American Journal of Contact Dermatitis最新文献

The aim of this study was to determine any occupationally relevant allergic contact sensitizations in hand dermatitis in a jeweler. Patch test with European Standard, vehicle, medicaments, and metal series (Finn chambers on Scanpor) was performed. Readings were taken on day 2 and day 4. Allergic positive reaction to colophonium 20% pet and silver nitrate 0.5% aq was detected. The contact sensitivities to silver and colophonium seem to be occupationally relevant in this case.

Iodopropynyl butylcarbamate (IPBC) is an internationally recognized chemical that has been used for years because of its wide field of application. Initially used as a water-based paint and wood preservative and then in metalworking fluids, its role has expanded into the more recent uses in cosmetic products. The need for a potent, broad-spectrum, and safe preservative system in cosmetics allowed for the discovery of several combinations of IPBC effective against a wide variety of organisms. Although IPBC has claimed to be safe when used at concentrations less than 0.1%, the introduction of IPBC into cosmetics has led to several reports labeling IPBC as a potential new contact allergen. As the use of this seemingly safe preservative becomes vast, an increased number of cases of IPBC-induced contact allergy is likely.

Since the passage of the United States Occupational Safety and Health Act (OSHA) in 1970, there have been extensive changes in United States workplaces that should have served to enhance the prevention of occupational skin disease (OSD). Analysis of skin diseases reported to OSHA (OSHA recordables) shows that the number of OSDs declined steadily from 1974 to 1983 to about half the previous annual incidence. After 1984, there was a modest resurgence peaking in 1994, with a subsequent decline. A similar but somewhat greater decline in the late 1990s has been observed for occupational respiratory diseases, diseases caused by toxic agents and for poisonings. Likely explanations for the trends in OSD are discussed; the initial decline probably reflected an improvement in workplace conditions, the later resurgence and decline may have been attributable to changes in recording behaviors and in worker's compensation. The decline in recorded OSD since 1996 has been fairly uniform in most major industrial sectors but has been less marked in agriculture, forestry, and fishing so that this sector has replaced manufacturing in recording the highest incidence rate. In 1999, the incidence rate of recorded OSD was 0.49 per 1,000 workers, which appears to grossly underreport the true incidence. OSD now constitutes about 10% of all occupational disease cases. Currently, there is increasing emphasis in corporate and occupational medicine on reducing costs and maintaining productivity as well as in preventing occupational injuries and diseases. This is shown by the trend for a greater proportion of workers with occupational conditions to return to modified duty positions rather than to be completely off work. Implications of this phenomena for management of OSD are discussed.

Background: Phytophotodermatitis is a phototoxic reaction, occurring in skin exposed to sunlight after contact with plants containing furanocoumarins. Typical reactions are mild, showing erythema with postinflammatory hyperpigmentation. A 6-year-old boy presented with marked, symmetric, painful erythema and edema of both hands that rapidly developed into dramatic bullae covering the entire dorsum of the hands. The history revealed that the hands had been bathed in lime juice for a prolonged period in the preparation of limeade. Objective: This report documents an unusual bullous presentation of phytophotodermatitis resulting from contact with furanocoumarins in local limes. This study was conducted to identify and measure the inciting substances from the rind and pulp of the limes. Methods: Psoralen, xanthotoxin, bergapten, and isopimpinellin content were measured by gas chromatography and high-pressure liquid chromatography Results: The rind contained 6- to 182-fold concentrations of all furanocoumarins measured when compared with pulp. Bergapten was the most abundant substance in the rind. Conclusion: Hydration of the skin during the preparation of limeade combined with increased levels of bergapten in local limes to produce a dramatic bullous reaction. We encourage clinicians to consider the possibility of phytophotodermatitis in severe bullous skin reactions.

Woods are capable of causing allergic or irritant contact dermatitis which typically occurs on the exposed areas of the arms, face, and neck. The allergens found in woods include quinones, stilbenes, phenols, and terpenes. We report an 84-year-old woodworker who developed allergic contact dermatitis from Bolivian rosewood and Cocobolo wood. The patient was patch-tested using the North American Contact Dermatitis Group Standard Tray; 2,6 dimethoxyl 1,4 benzoquinone; and wood that he had been exposed to on a regular basis. Positive patch test reactions occurred to methyldibromo glutaronitrile phenoxyethanol, sodium gold thiosulfate, Bolivian rosewood, and Cocobolo wood. Allergens found in Bolivian rosewood and Cocobolo wood caused this patient's chronic dermatitis, which cleared when he avoided these woods.

An 85-year-old male with glaucoma presented with a 1-[frac12] year history of tearing; red eyes; and pruritic, edematous, eczematous eyelids. Treatment for presumed ocular rosacea and seborrhea was unhelpful. Patch testing to our standard 64 antigens yielded a positive reaction to Balsam of Peru. Notably, benzalkonium chloride, thimerosal, and other preservatives elicited negative reactions. Repeat open application testing elicited positive results to Xalatan (latanoprost) 0.005% ophthalmic solution (Pharmacia [amp ] Upjohn, Kalamazoo, MI). A second session of patch tests to 10 personal products, in addition to Xalatan 0.005% solution and the Xalatan vehicle (provided by the manufacturer), elicited a strong positive reaction only to the full preparation of Xalatan 0.005% solution. This report describes the first known case of ACD to latanoprost, a new prostaglandin analog that is widely prescribed for treatment of glaucoma.