Occupational allergic contact dermatitis caused by wood dusts

Exposure to wood dusts may cause various skin and mucosal symptoms. Allergic dermatoses, caused by wood dusts, diagnosed at the Finnish Institute of Occupational Health during 1976-1999 are reported here. 16 had allergic contact dermatitis and, 2 had contact urticaria. 9 men (3 cabinet makers, 3 joiners, 1 carpenter, 1 knifemaker and 1 machinist) were mainly exposed to tropical hardwoods. 1 man had dermatitis caused by western red cedar. 5 patients, 3 men and 2 women, were exposed to Finnish pine or spruce dusts, and 1 man to aspen. 7 also had rhinitis, 4 asthma or dyspnoea and 3 conjunctivitis. On patch testing, 10 men reacted to 9 different wood dusts, including teak (5), palisander (3), jacaranda (2), mahogany (2), walnut (2) and obeche (1). Reactions to wood allergens, including lapachol (2), deoxylapachol (1), (R)-3,4-dimethoxydahlbergione (2), 2,6-dimethoxy-1,4-benzoquinone (1), mansonone A (2) and salicyl alcohol (1), were noted in 4 cases. All but 1 of 5 patients exposed to pine or spruce dusts reacted to the sawdusts, all 5 to colophonium, 3 to abietic acid, 2 to tall oil resin, 3 to wood tar mix and 4 to other wood gum resins. Of the 2 CU patients, 1 was prick and RAST positive to obeche, 1 reacted with urticarial dermatitis to punah wood dust on chamber exposure. Occupational allergic dermatoses are mainly caused by the dusts of hardwoods, mostly due to Type IV allergy, but may also be caused by softwood dusts. Patch tests can be done with wood dusts, but should be confirmed by patch testing with wood allergens if possible.     

Contact allergy to the UV-absorber Tinuvin P in plastics

Contact allergy to the UV-absorber 2-(2-hydroxy-5-methylphenyl)benzotriazole (Tinuvin P) was revealed in a patient with wrist dermatitis caused by a plastic watch strap. A high-performance liquid chromatography method was developed and subsequent chemical analysis showed the presence of Tinuvin P in the watch strap. The possibility of cross-reactions between Tinuvin P and various substituted benzotriazole compounds was investigated. No cross-reactions were found.     

Triclocarban: Evaluation of contact dermatitis potential in man

Triclocarban was subjected to a profiling of its dermatitis producing potential including irritancy (21–day cumulative irritancy potential and application to 213 normal controls), phototoxicity (method of Marzulli), predictive contact sensitization (modified Draize method), predictive phototesting and buttery screening in 2200 dermatitis patients, in an effort to define its relative dermatitis potential. The allergic contact dermatitis potential of triclocarban following bar soap use appears minimal.     

Occupational dermatitis in the aircraft industry: 35 years of progress

We report a 54-year-old female with allergic contact dermatitis from 2-(2-hydroxy-5-methylphenyl)benzotriazole (Tinuvin P) in a spandex tape sewn into underwear. Tinuvin P is used as an ultraviolet light absorber for stabilizing plastics and the other organic materials against discoloration and deterioration. It is effective in protecting synthetic and natural fibers, polyesters, chlorinated polyesters, polystyrene, polyvinyls, cellulose acetate, ethyl cellulose, acrylates, dyes, waxes, detergents, cosmetic formulations, etc. Our patient developed itchy erythema on her shoulders, chest and upper back after wearing underwear for 1 night. She showed positive reactions to spandex tape sewn into the underwear. She also reacted to 2-(2-hydroxy-5-methylphenyl)benzotriazole (Tinuvin P), which was contained in the spandex. No cross-reaction to other benzotriazoles was seen.     

Allergic contact dermatitis to laurel (Laurus nobilis L.): Isolation and identification of haptens

Summary Two methods, using methylenelactone dimethylamino adducts, were used to remove selectively -methylene -butyrolactones from Laurus nobilis L. extracts. Isolated lactones were identified and treated extracts recovered. Two guinea-pig groups were sensitized to crude extracts and treated extracts, respectively, and tested with primary sensitizer and with different lactones. Only the first group showed strong skin reactions to crude extracts and to the lactones. Treated extracts were shown to be anallergic.     

White petrolatum (Ph. Eur.) is virtually non-sensitizing. Analysis of IVDK data on 80 000 patients tested between 1992 and 2004 and short discussion of identification and designation of allergens

Sporadic cases of contact allergy to white petrolatum, which is used as a vehicle in patch test preparations, have been reported. The quantitative relevance of the phenomenon remains yet to be elucidated. Methods: Retrospective analysis of patch test data of the Information Network of Departments of Dermatology (IVDK, http://www.ivdk.org) between 1992 and 2004. Results: Analysis of 79 365 patients patch tested with pure petrolatum yielded 27 '+' (0.03%) and 2 '+++' (0.003%) reactions. The majority of non-negative reactions (0.3%) was interpreted as doubtful (235) or mild irritant (32). The negative reaction index (RI) (-0.8), and the high positivity ratio (PR) (93%) especially a lack of concordance with patch test preparations containing > or=99% petrolatum indicate that many of the 'positive' (+) reactions have to be considered as irritant. There were 2 '+++' reactions. In 1 case, an 'angry back reaction' was confirmed. The other case is probably a reading or documentation error, as the majority of patch test reactions to preparations containing petrolatum remained negative in this case also. Conclusions: True allergic patch test reactions to white petrolatum are extremely rare and probably due to an individually increased susceptibility to allergens and/or irritants. This is in agreement with considering petrolatum as a non-sensitizer.     

Double-blind placebo-controlled peroral challenges in patients with delayed-type allergy to balsam of Peru

Patch tests (PTs) with spices, such as clove, cinnamon, Jamaica pepper and vanillin sugar, and with balsam of Peru were made on 29 patients 0.8–2.9 years after an allergy to balsam of Peru had been detected. Positive reactions to balsam of Peru were seen in 17 patients, and to clove, Jamaica pepper or cinnamon in 5. Double-blind placebo-controlled peroral challenges (DBPCPCs) with balsam of Peru and spices (active substances) were performed on 22 patients. A substantial increase (30–280%) in the number of palmar vesicles after the DHPCPC with the active substances, but not with placebo, was seen in 8 patients, an increase with both the acme substances and placebo in 3. and with placebo but not the active substances in 1 patient. 4 of the 8 patients with positive DBPCPCs with the active substances were negative to balsam of Peru in the 2nd PT. No other objective symptoms were seen after the DBPCPCs. Balsam of Peru and the spices were retested 3 months after the DBPCPC. Both alleviation and aggravation of the PT reactions were seen. It is concluded that ingested flavoured foods might cause systemic contact reactions in some patients with allergy to balsam of Peru, but the benefits of a flavour-avoiding diet are questionable in all of them.     

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.     

Sensitizing capacity of some trimers in p-tert-butylphenol-formaldehyde resin

Contact allergy to p-tert-butylphenol formaldehyde resin (PTBP-F-R) is not rare. This resin consists of a large number of substances, most of which are still unknown. For diagnostic and preventive reasons the chemical identity of the sensitizers should be known, as well as their sensitizing capacities, cross-reaction patterns and presence in the environment. The aims of this study were to investigate the sensitizing capacities and potential cross-reacting patterns for 4-tert-butyl- 2,6-bis-(5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzyloxymethyl)-phenol (XIII), 4-tert-butyl-2- (5 - tert - butyl - 2 - hydroxy-benzyloxymethyl) - 6 - (5 - tert - butyl - 2 - hydroxy - 3 - hydroxymethyl-benzyloxy methyl)-phenol (XIVa) and 7,15,23-tri-tert-butyl-25,26,27-trihydroxy-2,3,10,11,18,19-hexahomo-3,11,19-trioxacalix(3)arene (XVIII) by the guinea pig maximization test. 4-tert-Butyl-2,6-bis-hydroxymethyl-phenol, 4-tert-butylbenzene-1,2-diol, 4-tert-butyl-2-hydroxymethyl-phenol, 4-tert-butyl-phenol, 4-tert-butyl-2-(5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzyloxymethyl)-6-hydroxymethyl-phenol, 4-tert-butyl-2-[5-tert-butyl-3-(5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzyloxymethyl) - 2 -hydroxy-benzyloxymethyl] - 6 - (5 - tert-butyl- 2 -hydroxy- 3 -hydroxymethyl-benzyloxymethyl)- phenol and were used as potential cross-reacting substances. In this study it is strongly indicated that the linear trimer XIII has a sensitizing capacity in the guinea pig which was significant when compared to the controls (p = 0.024). No cross-reactions were detected in animals induced with the linear trimer XIII. The linear trimer XIVa and the cyclic trimer XVIII failed to induce sensitization.