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

The possibility of system skin reactions caused by amantadine in patients sensitized for tromantadine is discussed. The practical question arises how to handle patients allergic tromantadine patients which may be helped by therapy with amantadine.

Three patients who occupationally had been in contact with p-tert.-Butylphenol (ptB) developed vitiligo. Patch tests were negative to ptB. Antithyroid and antiparietal cell antibodies in all three patients indicate a possibly beginning systemic disorder such as already described in literature as the symptom triad of "vitiligo, hepatosplenomegalia and struma".

Telangiectases were detected in 57 (46.7%) of 122 workers employed at the electrolysis department of the aluminium plant Lozovac/Sibenik, Yugoslavia. Of 116 workers employed in the smeltery of the same plant, telangiectases were observed in 19 persons (16.4%) and in a group of 121 public transportation workers from Sibenik 15 men (12.4%) displayed enlarged blood vessels. Statistical evaluation revealed the difference in number between workers showing telangiectases engaged in electrolysis and the other two samples to be significant. It may be assumed that telangiectases were caused by hydrogen fluoride and other fluorides. Further clinical parameters, as well as working conditions, are reviewed.

In the Department of Dermatology of the University of Graz (Austria) since 1985 an electronic data system is used for registration and evaluation of patch test data. The installed system (hardware and software), database and the possible methods for evaluation are presented. The necessity of global solution of the problem with possible access to complete database (patient data, product declaration and literature) is emphasized.

If a positive patch test reaction occurs in the absence of sensitization to a certain antigen, we call it a false positive reaction. There may be several reasons for this: impurities of the test substances, too high a concentration, wrong choice of test location and reading time; positive reactions against test vehicle, or adhesive tape, nonspecific reactions due to adjacent strongly positive patch test reactions and finally wrong interpretation by the doctor. Diagnosis of contact allergy, especially to potent allergens or topical medications and questions relating to occupational disease may be of eminent importance to the patient. Therefore false positive as well as false negative test reactions should be recognized; this also appears particularly important for medicolegal reasons.

A retrospective follow-up study is reported of 58 women and 3 men with nickel allergy and hand eczema, of at least 4 months duration, treated with 50 to 400 mg disulfiram per day for 4 to 56 weeks. 2 patients were given 2 treatment series, making a total of 63 treatment series. 11 patients (20%) developed biochemical evidence of hepatotoxicity. 5 of them developed clinical evidence of hepatitis, which, for 4, was verified by liver biopsy. The patients with hepatotoxcity were significantly older than those who did not have this side effect. No correlation could be seen between the cumulative or maximum dose of disulfiram, the duration of the therapy and whether or not the patients showed evidence of hepatotoxicity. In 29 treatment series the dermatitis healed, while improvement was seen in 19 and no change in 15. There was no difference in the results whether maximum daily doses of 50, 200 or 400 mg were given. Follow-up examinations showed that the eczema recurred within a month after termination of therapy in 50% of the patients who improved during disulfiram therapy. Recurrence was seen within 6 months for another 40% of the patients.

We report a case of a female laboratory worker in the chemical industry who acquired contact allergy to dicyclohexylcarbodiimide and N-hydroxyphthalimide. Both substances are used in the chemical synthesis of peptides. So far there have only been a few reports concerning contact allergy to these substances.

A case report is given of a 56-year-old female patient with a postthrombotic leg ulcer and stasis dermatitis, in whom contact dermatitis to a dexpanthenol-containing ointment was first described in 1965. Recent allergy testing confirmed this finding and revealed positive reactions to the pure substance dexpanthenol as well as to two additives. Based on this case history the importance of dexpanthenol as an allergen is discussed.

Next to oxygen silicium is the most common substance of our environment. It occurs mostly in form of quartz (SiO2). In the past silica was usually mentioned in connection with foreign body granulomas in dermatological papers. Recently relations between occupational silica exposure and several diseases were reported. Silica exposure was related to the development of scleroderma, lupus erythematodes and sarcoidosis. Pathogenetic connections may be due to a stimulating effect on fibroblasts and due to immunmodulating properties of silica.