Dermatosen in Beruf und Umwelt. Occupation and environment最新文献

The history of inpatients with Crohn's disease revealed several occurrences of contact dermatitis due to metal ions. Therefore, we considered the question as to whether allergic reactions to amalgam fillings or mercury, delivered in small amounts, could be a factor in the activity of regional enteritis. 23 patients with Crohn's disease (15 females, 8 males), aged from 20 to 44 years were screened by an extended standard patch test (following the rules of the ICDRG). Surprisingly, no case of hypersensitivity to amalgam and/or mercury was found. However, nickelsulfate yielded positive reactions in 39.1% of all tested patients (9/23). In comparison to the normal population this prevalence of nickelsulfate hypersensitivity is distinctly increased. It may be an epiphenomenon of Crohn's disease (sensitization via an enhanced permeability of the irritated mucous membranes for nutritive nickelsulfate) or an etiopathogenetic co-factor. In the latter case regional enteritis might be regarded as an allergic-irritative disease of the bowel.

A simple in vitro screening method was established, which allows estimation of the effect of environmental products on cell alteration or irritative potential. Primary cell suspensions, prepared from the epidermis of guinea pig ears through trypsination (0.2%) over night at 4 degrees C, were used. The cell suspension (3 mill./ml) and test substances were mixed in equal portions (500 microliters) and incubated at room temperature for approximately 90 min. The degree of cell alteration was determined by the trypan blue exclusion test. Chemically defined substances as well as disinfectants were employed. The cell alteration was clearly dependent upon substance concentration as well as incubation time. On the basis of the mean alteration time (AT50) measured in vitro, and the mean irritation time (IT50) determined in the patch test in vivo, the substances were ranked according to strength of cell alteration or irritative potency in vitro and in vivo. A good correlation (Spearman's rank correlation, rs = 0.76) was found between the in vitro and in vivo results. Thus, this method is suited for the screening of chemical products especially in industrial laboratories.

Occupational psoriasis accounts for about 1.2% of all cutaneous pathologic conditions due to work. It is especially important for subjects with slight signs of psoriasis, since patients already suffering from clear illness spontaneously avoid traumatic activities. Our interest was directed to cutaneous symptoms, signs for identifying subjects predisposed to traumatic dermatitis, also useful in vocational guidance. The necessity of official acknowledgement of such work-related dermatological pathologies is suggested.

Nine different tattoo dyes were analysed by various tests. Mixtures of organic dyes and inorganic filler were found; the inorganic filler consisted mainly of titanium dioxide (TiO2). Heavy metals, e.g. mercury, cadmium, or chrome as the common components of the traditional tattoo dyes, are capable of evoking unwanted skin reactions, but were not detected. Tattoo dyes are not officially controlled, and thus it is not known which substances-in addition to those identified by us-are presently used to produce ornamental tattoos. However, our results suggest that classic dyes have been superceded by newer, mainly synthetic dyes.

The lack of a first-pass effect for locally-applied substances is often not considered. This is especially true for such central nervous system agents as salicylic acid, hexachlorophene or caffeine which have a relatively low toxicity when applied orally. Manifestation of dermal irritation, such as a beginning rash or inflammation, are often tolerated because the beneficial effects of some topically applied substances outweight the damage (Dithranol, 5-Fluorouracil). This applies to some anti-phlogistics as well, which may also cause skin irritation. Some substances, such as benzoyl peroxide, vitamin-A acid and beta-estradiol have direct or indirect desiccative effects so that skin irritations may occur. Other substances, such as tar, for example, are applied locally although they may have a carcinogenic potential when misused, or when contraindications for its use are disregarded. Local risks can be recognized in clinical-experimental and clinical testing of dermatological products. One must, however, look carefully for an intensification of possible risks related to the method of application, the condition of the skin, the site of application, supporting therapeutic measures or changes in the composition of the vehicle. Lanolin, cetyl alcohol and myristyl alcohol, sorbitol, isopropyl-myristate as well as polyethylene glycols (PEG) penetrate the skin like active substances. Some have been connected with skin allergies. In addition, some preservatives have mutagenic properties. Many vehicles cause dehydration of the horny layer and thus result in chronic surface damage. This is true for hygroscopic substances such as PEG as well as for liquid paraffins, lipid solvents (alcohol, acetone), solvents such as propylene glycol and for some O/W emulsifiers.

Medical examinations were performed on 74 inductive oil wiring workers in contact with synthetic resins. 22 persons from a control group were examined. In the history, frequent complaints about the skin and mucous membranes were obtained, and clinically, moderate skin changes were observed in 9 individuals. These manifestations took the form of erythema and papules, appearing mainly on the uncovered parts of the body during the hot resin's hardening. In some of the workers, positive epicutaneous patch tests with cadmium, cobalt and epidian-3 and -5 were observed. Additional positive reactions were obtained via photo-patch tests with resins and solvents, indicating their photo-allergenic properties in some conditions.

150 questionnaires as well as epicutaneous tests in 56 individuals from a total of 675 persons cultivating and selling ornamental plants at the largest German flower market revealed that half of those investigated were suffering from allergic contact dermatitis. The leading plant species with sensitizing properties was found to be the chrysanthemum, followed by tulips and Alstroemeria cultivars. Allergic reactions to daffodils and primulas were rarely observed. Most of the reactions obtained with other Compositae species such as arnica, marguerite, sunflower, tansy and yarrow must be interpreted as cross-reactions due to the fact that cross-reactivity predominates within the sesquiterpene lactone constituents of the various Compositae species.

A pharmacist developed an allergic contact dermatitis while working with Arnica sachalinensis. Patch testing with sesquiterpene lactones was negative. The contact allergen of A. sachalinensis was identified as 10-acetoxy-8,9-epoxy-thymol-isobutyrate. This compound, or structurally related 8,9-epoxythymol-diesters, are often found in Asteraceae. In addition to sesquiterpene lactones, epoxythymol-diesters should be considered as contact allergens. Cross reactions between the two groups of compounds are not expected and could not be demonstrated in our patients.

In addition to an interview, skin tests and clinical examinations were performed on 211 randomly selected reindeer herders from 21 to 77 years of age (mean 45 years). Skin tests consisted of skin prick tests (SPT) with 9 allergens: cat and cow epithelium, dog, horse and reindeer epithelium, house dust mite, birch pollen, meadow grass pollen and mugwort pollen, as well as patch tests with 31 allergens. Of the 211 tested, 19 (9%) had positive SPT reactions to at least one allergen, and 19/173 (11%) showed a positive patch test result. Thirty-six of the 211 (17%) had past or present atopic dermatitis. These findings suggest that the prevalence of immediate and contact allergies and skin diseases is roughly the same as that of other Finns. A positive SPT reaction to birch pollen was encountered less frequently than in a previous Finnish study conducted in southeastern Finland.