Occupational airborne allergic contact dermatitis from azithromycin

The Dutch government has recently taken initiatives to improve the protection of labourers against diseases which are related to their work, and most especially, to reduce the rapidly increasing number of patients who have to definitely stop working and who, eventually, end up being dependent on social welfare. Firstly, a number of new laws have been adopted which define the responsibilities of both the employers and the employees. Secondly the cooperation is stimulated between the Dermatologist and the Occupational Health Physician of the patient. The latter is (according to law) employed by the employer of the patient and regularly visits the place of work. We now had the opportunity to treat and study both the social, medical and occupational aspects of a patient's case simultaneously.
We decided to eliminate the existing hesitation of consulting or referring, as well as the barriers created by matters of procedure, bureaucracy and waiting lists. In our paper we discuss the above‐mentioned laws and regulations, and the way in which cooperation takes place between the doctors. We will present figures showing the effects of this approach on sickleave.     

Occupational allergic contact dermatitis from anaerobic acrylic sealants

Anaerobic sealants are acrylates that polymerize in the absence of oxygen. They are used principally in the engineering and electronic industries. Their use can cause occupational dermatitis in the workers who handle them. In this work, we report our experience with 6 patients who presented with allergic contact dermatitis to these sealants.     

Anogenital allergic contact dermatitis, the role of spices and flavour allergy

Background: In patients with vulval or anogenital dermatitis, irritant contact dermatitis is more common than allergic contact dermatitis. The reported frequency and relevance of contact sensitivity in anogenital dermatitis varies greatly. Objective: To determine the frequency and relevance of contact sensitization in a Dutch group of female patients with chronic anogenital complaints. Methods: We reviewed patch test results of 53 women with chronic anogenital complaints, with sole vulval symptoms in 29 women and sole perianal in 5, in whom inflammatory skin diseases like lichen sclerosus, lichen planus, psoriasis, as well as infectious diseases were unlikely or excluded as a cause of their symptoms. All women were tested with the European baseline series plus additional test series according to their personal history. Results: Thirty‐five patients (66%) showed one or more positive test reactions. Seven of these patients (20%) had one or more clinically relevant positive reactions, most often to flavours and spices. Conclusion: A considerable number of patients with anogenital dermatitis have a contact sensitization. Clinically relevant reactions were mainly found to spices and flavours. This is in contrast to the data reported in the literature that shows most contact allergies in vulval patients to ingredients of topical medication.     

Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome

Protein contact dermatitis to meat is well known in butchers; spices are another source of potential contact allergy and usually are not recognized. We present a first case of contact-dermatitis to spice mix in a 39-year-old-butcher. The patient underwent skin prick testing (SPT) with standard allergens (ALK) and different meat and spice extracts (Stallergènes), scratch-patch testing with spice mix containing glutamate, paprika and other spices. Specific serum-IgE was measured with CAP-FEIA. SPT only showed an immediate-type sensitization to mugwort (+ +), as well as different spices (paprika +, curry +, cumin +) and camomile (+ + +). Scratch-patch tests were negative for different meat, but strongly positive for spice mix (+ + +) after 30 min (wheal and flare) and (+ +) after 48 h (infiltration and vesiculation). Two healthy controls were tested negative for spice mix used from that patient (scratch-patch). Specific IgE was slightly elevated for paprika 0.47 kU/L (CAP class 1), anise 0.43 kU/L, curry 0.36 kU/L and mugwort 3.83 kU/L. Sx1 atopy-multiscreen was 3.8 kU/L due to a sensitization to mugwort alone. The tests performed demonstrate an IgE-mediated contact allergy to spices but also a delayed type allergy to spice mix as a manifestation of the mugwort-spice syndrome in this individual. When testing for occupational dermatitis in butchers, protein contact allergy to spices must also be taken into consideration.