环境接触性因素在面部皮炎发病中的作用分析

目的研究环境接触性因素在面部皮炎发病中的作用。方法通过常见环境过敏原斑贴试验及问卷调查,对60例面部皮炎患者进行了研究。结果28例（46．7％）确诊为接触性皮炎,其中1例职业性接触性皮炎;10例其他原因皮炎;22例不能排除环境接触因素的作用,为可疑接触性皮炎。这些患者斑贴阳性率为60％,仍不能忽视接触过敏因素的作用。结论斑贴试验阳性结果与疾病的联系是寻找病因或加重因素的关键。     

187例湿疹、接触性皮炎等医务人员患者斑贴试验结果分析

目的 探讨湖南地区医务人员湿疹、接触性皮炎等皮肤病的致敏因素。方法 对长沙市部分医院及湖南省部分地区医院患该种皮肤病的工作人员进行斑贴试验。结果 187例患者对1种或1种以上变应原呈阳性反应者共122例，阳性率65．2％，其中湿疹患者斑试阳性55／102(53．9％)，接触性皮炎患者斑试阳性41／57(71．9％)。结论 湿疹皮炎患病与环境、职业有关，医务人员应加强在工作中的自我防护，防止湿疹皮炎的发生。     

接触性皮炎及湿疹斑贴试验结果

目的 通过斑贴试验能较为准确地确定皮炎湿疹类疾病的致病因素。提供正确的防治方法。方法 随机选择门诊接触性皮炎和湿疹患者１２６例进行斑贴试验。结果 对斑贴试验所用抗原出现１种阳笥反应者８１例（７８．６％）,２种以上阳性者３５例（３３．９％）。接触性皮炎与湿疹均可由不同种类的过原引起,差异有非常显著性（Ｘ＾２＝１８７．３５,Ｐ〈０．０１,Ｘ＾２＝１３７．７５,Ｐ〈０．０１）。结论 接触性皮炎与湿疹具有     

镍接触性皮炎的斑贴试验及其组织病理学特征

目的 探讨斑贴试验在金属过敏等环境与职业性皮炎中的诊断价值,了解镍接触性皮炎的组织病理学特征。方法 应用欧洲标准抗原系列斑贴试验检测110例疑诊为接触性皮炎患者,并对13例硫酸镍(5％)斑贴试验不同时段阳性反应皮肤进行活检。结果 39例接触性皮炎患者对硫酸镍敏感(占35．5％),其中阳性反应皮肤组织学特征为：24h时表皮轻度海绵变性和灶状空泡变性,少许嗜酸性粒细胞外渗;48-72h时表皮和真皮炎症达高峰,主要是CD45RO^ T细胞和CD68^ 巨噬细胞分布于炎症表皮及真皮血管周围。916h-5d时表皮轻度增生,不同细胞成分参与修复过程。结论 硫酸镍是引起湿疹皮炎类疾病的主要接触变应原,镍皮炎病理学改变符合变应性接触性皮炎的特征。     

桃红生产过程中接触性皮炎的病因和预防

为探讨桃红生产过程中工人患接触性皮炎的病因,对同一车间136个职工进行皮肤科检查。结果检出接触性皮炎患者56名(41％)。男女发病无差异,发病与工作时间长短无差异。密切接触可疑致病物质者68人,发病36人(64％)。对5种物质进行斑贴试验,结果冰醋酸阳性串者最高(33.33％),认为该物质是造成接触性皮炎的致病物质。皮炎好发于面部、额部、眼周暴露的部位,可能与接触车间空气中有害物质有关。作者提出了预防和治理措施。     

深圳市宝安地区151例斑贴试验结果分析

目的分析与研究深圳市宝安区接触性皮炎和湿疹患者主要的接触性致敏原及其特点。方法用瑞敏牌斑贴试验试剂对确诊为皮炎和湿疹的患者做斑贴试验。结果 151例患者中阳性者100例,阳性率66.22%。结论斑贴试验有助于明确慢性湿疹和皮炎患者的接触性致敏原及其性质,对临床治疗有重要的指导作用。     

45例皮炎湿疹类皮肤病斑贴试验结果分析

目的分析皮炎湿疹类皮肤病患者的致敏源,探讨常见的致病因素,以期对皮炎、湿疹类皮肤病有更好的治疗和诊断。方法对2012年2月—2013年2月在我院皮肤门诊确诊的45例皮炎湿疹类皮肤病患者进行诊断性斑贴试验,并对不同组之间的试验结果进行比较和分析。结果选用20种标准抗原对45例患者进行试验,有37例患者对其中的17种抗原出现了1种或多种阳性抗原反应,总的阳性率高达82.22%,且其中硫酸镍的阳性率为35.13%,重铬酸钾的阳性率为29.72%,卡巴混合物的阳性率为27.02%,其余为芳香混合物、硫柳汞、氯化钴的混合物。且接触性皮炎的阳性率为80.23%,湿疹的阳性率为73.33%,过敏性皮炎的阳性率为71.25%,复发性皮炎的阳性率为75%,脂溢性皮炎的阳性率为50%。结论硫酸镍、卡巴混合物、重铬酸钾是引发患者皮肤病的主要致病因素,接触性的过敏原是引发皮炎湿疹类皮肤病的一个主要原因,斑贴试验可以有效的诊断皮炎湿疹类皮肤病。     

530例皮炎湿疹类皮肤病斑贴试验结果分析

目的探讨皮炎湿疹类皮肤病患者的变应原，以期更好地诊断与治疗。方法对530例皮炎湿疹类患者进行瑞敏标准变应原系列斑贴试验检测。结果530例患者斑贴试验总阳性率87．2％。变应原阳性率位居前8位的分别是硫酸镍（35-8％）、重铬酸钾（34．9％）、卡巴混合物（31．3％）、芳香混合物（31．1％）、甲醛（15．1％）、硫柳汞（14、3％）、苯唑卡因（13．8％）及对苯类（13．0％）；男女性患者斑贴试验阳性率差异有统计学意义的变应原分别为卡巴混合物（46．8％，26．6％）、硫酸镍（26．6％，37．2％）、黑橡胶混合物（18．5％，10．6％）、对苯类（25．8％，9．1％）、甲醛（16．9％，7．9％）、苯唑卡因（20．2％，11．8％）及硫氢基混合物（11．3％，2．0％）；引起手部及面部皮损差异有统计学意义的变应原分别为甲醛（14．1％，6．1％）、黑橡胶混合物（18．6％，7．1％）、硫柳汞（8．3％，17．3％）。结论硫酸镍、重铬酸钾、卡巴混合物、芳香混合物是目前引起皮炎湿疹类患者的主要变应原。卡巴混合物、黑橡胶混合物、对苯类、甲醛、苯唑卡因、硫氢基混合物是男性患者的主要变应原，硫酸镍是女性患者的主要变应原。甲醛、黑橡胶混合物主要引起手部皮损，而硫柳汞则主要引起面部皮损。     

生物共振技术与斑贴试验检测接触性过敏原临床对比分析

目的 探讨生物共振技术与斑贴试验检测接触性过敏原的阳性率及其可比性.方法 选择接触性皮炎患者为研究对象,使用德国摩拉生物物理过敏原检测及脱敏治疗系统(MORA-SUPER)与斑贴试验先后对50例接触性皮炎患者进行过敏原检测,分别得出斑贴试验及生物共振治疗仪检测接触性致敏物质的阳性率,并以斑贴试验作为金标准,得出生物共振技术检测接触性过敏原的敏感度、特异度及其与斑贴试验的符合率.结果 50例患者中,斑贴试验有1项或1项以上阳性者48例,占96％,生物共振技术检测有1项或1项以上阳性者占46例,占92％,两种方法阳性率最高的几种物质均依次是重铬酸钾、硫酸镍、福尔马林、对苯二胺等;以斑贴试验的结果作为金标准,列出四格表,评价生物共振技术检测敏感度在50％～90％之间,特异度在77％ ～ 98％之间,其与斑贴试验的符合率均在80％以上.结论 重铬酸钾、硫酸镍、福尔马林、对苯二胺是本地区常见的接触性过敏原;生物共振技术检测与斑贴试验检测接触性致敏原符合率较高;生物共振技术与斑贴试验检测接触性过敏原均安全可靠.     

80例皮炎湿疹患者斑贴试验观察

皮炎湿疹病因不易确定,许多皮炎湿疹是接触了各种外界因素,特别是对各种化学物质过敏所致,即所谓的变态反应性接触性皮炎.斑贴试验是确定化学性致敏原一个较为简单可靠的方法.我们观察了80例皮炎湿疹患者斑贴试验结果,报告如下.     

Risk of contact allergy and dermatitis at a wind turbine plant using epoxy resin-based plastics

Aims: To identify workplace and individual risk factors for occupational contact allergy and dermatitis. Methods: A cross-sectional study was carried out at an international company producing wind turbine systems in Denmark. A cohort of 724 production workers at four facilities was highly exposed to epoxy resin as well as other chemicals. A screening questionnaire (participation rate 84.7%) was followed by an interview by an occupational physician and a dermatological examination, including patch testing, for a comprehensive list of potential workplace sensitizers. Results: Clinically diagnosed dermatitis was found among 214 workers (35.8%) and contact allergy to materials used in the workplace was found in 66 workers (10.9% of the total population and 20.3% of those who underwent patch testing). Of the 66 workers with a work-related allergy, 40 (60.6%) were allergic to epoxy compounds, 25 (37.9%) to hardeners and ten (15.2%) to other workplace materials, where one person showed an allergy only to these materials. Experiencing contact allergy was related to older age and longer employment in the workplace—however, neither of these risk factors was significant. The main risk factor for current dermatitis was contact allergy to materials used in the workplace, determined by patch testing, OR=5.4 (95% CI 3.9–9.9). Fewer days of absence from work was also related to current dermatitis, OR=2.0 (95% CI 1.2–3.5). Conclusions: In a cohort of workers with extensive exposure to chemicals related to epoxy-resin systems, contact dermatitis and allergy was prevalent. Older age and longer duration of employment at the workplace were individual risk factors for allergy to workplace materials, whilst work-related allergies and longer duration of employment at the workplace were significant risk factors for current dermatitis.     

A study of chromium induced allergic contact dermatitis with 54 volunteers: implications for environmental risk assessment.

Over the past 60 years, dose-response patch test studies by various methods have been conducted in an attempt to identify the minimum elicitation threshold (MET) concentration of hexavalent chromium (Cr(VI)) that produces an allergic response in Cr(VI) sensitive subjects. These data are not adequate, however, to provide an accurate estimate of the MET because of the variability in the patch testing techniques and the variability in diagnostic criteria used. Furthermore, the data were not reported in terms of mass of allergen per surface area of skin (mg Cr/cm2-skin), which is necessary for conducting occupational or environmental health risk assessments. Thus the purpose of this study was to determine the MET (mg allergen/cm2) for Cr(VI) and trivalent chromium (Cr(III)) by patch testing techniques. A patch test method that delivers a controlled amount of allergen per surface area of skin was used. A group of 54 Cr(VI) sensitised volunteers were patch tested with serial dilutions of Cr(VI) and Cr(III) to determine the cumulative response rate at several concentrations. The results indicate that the 10% MET for Cr(VI) based on the cumulative response was 0.089 micrograms Cr(VI)/cm2-skin. Only one of the 54 volunteers may have responded to 33 micrograms Cr(III)/cm2-skin, otherwise Cr(III) was unable to produce allergic contact dermatitis in these highly sensitive volunteers. Two supplemental studies were also conducted to assess whether the surface area of the patch and the concentration of Cr(VI) in the patch (related to patch thickness) were likely to influence the results. The data from these studies were used to assess the risk of developing allergic contact dermatitis due to contact with Cr(VI) and Cr(III) in soil. The findings indicated that soil concentrations at least as high as 450 ppm Cr(VI) and 165,000 ppm Cr(III) should not pose an allergic contact dermatitis hazard for at least 99.99% of the people in the community who might be exposed.     

Epoxy resin as a cause of contact allergic eczema

Epoxy resin-containing products of the plastic industry are increasingly employed. We retrospectively studied the incidence and course of epoxy resin contact dermatitis in 2265 patients in whom contact dermatitis was confirmed by patch testing. A positive patch test for epoxy resin was present in 31 patients (1.4%). Exposure to epoxy resin as the cause of contact dermatitis was 'certain' in 10, 'very likely' in 9, 'possible' in 4 and 'unclear' in 8 patients. Exposure to epoxy resin was related to occupational (55%) and leisure time activities (13%). In 48% patch tests were positive for multiple test allergens. Hands (56%), arms (38%) and face (38%) were mainly affected. Re-examination of 26 of 31 patients showed that a favourable course depended on identification of the cause of the exposure to epoxy resin, avoidance of further contact and absence of sensitization to multiple allergens.     

Prevalence and risk factors of occupational hand dermatoses in electronics workers

The electronics industry is becoming an important mainstream in the workforce in some developed countries and in Taiwan. Among patients with occupational hand dermatitis in northern Taiwan, workers from electronics industries were one of the most important groups. We conducted a field investigation to determine the prevalence, patterns and risk factors of occupational hand dermatoses among electronics workers. The survey was conducted in five electronics plants using a self-administered questionnaire on skin symptoms and risk factors. Skin examination and patch testing were followed for those with symptoms compatible with hand dermatitis. A total of 3070 workers completed the questionnaire. Among them, 302 (9.8%) reported to have symptoms (itching and with either redness/scaling) compatible with contact dermatitis on hands. Hand dermatitis was associated with working in the fabrication unit and personal history of atopy and metal allergy, as well as the following job titles: wafer bonding, cutting, printing/photomasking, softening/degluing, impregnation and tin plating. Among those with reported hand dermatitis, 183 completed skin examination and patch testing, 65/183 (35.5%) were diagnosed as having irritant contact dermatitis (ICD) and 7/183 (3.8%) allergic contact dermatitis. The most important allergens were nickel, cobalt and phenylenediamine. In conclusion, Taiwanese electronics workers have a high risk of having hand dermatitis, especially ICD. Preventive efforts should be focused on the workers with risk factors or at certain worksites.     

Occupational dermatoses among workers in a porcelain manufacturing factory

The objectives of the present work are to determine the prevalence and risk factors of occurrence of occupational dermatoses among workers in a porcelain manufacturing factory. The study included 235 workers (132 males and 103 females). After history taking, dermatological examination was performed at the work place. Cases of contact dermatitis (CD) were patch tested using potassium dichromate 0.5%, Cobalt chloride 1% and Nickel sulphate 5% in petrolatum. Results showed that the prevalence of occupational dermatoses (OD) was 26.8% among exposed workers. The highest percentage of OD was found among workers in the decoration department. It represented 30.2% of all cases. CD was the commonest presentation among the studied group, it represented 27% of all cases of OD. Results of patch testing indicated that out of 17 cases of CD 12 cases (70%) were of the irritant variety and 5 cases (30%) were of the allergic type. The prevalence of OD was found to be affected by age, duration of work, type of exposure and daily bathing after work.     

Allergic contact dermatitis

Allergic contact dermatitis is a common skin condition that can be difficult to diagnose without the aid of a specific diagnostic tool called patch testing. The pathophysiology, clinical features, diagnosis, and treatment of allergic contact dermatitis are summarized in this review. The process of patch testing, the gold standard for diagnosing allergic contact dermatitis, is discussed in detail.     

Occupational allergy in health personnel

BACKGROUND: Health care workers are exposed to many agents that can cause irritant or allergic contact dermatitis. In nurses with eczema of the hands latex sensitivity can play an important role in the occurrence of urticaria, rhinitis and asthma. OBJECTIVES: To determine the prevalence of irritant and allergic contact dermatitis and contact urticaria and the role of skin sensitization to common and occupational haptens and allergens in a group of health care workers with skin problems. METHODS: Retrospective review of 204 health care workers assessed by prick and patch testing in an occupational health clinic. RESULTS: The diagnoses included 35.3% with irritant contact dermatitis, 64.7% with allergic contact dermatitis and 7.3% with contact urticaria to latex. Three workers complained of asthma and 5 complained of rhinitis related to latex sensitization. At present 12.9% of atopic subjects were sensitized to latex by skin prick against 21.9% in 1998, so sensitization showed a decline in the years considered. CONCLUSIONS: Contact dermatitis and sensitization to natural rubber latex is a significant problem and nurses should be tested for both types of hypersensitivity, as well as being patch tested to standard, rubber and disinfectants series. The need is stressed for preventive measures to prevent the onset of contact dermatitis and to avoid latex exposure.     

A case of occupational contact dermatitis due to hydroxylamine

A 36-year-old man, working in a chemical industry, had a generalized pruritic eruption. A forty-eight hour patch test revealed positivity for 1% hydroxylamine. Prevention of exposure to this chemical resulted in a dramatic improvement of the symptoms. Based on these findings, we diagnosed this case as occupational contact dermatitis due to hydroxylamine. There has been few case reports of contact dermatitis due to hydroxylamine. Histopathological examination revealed a marked spongiosis and a spongiotic bulla formation in the epidermis and follicular infundibulum, suggesting an allergic reaction.