Foot dermatitis caused by the textile dye Basic Red 46 in acrylic blend socks

17 male subjects are described with foot dermatitis in association with positive patch test reactions to the textile dye Basic Red 46. Chromatographic analysis of the socks of 2 affected patients confirmed the presence of Basic Red 46. Withdrawal of the acrylic blend socks suspected of having been dyed with Basic Red 46 resulted in the improvement of symptoms in 12 of 17 patients (70.6%). However, equivocal or negative patch test results to their own socks were frequently noted in those patients. A highly significant association between the presence of foot dermatitis and a positive Basic Red 46 patch test reaction was noted in 555 patients from a patch test clinic population ( P  < 0.001). The prevalence of positive patch test reactions to Basic Red 46 was 1.2%. We suggest that patients with foot dermatitis be routinely patch tested for textile dyes. In particular, testing with Basic Red 46 should be considered in those with a history of use of dark-coloured acrylic and/or acrylic blend socks.     

Multiple azo disperse dye sensitization mainly due to group sensitizations to azo dyes

A female patient, with a previous episode of contact dermatitis caused by a blue dress developed similar dermatitis due to a navy -blue dress. Patch tests revealed multiple allergic positive reactions to paraphenylenediamine (PPD). The navy-blue dress, its extracts, 6 azo disperse dyes in a textile series, as well as 3 dye components, including Disperse (DP) Red 153, which were present in the dress: these were composed of 9 azo disperse dyes, all dyes being of a different chemical structure. On the basis of chemical similarities between these 16 azo dyes including PPD, these are classified into the following 4 groups: thiazol-azoyl-PPD group (including DP Blue 106. DP Blue 12-1 and 5 used dyes), aminoazobenzene group (DP Red 1. DP Red 17. DP Brown 1 and 2 used dyes). PPD group (PPD and DP Orange 3) and benzothiazol-azoyl-PPD group (2 dyes in DP Red 153). With few exceptions, cross-sensitizations between dyes in the same group have been reported by other authors, or are suggested by us, in the former 3 groups. Multiple azo disperse dye sensitization is therefore considered lo be attributable mainly to group sensitizations to azo dyes.)     

Red ginseng for atopic dermatitis

Red ginseng is known for its significant biological activities which include anti-inflammation. Red ginseng may be used for the management and prevention of atopic dermatitis based on its effect on an atopic dermatitis animal model. More therapeutic efficacies other than atopic dermatitis are also reviewed briefly.     

Brilliant Lake Red R as a cause of pigmented contact dermatitis

Twenty-three patients suffering from pigmented contact dermatitis caused by cosmetics containing Brilliant Lake Red R were observed. Commercial samples of Brilliant Lake Red R proved to contain many ethyl acetate extractable impurities; 1-phenylazo-2-naphthol and azobenzene were isolated and identified. To determine the responsible allergens, five patients were examined by patch tests with purified samples of azo-dyes and the unidentified fractions of ethyl acetate extractable impurities. Three out of five showed weaker reactions to purified samples of Brilliant Lake Red R and the other two showed equal reactions compared to the commercial product. 1-Phenylazo-2-naphthol was found to be a strong allergen in all cases but none showed a positive reaction to azobenzene. Some unidentified fractions also gave positive results. Patch tests were performed with 4-phenylazo-1-naphthol, 4-phenylazo-1-naphthol-2-carboxylic acid, and 2,4-bis(phenylazo)-1-naphthol, as structurally related compounds derived from 1-naphthol. All gave negative and they were not detected in the ethyl acetate extractable impurities by thin-layer chromatography.     

Sensitization to reactive textile dyes in patients with contact dermatitis

Reactive dyes are used especially for colouring natural fibres (cotton, silk and wool) that arc widely used in Western countries, particularly Italy, in the production of clothes. The aim of our study was to investigate sensitization to the most commonly used reactive textile dyes in patients undergoing patch tests, and to assess the clinical relevance of contact sensitization of these dyes. 1813 consecutive patients underwent patch tests with the GIRDCA standard series and an additional textile series of 12 reactive dyes. 18 of these patients were sensitized to reactive dyes (0.99) (4 only to reactive dyes). The dyes most frequently responsible for positive patch tests were Red Cibacron CR and Violet Remazol 5R (respectively, 8 and 5 positivities). In 5 cases only was a history of intolerance to particular garments given; of 4 patch tests performed with pieces of garment, 2 were positive. In 1 occupationally-exposed patient, airborne contact dermatitis was suspected. Owing to the lack of up-to-date patch test series, some cases of allergic contact dermatitis from textile dyes are probably misdiagnosed: new colouring agents are continuously introduced to the market, so that a close relationship with textile industry is necessary to improve our diagnostic tools.     

Prevalence of contact allergy to non-disperse azo dyes for natural fibers: a study in 1814 consecutive patients

5 non-disperse azo dyes, used for colouring natural fibers, were added to the standard patch test series, as 5% pet. Preparations, 1814 consecutive patients attending the patch test clinic were patch tested, of whom 16 (0.88%) reacted to the newly added dyes: 8 to Direct Orange 34. 5 to Acid Yellow 61. 2 to Acid Red 359 and 1 to Acid Red 118. On the basis of clinical history and results of patch tests with pieces of rubrics, contact sensitization to non-disperse azo dyes seemed to be related to the appearance of skin lesions at least in 8 subjects. We conclude that systematic exploration of the sensitizing potential of textile dyes, selected after careful investigation, can provide additional information on the frequency of occurrence of textile dye dermatitis, supporting individual investigation in sensitized subjects.     

Pigmented contact dermatitis from azo dyes

Eight patients suffering from pigmented contact dermatitis caused by the commercial Brilliant Lake Red R were patch tested with purified Sudan I and its several chemical analogues. Positive reactions were observed to Sudan I, Orange SS, Brilliant Lake Red R, Vacanceine Red, Yellow OB and Sudan II. Negative patch tests were obtained with Toluidine Red, Permanent Orange, Lithol Red and Sudan III.
We found that the commercial Brilliant Lake Red R which had been said to be the most important causative agent of pigmented contact dermatitis, contained Sudan I as a major impurity. The patients reacting to Brilliant Lake Red R always gave a positive reaction to Sudan I, hut these reacting to Sudan I did not always give a positive reaction to Brilliant Lake Red R.
This suggests that Sudan I is a potent sensitizer and may induce contact sensitivity and that Brilliant Luke Red R itself is a weak sensitizer or a cross-reacting substance.     

Red face and fungi infection

Red face syndrome is characterized by an erythematous dermatitis that is produced by different entities. These include rosacea, seborrheic dermatitis, contact dermatitis, atopic dermatitis, psoriasis, cutaneous lupus, photodermatosis, post-topical steroid dermatosis, demodicosis, borderline borderline (BB) leprosy, mastocytosis, carcinoid, postneoplasia flushing, cutaneous lymphoma, tineas, ulerythema ophryogenes, and psychosomatic flushing. Red face is a relatively common dermatologic manifestation. Our goal is to review tinea corporis and other fungi that affect this region causing facial erythema and its therapeutic management.     

Contact sensitization to textile dyes: description of 100 subjects

We have described 100 subjects sensitized to textile dyes. Of these, 16 had clinically been suspected of having a textile dermatitis from among 1145 patients referred for patch testing. 41 patients were identified from among 861 consecutive subjects tested with the GIRDCA (Italian Research Group on Contact and Environmental Dermatitis) standard series supplemented with 4 disperse dyes (Disperse Blue 124, Disperse Red 1, Disperse Yellow 3, Disperse Orange 3). The remaining 43 patients were identified from among 746 subjects tested with the GIRDCA standard series, supplemented with the 4 disperse dyes mentioned above and a further series of 12 other textile dyes. The clinical picture was extremely variable: most patients had a typical eczematous dermatitis, but we also observed persistent erythematous-wheal-type reactions, a transient urticarial dermatitis and an erythema-multiforme-like eruption. Among these textile dyes, Disperse Blue 124 caused most reactions. With the addition of the 4 disperse dyes to the GIRDCA standard series, we identified 4.8% sensitized to textile dyes, a much higher figure than the 1.4% observed among patients being patch tested on the basis of their history and the clinical findings; the addition of a further 12 textile dyes to the series further increased the detection rate to 5.8%. We stress the importance of routinely patch testing with textile dyes, which can help to elucidate the cause of certain kinds of atypical dermatitis.     

Textile allergy--the Melbourne experience

Background. Textile allergy is a well‐established entity, but there are relatively few Australian reports in this area. Objectives. To report the combined experience of textile contact dermatitis from the general and occupational contact dermatitis clinics at the Skin and Cancer Foundation, Melbourne, Victoria, Australia. Patients/Methods. On the basis of the clinical suspicion of textile allergy, 2069 patients were tested with a textile series. Results. One hundred and fifty‐seven (7.6%) patients reacted to any of the textile‐related allergens. The most common allergen was Basic Red 46 (20.2% of the positive reactions), followed by Disperse Blue 106 and Disperse Blue 124 (11.8% and 11.2%, respectively). Reactions to formaldehyde and formaldehyde‐releasing chemicals accounted for 30.6% of the concomitant reactions, and reactions to p‐phenylenediamine accounted for 12.6% of the concomitant reactions. The use of Disperse Blue mix yielded only 12.2% of patients sensitive to either of these two allergens, and it is not endorsed as a screening agent for textile dye allergy. Conclusion. Textile allergy is not uncommon. In Melbourne, Basic Red 46 in inexpensive, dark‐coloured, acrylic‐blend, men's work socks is the most important cause. It is important to test with samples of patients' clothing.     

Occupational contact dermatitis among the traditional 'tie and dye' cottage industry in Western Rajasthan

BACKGROUND: Dyeing is an age-old process and forms an integral part of textile industries. Tying is a process by which a particular part of cloth is prevented from the process of dyeing. The skin diseases in workers engaged in the 'tie and dye' industry have not been extensively studied. AIMS: To study the prevalence of contact dermatitis among workers engaged in the 'tie and dye' industries in and around Jodhpur (Western Rajasthan). METHODS: One thousand three hundred workers engaged in 'tie and dye' work were evaluated for occupation-related dermatitis. Those with skin lesions were subjected to patch tests using 2% aqueous solution of the dyes and chemicals commonly used by them. These included direct dyes, VAT dyes, sulfur dyes and azo dyes. Fifty workers without skin lesions served as controls. RESULTS: One hundred patients (7.69%) had dermatitis involving the exposed sites, mainly the hands and forearms. Eighty-one patients showed positive reactions to one or more dyes, most commonly Red RC base (azo dye), followed by naphthol. CONCLUSION: Red RC base and naphthol were the commonest allergens in the 'tie and dye' industry.     

Sensitization to azo dyes: negative patch tests to yellow and red azo dyes in printed paper

An over 2 x fold increase in para-aminoazobenzene allergy was observed in patients with allergic contact dermatitis during the years 1990-1991. Presuming that an increase in colour-printed newspapers might be a new unrecognized source of clinical allergy to azo dyes, patch tests were performed in 32 patients with an established p-aminoazobenzene allergy using a series of important azo dyes used in offset printing ink (Pigment Yellow 12, Pigment Yellow 13, Pigment Red 53, Pigment Red 57), as well as with dye-containing inks and specimens of colour-printed newspaper containing these azo dyes. In 25 out of the 32 patients (78%), positive patch tests were seen to textile azo dyes, in particular to Disperse Orange 3 (24 patients). In none of the 32 patients were reactions observed to the azo dyes used in printing ink, to the inks used or to the colour-printed paper specimens, indicating that these products were apparently not a cause of contact dermatitis in our group of patients with azo dye sensitization.     

Contact allergy to Disperse Blue 106 and Blue 124 in black "velvet" clothes

9 cases of allergic contact dermatitis due to black "velvet" fabrics, mostly leggings, are reported. In all cases, the 2 disperse dyes Blue 106 and 124 were shown to be the responsible contact sensitizers. Preparation of a chloroform extract and separation of the different disperse dyes by analytical and preparative thin-layer chromatography showed that 8 of the 9 black "velvet" clothes contained the same composition, namely Disperse Blue 1, 106, and 124, Disperse Red 1 and Disperse Yellow 3. In experimental studies performed previously. Disperse Blue 124 has been demonstrated to be a moderate sensitizer while Disperse Blue 106 proved to be the strongest found so far among the azo disperse dyes.     

Purpuric contact dermatitis in patients with allergic reaction to textile dyes and resins

BACKGROUND: Purpuric lesions have been described as an uncommon manifestation of allergic contact dermatitis in individual case reports. OBJECTIVE: We describe a series of patients who developed purpuric allergic contact dermatitis to textile dyes and resins in their personal clothing. Our purpose was to study the patients clinically and histopathologically and to define the most frequent allergens, which cause purpuric allergic contact dermatitis. METHODS: One hundred and three patients were clinically evaluated and tested with the Textile Color & Finish Series (TCFS) (Chemotechnique Diagnostics) and Standard Series (TRUE Tests) because of suspected allergic contact dermatitis (ACD) to clothing. The patients with clinical features of purpura as presenting sign of ACD were studied. Biopsies from the purpuric lesions were performed in three patients. RESULTS: Thirty of the 103 patients (29.1%) had positive reaction to an allergen from the TCFS. Clinically purpuric ACD was observed in 8.7% of all the cases studied (n = 9 of 103). Nine of the 30 patch-positive patients to the TCFS (30%) demonstrated purpuric macules, papules and patches. Patch testing of the nine patients with purpuric contact dermatitis, with the TCFS, resulted in 26 positive patch test results. The major causative allergens were the following: Disperse Blue 106 and Disperse Blue 124 in 26.9% each, Disperse Blue 85 in 11.5%, and ethyleneurea melamine formaldehyde in 7.7%. Positive patch tests were observed to dimethylol dihydroxyethyleneurea, dimethylol propyleneurea, tetramethylol acetylenediurea, urea formaldehyde, melamine formaldehyde, Disperse Red 17, and Basic Red 46 3.8% in each. Purpuric patch test reaction was observed in five cases. The patch test results had present relevance in all the cases. Lesional biopsies demonstrated acanthosis, spongiosis and parakeratosis. The blood vessels were dilated, without signs of vasculitis. The inflammatory infiltrate was composed of lymphocytes and erythrocytes. The extravasated erythrocytes had a perivascular and interstitial distribution in the superficial and deep plexus and were observed at the dermo-epidermal junction as well as in the epidermis. CONCLUSION: Purpuric contact dermatitis is not an uncommon clinical form of ACD to textile dyes and resins. New allergens, which can evoke the development of purpuric allergic contact dermatitis and have not been described in the literature until now include: ethyleneurea melamineformaldehyde, dimethylol dihydroxyethyleneurea, tetramethylol acetylenediurea, urea formaldehyde, melamine formaldehyde and Disperse Red 17.     

Contact dermatitis in tie and dye industry Workers

A survey of the 'Tie and Dye' industry of Jodhpur City in India was made to investigate occupational dermatoses. 49 (16.6%) of 250 workers had incapacitating dermatitis. Skin lesions were seen mostly over the dorsa of the hands and fingers. 26 patients were patch tested with various dyes and chemicals; 14 were positive. Fast Red RC salt was the most potent sensitizer. Other dyes showing positive reactions were Orange GC salt, Bordeaux GP salt, Blue B salt, Red B base and naphthol.     

Textile dermatitis in Israel: a retrospective study.

BACKGROUND:The diagnosis of contact dermatitis caused by clothing may be difficult because of its clinical polymorphism. Data in the literature suggest that textile dermatitis is more common than previously thought. OBJECTIVE: Our purpose was to study our patients suspected of having textile contact dermatitis from 1991 to 1997. METHODS: The records of the patients with positive reactions to allergens from the Textile Colors and Finish series in 3 contact dermatitis clinics were reviewed. All the patients were clinically evaluated and patch tested with the European Standard series and the Textile Colors and Finish series (Chemotechnique Diagnostics, Malm?, Sweden). RESULTS: Twenty-two of the 55 patients (40%) had positive patch tests to the textile dye allergens. Four of them had occupationally related textile dermatitis. The most frequent allergens were Disperse Blue 124, Disperse Blue 85, Disperse Red 17, and Disperse Blue 106. Erythematosquamous lesions were the most common forms of textile dermatitis (56%), followed by pustular lesion (16%) and hyperpigmented patches (8%). CONCLUSIONS: The relatively high percentage of positive results (40%) was attributable to the selected cohort of patients. In our series, positive reactions to the allergens Disperse Blue 124, 85, and 106 were common findings. Clinically, pustular allergic contact dermatitis, triggered by textile dyes was observed along with the more frequent erythematosquamous clinical form.     

Contact allergy to textile dyes in southern Sweden

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.     

Disperse dyes in fabrics of patients patch-test-positive to disperse dyes.

BACKGROUND: Little evidence exists that dyes to which individuals are patch test positive are in those garments that they suspect cause their dermatitis, which makes diagnosis and management of colored-textile allergic contact dermatitis difficult. OBJECTIVE: We determined whether disperse dyes to which a patient suspected of having a colored garment-dye contact allergy were in the garment that the patient suspected to be the cause of his or her skin lesions. METHODS: Each patient was patch-tested with 12 disperse dyes in a commercial patch test series. Disperse dyes in the submitted garment(s) were identified. The dyes to which each patient was patch test positive were compared with the dyes identified in that patient's submitted fabric(s). When a dye appeared in both lists, a correlation was found. RESULTS: Twenty-two of 32 garments received contained disperse dyes. In all, 35 different disperse dyes were identified. Twelve dyes elicited a reaction in at least one patient. Only nine patients were patch test positive to at least one dye identified in the fabric submitted. Dyes appearing in both lists were Blue 106 (8 times), Blue 124 (2 times), Yellow 3 (once), and Red 1 (once). CONCLUSION: Dyes to which a patient was patch test positive were infrequently identified in the fabric suspected to be the cause of the skin lesions, which means that the next step will be to patch-test with fabric swatches and extracts of dye from the submitted garments.     

Hand dermatitis as an unsuspected presentation of textile dye contact sensitivity

The aim of this study was to evaluate disperse dye sensitization in patients with hand dermatitis. From January 1996 to December 2000, we identified 130 patients with hand dermatitis reacting to one of the 7 dyes included in our standard series. In 82 subjects the dermatitis was localized to the hands alone, whereas 48 patients had lesions both on the hands and on other skin sites. Disperse Blue dyes, and Disperse Orange 3 were the most common sensitizers. Among the 13 subjects allergic to disperse dyes alone, we found 3 cases of occupational allergic contact dermatitis, 1 child with atopic dermatitis worsening after the use of synthetic fibre garments, 4 subjects affected by clothing dermatitis, and 5 individuals occupationally exposed to irritants with a dermatitis involving the hands alone. In the latter, the hands may represent a 'locus minoris resistentiae', and both induction and elicitation of contact sensitization could be caused by impaired barrier function at a skin site repeatedly exposed to sensitizing garments.     

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.