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Irritant Reactions (irritant + reaction)

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Medical Sciences	100%

Selected Abstracts

FS06.7 The new fragrance mix II , test results of a multicentre European Study

CONTACT DERMATITIS, Issue 3 2004
Peter Frosch
A new fragrance mix (FM II) with 6 frequently used chemicals was evaluated in consecutive patients patch tested in 6 dermatological centres in Europe. 28% FM II contained 5% Lyral, 1% citral, 5% farnesol, 5% coumarin, 1% citronellol and 10% alpha-hexyl cinnamic aldehyde (AHCA); in 14% FM II the single constituents' concentrations was lowered to 50% and in 2.8% FM II to 10%. Each patient was classified regarding a history of adverse reactions to fragrances: certain, probable, questionable and none. The frequency of positive reactions to the currently used 8% fragrance mix (FM I) and the new mix in 1703 patients was as follows: FM I, 6.6%; 2.8% FM II, 1.3%; 14% FM II, 2.9%; 28% FM II, 4.1%. The number of doubtful/irritant reactions was 7.2% for FM I and ranged from 1.8% to 10.6% for FM II. 8.7% of tested patients had a certain fragrance history. Of these 25.2% were positive to FM I, reactivity to FM II was dose-dependent and ranged from 8.1% to 17.6% in this subgroup. Comparing 2 groups of history , certain and none , values for sensitivity (sens) and specificity (spec) were calculated. Sens: FM I, 27.2%; 2.8% FM II, 8.7%; 14% FM II, 15.9%; 28% FM II, 21.5%. Spec: FM I, 96.3%; 2.8% FM II, 99.5%; 14% FM II, 98.7%; 28% FM II, 97.9%. 31/70 (44.3%) patients positive to 28% FM II were negative to FM I. In the group of patients with a certain history a total of 6 patients was found reacting only to FM II. Simultaneous break-down testing with the single constituents produced positive reactions in 54.3% for 28% FM II and 48% for 14% FM II. Lyral was the dominating single constituent with positive reactions (37.1% for 28% FM II, 36% for 14% FM II), followed by citral, farnesol, citronellol, AHCA and coumarin. Chemical analysis for the 6 constituents of FM II was performed on 25 products used by 12 patients being patch test positive to FM II. Lyral was detected in 76% of these products, citral in 16% and AHCA in 8%. In conclusion, the new FM II detects additional patients with contact allergy to fragrances missed by the currently used FM I. The medium concentration, 14% FM II, is probably the most useful one for diagnostic screening. [source]

Sequential application of cold and sodium lauryl sulphate decreases irritation and barrier disruption in vivo in humans

BRITISH JOURNAL OF DERMATOLOGY, Issue 4 2005
J.W. Fluhr
Summary Background, Irritant contact dermatitis (ICD) is one of the most frequent types of occupational dermatitis. Different factors are involved in the development of contact dermatitis. In the food-processing industry, the combined exposure to different irritants may be involved in the development of ICD. Few data have been published regarding the irritant potential of sodium lauryl sulphate (SLS) in combination with cold. Objectives, The present study was intended to analyse whether cold exposure and low skin temperature influence the development of ICD. Methods, Twenty (part I) and 12 (part II) healthy volunteers were exposed twice daily for 4 days to SLS alone, different low temperatures alone (4 °C six times for 90 s with an interval of 20 s or 15 °C for 10 min) or a combination of cold and SLS (19·6 µL SLS 1% cm,2, part I; or 52·6 µL SLS 0·5% cm,2, part II) using the tandem repetitive irritation test. Irritant cutaneous reactions were measured by noninvasive biophysical methods with transepidermal water loss as a parameter for permeability barrier function and skin colour reflectance together with visual scoring as parameters for inflammatory reactions. Results, Cold alone caused no significant skin reaction compared with untreated control. Exposure to SLS alone and SLS together with cold (independent of the applied temperature of 4 or 15 °C) twice daily induced a clear irritant reaction and barrier disturbance. Reactions did not differ whether SLS was applied before or after cold. Furthermore, ,tandem application' of cold and SLS diminished the barrier disruption and irritant reaction compared with SLS alone. Conclusions, We conclude that the application of cold may have a protective effect on the development of ICD, at least in our short-term model. [source]

Simultaneous sodium lauryl sulphate testing improves the diagnostic validity of allergic patch tests.

BRITISH JOURNAL OF DERMATOLOGY, Issue 4 2005
Results from a prospective multicentre study of the German Contact Dermatitis Research Group (Deutsche Kontaktallergie-Gruppe
Summary Background, There is evidence that a higher skin susceptibility may induce nonspecific erythematous or weak positive reactions to contact allergens in patch testing. Objectives, To evaluate whether simultaneous application of sodium lauryl sulphate (SLS) along with diagnostic patch tests with contact allergens can provide information regarding skin irritability which may help to discriminate allergic from nonspecific irritant reactions to contact allergens. Methods, Between July 2001 and June 2003, this prospective study collected patch test data of 5971 patients from 19 centres in Germany and Austria in the Information Network of Departments of Dermatology (IVDK). In addition to contact allergens (standard series and eight known ,problematic' allergens with a low reaction index and a high positivity ratio: 1,3-diphenylguanidine, amerchol L-101, benzalkonium chloride, benzoyl peroxide, cocamidopropyl betaine, octyl gallate, phenyl mercuric acetate and propylene glycol), patches with SLS 0·5% and 0·25% aq. were applied. Reactions to the allergens and to SLS were analysed at the IVDK data centre. The association between an erythematous or positive reaction to a certain allergen and an irritant reaction to SLS was assessed with logistic regression analysis, at the same time controlling for the influence of age and sex. Results, Of the 29 allergens of the standard series, 23 and 21 gave a higher percentage of nonspecific erythematous reactions in patients with an irritant reaction to 0·25% and 0·5% SLS, respectively, in comparison with SLS-negative patients. All eight ,problematic' allergens gave an increased percentage of nonspecific erythematous reactions. Similarly, 22 and 21 allergens of the standard series gave a higher percentage of positive allergic reactions in patients with an irritant reaction to 0·25% and 0·5% SLS, respectively, and seven of the eight ,problematic' allergens gave a higher percentage of positive allergic rections (exception: octyl gallate). For most allergens, the markers of skin reaction (reaction index and positivity ratio) were worse in SLS-positive patients. Differences were more pronounced when testing with SLS 0·25% than with SLS 0·5%. Conclusions, Because there is a convincing association between skin irritability (evaluated by SLS test) and the degree of skin reaction to contact allergens, the SLS test may help in deciding whether a doubtful erythematous or weakly ,positive' skin reaction should be interpreted as allergic or irritant. [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]

Skin-sensitizing and irritant properties of propylene glycol

CONTACT DERMATITIS, Issue 5 2005
Data analysis of a multicentre surveillance network (IVDK, review of the literature
In the several publications reviewed in this article, propylene glycol (PG; 1,2-propylene glycol) is described as a very weak contact sensitizer, if at all. However, particular exposures to PG-containing products might be associated with an elevated risk of sensitization. To identify such exposures, we analysed patch test data of 45 138 patients who have been tested with 20% PG in water between 1992 and 2002. Out of these, 1044 patients (2.3%) tested positively, 1083 showed a doubtful, follicular or erythematous reaction (2.4%) and 271 explicit irritant reactions (0.6%). This profile of patch test reactions is indicative of a slightly irritant preparation, and thus, many of the ,weak positive' reactions must probably be interpreted as false positive. No private or occupational exposures associated with an increased risk of PG sensitization were identified, except for lower leg dermatitis. Therefore, according to our patch test data, PG seems to exhibit very low sensitization potential, and the risk for sensitization to PG on uncompromised skin seems to be very low. [source]

FS04.5 Iodopropynylbutyl carbamate (IPBC) 0.2% is suggested for patch testing of patients with eczema possibly related to preservatives

CONTACT DERMATITIS, Issue 3 2004
Jochen Brasch
Iodopropynylbutyl carbamate (IPBC)is a preservative that has been increasingly used for skin care products and cosmetics within the last years and the first cases of contact sensitization have meanwhile been reported. Therefore, a surveillance for IPBC contact allergy is now necessary. Our study was aimed to find out a suitable test concentration of IPBC for this purpose. The data 8106 patients tested by 23 centres of the German Contact Dermatitis Research Group (DKG) and the Information Network of Departments of Dermatology (IVDK)in the time from May 2001 to July 2003 with IPBC in concentrations of 0.1%, 0.2%, 0.3%, and 0.5% were retrospectively evaluated. Criteria considered to determine the optimal test concentration of IPBC were the reaction index, the positivity ratio, the rate of crescendo reactions, and the relation of IPBC-reactions with MOAHLFA-indices, with irritant reactions to sodium lauryl sulfate, and with positive reactions to the most common standard contact allergens and 4 other preservatives. For statistical evaluations the exact McNemar test was applied and odds ratios were calculated according to the profile likelihood method, as derived from logistic regression analyses. The rate of positive reactions to IPBC increased from 0.5% with IPBC 0.1% to 1.7% with IPBC 0.5%, but there was a problem with sensitivity or specificity with both of these 2 concentrations. Therefore, we focused on IPBC 0.2%(0.8% positive reactions) and IPBC 0.3%(1.3% positive reactions) for further detailed analyses. An evaluation of the related parameters revealed that with IPBC 0.2% as compared to IPBC 0.3% a higher percentage of crescendo reactions, a higher reaction index, a lower number of doubtful reactions, a plausible association of positive reactions with reactions to other preservatives, nd no association with a pronounced skin irritability was found. In conclusion, we recommend to start with IPBC 0.2% for patch testing of all persons with contact dermatitis that may be related to preservatives. [source]

Cosmetics and contact dermatitis

DERMATOLOGIC THERAPY, Issue 3 2001
Ronni Wolf
Modern cosmetic and skin care products are safe for most users and adverse reactions to them are very rare considering the number of people in contact with numerous products over a lifetime of use. Improvements in safety, tolerance, and skin compatibility will not prevent cosmetic product side effects from increasing in the future because of the continuing goals of intensifying their biological activity and therapeutic efficacy. Therefore, now more than ever, dermatologists should be familiar with all possible untoward reactions to cosmetics. Adverse reactions include an extreme variant of sensitive skin, called "cosmetic intolerance syndrome," describing individuals who are no longer able to tolerate a wide range of cosmetic products. "True" allergic reactions to cosmetics occur much less commonly than irritant reactions. These are of great importance to the dermatologist because they are more serious, more difficult to treat, and require absolute abstention from the causative agent. Eczematous, damaged skin is especially prone to develop allergies. [source]

Human papillomavirus-negative ileostomal chronic papillomatous dermatitis

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 4 2003
Christy M. Williams
Background:, Papillomatous stoma-related skin lesions may result from irritant reactions or infection with epidermodysplasia verruciformis human papillomavirus (HPV) types. Methods:, ,We report upon a papillomatous lesion at the ileostoma of a 63-year-old male with familial adenomatous polyposis and colorectal adenocarcinoma. We thoroughly tested the lesion for HPV using immunohistochemistry, transmission electron microscopy, and polymerase chain reaction analyses. Results:, ,The lesion was a fleshy, multilobulated, and verrucous plaque, with hyperkeratosis, hypergranulosis, acanthosis and marked papillomatosis. The clinical and light microscopic features were suggestive of a condyloma. However, no HPV was detected. Conclusions:, We suggest that the lesion most likely represents chronic papillomatous dermatitis, a reaction to mechanical and/or chemical irritation usually associated with urostomies and only rarely observed with ileostomies. This case highlights the clinical, diagnostic and therapeutic aspects of an unusual cutaneous morbidity associated with ileostomies. [source]