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Biomedical subjects

K Kaaber

Publications and source records attributed to K Kaaber.

At least 19 recordsLinked to original sources

[Aluminum allergy caused by DTP vaccine].

All children referred to two private dermatological practices from 1 Jan. 1985 to 31 Dec. 1990 who had pruritus and subcutaneous infiltrates in the areas of immunization with Di-Te-Pol vaccine were patch tested with a Finn Chamber or with 2% aqueous aluminium chloride. Di-Te-Pol vaccine contains aluminium hydroxide. Contact allergy to aluminium was demonstrated in 32 children (20 girls and 12 boys). Of the three patch test methods used, testing with 2% AlCl3 occluded with a Finn Chamber proved to be the most sensitive. Immunization of children who have been shown to be allergic to aluminium should be carried out with vaccines which do not contain aluminium.

Aluminum

Vaccination granulomas and aluminium allergy: course and prognostic factors.

21 children who had cutaneous granulomas following immunization with a vaccine containing aluminium hydroxide, and who had positive patch tests to aqueous aluminium chloride and/or to a Finn Chamber, were followed for 1 to 8 years. During the period of observation, the symptoms cleared in 5 children, improved in 11, and remained unchanged in 5. The course of the granulomas could not be correlated with sex or atopy, nor with intensity of the initial aluminium patch test. 4 children were patch tested again with aluminium.

Adolescent

[Reactions after MMR vaccination].

Four months after introducing routine vaccination against measles, mumps and German measles (MMR-vaccination) in Denmark, a questionnaire study of reactions in vaccinated children was carried out. There were significantly fewer reactions in children who had previously developed immunity to measles, either by having had the disease or by vaccination. The reaction frequency after MMR-vaccination of children immune to measles was no greater than that after other vaccinations. Moreover, for all vaccinations, the frequency of reaction was found to decrease significantly with increasing age. The study suggests that a large proportion of the so-called reactions were not caused by vaccination, but were due to common viral infections occurring at random and concurrently with it. The reactions that arose in connection with MMR-vaccination are considered to be of minor importance when compared with often prolonged and more severe course of these diseases.

Adolescent

[Knowledge of, attitudes toward and participation in the new vaccinations against measles, mumps and rubella during the first 2 years].

The new vaccinations for measles, mumps and rubella (MMR) for children and the new vaccination for rubella for adult women were introduced in Denmark on 1.1.1987. An account is presented of 1) knowledge about and attitudes to the new vaccinations, investigated three months after commencement of the programme as assessed by means of a marketing investigation and 2) participation in vaccination during the first two years after introduction of the vaccination programme assessed by registration of services in the Danish National Health Service. The calculated participation in the MMR vaccination programme at the age of 15 months was found to be 72% and 31% at the age of 12 years. The calculated participation in the rubella vaccination programme at the age of 18 years was 13% in 1988 and even less for the remaining women. 95% of persons with children aged 0-12 years in the household who were questioned had heard about the new vaccinations for children and more than 50% had detailed knowledge about MMR vaccination. More than 10% were against MMR vaccination mainly because they considered that it was better for children to have these infections naturally. 90% of the women questioned knew why adult women were offered vaccination for rubella, although the percentage was less in the younger women. Compared with the goals established, participation in the MMR vaccination programme is insufficient. Participation in the rubella vaccination programme for adult women is entirely inadequate. The reasons for defective participation and proposed improvements are discussed. It is important that general practitioners and health nurses instruct parents about these possibilities.

Attitude to Health

Clinical patch test data evaluated by multivariate analysis. Danish Contact Dermatitis Group.

The aim of the present study was to evaluate the influence of individual explanatory factors, such as sex, age, atopy, test time and presence of diseased skin, on clinical patch test results, by application of multivariate statistical analysis. The study population was 2166 consecutive patients patch tested with the standard series of the International Contact Dermatitis Research Group (ICDRG) by members of the Danish Contact Dermatitis Group (DCDG) over a period of 6 months. For the 8 test allergens most often found positive (nickel, fragrance-mix, cobalt, chromate, balsam of Peru, carba-mix, colophony, and formaldehyde), one or more individual factors were of significance for the risk of being sensitized, except for chromate and formaldehyde. It is concluded that patch test results can be compared only after stratification of the material or by multivariate analysis.

Adolescent

Tin: an overlooked contact sensitizer?

Patch tests with metallic tin in 73 nickel-sensitive patients revealed 6 positive allergic reactions. Only 4 doubtful reactions were seen, which makes irritancy unlikely. The relevance and clinical significance of the unexpected finding deserves further evaluation.

Adult

Elbow eruptions in nickel and chromate dermatitis.

In 7 patients with nickel or chromate allergy and dyshidrotic hand eczema, we observed symmetric hyperkeratotic lesions on the elbows which ran a similar course to the hand dermatitis. Histopathological examinations show findings suggestive of lichen simplex chronicus and subacute-chronic dermatitis, but exclude psoriasis. We conclude that these elbow lesions are a characteristic of systemic allergic contact dermatitis.

Adult

Treatment of nickel dermatitis with Antabuse; a double blind study.

A double blind, placebo-controlled treatment with Antabuse was carried out in 24 patients with hand eczema and nickel allergy. The amount of Antabuse given was gradually increased from 50 to 200 mg daily. The maximum dose was given for 6 weeks. During the treatment period, the dermatitis of 5 out of 11 patients in the group treated with Antabuse healed, compared with 2 out of 13 in the group receiving the placebo. A statistical analysis was made of changes observed during the study, through the parameters: scaling, frequency of flares, erythema, area involved and number of vesicles. Differences in results obtained with Antabuse and the placebo were statistically significant only for the parameters scaling and frequency of flares (p less than 0.05). The difference between the sums of parameters following the 2 forms of treatment was not statistically significant (p = 0.11). 2 patients treated with Antabuse showed signs of hepatic toxicity; 1 of them had toxic hepatitis. No other significant side effects were seen.

Adult

Exposure of nickel and the relevance of nickel sensitivity among hospital cleaners.

The nickel content of water specimens from consecutive stages during the cleaning process in a Danish hospital was analyzed. Statistically significant increases of the nickel concentrations were found from step to step of the cleaning, eventually exceeding the theoretical sensitizing safety limit. The relevance of the findings in relation to hand eczema is discussed.

Dermatitis, Contact

Antabuse treatment of nickel dermatitis. Chelation--a new principle in the treatment of nickel dermatitis.

Eleven nickel-hypersensitive patients with chronic, dyshidrotic hand eczema aggravated by oral challenge with 0.6-2.5 mg nickel were treated with 100 mg tetraethylthiuramdisulfide (Antabuse) two to four times daily for 4-10 weeks. Nine of the patients experienced a flare of the dermatitis shortly after initiation of the treatment. During the course of treatment the dermatitis of seven patients cleared, improvement was seen in two patients, and in two the dermatitis remained unchanged. Flare was seen in six patients when the treatment was discontinued. Seven patients experienced side effects such as fatigue, headache and dizziness. The treatment of four patients was discontinued due to side effects. During the treatment high levels of nickel were found in the serum and urine.

Allergens

Nickel, cobalt and chromium sensitivity in patients with pompholyx (dyshidrotic eczema).

Sixteen patients with negative routine patch tests were challenged orally in a controlled trial with 2.5 mg nickel, 1 mg cobalt, and 2.5 mg chromium given as salts of the respective metals. All of the patients had symmetrical, vesicular hand dermatitis and in some cases also foot involvement. The dermatitis of two patients flared after challenge with cobalt; in two patients flare occurred following chromate ingestion. Prior to the oral challenge all the patients were patch tested with nickel sulphate, cobalt chloride and potassium dichromate after adhesive tape stripping. Solutions of the same metal salts were used for intradermal testing. The intradermal test sites were read after 20 minutes and 48 hours, the patch tests after 48 h. Skin test reactivity correlated poorly to the results of the oral challenge, possibly due to nonspecific skin test reactivity. It is concluded that oral challenge is a valuable adjunctive diagnostic procedure in patients with pompholyx who have negative routine patch tests.

Chromium

Antibodies against nickel-albumin in rabbits and man.

Five albino rabbits were immunized every 2 weeks by intradermal injections of a nickel rabbit-albumin complex and during alternate weeks by occluded cutaneous applications of 5% nickel sulphate in petrolatum. After 6 weeks of immunization, passive immunodiffusion disclosed precipitating antibodies against the nickel-albumin complex in the serum of the rabbits. The specificity of these antibodies was substantiated by the precipitation of anti-albumin antibodies with rabbit albumin prior to immunodiffusion. Passive immunodiffusion was used to examine serum from 14 nickel-sensitive patients for precipitating antibodies against nickel human-albumin complex. Five of the patients had widespread erythematous, non-eczematous reactions following oral challenge with 2.5 mg nickel as nickel sulphate, while five others suffered an aggravation of their nickel dermatitis. Precipitating antibodies were found in three patients, all of whom had experienced rapid-onset erythema after oral challenge. A weak precipitate was seen in one of nine controls. The specificity of the precipitates was substantiated by reproducibility and by negative immunodiffusion after precipitation in the positive sera with the antigen.

Albumins

Low nickel diet in the treatment of patients with chronic nickel dermatitis.

Of 28 patients with chronic nickel dermatitis 17 experienced aggravation following oral ingestion of 2.5 mg nickel, but not a placebo tablet. The dermatitis of 9 of the 17 patients improved during a period of 6 weeks on a low nickel diet. The dermatitis of 7 of the 9 patients flared again when a normal diet was resumed. Nickel excretion over a 24-h period was measured for 14 of the 17 patients by atomic absorption spectrophotometry before, during, and after the diet. Reduced excretion was seen during the diet with no statistically significant difference between patients whose dermatitis improved during the diet and those whose dermatitis showed no change.

Chronic Disease