Contact allergy to unsaturated polyester in a boat builder.
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Biomedical subjects
Publications and source records attributed to A Dooms-Goossens.
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This article offers some considerations on the reduction of the sensitizing potential of pharmaceutical and cosmetic products by means of proper design. First, there is the obvious strategy of the elimination or reduction in the concentration of notorious sensitizers, but cross-reactions may be significant. The purity and standardization of both natural and synthetic products are of utmost importance. The role of antioxidants, sequestering agents, neutralizers, and quenching agents is discussed since such substances may inhibit the action or formation of skin-sensitizing products.
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5 patients, all using a mephenesin -containing ointment, with an acute contact dermatitis also presented an id-like spread with erythema multiforme features. In 4 patients, patch tests were performed and since mephenesin was the common allergen in each of these cases, we may assume that this is also the cause of the erythema multiforme-like lesions.
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46 yellow and white petrolatums were screened for their skin sensitizing properties in 3 subjects with known histories of contact sensitivity to yellow petrolatum. Patch testing revealed that all the petrolatums examined contain sensitizing substances in varying amounts. The results were analyzed with regard to origin, color, purification procedures involved in the production of pharmaceutical grade petrolatum, and pharmacopoeial requirements satisfied. Allergenicity correlated positively with these parameters, but only among petrolatums of the same brand. Petrolatum sensitivity may sometimes account for false positive patch test reactions to substances diluted in it. A petrolatum which causes no reaction on healthy skin may cause eczematous reactions on damaged skin.
Using several chromatographic and spectrometric procedures, it was established that the allergens present in pharmaceutical and cosmetic petrolatums are probably polycyclic aromatic hydrocarbons. These substances are impurities, and the quantity present is largely a function of the source of the petrolatum and the purification procedures. As the aromatic portion in petrolatum is a very complex and unstable mixture of chemically-related agents, only 2 out of the several possible allergens present could be identified: they were most probably phenanthrene derivatives with molecular weights of 230 and 244.
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Several pharmacopoeias set limits on the polycyclic aromatic hydrocarbon content in petrolatum. UV absorbance measurement of aromatic extracts of petrolatum samples has been shown to be a more reliable method than direct UV absorbance measurement as prescribed by several pharmacopoeias for the determination of that content, but the presence of allergenic polycyclic aromatic hydrocarbons does not always correlate with lower UV absorbance. Biological tests are ultimately the only certain method of detecting biologically active compounds. Polycyclic aromatic hydrocarbons can also be irritant and carcinogenic. Therefore, universally uniform and very stringent limits should be set restricting their presence in pharmaceutical grade petrolatum.
2 case reports are given of patients with positive patch test reactions to clobetasol propionate. One of the patients also reacted to clobetasone butyrate. 30 other steroids that were chemically very closely related to these two 21-chloro-9-alpha-fluoro-corticosteroids, were patch test negative. The literature on contact dermatitis reactions to corticosteroids is reviewed.
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