ALCOHOLISM, Issue 8 2009
C. Vidal
Background:, N-glycans in plant and invertebrate glycoproteins can induce extensive IgE cross-reactivity therefore limiting the specificity of in vitro allergy tests. IgE sensitization to N-glycans (cross-reactive carbohydrate determinants, CCDs) may be increased in heavy drinkers, who therefore show IgE reactivity to aeroallergens, latex, and Hymenoptera venoms. The peanut, a CCD-bearing allergen, is the leading cause of severe food allergic reactions in many populations. Aim of the study:, To investigate the potential interference of CCDs with determinations of IgE to peanuts in heavy drinkers. Methods:, We determined IgE to peanuts and IgE to a CCD marker (MUXF3, the N-glycan from bromelain) in 41 heavy drinkers admitted to the hospital and 54 healthy controls. None of the participants reported symptoms of peanut allergy. In cases with positive (,0.35 kU/l) IgE to peanuts, we performed inhibition assays with a neoglycoprotein consisting of MUXF3 molecules coupled to bovine serum albumin (MUXF3 -BSA) and a similar neoglycoprotein lacking xylose and fucose (MM-BSA). In the same cases, we screened for IgE to a panel of recombinant nonglycosylated peanut allergens. SDS-PAGE immunoblotting and inhibition assays were performed in selected cases. Results:, The prevalence of positive IgE to peanuts was 22 and 3.7% in heavy drinkers and healthy controls, respectively (p < 0.001). Peanut-IgE positivity was closely related to the presence of IgE to CCDs. In most (8/9) heavy drinkers with positive IgE to peanuts, reactivity was inhibited by preincubation with MUXF3 -BSA, but not with MM-BSA. IgE binding to multiple bands on immunoblotting studies was also inhibited by MUXF3 -BSA preincubation. IgE to nonglycosylated recombinant peanut allergens was uniformly negative. Conclusion:, Heavy drinking is associated with clinically asymptomatic IgE reactivity to peanuts, a relevant food allergen, in relation to CCD interference. [source]

The allergen Bet v 1 in fractions of ambient air deviates from birch pollen counts

ALLERGY, Issue 7 2010
J. T. M. Buters
To cite this article: Buters JTM, Weichenmeier I, Ochs S, Pusch G, Kreyling W, Boere AJF, Schober W, Behrendt H. The allergen Bet v 1 in fractions of ambient air deviates from birch pollen counts. Allergy 2010; 65: 850,858. Abstract Background:, Proof is lacking that pollen count is representative for allergen exposure, also because allergens were found in nonpollen-bearing fractions of ambient air. Objective:, We monitored simultaneously birch pollen and the major birch pollen allergen Bet v 1 in different size fractions of ambient air from 2004 till 2007 in Munich, Germany. Methods:, Air was sampled with a ChemVol® high-volume cascade impactor equipped with stages for particulate matter (PM)>10 ,m, 10 ,m>PM>2.5 ,m, and 2.5 ,m>PM>0.12 ,m. Allergen was determined with a Bet v 1-specific ELISA. Pollen count was assessed with a Burkard pollen trap. We also measured the development of allergen in pollen during ripening. Results:, About 93 ± 3% of Bet v 1 was found in the PM,>,10 ,m fraction, the fraction containing birch pollen. We did not measure any Bet v 1 in 2.5 ,m,>,PM,>,0.12 ,m. Either in Munich no allergen was in this fraction or the allergen was absorbed to diesel soot particles that also deposit in this fraction. Pollen released 115% more Bet v 1 in 2007 than in 2004. Also within 1 year, the release of allergen from the same amount of pollen varied more than 10-fold between different days. This difference was explained by a rapidly increasing expression of Bet v 1 in pollen in the week just before pollination. Depending on the day the pollen is released during ripening, its potency varies. Conclusion:, In general, pollen count and allergen in ambient air follow the same temporal trends. However, because a 10-fold difference can exist in allergen potency of birch pollen, symptoms might be difficult to correlate with pollen counts, but perhaps better with allergen exposure. [source]

Dermatitis from common ivy (Hedera helix L. subsp. helix) in Europe: past, present, and future

CONTACT DERMATITIS, Issue 4 2010
Evy Paulsen
Common ivy (Hedera helix subsp. helix) is a well-known native and ornamental plant in Europe. Reports on contact dermatitis from ivy have regularly appeared since 1899. Recently, it has been suggested that allergic contact dermatitis from the plant may be under-diagnosed, partly due to lack of commercial patch test allergens. The objective of the article is to present the results of aimed patch testing with the main common ivy allergen, falcarinol, during a 16-year period and review the newer literature. Consecutive patients tested with falcarinol 0.03% petrolatum from May 1993 to May 2009 were included. Cases published since 1987 were retrieved from the PubMed database. One hundred and twenty-seven Danish patients were tested with falcarinol and 10 (7.9%) tested positive. Seven were occupationally sensitized. Between 1994 and 2009, 28 new cases of contact dermatitis from ivy were reported, 2 of which were occupational. Only 11 of the 28 patients were tested with pure allergens. Falcarinol is not only widely distributed in the ivy family, but also in the closely related Apiaceae. Sensitization may occur in childhood or in adults pruning ivy plants or handling them in an occupational setting. In view of the ubiquity of falcarinol-containing plants and the relatively high prevalence of positive reactions in aimed patch testing, falcarinol should be the next plant allergen to be commercially available and included in the plant series worldwide. [source]

Skin sensitizing properties of the ethanolamines mono-, di-, and triethanolamine.

CONTACT DERMATITIS, Issue 5 2009
Data analysis of a multicentre surveillance network (IVDK, review of the literature
Numerous publications address the skin sensitizing potential of the short chain alkanolamines triethanolamine (TEA), diethanolamine (DEA), monoethanolamine (MEA), which are not skin sensitizing according to animal studies. Regarding TEA, we analysed patch test data of 85 098 patients who had been tested with TEA 2.5% petrolatum by Information Network of Departments of Dermatology (IVDK) to identify particular exposures possibly associated with an elevated risk of sensitization. Altogether, 323 patients (0.4%) tested positive. The profile of patch test reactions indicates a slightly irritant potential rather than a true allergic response in many cases. Although used widely, no exposure associated with an increased risk of TEA sensitization was identified. Therefore, the risk of sensitization to TEA seems to be very low. MEA and DEA were patch tested in a much more aimed fashion in 9602 and 8791 patients, respectively when prevalence of contact allergy was 3.8% and 1.8%. MEA is the prominent allergen in metalworkers with exposure to water-based metalworking fluids (wbMWFs); DEA is probably used in cutting fluids less frequently nowadays. Chronic damage to the skin barrier resulting from wbMWF, the alkalinity of ethanolamines (increasing from TEA to MEA), and other cofactors may contribute to a notable sensitization risk. [source]

Dendritic cells: biology of the skin

CONTACT DERMATITIS, Issue 1 2009
Mascha J. Toebak
Allergic contact dermatitis results from a T-cell-mediated, delayed-type hypersensitivity immune response induced by allergens. Skin dendritic cells (DCs) play a central role in the initiation of allergic skin responses. Following encounter with an allergen, DCs become activated and undergo maturation and differentiate into immunostimulatory DCs and are able to present antigens effectively to T cells. The frequency of allergic skin disorders has increased in the past decades. Therefore, the identification of potential sensitizing chemicals is important for skin safety. Traditionally, predictive testing for allergenicity has been conducted in animal models. For regulatory reasons, animal use for sensitization testing of compounds for cosmetic purposes is shortly to be prohibited in Europe. Therefore, new non-animal-based test methods need to be developed. Several DC-based assays have been described to discriminate allergens from irritants. Unfortunately, current in vitro methods are not sufficiently resilient to identify allergens and therefore need refinement. Here, we review the immunobiology of skin DCs (Langerhans' cells and dermal dendritic cells) and their role in allergic and irritant contact dermatitis and then explore the possible use of DC-based models for discriminating between allergens and irritants. [source]

Analysis of allergens in metalworking fluids

CONTACT DERMATITIS, Issue 5 2008
Maj-Len Henriks-Eckerman
Background:, Metalworking fluids (MWFs) are well-known causes of occupational contact dermatitis in machinists. Objective:, To gain information about skin sensitizers in MWFs and to compare it with the information in safety data sheets (SDSs). Methods:, A total of 17 samples of MWF concentrates were analysed for skin sensitizers known or suspected to be used in MWF. Alkanolamines, formaldehyde, isothiazolinones, methyldibromo glutaronitrile (MDBGN), and iodopropynyl butylcarbamate (IPBC) were separated by liquid chromatography. Resin acids of colophonium (colophony) were separated by gas chromatography. The substances were identified with mass spectrometric detection and ultraviolet detection. Results:, Of the MWFs, 15 contained 6,39% of alkanolamines, mostly monoethanolamine and triethanolamine. Formaldehyde was detected in all MWFs: the concentrations of total formaldehyde ranged between 0.002% and 1.3%. Benzisothiazolinone and octylisothiazolinone were detected in one fluid each. IPBC was detected in nine MWFs, and the highest concentration was 0.09%. Methylisothiazolinone and MDBGN were not detected in any of the fluids. Resin acids of colophonium were detected in seven MWFs in concentrations ranging from 0.41% to 3.8%. On the whole, the allergens analysed were poorly declared in the SDSs. Conclusions:, The content of total formaldehyde was not declared in any SDS. IPBC, a relatively new allergen, seems to be common in MWFs. Isothiazolinones may be relevant allergens of machinists, and they should be analysed in MWFs in case other sources are not identified. The occupational relevance of positive patch test results to MWF ingredients in machinists is difficult to determine if information in the SDSs is relied upon. [source]

The epidemiology of contact allergy in the general population , prevalence and main findings

CONTACT DERMATITIS, Issue 5 2007
Jacob Pontoppidan Thyssen
A substantial number of studies have investigated the prevalence of contact allergy in the general population and in unselected subgroups of the general population. The aim of this review was to determine a median prevalence and summarize the main findings from studies on contact allergy in the general population. Published research mainly originates from North America and Western Europe. The median prevalence of contact allergy to at least 1 allergen was 21.2% (range 12.5,40.6%), and the weighted average prevalence was 19.5%, based on data collected on all age groups and all countries between 1966 and 2007. The most prevalent contact allergens were nickel, thimerosal, and fragrance mix. The median nickel allergy prevalence was 8.6% (range 0.7,27.8%) and demonstrates that nickel was an important cause of contact allergy in the general population and that it was widespread in both men and women. Numerous studies demonstrated that pierced ears were a significant risk factor for nickel allergy. Nickel was a risk factor for hand eczema in women. Finally, heavy smoking was associated with contact allergy, mostly in women. Population-based epidemiological studies are considered a prerequisite in the surveillance of national and international contact allergy epidemics. [source]

Dose per unit area , a study of elicitation of nickel allergy

CONTACT DERMATITIS, Issue 5 2007
Louise Arup Fischer
Background:, Experimental sensitization depends upon the amount of allergen per unit skin area and is largely independent of the area size. Objectives:, This study aimed at testing if this also applies for elicitation of nickel allergy. Patients/methods:, 20 nickel allergic individuals were tested with a patch test and a repeated open application test (ROAT). Nickel was applied on small and large areas. The varying parameters were area, total dose and dose per unit area. Results:, In the patch test, at a low concentration [15 ,g nickel (,gNi)/cm2], there were significantly higher scores on the large area with the same dose per area as the small area. At higher concentrations of nickel, no significant differences were found. In the ROAT at low concentration (6.64 ,gNi/cm2), it was found that the latency period until a reaction appeared was significantly shorter on the large area compared to the small area. It was also found that the ROAT threshold (per application) was lower than the patch test threshold. Conclusion:, For elicitation of nickel allergy, the size of the exposed area and therefore the total amount of applied nickel, influence the elicitation reaction at some concentrations, even though the same dose per unit area is applied. [source]

Patch testing with components of water-based metalworking fluids: results of a multicentre study with a second series

CONTACT DERMATITIS, Issue 6 2006
Johannes Geier
Background:, Although many allergens in metalworking fluids (MWF) are identified, there are still some MWF components, which are not sufficiently investigated concerning their sensitizing properties. Objectives:, To investigate sensitization to 10 frequently used MWF components, which are not part of the established MWF test series, in metalworkers with suspected occupational dermatitis due to MWF. Patients/Methods:, Oleyl alcohol, myristyl alcohol, dimethylolurea, 4,4,-methylenebis morpholine, imazalil, 1-amino-2-propanol (monoisopropanolamine; MIPA), 2-amino-2-ethyl-1,3-propanediol (AEPD), 2,5-bis(n-octyldithio)-1,3,4-thiadiazole, zinc alkyl dithiophosphate and dibenzyl disulfide have been patch tested in 144 patients. Results:, 7 patients reacted positively to the formaldehyde releaser 4,4,-methylenebis morpholine, and 6 of these patients also reacted to formaldehyde and/or other formaldehyde releasers. 4 patients reacted positively to myristyl alcohol tested at 10% petrolatum (pet.). Additionally, 20 doubtful or irritant reactions occurred. 1 patient each reacted positively to oleyl alcohol, MIPA, and AEPD. None of the other test substances mentioned above elicited any clear-cut positive reaction. Patch testing with well-known MWF allergens showed proportions of positive reactions, which were comparable to those from other studies, e.g. 11% to monoethanolamine, 8% to colophonium and 3%,5% to various preservatives. Conclusions:, 4,4,-methylenebis morpholine may be an important MWF allergen, although clinical relevance could not be stated definitely in every case. Myristyl alcohol should not be patch tested at 10% pet., but at a lesser concentration, due to irritant properties. [source]

Miconidin and miconidin methyl ether from Primula obconica Hance: new allergens in an old sensitizer

CONTACT DERMATITIS, Issue 4 2006
Evy Paulsen
Several chemical and clinical observations have suggested the presence of at least one more allergen in addition to primin in Primula obconica. The aim of this study was to investigate the allergenicity of the primin precursor miconidin and the related miconidin methyl ether, both isolated from P. obconica. 12 primin-positive persons were patch tested with miconidin 0.01% petrolatum (pet.), miconidin in 96% ethanol incorporated into 0.01% pet., and miconidin methyl ether 1.0% pet. All persons were positive to miconidin 0.01% pet., with the strength of reactions very similar to those of the individual primin reactions, and remained inexplicably negative while testing with miconidin in 96% ethanol and pet., while miconidin methyl ether elicited 7 positive reactions. Although both miconidin and miconidin methyl ether may be allergenic only due to their conversion to primin in the skin, the presence of these substances nevertheless has to be taken into account when assessing the allergenicity of new P. obconica cultivars. [source]

Contact allergy to textile dyes in southern Sweden

CONTACT DERMATITIS, Issue 6 2006
K. Ryberg
Contact allergy to disperse dyes in textiles is documented in prevalence studies from southern Europe. To evaluate the prevalence of allergic patch test reactions to different textile dyes in southern Sweden, and to look at the sites of dermatitis in individuals hypersensitive to textile dyes, we retrospectively investigated 3325 consecutively patch-tested patients. They had all been patch tested with the standard test series supplemented with a textile dye mix (TDM) consisting of 8 disperse dyes, i.e. Disperse (D) Blue 35, 106 and 124, D Yellow 3, D Orange 1 and 3 and D Red 1 and 17. All but 3 of the TDM-positive patients were additionally tested with the separate dyes included in the mix. The frequency of contact allergy to TDM was 1.5%, which is comparable with studies from southern Europe. The most common dye allergen was D Orange 1. The high prevalence of allergic reactions to D Orange 1 was unexpected, whereas test reactions to D Blue 106 and 124 were lower than expected from other studies. Compared to all tested patients, the TDM-positive patients more often had dermatitis on their arms, face, neck and axillary folds, and women also had a higher frequency of hand dermatitis. [source]

Erythema multiforme-like generalized allergic contact dermatitis caused by Alpinia galanga

CONTACT DERMATITIS, Issue 2 2006
Song Jen Hong
This study reports a case of localized contact dermatitis and subsequently generalized erythema multiforme-like eruptions after topical application of herbal remedies. Patch tests showed there was an allergen in fresh and dried Alpinia galanga, which is also a popular spice in Southeast Asian cuisines. [source]

Contact dermatitis around a tracheostoma due to salbutamol sulfate and Aldecin®

CONTACT DERMATITIS, Issue 2 2006
Daisuke Tsuruta
Contact dermatitis around a tracheostoma is quite rare. So far, there have been only 2 reports about this in medical literature. We, in this study, report herewith contact dermatitis in a 61-year-old Japanese man around a tracheostoma due to salbutamol sulfate and Aldecin®. The patient used inhaled Sultanol® and Aldecin® for the treatment for allergic asthma. On examination, it was found that there was lichenified, exudative erythema with pigmentation around the tracheostoma. Patch testing with 1% aq. Sultanol® and Aldecin® revealed a positive reaction. Furthermore, patch testing for salbutamol sulfate 1% pet. also showed positive reaction. Although the contact allergen of our patient has not been fully determined (beclomethasone or other ingredients), this must be the first reported case of double contact dermatitis around a tracheostoma from salbutamol and Aldecin®. [source]

The relation between the localization of foot dermatitis and the causative allergens in shoes: a 13-year retrospective study

CONTACT DERMATITIS, Issue 4 2005
A. Nardelli
The purpose of this retrospective study was to test whether the initial pattern of clinical presentation of shoe dermatitis could indicate the causative allergen(s) and to estimate the odds on foot dermatitis in patients with a positive patch test versus those with a negative patch-test result. Between 1990 and 2002, 8543 patients were patch tested with the standard series (and additional allergens, if appropriate). Of them, 1168 (14%) had been referred because of foot dermatitis and 474 of these patients (5.5% of the total group) presented a positive reaction to one or more substances related to shoes. We found that 6 standard allergens in the male group and 8 standard allergens in the female group were statistically significant for the shoe dermatitis group. The data showed a relationship between the distribution pattern of the foot lesions and most of the allergens. These results have clinical applications since the gender of the patients and the localization of the foot eruptions can, indeed, indicate what allergen is involved. [source]

Regulation of nickel-induced T-cell responsiveness by CD4+CD25+cells in contact allergic patients and healthy individuals

CONTACT DERMATITIS, Issue 2 2005
H. Moed
In this study, we investigated the capacity of CD4+CD25+ regulatory T cells to suppress nickel-specific effector T cells, both in nickel-allergic patients and healthy controls. CD4+ cells isolated from allergic patients showed an increased proliferative response to nickel, whereas CD4+ cells from negative controls did not respond to allergen. When CD4+CD25+ cells were depleted, nickel-specific responsiveness was strongly increased both in allergic and in non-allergic individuals, with the most pronounced effect in allergic patients. These regulatory T cells were anergic to nickel but inhibited nickel-specific CD4+CD25, effector T cells in coculture experiments. CD4+CD25+ cells from nickel-allergic patients showed only a limited capacity to suppress effector T-cell responsiveness, because an increased nickel reactivity could still be detected in these cocultures. None of the isolated CD4+CD25+ cells, either isolated from healthy controls or allergic patients, produced IL-10 in response to nickel. Overall, these results support the view that CD4+CD25+ cells can control the activation of nickel-specific effector T cells in non-allergic individuals, whereas this regulatory capacity is impaired in allergic patients. To investigate the presence of allergen-specific regulatory T cells in truly naïve, non-sensitized individuals, T-cell reactivity should also be studied with non-environmental contact allergens, such as para-phenylenediamine. [source]

Positive lymphocyte transformation test in a patient with allergic contact dermatitis of the scalp after short-term use of topical minoxidil solution

CONTACT DERMATITIS, Issue 1 2005
Tobias Hagemann
Topical 2,4-diamino-6-piperidinopyrimidine-3-oxide (minoxidil) solution has been widely used for the treatment of androgenetic alopecia for over 15 years now and the substance is currently approved for this indication in 2% and 5% formulation. Typical side effects of this topical treatment include irritative dermatitis going along with pruritus, erythema, scaling and dryness, which occur especially at the onset of the therapy. In some cases, allergic contact dermatitis or exacerbation of seborrhoic dermatitis has been reported. While most of the patients with allergic contact dermatitis described in the literature showed a positive sensitization to the vehicle substance propylene glycol evaluated by patch testing, reactions to the active ingredient minoxidil are rare. Here, we report a case of allergic sensitization to minoxidil, which we evaluated and differentiated from an irritative reaction by a combination of patch testing and lymphocyte transformation test. The differentiation of allergic and irritative adverse effects and the identification of the causative allergen are of major relevance for the proceeding and adjustment of the therapy. Patients with sensitizations against propylene glycol are candidates for preparations with alternative solvents but can proceed treatment with minoxidil. In contrast, patients with allergies to the active ingredient itself are no longer candidates for treatment with minoxidil and should undergo alternative therapeutic options. [source]

Augmentation of skin response by exposure to a combination of allergens and irritants , a review

CONTACT DERMATITIS, Issue 5 2004
Line Kynemund Pedersen
Clinical experimental studies on contact dermatitis (CD) often evaluate the effect of one allergen or one irritant at a time. In real life, the skin is often exposed to more allergens, more irritants or allergens and irritants in combination. This combined exposure may potentially influence irritant effects as well as allergenicity of the substances. Mechanisms for a changed response can be immunological effects or enhanced penetration. Knowledge about the influence on skin reaction of combined exposures may influence skin reactivity and is important for prevention of CD. For allergens, threshold values may be influenced by the presence of other allergens or irritants, and prevention of CD by regulation of threshold values may not be sufficient if this is not taken into account. [source]

Seminal fluid as a missed allergen in vulvar allergic contact dermatitis

CONTACT DERMATITIS, Issue 5 2004
G. Guillet
No abstract is available for this article. [source]

Strong irritants masquerading as skin allergens: the case of benzalkonium chloride

CONTACT DERMATITIS, Issue 4 2004
David A. Basketter
Chemicals may possess a number of hazards to human health including the ability to cause skin irritation and contact allergy. Identification and characterization of these properties should fall within predictive toxicology, but information derived from human exposure, including clinical experience, is also of importance. In this context, it is of interest to review the case of benzalkonium chloride, a cationic surfactant. This chemical is a well-known skin irritant, but on occasions it has also been reported to have allergenic properties, typically on the basis of positive diagnostic patch test data. Because the accumulated knowledge concerning the properties of a chemical is employed as the basis for its regulatory classification (e.g. in Europe), as well as for informing the clinical community with respect to the diagnosis of irritant versus allergic contact dermatitis (ACD), it is important to distinguish properly which chemicals are simply irritants from those which are both irritant and allergenic on skin. A review of the information on benzalkonium chloride confirms that it is a significant skin irritant. However, both predictive test results and clinical data lead to the conclusion that benzalkonium chloride is, at most, an extremely rare allergen, except perhaps in the eye, but with many supposed cases of ACD being likely to arise from the misinterpretation of patch test data. As a consequence, this substance should not normally be regarded as, or classified as, a significant skin sensitizer. [source]

A medicolegal controversy due to a hidden allergen in cutting oils

CONTACT DERMATITIS, Issue 4 2004
Monica Corazza
No abstract is available for this article. [source]

Contact allergy to farnesol in 2021 consecutively patch tested patients.

CONTACT DERMATITIS, Issue 3 2004
Results of the IVDK
Farnesol is one of the fragrances considered to be a significant contact allergen. Therefore, it was decided by the European Union to label products containing farnesol. Farnesol was tested [5% petrolatum (pet.)] together with the standard series between 1 January 2003 and 30 June 2003 in 2021 consecutive patients, 1243 females and 778 males. Of these, 22 [1.1%, 95% confidence interval (CI): 0.7,1.6%] had a positive reaction to farnesol. 147 (8.1%) of those 1825 tested to Myroxylon pereirae resin (balsam of Peru, 25% pet.) at the same time reacted positively, 143 (7.8%) of those 1823 tested to the fragrance mix (FM) (8% pet.) and 34 (1.9%) of 1831 tested to propolis (10% pet.). With regard to concomitant reactions in farnesol-positive patients, 5 of 22 reacted additionally to the FM [odds ratio (OR): 4.3; CI: 1.53,12.15] and 2 (of these 5) additionally to M. pereirae resin (OR: 1.27; CI: 0.29,5.54). The strongest association was seen to propolis (OR: 6.2; 95% CI: 1.4,27.7). Compared to those with negative reactions to farnesol, the group of patients allergic to farnesol was characterized by a higher proportion of young females and office workers, and the hand and the face were more often affected. In conclusion, farnesol is an important allergen. We recommend that farnesol should be included in a fragrance patch-test preparation and that its use should be regulated for consumer safety reasons. Furthermore, the extent of exposure to farnesol should be further studied. [source]

FS01.2 Contact dermatitis to disperse blue 106 in Portugal

CONTACT DERMATITIS, Issue 3 2004
Francisco M Brandao
Disperse blue 106 is one of the most important allergenic textile dyes. We reviewed all the patients that proved to be allergic to this dye, in 10 contact clinics, in Portugal, from 01/2000 to 06/2003. In the first 2 years disperse blue 106 was only tested in suspected cases, while in 2002/2003 it was routinely tested in our standard series. A total of 8957 patients (2797M + 6160F) were tested; fifty five patients (17M + 38F)(0.6%) were allergic to the dye, with a significant difference in incidence between the 2 periods (0.2 to 0.9%); a current relevance was found in 38 (69%) patients. In 5 patients the dermatitis was considered occupational. The main localizations were the axillae (25p), the antecubital fossae and the face (13p each), the neck (11p), the feet (8p), the hands and then trunk (7p each). Thirty six out of 44 patients (80%) that were tested with disperse blue 124 were allergic to this dye. Simultaneous reactions to PPDA and to fragrance mix were observed in 12 and 11 patients, respectively. Allergy to other dyes was found in 15 patients. Blouses and skirts were the main offending garments that induced contact allergy. Although both disperse blue 106 and 124 have been reported as frequent sensitizers, it proved not to be such an important allergen in Portugal. However, if tested routinely it can pick up some unexpected relevant allergic patients. [source]

FS09.1 Diacetylmorphine (heroin) allergy

CONTACT DERMATITIS, Issue 3 2004
Aliet J Hogen Esch
Since heroin is delivered to a selected group of drug addicts under supervision of nurses in the Netherlands, we reported about several nurses who presented with work-related eczema and positive patch tests to heroin. To investigate the prevalence of heroin contact allergy among all workers in this heroin delivery project, a study was started using questionnaires. Altogether 31 nurses reported work-related complaints out of 100 who returned questionnaires. Besides reports of eczema, mainly of eyelids (probably airborne) and hands, there were mucosal and respiratory complaints. Patch tests were performed in 25 nurses with complaints; in 9 of them a heroin contact allergy could be confirmed. In 6 out of these 9 nurses this was combined with mucosal or respiratory complaints. There were also 6 nurses with mucosal or respiratory complaints without a contact allergy. Contact dermatitis from opioids, such as morphine and codeine, has been documented among opioid industry workers, nurses, doctors, pharmacists, and in patients. In conclusion heroin appears to be a potent contact allergen, causing contact dermatitis. Mucosal and respiratory complaints however, cannot be explained by this contact allergy; they might be caused by a type-1-allergy to heroin, or by a direct histamine liberating effect. Opioids are known histamine liberators causing urticaria, rhinitis and anaphylactoid reactions; therefore intracutaneous tests with heroin are unreliable. In an ongoing research project it will be attempted to detect specific IgE to heroin in the 12 workers with mucosal or respiratory complaints; within the next few months results will be available. [source]

FS09.2 Contact allergy to a commercial alcohol prep swab

CONTACT DERMATITIS, Issue 3 2004
James S Taylor
Allergic contact dermatitis to prepackaged disposable alcohol prep swabs is infrequently reported. A 60-year-old woman developed repeated episodes of dermatitis at sites of injections and venipunctures. History and patch testing revealed contact allergy to Kendall Webcol alchol prep swabs. There were negative patch test results to isopropyl alcohol (IPA), but positive reactions to the Webcol swab, to the inner surface of the packaging foil, to two other brands of alcohol swabs, and to bacitracin. UV absorbance profile analysis revealed the presence of UV absorbing materials at peaks of 221 and 280 nm within commercial IPA samples, including one from Kendall, which were absent from reagent grade IPA. Reports of similar cases identified IPA, propylene oxide, or both as the allergens; when swab ingredients were negative, compound allergy was proposed. A recent report from Korea identified dodecyldiaminoethylglycine and IPA as the allergens in the commercial disinfectant swab. Although the exact allergen is undetermined in our case, it may represent a chemical compound or contaminant that is used or acquired during the manufacturing of the swabs or foils. [source]

FS11.1 Primula obconica , a falling allergen

CONTACT DERMATITIS, Issue 3 2004
Maureen Connolly
Objective:, We believe the incidence of primula contact allergic dermatitis has fallen since the introduction of primin-free primula onto the European market and thus our study aims were twofold. Firstly to see if the incidence of primula contact allergic dermatitis was truly on the decline and secondly to confirm the presence and document retailers' knowledge and awareness of primin-free primula in the UK. Methods:, A questionnaire was sent to 22 contact dermatitis departments throughout the UK and Ireland looking at the number of primin positive patch tests in the years 1995/96, 1998, 2000 and 2002 compared with the total number of patch tests. 10 seed suppliers and 12 plant retailers were asked to complete a telephone survey. Results:, We showed a significant fall in the yearly incidence of contact allergy to primin from 0.785% in 1995/96 to 0.457% in 2002. This downward trend was statistically significant (p = 0.001). The telephone survey showed 90% of seed suppliers were aware that the older varieties of P. obconica could cause an allergic reaction whereas only 60% of them were aware that new primin-free varieties were now being bred. 50% of suppliers were in fact selling these primin-free varieties with 60% of them stocking a primin-free variety exclusively. 90% of retailers were not currently selling any variety of P. obconica. Conclusion:, Our study shows that the incidence of primula contact dermatitis is falling. The overall trend is moving towards primin-free varieties provided they continue to be horticulturally viable long term. [source]

P01 Contact dermatitis from textile colours in three Spanish towns

CONTACT DERMATITIS, Issue 3 2004
Begoña Garcia-Bravo
Objective:, Prevalence of textile dye contact dermatitis (TD-CD) are lacking in many countries. Our aim is to know the frequency of TD-CD in three different areas of Spain. Methods:, 100 patients were tested with Spanish standard series and the five most frequent TD in each city. D. Orange 1, D. Orange 3, D. Blue 35, D. Blue 106, D. Blue 124 were included in Murcia and Seville, and the three last and D. Red 1, D. Red 17 in Santiago. Results:, 23/300 (15 women and 8 men) were positives to one or more TD. D. Blue 124 was the most frequent allergen (18/300), followed by D. Blue 106 (17/300). D. Red 1, D. Red 17 and D. Orange 1 were positives in 2/200. D. Orange 3 and D. Blue 35 were positives in 1/200. Eczema was located on hands in 13 cases. Clinical picture was variable. Origin of sensitization was clothing and occupational. Relevance was obtained in 20/23 cases. Conclusions:, The study confirm an high frequency of disperse dye allergy in Spain with a very different prevalence in the three areas: Seville 14%, Murcia 5% and Santiago 4%, that are probably due to social and cultural factors. We recommend the inclusion of D. Blue 106, D. Blue 124, D. Blue 35, D. Red 1, D. Red 17, D. Orange 1 and D. Orange 3 in standard series in order to detect sensitivity to textile colours that is most frequent than previously suspected. [source]

P17 Allergic contact dermatitis from hydrolyzed wheat protein

CONTACT DERMATITIS, Issue 3 2004
Olivia Bordalo
Allergic Contact Dermatitis (ACD) from hydrolysed wheat protein (HWP) is rarely reported in the literature. We describe 2 cases of ACD to this new allergen. Case1- A 39-year-old non atopic woman presented with a dermatitis of the face, mainly eyelids and neck. She had been using a new cosmetic cream for 2 months. The lesions subsided with topical corticosteroids. Patch tests with the standard, cosmetic, fragrance series and with her own products gave positive reactions only to the new cosmetic cream. We also tested all the components of this cream and only HWP gave a doubtful reaction with occlusive tests and positive reaction with ROAT. Case 2 , A 48-year-old atopic woman presented with a dermatitis of the face and hands for 1 month. She had been using a new cosmetic cream for 11 months and kept using the product without any suspicion. The dermatitis subsided with cetirizine and topical corticosteroids. Patch tests with the standard, cosmetic, fragrance series and her own products revealed positive reactions to the cosmetic cream. Again, testing all the components of the cream, only HWP gave doubtful reactions with occlusive tests and positive reactions with ROAT. Discussion:, In recent years, a number of protein hydrolysates have been introduced into cosmetic manufacture. HWP is being used in cosmetic creams for its moisturizing properties. As far as we know, there is only one previously reported case of ACD induced by this allergen. More cases may be expected. [source]

P16 Eyelid dermatitis with positive patch test to coconut diethanolamide

CONTACT DERMATITIS, Issue 3 2004
Yves Dejobert
Objective:, The aim was to detect a possible allergen in a patient with eyelid dermatitis. Patient and methods: a non atopic 27-year-old female presented with eyelid dermatitis since 3 months. This dermatitis persisted despite the fact she had stopped the use of make up; she had acrylic artificial nails since 2 months and sometimes used hair dyes;patch tests were performed with Finn Chamber® tests with readings at D2 and D3, according ICDRG criteria, with European standard series, additional series (including toluenesulfonamide formaldehyde resin), cosmetic, acrylates, hairdressing series, in 3 patch test sessions, using Chemotechnique Diagnostics® allergens. Results:, The only positive patch test was coconut diethanolamide (0.5% pet.)++ at D2 and D3. After removal of the shampoo containing this allergen, the dermatitis cleared. Coconut diethanolamide (cocamide DEA), tensioactive synthesized with coconut oil is widely used in shampoos, soaps, shower gels, barrier creams, washing up liquids, metalworking fluids, hydraulic oils. Involvement of eyelids is not frequently described in the literature with this allergen. Conclusion:, Coconut diethanolamide should be added in cosmetic series, and it should be useful to test this allergen in patients with eyelid dermatitis. [source]

P28 Interleukin-8 from keratinocytes can be used to test for contact allergy

CONTACT DERMATITIS, Issue 3 2004
Bolli Bjarnason
Objective:, To investigate whether secretion of interleukin-8 (IL-8) proteins by keratinocytes following in vitro exposure to a contact allergen can be used to detect contact allergy. Methods:, Suction blisters were made on skin of allergic and anergic subjects to urushiol, the contact allergen of poison ivy. Keratinocyte cultures were prepared and exposed to the allergen in vitro. Controls were the allergen solvent. Variable allergen concentrations, allergen exposure times and cell culture times were used. At the end of each culture time, IL-8 RNA and protein of the culture supernatants were analyzed by PCR and ELISA. Results:, The concentration of IL-8 in the supernatants proved to be a successful way to distinguish between subjects who patch tested positive with a non-toxic concentration of urushiol and subjects who tested negative. In the allergic subjects, a correlation was established between the dose of the allergen and the IL-8 protein concentration in the supernatants. Conclusions:, In vitro testing of contact allergies in patients makes possible an objective assessment of their allergic status without causing a booster effect or risking active sensitizations. The results indicate that the method may be used as an alternative method to animal models for testing consumer products before their marketing, thus avoiding ethical problems and problems related to interpretation of tests because of biological differences between animals and humans. [source]