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Biomedical subjects

Birgitta Gruvberger

Publications and source records attributed to Birgitta Gruvberger.

18 recordsLinked to original sources
PubMed2007

Variation in the amount of petrolatum preparation applied at patch testing.

The elicitation of a positive patch test reaction in a given individual depends upon the dose of the sensitizer applied, the patch test technique and the occlusion time. The dose is determined by the concentration and volume/amount of test preparation applied. If the same amount/volume of a test preparation is applied all the time with the same test technique (same area of skin) and occlusion time, it is appropriate to use concentration as a dose parameter. Most contact sensitizers are incorporated in petrolatum (pet.). With pet. as vehicle, it is impossible to repeatedly apply an exact volume/amount. This study was performed to investigate the inter- and intra-individual variation of pet. preparation applied at patch testing by 3 technicians. Weighing demonstrated that the 3 technicians had about the same precision in their pet. application. The investigation demonstrates that there is both an inter-individual (statistically significant) and intra-individual variation in the amounts of pet. applied at patch testing for the 3 technicians. Presently, there is no recommendation on what amount of pet. preparation to apply, which merits a decision to be taken based on thorough investigations on the appropriate volumes of pet. preparation to be applied in various patch test systems.

Dermatitis, Contact↗
PubMed2006

Contact allergy to herbal teas derived from Asteraceae plants.

Contact allergy to herbal teas derived from the Asteraceae plant family was investigated in patients allergic to sesquiterpene lactones (SLs). 20 patients with a known contact allergy to SLs were recalled and patch tested with aqueous extracts of 8 different herbal teas based on Asteraceae plants as well as with parthenolide and other SLs. In 18 of 20 patients with SL allergy, there were positive test reactions to the Asteraceae teas, mainly to those based on German chamomile, dandelion and wormwood. Among the SLs, parthenolide was the most frequent co-reactor. Obviously, most patients with a contact allergy to SLs are allergic to commercial teas derived from the Asteraceae plant family as well.

Adult↗
PubMed2006

A clinically relevant contact allergy to methyldibromo glutaronitrile at 1% (0.32 mg/cm) detected by a patch test.

Recently, the preservative methyldibromo glutaronitrile (MDBGN) at 0.5% w/w in petrolatum was included in the European standard patch test series based on the studies on chemical stability and consideration of rates of contact allergy, doubtful and irritant reactions as well as information on clinical relevance represented by results of a repeated open application test (ROAT) and patch test concentrations required to diagnose allergic contact dermatitis from MDBGN in individual cases. In this report, a case with a clinically relevant contact allergy to MDBGN, which on the mandatory reading occasion on D3 only was traced by a patch test with MDBGN at 1.0% (0.32 mg/cm2), is presented. The patient suffered from a chronic hand dermatitis, and when the patient stopped using a liquid soap containing MDBGN, the hand dermatitis substantially improved. A ROAT performed in a blinded and controlled way with applications twice daily on the hands with 2 moisturizers with and without MDBGN resulted in a deterioration of the hand dermatitis on the hand to which the MDBGN-preserved moisturizer had been applied.

Allergens↗
PubMed2006

Can an imidazolidinyl urea-preserved corticosteroid cream be safely used in individuals hypersensitive to formaldehyde?

A topical corticosteroid preparation on the Swedish market, Flutivate cream, contains a fairly high concentration of formaldehyde (FA). In this study, we have investigated the clinical relevance of contact allergy to FA when treating an allergic eczema with Flutivate cream, containing an FA-releasing preservative. In a randomized, double-blind study, 7 patients hypersensitive to both FA and nickel repeatedly applied Flutivate cream containing FA or Betnovate cream not containing FA to areas of experimentally induced nickel dermatitis. 17 controls allergic to nickel, but not FA, went through the same procedure. In 29 per cent of the FA-allergic individuals, the experimental dermatitis healed when treated with Flutivate cream compared with 71 per cent of the controls (P = 0.04). The conclusion to draw from this study is that an individual hypersensitive to FA should not use the corticosteroid preparation Flutivate cream on dermatitis skin.

Adult↗
PubMed2006

The validity of a questionnaire-based epidemiological study of occupational dermatosis.

The aim of this study was to evaluate the validity of a questionnaire and medical anamnesis to identify persons with dermatitis in an occupational setting. The design was a clinical epidemiological cross-sectional study. The study was performed between the second and fourth week of January 2001. A questionnaire was followed a week later by a medical occupational interview and a clinical dermatological examination, including a comprehensive patch test with potential workplace chemicals. The anamnesis and the clinical examination were made independently by occupational and dermatological physicians, and the skin examination was performed blinded to anamnestic data. The setting was the mother plants of a Danish-based international company producing wind turbine systems. The study population was a workplace cohort, highly exposed to epoxy resin systems and other chemicals, and totalled 724 production workers at 4 facilities. The rate of participation was 84.7%. Using enquete questions of current skin rash against the clinical presence of dermatitis, we found a sensitivity of 22% and a specificity of 89%, compared to 45% and 87%, respectively, when the anamnestic work history, taken by an occupational physician, was the screening parameter. Using 'workplace periodic prevalence' of dermatitis, we found sensitivities in the range of 63-76% by a questionnaire and 70-83% by medical anamnesis. Questionnaire screening by skin symptoms gave the highest values for redness, a sensitivity of 33% and a specificity of 76%, and decreasing validity parameters as more symptoms were added to the list of screening questions. We found that the use of a questionnaire and medical anamnesis were problematic, when the purpose was screening for contact dermatitis and allergy, in this industrial cohort manufacturing reinforced plastic products. But these instruments might be useful for epidemiological surveillance, when the questionnaire has been validated in the given occupational setting.

Cross-Sectional Studies↗
PubMed2005

Recommendation to include methyldibromo glutaronitrile in the European standard patch test series.

The preservative methyldibromo glutaronitrilc (MDBGN) is used non-occupationally and occupationally. High contact allergy rates have been reported when tested in consecutive dermatitis patients as well as clinical cases with allergic contact dermatitis. Up till now there has been no agreement on which patch test preparation to use to trace contact allergy to MDBGN. From the year 2005 on, MDBGN at 0.5% w/w in petrolatum is recommended for the European standard patch test series. The choice of 0.5% is based on consideration of rates of contact allergy, doubtful and irritant reactions, as well as on information on clinical relevance represented by results of a repeated open application test, and patch test concentrations to diagnose allergic contact dermatitis from MDBGN in individual cases.

Allergens↗
PubMed2005

Gold trichloride and gold sodium thiosulfate as markers of contact allergy to gold.

The usefulness of a trivalent gold salt, gold trichloride (GTC), was evaluated as a marker of contact allergy to gold. Patients patch test-positive or patch test-negative to gold sodium thiosulfate (GSTS), 13 subjects of each, were patch tested with dilution series of GTC and equimolar concentrations of GSTS. In order to avoid false-positive and false-negative test reactions, the salts were buffered and placed on polypropene chambers. Allergic reactions were registered in 9/13 gold-allergic patients with GSTS and in 2/13 with GTC. The sum of positive reactions was 18 with GSTS and 5 with GTC. Irritant reactions were none with GSTS and 2 with GTC in the gold-allergic patients. It is concluded that GTC can elicit positive patch test reactions in patients with gold allergy but to a lesser degree when compared with GSTS. Thus, GTC cannot be recommended in patch testing, and GSTS is still the test agent of choice.

Aged↗
PubMed2005

Allergic contact dermatitis from methyldibromoglutaronitrile.

BACKGROUND: Arriving at a diagnosis of allergic contact dermatitis is a multistep procedure including the establishing of contact allergy, demonstration of current exposure to the sensitizer, and assessment of clinical relevance. Sometimes, these steps are easy to get through; at other times, there may be problems with every step. OBJECTIVE: To demonstrate the possible difficulties and pitfalls in establishing the presence of contact allergy and diagnosing allergic contact dermatitis from exposure to the preservative methyldibromoglutaronitrile (MDBGN). METHODS: Simultaneous patch-testing with petrolatum preparations of MDBGN at various concentrations, use testing, and chemical analysis with high-performance liquid chromatography (HPLC). RESULTS: Contact allergy to MDBGN was established in two cases, with MDBGN in petrolatum at 0.5%. Results of HPLC investigation of moisturizers used by the patients and yielding positive results on patch and use tests disagreed with the information about preservatives on the labels of the moisturizers and with the Material Safety Data Sheets (MSDSs). CONCLUSIONS: Patch testing with MDBGN in petrolatum at a concentration of less than 0.5% may fail to diagnose a clinically relevant contact allergy. The information on labels of products, on MSDSs, and from manufacturers may not be reliable, which indicates the need for chemical analyses.

Adult↗
PubMed2004

Epoxy-based production of wind turbine rotor blades: occupational contact allergies.

BACKGROUND: An industry producing rotor blades for wind turbines with an epoxy-based technology had experienced an increasing number of workers with dermatitis, among whom the frequency of occupational contact allergy (OCA) was suspected to be underestimated. OBJECTIVE: To investigate the frequency of OCA by patch-testing with a specially profiled occupational patch test series. METHODS: In a blinded study design, 603 workers were first interviewed and thereafter clinically examined. Based on a history of work-related skin disease, clinical findings of dermatitis, or both, 325 (53.9%) of the workers were patch-tested with an occupational patch test series and the European Standard patch test series. RESULTS: Of the 603 investigated workers, 10.9% had OCA and 5.6% had contact allergy to epoxy resin in the standard test series. Contact allergy to amine hardeners/catalysts was found in 4.1% of the workers. Among the workers with OCA, 48.5% reacted to work material other than epoxy resin in the European Standard patch test series. CONCLUSION: Approximately 50% of the workers with OCA would not have been detected if only the European Standard patch test series had been used.

Adolescent↗
PubMed2004

Occupational contact allergy and dermatitis from methylisothiazolinone after contact with wallcovering glue and after a chemical burn from a biocide.

Skin exposure to biocides containing high concentrations of methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) may cause severe chemical burns and may also induce sensitization. We report two cases in which skin exposure to a newly launched biocide containing 2-methyl-4-isothiazolin-3-one (MI) and 1,2-benzisothiazolin-3-one led to sensitization to Ml, which in the second case was preceded by a chemical burn. A study was performed to investigate the pattern of reactivity to MCI and Ml in two patients who presumably had a primary sensitization to Ml and in one patient who had been sensitized to MCI/MI by being patch-tested. The patients were patch-tested with serial dilutions of MCI/MI, MCI, MI, and 2-n-octyl-4-isothiazolin-3-one. The first two patients reacted to both MCI/MI and the separate active ingredients, with a higher level of reactivity to Ml than to MCI. The third patient reacted to MCI/MI and MCI only. A biocide containing Ml caused sensitization and occupational contact dermatitis in the first two patients, through contact with wallpaper glue in one case and after a chemical burn in the other case.

Adhesives↗
PubMed2003

Presence of formaldehyde in topical corticosteroid preparations available on the Swedish market.

The aim of this study was to investigate the formaldehyde content of topical corticosteroid preparations available on the Swedish market. 73 samples were analysed with the chromotropic acid (CA) method for semi-quantitative formaldehyde determination and 30 samples with a high-performance liquid chromatographic method. These included 24 ointments, 28 creams, 1 lotion, 6 liniments, 2 gels, 9 solutions, 2 mousses and 1 oral paste. Formaldehyde was found in 5 creams and 1 ointment. Sources of formaldehyde in these preparations were discussed. Isopropanol was identified as a probable source of yellow discoloration, leading to false-negative results with the CA method.

Administration, Cutaneous↗
PubMed2003

Occupational dermatoses in a metalworking plant.

In a plant producing advanced components for engines and drivelines we undertook a survey of occupational dermatoses, based on a questionnaire, clinical examination, and patch testing with a standard series and a series of samples from the working environment. The questionnaire was given to all 430 employees and it was answered and returned by 382 of these. 214 reported having had or having skin manifestations during the time of employment suspected of being work-related. 183 employees (164 metal workers, 19 office staff) participated in the clinical investigation, 182 (163 metal workers, 19 office staff) being patch tested. Occupational dermatoses were diagnosed in 23 of these 163 (14.1%) and in 1 of these 19 (5.3%). In all, irritant contact dermatitis was diagnosed in 12 metal workers, occupational allergic contact dermatitis in 11 (10 metal workers and 1 office clerk) and folliculitis in 1 metal worker. In the 11, neat oils were the cause in 4 workers, a water-based cutting fluid in 3 and various biocides in 4.

Adult↗
PubMed2002

Contact allergy to the Asteraceae plant Ambrosia artemisiifolia L (ragweed) in sesquiterpene lactone-sensitive patients in southern Sweden.

Ambrosia artemisiifolia L. a classical cause of ragweed dermatitis in North America, is also found in Europe. 17 patients with contact allergy to sesquiterpene lactone (SL) mix were recalled for patch testing with extracts of North American and Swedish ragweed, the latter harvested in summer and autumn. 8/17 patients were test-positive to the American extract, 14/17 to the Swedish summer extract and 15/17 to the autumn extract. All patients except 1 were found to have a chronic hand eczema of the pompholyx type. 5/16 hand eczema patients had a flare-up of their pompholyx at patch testing. We concluded that patients with SL mix allergy are allergic to American as well as to Swedish ragweed. Pompholyx seems to be a frequent clinical picture in patients with SL mix allergy.

Adult↗