[What do we know about atopic dermatitis in children?].
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Biomedical subjects
Publications and source records attributed to N Hjorth.
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Benzocaine-reactive patients were patch tested to two commercial sources of glyceryl p-aminobenzoate containing varying concentrations of benzocaine as a contaminant. Eleven of 20 reacted to the source with approximately 0.3% benzocaine; none reacted to the source with approximately 0.001% benzocaine.
In Danish bacon factories workers eviscerating and cleansing gut casings commonly develop a vesicular eczema starting in the finger webs, from where it spreads to the sides of the fingers. The eruption is called "gut eczema" or "fat eczema" by the workers. It is self-limiting, lasts for 1--2 weeks, and can recur at intervals of months or years. The etiology is unknown. Prick tests with extracts of ascaris and several organs of the pigs were negative.
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Triclocarban was subjected to a profiling of its dermatitis producing potential including irritancy (21-day cumulative irritancy potential and application to 213 normal controls), phototoxicity (method of Marzulli), predictive contact sensitization (modified Draize method), predictive phototesting and battery screening in 2200 dermatitis patients, in an effort to define its relative dermatitis potential. The allergic contact dermatitis potential of triclocarban following bar soap use appears minimal.
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An outbreak of rubber fingerstall dermatitis in a Danish post office was found to be caused by minute amounts of isopropylphenyl-para-phenylenediamine (IPPD) in the fingerstalls. The presence of IPPD in the fingerstalls could not be explained by the manufacturer and had to be confirmed by gas chromatographic analysis.
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In a search for contact sensitivity to antioxidants we patch tested consecutive patients referred with eczematous dermatitis. Six cases of allergic contact sensitivity to nordihydroguairetic acid (NDGA) were observed. Three had been sensitized by one brand of cream containing 0.1% NDGA, in three patients the source of sensitization could not be traced. In four patients we found positive patch tests to butylated hydroxyanisole and/or to butylated hydroxytoluene. In two cases the positive patch tests were relevant, since both patients remained asymptomatic when antioxidants were avoided in food. They both had acute flares of vesicular eczema on the fingers after oral administration of small amounts. Gallate esters and Vitamin E (d,l-alpha-tocopherol) each gave one unexplained positive patch test. The present data suggest that further search for hidden sensitizers in topical medicaments and cosmetics is warranted. A declaration of all ingredients in industrial products should be placed on the label.
American ragweed (Ambrosia) dermatitis has an airborne pattern and is caused by lipid soluble oleoresins of pollens. A similar weed dermatitis has been described in India and Australia. The weeds involved were all of the Compositae family and contain sesquiterpene lactones with one common antigenic determinant. This study reports seven Danish patients treated for many years under the diagnosis of photodermatitis, who eventually proved to suffer from Compsoitae oleoresin dermatitis. Probably, Compsitae dermatitis is a world-wide disease, although aften misdiagnosed as has happened in Scandinavia.
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The preparation of food in restaurant kitchens carries a high risk of occupational dermatoses. Analysis of 33 cases revealed four different etiological types. Simple irritant dermatitis was rare (2 cases), plain contact dermatitis was more common (6 cases). Fifteen patients had relevant patch tests and scratch tests; ten had positive scratch tests only to explain the cause of their dermatitis. The last type was termed protein contact dermatitis. The major type IV allergens incriminated were metals, onion and garlic. The major proteinaceous allergens indicated by history and test results were fish and shell-fish. Open patch tests with the incriminated foods may cause erythema or oedema on normal skin after 20 minutes. Previously eczematous, now normal looking, skin often responds with a crop of dyshidrotic vesicles preceded by erythema and itching 30 minutes after the application of an open test. Examination for specific IgE is not always positive in such cases. Inhalant allergy was rare. The results indicate that food handlers are sensitized by the protein they touch, and then react to later contact with the proteins. Protein contact dermatitis is similarly common among veterinary surgeons, while the importance in other occupational groups remains to be studied.