (Shore & Binnick 1977), we could show release of nickel from the clips by the permanent wave liquid. A cotton tipped applicator was dipped in permanent wave liquid and rubbed against the clip. Then a few drops of DMG 1 % in alcohol were added and a characteristic rose color appeared in the cotton tip. Recently, Dahlquist et a!. (1979) demonstrated by means of atomic absorption spectrophotometry that nickel was released in considerable amounts when nickel-plated utensils were soaked in permanent wave liquids. With a simpler method, we could prove that our patients eczema was almost certainly nickel related.

Chromium in industrial leather gloves

Most leather qualities are tanned with basic chromium (III) sulfate, particularly if the leather should be wear-proof. This chromium does not contain hexavalent chromium but can produce allergic reactions. It is well known that most protective leather gloves used in industry can induce contact allergy to chromium and elicit chromium hand eczema. The chromium is released particularly when the leather is moistened by hand sweat or water. For this reason gloves made of vegetable-tanned leather are now marketed. We have determined the total chromium content of some gloves and the chromium released during 1 week into synthetic sweat of pH 6.5. The chromium was determined by atomic absorption spectrophotometry. It is obvious from this result that at least eight, probably 12, gloves were chromiumtanned, though labeled vegetable-tanned. Three of these gloves were examined because they had caused severe hand eczema in persons sensitive to chromium, who had tried to avoid chromium-tanned gloves. The vegetable-tanned leather contained chromium in amounts common in animal tissues. However, this chromium does not elicit allergic reactions.

Chromate and cobalt eczema due to magnetic tapes

the allergens. Archives of Dermatological Research 255, 111-121. Lonkar, A, Mitchell, J. C. & Calnan, C. D. (1974) Contact dermatitis from Parthenium hysterophorus. Transactions of the St. Johns Hospital Dermatological Society 60, 43-53. Mitchell, J. C. (1969) Allergic contact dermatitis from Compositae. Transactions of the St. Johns Hospital Dermatological Society 55, 174-183. Mitchell, J. C. & Dupuis, G. (1971) Allergic contact dermatitis from sesquiterpenoids of the Compositae family. British Journal of Dermatology 84, 139-150. Mitchell, J. C. (1975) Contact allergy from plants. In Recent Advances in Phytochemistry, ed. Runeckles, V. C., pp. 119-139. New York: Plenum Press. Rodriguez, A, Dillon, M. 0., Mabry, T. J., Mitchell, J. C. & Towers, G. H. N. (1976) Dermatologically active sesquiterpene lactones in trichomes of Parthenium hysterophorus L. (Compositae). Experientia 32, 236-238. Rook,A (1962) Plant dermatitis in general practice. The Practitioner 188, 627-638. Yoshioka, H., Mabry, T. J. & Timmermann, B. N. (1973) Sesquiterpene Lactones: Chemistry, NMR and Plant Distribution. Tokyo: University of Tokyo Press.

Sensitzation to mercury in kerosene and exacerbation from red tattoo

A 25-year-old man, after one years daily work with a wood preservative containing kerosene as a solvent, developed a slight eczema of the arms and on the face, but not on the hands which were protected by plastic gloves. Three months after the eczema had started he was tattooed, partly with a red colour. Within a week he developed eczema on the legs and trunk, and the eczema on the arms exacerbated. He was then treated with steroid creams, and four weeks later he showed only erythema and dry skin. The red part of the tattoo was, however, swollen and had been so from the very beginning. Patch test showed a strong reaction to 0.5 % mercury metal in petrolatum. Analysis with atomic absorption spectrography of the preservative showed traces of mercury. The solvent (kerosene) contained 0.1 flg mercury/mi. The excised tattoo contained 670 flg mercury. A few weeks after the excision, the eczema had healed completely. Sensitization to mercury in tattoos usually develops after months or years. The fact that the red tattoo was swollen from the beginning indicates that the patient was sensitized before the tattooing was carried out. The slight eczema which had persisted for about three months prior to the tattooing might have been caused by mercury in the preservative. The concentration was low but the absorption may have been facilitated by the solvent. The exacerbation and spreading of the eczema might be due to leaking of soluble mercury from the tattoo. The reason why the solvent was contaminated with mercury is unknown but will be investigated. Eczema from work with kerosene is usually diagnosed as contact dermatitis of irritant type, but in future, we may have to suspect mercury allergy in some of these cases.