染发皮炎的病因探讨及预防

本文报告了多见于中年女性的染发皮炎39例,用1%对苯二胺对其中的19例进行斑贴试验,阳性率为94.7%,证实染发皮炎的致敏原主要是对苯二胺,以染过的头发作斑贴试验均为阴性。本文对染发剂的种类、染发原理及染发皮炎的病因进行了讨论,并在此基础上提出了预防措施。     

N-乙酰基转移酶2基因与染发皮炎的关系

染发皮炎是由染发剂引起的急性炎症反应,对苯二胺是导致染发皮炎最主要的致敏原之一.N-乙酰转移酶(NAT)催化芳香胺类和肼类物质的乙酰化反应.NAT基因定位于人类染色体8p21.3-p23.1,包含编码NAT功能蛋白的NATI、NAT2基因和无编码功能蛋白的NATP假性基因.     

血管紧张素转化酶基因插入/缺失多态性与染发皮炎关系的研究

染发皮炎是临床上常见的一种接触性皮炎,其发病机制尚未完全明了,可能与环境因素和个体遗传易感性相关.血管紧张素转化酶(ACE)可以调节接触性皮炎的炎症反应,其机制可能是ACE通过灭活缓激肽和P物质来调节皮肤的炎症反应[1].有研究表明,ACE与冠心病、高血压、糖尿病、肾病及银屑病等发病有关,而与染发皮炎的关系国内尚未见报道.我们采用病例对照的方法,对天津地区染发皮炎患者进行ACE基因多态性分析,以阐明ACE基因多态性与染发皮炎易感性之间的关系.     

干扰素与界面皮炎相关性的研究进展

界面皮炎指的是一种特定的组织学炎症类型,主要表现为基底细胞液化变性和真皮浅层血管周围,尤其是乳头部位致密的炎症细胞浸润.多种炎症及肿瘤性疾病的组织学改变中均有界面皮炎的表现,包括扁平苔藓、红斑狼疮、单纯疱疹病毒感染的皮损、病毒疣、苔藓样型日光角化病和鳞状细胞癌等.研究显示,Ⅰ型干扰素可能参与界面皮炎的发病.可能在不同的情况下,干扰素诱导细胞毒性攻击行为,作用于基底细胞引起界面皮炎的表现.     

湿疹及皮炎

20100482N-乙酰基转移酶2基因与染发皮炎的关系/徐宏俊(天津医大总医院皮肤科),刘原君,孙晨薇…∥中华皮肤科杂志.-2009,42(9).-642～643采用病例对照的方法,对天津地区染发皮炎组及健康对照组进行N-乙酰转移酶(NAT)2基因多态性分析,采用卡方检验比较两组间NAT2基因各等位基因频率及基因型频率分布的差异。结果,NAT2等位基因在染发皮炎组与对照组的分布比较,差异无统计学意义(χ2=3.0,P>0.05);NAT2基因型与染发皮炎易感性的关系显示NAT2快、慢乙酰化基因型在染发皮炎组中分布频率为92.9%,7.1%,在对照组中为87.5%,12.5%,两组比较,差异均无     

185例面部皮炎患者临床及斑贴试验结果分析

目的:测定面部皮炎患者过敏原.方法:对185例面部皮炎患者进行国际接触性皮炎研究组认定产品-瑞敏接触变应原斑贴试验.结果:斑贴试验阳性者136例(73.5%),其中常见的致敏原依次为硫酸镍(25.9%),硫柳汞(20.5%)、重铬酸钾(16.2%)、甲醛(13.5%)、对苯二胺(11.4%)、芳香混合物(10.3%)等.结论:所有面部皮炎患者均应进行斑贴试验以寻找可能致敏原.     

不同部位的慢性湿疹与斑贴试验相关性研究

皮炎湿疹与多种变应原之间存在联系,并且发现不同部位的皮炎湿疹的常见变应原各不相同。引起面部湿疹和皮炎的致敏原主要为硫酸镍、重铬酸钾、对苯类、芳香混合物,手部主要为硫柳汞、芳香混合物、重铬酸钾、对苯二胺,脐周主要为硫酸镍。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,并发现不同部位皮炎和湿疹常见致敏原的不同。提示临床上应根据不同部位的皮炎湿疹采取不同措施。     

N-乙酰基转移酶1基因多态性与染发皮炎的关系

目的探讨N-乙酰基转移酶1(NAT1)基因多态性与中国人染发皮炎的关系。方法应用聚合酶链反应(PCR)及限制性片段长度多态性(RFLP)技术检测和分析天津地区60例染发皮炎患者及73例正常对照者的NAT1基因多态分型,比较NAT1各等位基因及基因型频率在染发皮炎患者组与对照组间分布差异。结果病例组NAT1*10等位基因频率为35.80%,明显低于对照组(χ2=3.954,P0.05)。NAT1基因型NAT1*4/*4,NAT1*4/*10,NAT1*10/*10,NAT1*3/*10,NAT1*3/*4在病例组的频率分别是36.70%,40.00%,15.00%,1.70%,6.70%,在对照组为26.00%,42.50%,24.70%,4.10%,2.70%,两组相比差异无统计学意义。病例组基因型中含有NAT1*10者的表型(快型)频率为56.70%,略低于对照组的71.20%(χ2=3.058,P=0.08)。结论 NAT1*10可能是中国人染发皮炎发病的遗传学保护因素之一。     

65例面部化妆品皮炎致病因素的调查分析

采用斑贴试验的方法，用原有可疑化妆品和北医大研制的标准筛选系列抗原，对65例化妆品所致面部损害的患者进行了分析。65例中，以中年女性为主；引起化妆品皮炎时间：以24－48h居多；皮肤损害的类型，常见的是变应性接触性皮炎；致病化妆品类型常见是护肤类化妆品。标准抗原系列做斑贴试验，阳性反应最多是香料和防腐剂，另外对苯二胺、硫酸镍、松香等也是与化妆品皮炎有关的主要抗原。     

Allergic contact dermatitis caused by henna tattoo:a case report

报告1例暂时性文身后出现的变应性接触性皮炎.患者女,42岁.左小腿外侧和右下腹部出现水肿性红斑2 d就诊.发疹前2周,患者在患病部位进行了暂时性指甲花文身.文身后2周,局部有轻度瘙痒,1 d后出现明显红斑.患者既往有染发皮炎病史.皮肤科检查:左侧小腿外侧和右下腹部文身部位出现水肿性红斑,同时有散在丘疱疹和小水疱.皮疹边界清楚,略超出文身范围.外用氢化可的松软膏3周后皮损消退,遗留明显色素沉着.患者于皮疹消退后1周接受斑贴试验,结果在48 h后出现对苯二胺的强阳性反应.     

55 cases of allergic reactions to hair dye: a descriptive,consumer complaint-based study

Severe facial and scalp dermatitis following the use of permanent hair dyes has been reported in several cases. Para-phenylenediamine (PPD) is known as a potent contact allergen, and PPD is allowed in hair dye at a concentration of 6%. Hair dye reactions are usually diagnosed by the patients themselves, and adverse reactions to hair dye may not necessarily be recorded by the health care system, unless the reactions are especially severe. Based on this assumption, we suspected that hair dye dermatitis was occurring more frequently than reported in the literature. Consumer complaint-based data were obtained by advertising for persons with adverse reactions to hair dye. Among those responding to the advertisement, 55 cases of severe, acute allergic contact dermatitis were identified. The main symptoms were severe oedema of the face, scalp and ears, and clinically this was often mistaken for angio-oedema. The 55 cases comprised a total of 75 visits to the health service and 5 admissions to hospital. 18 persons had sick leave, which supports the impression of very severe dermatitis reactions. 60% were treated with antihistamine, while 52% were treated with corticosteroids. 29% of the cases were patch tested and all were found positive to PPD. Our data presented here clearly show that PPD and its derivatives in hair dye at the present concentrations presents a significant health risk for the population. Furthermore, the severe acute allergic skin reactions are often misdiagnosed in the health care system. The frequency of allergic contact dermatitis resulting from hair dye is likely to be underestimated. New methods to survey the frequency of adverse reactions should be considered.     

Beard dermatitis due to para-phenylenediamine use in Arabic men

The most common active ingredient in hair coloring is para-phenylenediamine (PPDA), which can produce contact dermatitis, particularly in persons who dye their scalp hair and in hairdressers. We have identified another group of patients also at risk, namely men from Arab countries, who commonly grow beards and dye them. We searched the computerized patient database at the Mayo Clinic for patients with beard dermatitis associated with dye use. Eight Arabic men presented to the Mayo Clinic between 1994 and 1999 with beard dermatitis and a positive patch test to PPDA. The lesions were described as pruritic, erythematous, papular eruptions that developed in the jaw area after each application of beard dye. The symptoms subsided after the patients discontinued use of the PPDA-containing dye and received treatment with topical corticosteroids. Allergic contact dermatitis in the beard area due to PPDA occurs in Arabic men as a result of their propensity to dye their beards.     

Hair dye contact allergy: quantitative exposure assessment of selected products and clinical cases

Colouring of hair can cause severe allergic contact dermatitis. The most frequently reported hair dye allergens are p-phenylenediamine (PPD) and toluene-2,5-diamine, which are included in, respectively, the patch test standard series and the hairdressers series. The aim of the present study was to identify dye precursors and couplers in hair dyeing products causing clinical hair dye dermatitis and to compare the data with the contents of these compounds in a randomly selected set of similar products. The patient material comprised 9 cases of characteristic clinical allergic hair dye reaction, where exposure history and patch testing had identified a specific hair dye product as the cause of the reaction. The 9 products used by the patients were subjected to chemical analysis. 8 hair dye products contained toluene-2,5-diamine (0.18 to 0.98%). PPD (0.27%) was found in 1 product, and m-aminophenol (0.015 to 0.38%) and p-aminophenol (0.16 to 2.1%) were found in 3 products. The concentration levels were similar in the patient's products compared to a random sample of 16 hair dye products. The concentration present of toluene-2,5-diamine elicited allergic reactions in concentrations that were 10-fold lower than the legal EU limit of 10%. Hair dye allergy may cause severe clinical reactions, and the current regulation is insufficient in protection of the users. A preventive strategy is needed.     

Positive patch-test reactions to para-phenylenediamine, their clinical relevance and the concept of clinical tolerance

406 patients were patch tested over an 18-month period (January 1998 to June 1999) at a dermatology referral centre. 33 patients (8.1%) had a positive reaction to para-phenylenediamine (PPD). 20 patients were experiencing PPD hair dye dermatitis (present relevance, 61%), 2 were using PPD hair dyes without developing dermatitis (clinical tolerance, 6%), 4 had previously used PPD hair dyes with dermatitis in the past (past relevance, 12%), 3 had previously used PPD hair dyes without dermatitis (past exposure, 9%) and 4 had no known exposure to PPD (unknown relevance, 12%). Of the 20 patients whose test results were of present relevance, 17 avoided PPD hair dyes, resulting in total clearance of the dermatitis in all except 3, who had concurrent endogenous eczema. 3 continued using PPD hair dyes: 2 had recurrent contact dermatitis and 1 avoided dermatitis with meticulous technique. The 2 patients with clinical tolerance continued using PPD hair dyes with no dermatitis.     

Textile dye allergic contact dermatitis following paraphenylenediamine sensitization from a temporary tattoo

Textile dye allergy is frequently caused by azo dyes, which can cross-react with structurally similar compounds, including paraphenylenediamine. A case of allergic contact dermatitis to azo textile dyes, presenting principally as a sock dermatitis, is presented. The patient also gave a history of an episode of scalp dermatitis consistent with contact allergy to paraphenylenediamine in hair dye. It is proposed that paraphenylenediamine sensitization from a temporary skin tattoo may have been the primary sensitizing event for these reactions.     

Erythema multiforme following application of hair dye

Erythema multiforme (EM) is an acute mucocutaneous hypersensitivity reaction with varying degrees of blistering and ulceration. Common causes of EM are herpes simplex virus infection, mycoplasma infection, drug hypersensitivity, vaccination and drug-virus interaction. EM induced by contact dermatitis is rare. Paraphenylene diamine, a common ingredient in many hair dyes, is well known to produce allergic contact dermatitis. We report a 35-year-old lady presenting with EM following severe contact dermatitis to hair dye. So far as we know, this is the first report from India describing EM following contact dermatitis.     

Allergy to 3-nitro-p-hydroxyethylaminophenol and 4-amino-3-nitrophenol in a hair dye

Contact allergy to 3‐nitro‐p‐hydroxyethylaminophenol in a hair dye is described for the first time. p‐Phenylenediamine is the most common screening allergen when allergic contact dermatitis is suspected, but sometimes the allergen is not sufficient for diagnosing allergic contact dermatitis to hair dyes. A 50‐year‐old woman developed a severe scalp dermatitis and developed vesicular hand eczema for the first time in her life. Patch testing was performed with the European Standard Series. The patch testing was supplemented with a local series of cosmetic allergens and the hairdresser's series. At the initial patch testing, there was a + reaction to nickel and a +? to PPD at days 3 and 7. Further, she reacted with a +? to her own hair collected at day 3 after the hair dying which elicited the dermatitis reaction. Open exposure to the product, which had initiated the dermatitis, was negative both before and after the allergic reaction to the product. None of the screening chemicals in the hairdresser's series gave a definite positive reaction. Only by patch testing with the individual hair dye product ingredients, the patient's reactions were explained. The patient gave a positive patch test to 4‐amino‐3‐nitrophenol and 3‐nitro‐p‐hydroxyethylaminophenol at days 3–4 reading.     

Contact dermatitis from a presumed allergy to paraphenylenediamine

Paraphenylenediamine (PPD) is a potent skin allergen found in permanent hair dye and temporary henna tattoo ink. Several cases of adverse skin reactions to PPD have been reported in the literature. Here we present a case involving a patient who acquired a temporary tattoo while vacationing in Mexico and subsequently developed contact dermatitis at the tattoo site. He provided a history of permanent hair dye use in the past with associated cutaneous reaction. Temporary tattoos have become increasingly popular with travelers and as a result so have reports of associated allergic contact dermatitis. Of concern is cross‐reaction of PPD to related compounds, severe reactions in younger populations and sequelae including increased sensitization, permanent scarring, and persistent postinflammatory hyperpigmentation.