常见环境接触因素在手部皮炎发病中的作用

通过问卷调查及斑贴试验对常见环境接触因素在48例手部皮炎患者发病中的作用进行了研究。结果确诊接触性皮炎7例(14．6％),其中5例为职业性接触性皮炎;其余41例为可疑接触性皮炎。手部皮炎患者斑贴阳性率偏低(51％);洗涤剂引起或加重患者病情的占41．7%。水引起或加重患者病情的占39．6％;说明刺激因素在手部皮炎中也很重要。可疑接触性皮炎患者斑贴阳性率为46．3％,接触过敏因素在这部分患者发病中的作用仍不能忽视。明确斑贴试验阳性结果与疾病的联系是进一步必须研究的课题。     

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。     

镍变应性反应的流行病学:镍斑试阳性病人的追踪分析结果

作者1982年报告了5个国家2400名镍过敏的病人中,有157人镍斑贴试验呈阳性反应。3年后作者对104名82年斑试阳性的病人进行了追踪研究,发现有68人不再患镍皮炎,16人患轻度手部皮炎或出汗障碍,13人患慢性手部湿疹,1人因不愿摘掉耳环患耳垂皮炎,6人证实为异位性皮炎。几乎所有的病人主诉,不能接触服装服饰、镍的盘子、手表和金属扣子。作者采用与1982年相同的斑试方法,用统一批号的硫酸镍对100例病人再次进行了斑试,结果13人对镍呈阴性反应,对镍呈阳性反应的病人中,有1/3的人反应程度     

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。     

斑贴试验在诊断接触性皮炎中的应用及体会

统计分析56例接触性皮炎患者的致敏原斑贴试验结果。致敏原分别是硫酸镍、甲醛、香料、对苯二胺、重铬酸钾、松香、橡胶、乙二胺和环氧树脂。斑贴试验不仅有助于确定接触性皮炎患者的致敏原,还有助于确定职业性皮炎的致病原因。     

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.     

百菌清所致变态反应性皮炎分析

目的了解某制革厂百菌清对接触人群的致敏反应,为采取相应的预防对策提供参考。方法选取该厂36名接触工人为调查对象,从中筛选33人进行皮肤斑贴试验,采用左前臂屈侧为试验臂,右前臂屈侧为对照臂,斑贴保持24 h后除去,立即用75%的酒精洗净,15 min后观察并记录结果,并连续观察4 d,记录局部反应。结果 36例调查者中有33.3%的工人发生皮炎,7例嗜酸性粒细胞增多;33例皮肤斑贴试验中,24 h阳性反应42.42%,48、72 h分别增至63.9%、69.7%,反应强度(++)者48、72 h为24.24%;5例有皮炎症状者嗜酸性粒细胞增多者的斑贴试验48、72 h发生阳性反应。结论百菌清为一强致敏物,能引起迟发型变态反应性皮炎。     

495例面部皮炎的斑贴试验分析及临床意义

目的:研究面部皮炎患者斑贴试验的结果及临床意义。方法:对本科门诊确诊的495例面部皮炎患者进行斑贴试验,并对结果作统计学处理。结果:斑贴试验总阳性率89.49%,其中老年组患者阳性率明显低于青年组和中年组,性别差别无统计学意义。阳性率居前5位的变应原依次为:重铬酸钾、硫酸镍、芳香混合物、甲醛和卡巴混合物,其中卡巴混合物的阳性率男性明显高于女性,硫酸镍阳性率女性明显高于男性。58.47%的病例同时存在3种及以上的阳性变应原。结论:重铬酸钾、硫酸镍、芳香混合物、甲醛和卡巴混合物是本地区面部皮炎的常见变应原,男女患者对卡巴混合物和硫酸镍的反应存在差异,斑贴试验对面部皮炎寻找致敏原及防治具有重要的参考价值。     

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。     

Tissue reaction to the nickel implants in the guinea pigs

Objectives

The aim of the study was the assessment of local tolerance to nickel implants during 9 months observation in guinea pigs sensitized to nickel before implantation and non-sensitized ones.

Materials and Methods

Three groups of guinea pigs were included in the study: 10 sensitized to nickel by the guinea pig maximization test; 10 previously non-sensitized and 10 in control group. In 20 animals (except control group) the nickel implants were inserted in the muscle of the back. After 9 months of observation, the animals were patch-tested with 5% nickel sulfate. Also percentage of eosinophils in peripheral blood was examined. Next, the tissue surrounding the implant and skin from the area of patch tests were collected for the histological examination.

Results

In 70% of previously sensitized animals, the patch test confirmed the sensitivity to nickel. In 60% of previously non-sensitized animals, a positive reaction to nickel occurred. The results of patch tests in control group were negative. Percentage of eosinophils in peripheral blood was fourfold higher in animals sensitized to nickel than in control group. In histological examination, in the tissue surrounding the implant a dissimilarity concerning the intensity of cellular infiltration was observed between animals previously allergic and non-allergic to nickel. In the 2 of 10 previously sensitized guinea pigs quite severe inflammatory reactions in the inside of connective tissue capsule were noted which may indicate a local allergic reaction. The histological images of skin collected from the positive patch test site corresponded with the typical allergic contact dermatitis.

Conclusions

Nickel implants may cause primary sensitization to nickel. The nature of the histological changes in the tissues around the implants in guinea pigs sensitized to nickel may correspond to an allergic reaction. The examination of percentage of eosinophils in blood of guinea pigs may be useful in assessing the allergenic activity of metal alloys containing nickel.     

Investigation of the cause of contact dermatitis due to heavy metal in a metal spray process in a film-condenser factory]

To investigate causes of contact dermatitis in the metal spray process in a film-condenser factory, we developed a questionnaire survey for workers exposed to metal dust, analyzed the metal dust, and conducted patch tests with the metal dust and its constituents. In the questionnaire survey, we identified 12 workers (12/26, 46.2%) who had had dermatitis. The main symptoms were itching, itchy red skin and itchy papules. Analysis of the metal dust showed that there was no copper oxide, but nickel, not contained in the materials of the metal spray, was detected. One worker with dermatitis had a positive reaction to 2.5% nickel sulphate. Some of the workers showed primary irritant reactions to 5% copper sulphate. As a result, we considered that these cases of dermatitis involved irritant contact dermatitis due to copper and/or allergic contact dermatitis due to nickel. To prevent dermatitis, we recommended improvement in ventilation, reducing the room temperature to reduce sweating, and to educate workers on the importance of frequent hand washing. Thereafter, the incidence of dermatitis decreased, and there were no cases requiring medication.     

62例面部皮炎患者斑贴试验分析

目的：探讨面部皮炎的致敏原及其特点。方法：采用欧洲标准筛选变应原对62例面部皮炎患者进行斑贴试验。结果：列前10位的常见致敏原分别是芳香混合物，对苯二胺、重铬酸钾、松香、硫酸镍。结论：斑贴试验是面部皮炎患者寻找致敏原的有效方法。     

Occupational allergic and irritant contact dermatitis in workers exposed to polyurethane foam

Objectives

To evaluate sensitization to chemicals present in work environment after an outbreak of contact dermatitis in workers of vehicle equipment factory, exposed to polyurethane foam, based on 4,4′-diphenylmethane diisocyanate (MDI).

Material and Methods

From among 300 employees, 21 individuals reporting work-related skin and/or respiratory tract symptoms underwent clinical examination, patch testing, skin prick tests, spirometry and MDI sIgE measurement in serum. Patch tests included isocyanates series, selected rubber additives, metals, fragrances, preservatives, and an antiadhesive agent.

Results

Clinical examination revealed current eczema in the area of hands and/or forearms in 10 workers. Positive patch test reactions were found in 10 individuals, the most frequent to diaminodiphenylmethane and 4-phenylenediamine (7 persons). Reactions to an antiadhesive agent were assessed as irritant (5 workers). Except for sensitization to common aeroallergens, no significant abnormalities were found in the remaining tests. Occupational allergic contact dermatitis was diagnosed in 7 workers, irritant contact dermatitis in 10 and coexisiting allergic and irritant contact dermatitis in 3 workers.

Conclusions

In workers manufacturing products from polyurethane foam, attention should be paid to the risk of developing contact dermatitis. Skin problems in our study group were attributable probably to insufficient protection of the skin.     

Allergy to orthopedic metal implants — A prospective study

Objectives

Evaluation of the allergenic properties of the metal knee or hip joint implants 24 months post surgery and assessment of the relation between allergy to metals and metal implants failure.

Materials and Methods

The study was conducted in two stages. Stage I (pre-implantation) — 60 patients scheduled for arthroplasty surgery. Personal interview, dermatological examination and patch testing with 0.5% potassium dichromate, 1.0% cobalt chloride, 5.0% nickel sulfate, 2.0% copper sulfate, 2.0% palladium chloride, 100% aluminum, 1% vanadium chloride, 5% vanadium, 10% titanium oxide, 5% molybdenum and 1% ammonium molybdate tetrahydrate were performed. Stage II (post-surgery) — 48 subjects participated in the same procedures as those conducted in Stage I.

Results

Stage I — symptoms of “metal dermatitis” were found in 21.7% of the subjects: 27.9% of the females, 5.9% of the males. Positive patch test results were found in 21.7% of the participants, namely to: nickel (20.0%); palladium (13.3%); cobalt (10.0%); and chromium (5.9%). The allergy to metals was confirmed by patch testing in 84.6% of the subjects with a history of metal dermatitis. Stage II — 10.4% of the participants complained about implant intolerance, 4.2% of the examined persons reported skin lesions. Contact allergy to metals was found in 25.0% of the patients: nickel 20.8%, palladium 10.4%, cobalt 16.7%, chromium 8.3%, vanadium 2.1% Positive post-surgery patch tests results were observed in 10.4% of the patients. The statistical analysis of the pre- and post-surgery patch tests results showed that chromium and cobalt can be allergenic in implants.

Conclusions

Metal orthopedic implants may be the primary cause of allergies. that may lead to implant failure. Patch tests screening should be obligatory prior to providing implants to patients reporting symptoms of metal dermatitis. People with confirmed allergies to metals should be provided with implants free from allergenic metals.     

过敏性皮肤病患者斑贴试验的结果分析

目的：探讨过敏性皮肤病中斑贴试验的价值及常见变应原的特点,为疾病的防治提供参考。方法：选用包括了20项中国地区常见过敏原的斑贴试剂,对116例过敏性皮肤病患者进行斑贴试验。结果：116例过敏性皮肤病患者中91例斑贴试验阳性,总阳性率为78.45%。阳性率较高的前3位过敏原依次是：甲醛（36.26%）、芳香混合物（31.87%）和硫酸镍（28.57%）,其中芳香混合物和硫酸镍在女性中多见。结论：斑贴试验在过敏性皮肤病诊治中具有重要价值,试验提示甲醛、芳香混合物和硫酸镍是现今过敏性皮肤病的常见变应原。     

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。