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Biomedical subjects

F J Storrs

Publications and source records attributed to F J Storrs.

At least 19 recordsLinked to original sources

Abnormal skin irritancy in atopic dermatitis and in atopy without dermatitis.

BACKGROUND AND DESIGN: Past observations have shown increased irritancy in patients with "conditioned hyperirritability" due to active dermatitis, including atopic dermatitis (AD). In less active atopic conditions, irritancy levels are less certain. We have utilized 48-hour Finn Chamber testing with graded dilutions of sodium lauryl sulfate to detect irritancy thresholds in well-defined groups of patients with AD, inactive AD, and allergic respiratory disease with no dermatitis and in normal nonatopic subjects. RESULTS: Significantly greater frequency of response to sodium lauryl sulfate in both AD groups and also in patients with allergic rhinitis with no dermatitis was seen. Effective concentrations of sodium lauryl sulfate causing irritation in 50% or more of subjects (ED50) ranged from 0.0625% to 0.31% in all atopic groups, percentages that were significantly lower than the normal ED50 of 0.60%. Response intensity was also significantly greater in each atopic group. CONCLUSIONS: Our results showed significantly greater irritant responses in atopic subjects with no skin disease or in subjects with inactive AD and confirmed past findings that showed greatly increased irritancy in patients with active AD. We hypothesize that abnormal intrinsic hyperreactivity in inflammatory cells, rather than in skin cells, in atopic individuals predisposes to a lowered threshold of irritant responsiveness.

Adolescent

Allergic contact dermatitis to two antioxidants in latex gloves: 4,4'-thiobis(6-tert-butyl-meta-cresol) (Lowinox 44S36) and butylhydroxyanisole. Allergen alternatives for glove-allergic patients.

Allergic contact dermatitis developed on the hands and/or face of two patients after exposure to latex examination gloves. Both patients were patch test negative to the usual rubber allergens, but both had a positive patch test reaction to 4,4'-thiobis(6-tert-butyl-m-cresol) (Lowinox 44S36). Patient 2 was also patch test positive to butylhydroxyanisole. The patients were tested with other gloves, to find gloves that they could safely use. Glove manufacturers were queried to ascertain the occurrence of Lowinox 44S36 and butylhydroxyanisole in different brands of latex and vinyl examination gloves. A list of gloves and their associated allergens was generated and is provided to assist dermatologists in helping patients choose gloves free of specific allergens.

Allergens

Methylchloroisothiazolinone-methylisothiazolinone reactions in patients screened for vehicle and preservative hypersensitivity.

More than 1100 patients were tested with methylchloroisothiazolinone-methylisothiazolinone, 100 ppm, in aqueous and petrolatum-based patch test materials from 1985 to 1987 by members of the North American Contact Dermatitis Group. Thirteen reactions to the aqueous materials and 10 to the petrolatum-based materials were observed. Irritant reactions were infrequent, and about half the reactions were deemed relevant. From 1984 to 1985, patch tests with this substance at a concentration of 250 ppm in petrolatum were conducted. Thirteen persons were identified as allergic, but three others were sensitized by the patch test procedure. Sensitization as not observed in tests with aqueous or petrolatum-based substance at a concentration of 100 ppm, and this concentration appears to be the best compromise between safety and sensitive detection of allergy. Use tests are helpful but not infallible as a guide in establishing relevance with methylchloroisothiazolinone-methylisothiazolinone. Wash-off products are frequently well tolerated by patients with positive reactions to this substance.

Adult

Allergic contact dermatitis to adhesive bandages.

More than two billion Band-Aid Brand Sheer Strips are used in the United States yearly, yet allergic contact dermatitis resulting from their use is nearly nonexistent. We report four patients with allergic reactions to these strips. One patient reacted to tricresyl phosphate, the plasticizer in the vinyl backing; another patient was allergic to 2,5-di(tertiary-amyl)hydroquinone, the antioxidant in the adhesive. In the other two patients, the allergic contact dermatitis remains unexplained.

Adhesives

Prevalence and relevance of allergic reactions in patients patch tested in North America--1984 to 1985.

Between Jan. 1, 1984, and May 1, 1985, 1199 patients with suspected allergic contact dermatitis were patch tested with 32 "standard" allergens, 707 patients with 19 "vehicle and preservative" allergens, and 613 patients with 10 "special study" allergens. Ten dermatologists representing nine geographic centers collected and analyzed data with the use of the American Academy of Dermatology's mainframe computer in Evanston, Illinois. The most common sensitizers identified were nickel, p-phenylenediamine, quaternium-15, neomycin, thimerosal, formaldehyde, cinnamic aldehyde, ethylenediamine, potassium dichromate, and thiuram mix. Each positive reaction was assessed for its clinical relevance.

Adult

Contact lens intolerance; allergic conjunctivitis?

20 patients complaining of contact lens intolerance were patch tested to a contact lens solution and a contact lens components battery. Contact urticaria testing was also carried out. 8 patients had positive delayed reactions on patch testing, 6 patients had positive contact urticaria reactions, and 9 patients had no reactions. These results are discussed and possible alternative diagnoses for the 9 undiagnosed patients are proposed.

Conjunctivitis, Allergic

The case for patch test readings beyond day 2. Notes from the lost and found department.

Additional patch test readings taken after 2 days (48 hours) are valuable in distinguishing false-positive reactions, which may occur up to 22% of the time. Second readings taken on days 3 through 7 may detect an additional 34% positive reactivity. Those reactions, both lost (initially positive, later negative) and found (initially negative, later positive) by delayed readings, require clinical correlation for relevance as do the readings that persist at and beyond day 2 (positive at both readings).

Allergens

Persistence of an allergen in hair after glyceryl monothioglycolate-containing permanent wave solutions.

Glyceryl monothioglycolate, a reducing agent used in permanent waving solutions, is a recognized cause of allergic contact dermatitis. Because of an unexplained persistence of dermatitis in beauty shop clients after exposure to permanent wave solutions containing glyceryl monothioglycolate, we looked for the presence of this or a cross-reacting substance in permanent-waved hair as a possible source of continued exposure to the allergen. Seventeen subjects sensitive to glyceryl monothioglycolate underwent patch testing with hair samples collected before and at various times after a permanent wave containing glyceryl monothioglycolate. None reacted to hair that had not received a permanent, while 7 of 17 showed positive reactions to the permanent-waved hair. Positive reactions were seen in hair collected as long as 3 months after the permanent. This suggests that a glyceryl monothioglycolate-related allergen is retained in hair for up to 3 months after the permanent, which may explain the long-lasting dermatitis that occurs in clients sensitive to glyceryl monothioglycolate.

Adult

Poison ivy/oak dermatitis. Use of polyamine salts of a linoleic acid dimer for topical prophylaxis.

Closed patch tests were used to evaluate the ability of 156 different preparations (based on 22 different chemicals) to prevent poison ivy dermatitis. Several polyamine salts of a linoleic acid dimer were identified that were totally able to prevent the usual dermatitis in approximately 70% of subjects. The effectiveness of the preparations improved when the antigen and the protectant were washed off within eight to 12 hours, instead of remaining on the skin for 48 hours. When washed off, and depending on the protectant, concentration, and vehicle used, several of the preparations were totally able to prevent a dermatitis in a range of 56% to 100% of subjects tested. Further work with these compounds may greatly benefit the many people currently plagued by their allergy to poison ivy and poison oak.

Adult

Contact allergy to aziridine paint hardener.

A painter experienced an extensive dermatitis when exposed to a paint primer (undercoating) used to protect wood siding. The primer was an acrylic emulsion with a polyfunctional aziridine added as a self-curing cross-linker or hardener. The polyfunctional aziridine cross-linker was made by reacting propyleneimine with a polyfunctional acrylate, trimethylolpropane triacrylate (TMPTA). Our patient reacted to the cross-linker and also reacted to TMPTA, which is present in excess in the cross-linker. He also cross-reacted to pentaerythritol triacrylate (PETA). Both TMPTA and PETA can be used in the production of aziridine hardeners and both are well known as sensitizers in radiation-dried acrylic printing inks and coatings.

Acrylates

Permanent wave contact dermatitis: contact allergy to glyceryl monothioglycolate.

Eight hairdressers and four clients were found to be allergic to glyceryl monothioglycolate (GMTG) contained in "acid" permanent waves used in American beauty salons only since 1973. Previous studies in Germany showed that compounds closely related to GMTG were strong sensitizers. In contrast, ammonium thioglycolate (ATG) has been used since 1943 in cold "alkaline" permanent waves both in homes and in salons with no clearly documented cases of contact allergy. Our allergic patients reacted to GMTG in concentrations as low as 0.25%, although their exposure in practice could reach concentrations of 20% to 80%. GMTG-allergic patients reacted to GMTG when it was tested through a variety of glove fabrics. Household-weight neoprene gloves were protective.

Adult