PubMed Health⌕ Search

Biomedical subjects

T Estlander

Publications and source records attributed to T Estlander.

At least 55 records · Page 3Linked to original sources
PubMed1997

Rhinitis caused by ninhydrin develops into occupational asthma.

Ninhydrin (2,2-dihydroxy-1,3-indanedione or 1,2,3-triketo-hydrindene hydrate) is a chemical used in the detection of free amino and carboxyl groups in proteins and peptides. Allergic, immunoglobulin E (IgE)-mediated rhinitis caused by ninhydrin was diagnosed earlier in a 41 yr old woman working as a laboratory technician in a forensic laboratory. Despite handling ninhydrin only in a flow cabinet, symptoms of dyspnoea developed 6 months later. Peak flow was found to vary by 20% during working days. In the specific inhalation challenge it was shown that occupational asthma had also developed due to continuing slight exposure to ninhydrin. The titre of ninhydrin-specific IgE also increased from 0.6 to 1.1 kU x L(-1) in the follow-up. This case stresses the importance of cessation of allergen exposure in occupational allergic rhinitis, in order to prevent asthma.

Adult↗
PubMed1997

Occupational asthma caused by triglycidyl isocyanurate (TGIC).

BACKGROUND: Polyester powder paints are extensively used in metal painting. Triglycidyl isocyanurate (TGIC), an epoxy compound, is often used as a hardener. Several cases of allergic eczema from occupational exposure to TGIC have been reported in the literature. OBJECTIVE: We examined a 36-year-old non-smoking man who worked mainly as a spray painter, using a polyester powder paint containing 4% TGIC. During painting he used protective clothing and a motorized breathing protector. After 4 years he developed eczema on his hands, face and body, and an occupational allergic eczema caused by TGIC was diagnosed. He also suffered from powder-paint-related asthmatic symptoms. METHODS: Occupational asthma was diagnosed in accordance with the accepted guidelines. Inhalation challenge tests were performed with the paint and TGIC. RESULTS: Spirometry showed slight obstruction; the blood eosinophils and serum IgE value were elevated. Skin-prick tests with common environmental allergens were negative. The challenge test with lactose powder was also negative. A challenge test with a paint containing TGIC (4%) induced a dual reaction in PEF and a late 23% fall in FEV1. A test with TGIC (4%) mixed with lactose induced a dual PEF reaction, and also dual changes in spirometry. The PD15 in the histamine challenge test decreased significantly after the challenge tests. CONCLUSIONS: To our knowledge this is the first diagnosed case of occupational asthma caused by TGIC. This case report emphasizes the importance of protecting both the skin and respiratory tract of workers against chemicals such as TGIC, capable of causing skin and respiratory allergy.

Adult↗
PubMed1997

Immediate and delayed skin allergy from cow dander.

BACKGROUND: Cow dander is the most common cause of occupational contact urticaria in Finland. Occasionally cow dander also causes allergic contact dermatitis, which can be revealed by patch testing with cow dander. OBJECTIVE: A patient with a combined type I and type IV allergy to cow dander is the subject of this report. RESULTS: She had intense pruritus, whealing, and severe dermatitis, but no respiratory symptoms. Skin tests and radioallergosorbent test indicated that she had both type I and type IV allergy to cow dander. CONCLUSION: Increasing numbers of cases with both type I and type IV allergy are reported, but the mechanism is not clear. In our clinic, we classify immediate reactions as contact urticaria if the clinical picture involves whealing, and as protein contact dermatitis if dermatitis dominates the clinical picture. If delayed allergic patch test results are obtained, we consider it allergic contact dermatitis.

Allergens↗
PubMed1996

Occupational laryngitis with immediate allergic or immediate type specific chemical hypersensitivity.

Reports of allergic laryngitis are sparse. In some reports allergy has been mentioned as an aetiological factor, but the diagnosis has not been confirmed with provocation tests. This paper reports on 20 patients in order to show that laryngitis can be caused by organic substances and chemicals with mechanisms of immediate allergy or immediate type specific hypersensitivity. The agents in the former group consisted of flours, obeche, plants and acid anhydrides, whereas these in the latter group included chemicals like formaldehyde, acrylate compounds, and chemicals used in hairdressing. All the cases were confirmed with provocation tests in which the patients displayed a change in vocal cord status. Thirteen patients had positive skin-prick test results with suspected causative agents. Eleven of these 13 patients had an elevated level of specific IgE-antibodies to the same agents.

Adult↗
PubMed1996

Occupational allergic contact dermatitis caused by 2,4,6-tris-(dimethylaminomethyl)phenol, and review of sensitizing epoxy resin hardeners.

BACKGROUND: Epoxy resin compounds (ERC) include a large number of sensitizing chemicals such as epoxy resins (ER), hardeners (curing agents), and reactive diluents. Allergic contact dermatitis (ACD) caused by ERCS is often occupational. MATERIALS AND METHODS: We report a patient, sensitized to a hardener of a two-component epoxy paint. Three conventional patch test sessions were performed to diagnose the causative chemical. We also review the literature on sensitizing epoxy-resin hardeners. RESULTS: A 47-year-old nonatopic woman developed dermatitis from a two-component epoxy paint. Patch testing with epoxy resin was negative, but 2,4,6-tris(dimethylaminomethyl)phenol (tris-DMP), used in the paint hardener, induced an allergic patch test reaction. We also review briefly other epoxy hardeners that have caused allergic dermatitis, including: (1) aliphatic polyamines, e.g., ethylenediamine, diethylenetriamine, triethylenetetramine, 3-dimethylaminopropylamine, and trimethylhexamethylenediamine; (2) cycloaliphatic polyamines, e.g., isophoronediamine and 3,3'-dimethyl-4,4-diaminodicyclohexylmethane; (3) aromatic amines, such as 4,4'-diaminodiphenylmethane, m-phenylene diamine, and 1,3-xylylene diamine; (4) dicyanodiamide; (5) triglycidyl isocyanurate, an epoxy compound that may be used as an epoxy-resin hardener; and (6) additives in epoxy accelerators, such as hexavalent chromate. CONCLUSIONS: No one chemical can be used to screen for sensitization to the many different epoxy hardeners. Extensive patch testing may be required to reveal the hardener that has caused the allergy. The hardener, 2,4,6-tris-(dimethylaminomethyl)phenol (tris-DMP), is a new sensitizer. To verify ACD caused by tris-DMP, patch-testing at 1% in petrolatum is suggested.

Dermatitis, Allergic Contact↗
PubMed1996

Occupational conjunctivitis associated with type IV allergy to methacrylates.

On rare occasions, exposure to methacrylates (MAs) may induce mucosal symptoms. Three patients, two dental laboratory workers and one hearing aid laboratory worker, are presented. All three had allergic contact dermatitis from MAs which disappeared after avoidance of contact with uncured MA compounds. Two of the patients, the dental laboratory assistant and the hearing aid worker, had also developed symptoms of conjunctivitis. Both were exposed to chemically curable and light-curable MAs. The association between their conjunctivitis and type IV allergy to MAs was supported by the following observations: 1) sensitization to several MAs including methylMA, 2-hydroxyethylMA, ethyleneglycol diMA, triethyleneglycoldiMA, tetrahydrofurfuryldiMA, and 1,4-butanedioldiMA, as well as to pentaerythritol triacrylate; 2) simultaneous appearance of their eye symptoms and allergic contact dermatitis; 3) high exposure to MAs because of disturbances of ventilation; 4) disappearance of the eye symptoms during holidays; and 5) opthalmologist's findings of follicular conjunctivitis with some papillae, eosinophilia, and lymphocytosis in conjunctival scrapings corresponding to allergic contact conjunctivitis. In addition, the activation of eosinophils in the conjunctival scrapings was demonstrated with the monoclonal antibody technique, and an elevated level of eosinophilic cationic protein was found in the tear fluid. Our cases suggest that conjunctivitis may be caused by type IV allergy to MAs, although type I allergy (even though prick tests were negative), other hypersensitivity mechanisms, or irritation cannot be excluded. 4H-Gloves seem to give adequate hand protection even to allergic patients. More attention should be paid to ventilation systems if MA exposure occurs. In some cases, patients with eye symptoms need to be patch tested.

Conjunctivitis, Allergic↗
PubMed1996

Occupational IgE-mediated rhinitis caused by ninhydrin.

Ninhydrin is a laboratory chemical used as a reagent in the detection of free amino and carboxyl groups in proteins and peptides. We present the case of a laboratory technician who developed symptoms of rhinitis when handling papers immersed in a solution containing ninhydrin. Prick tests for ninhydrin and ninhydrin RAST were positive. The inhalation provocation test in an exposure chamber gave an immediate nasal response. A positive prick test to ninhydrin, an elevated level of specific IgE antibodies to ninhydrin, and the RAST inhibition test confirmed an IgE-mediated type I allergic reaction. We are not aware of any other report of ninhydrin as a cause of IgE-mediated allergy.

Adult↗
PubMed1996

Allergic patch test reactions caused by the rubber chemical cyclohexyl thiophthalimide.

Rubber chemicals are among the most common occupational contact sensitizers. The most common rubber sensitizers are thiurams, thiazoles, carbamates and paraphenylenediamine derivatives. Here we present data on a less-well-known rubber chemical, N-(cyclohexylthio)phthalimide (CTP; CAS 17796-82-6). This chemical is currently the most widely used vulcanization retarder, but data on allergic contact dermatitis caused by CTP are lacking. We conducted a survey of 310 patients who had been patch tested with 30 rubber chemicals including CTP. 11 (3.5%) showed an allergic patch test reaction provoked by CTP, and 9.0% by thiurams. 4 of the patients reacted only to CTP and not to other rubber chemicals, whereas the other 7 concomitantly reacted to other rubber chemicals. After analyzing the patch test data of these 11 patients, it was concluded that CTP probably did not cross-react with the other rubber chemicals. Therefore the patch test results may indicate independent sensitization to CTP and other rubber chemicals. Because very little data on the components of rubber chemicals in rubber products are available, the source of the putative sensitization to the rubber vulcanization retarder CTP is unknown.

Cross Reactions↗
PubMed1996

Oral mucosal diseases investigated by patch testing with a dental screening series.

The rôle of contact allergies in oral mucosal diseases was studied. The subjects were 24 patients out of 479 tested, who had oral mucosal symptoms and positive patch test reactions in a dental series during 1987-1994 at the Department of Dermatology, Helsinki University Hospital. The clinical diagnoses were oral lichen planus (LPO, 13 patients), leukoplakia (2), glossodynia, i.e., 'burning mouth syndrome' (4), stomatitis (3) and recurrent angioedema (2). Only 1 patient had symptoms in relation to dental care. All but 2 patients had allergic reactions to mercury (Hg) (12 patients), gold sodium thiosulfate (Au) (13 patients) or both. A clinical connection between oral symptoms and contact allergy was seen in 10 patients. 9 patients (7 LPO, 2 leukoplakia) had Hg allergy. In these cases, the oral lesions disappeared after the amalgam fillings had been removed. 1 patient had recurrent stomatitis and perioral eczema after dental care and 2,2-bis(4-(2-hydroxy-3-methacryloxypropoxy)phenyl)propane (BIS-GMA) allergy. Her symptoms were caused by drilling of acrylic fillings. In addition, a connection between localized stomatitis and contact allergy was considered probable in 2 cases. 1 patient had stomatitis from contact with an orthodontic device and nickel allergy. The other had stomatitis from contact with a dental gold crown and gold allergy. No clinical connection was found between gold allergy and the oral symptoms of other patients.

Adult↗
PubMed1996

Occupational allergic contact dermatitis caused by decorative plants.

12 cases of occupational allergic contact dermatitis caused by decorative plants were diagnosed in a 14-year period. The patients were middle-aged, and their average exposure time was 13 years. The plant families and plants causing occupational contact dermatitis were Compositae (5 patients; chrysanthemum, elecampane, gerbera, feverfew), Alstroemeriaceae (5 patients, Alstroemeria), Liliaceae (4 patients; tulip, hyacinth), Amaryllidaceae (2 patients; narcissus) and Caryophyllaceae (2 patients; carnation, cauzeflower). The known chemical allergens causing dermatitis were tuliposide-A and sesquiterpene lactones, such as alantolactones and parthenolide, in the Liliaceae and Compositae families. 7 of the 12 patients were able to continue their work; 5 were not because of severe relapses of skin symptoms. The plant allergen and extract series currently available are of great help in the diagnosis.

Adult↗
PubMed1996

Occupational dermatoses from exposure to epoxy resin compounds in a ski factory.

Of 22 workers in a ski factory, occupational allergic contact dermatitis was found in 8. 6 were sensitive to epoxy resin compounds, i.e., epoxy resins, hardeners or diluents, 1 to cobalt in glass-fiber reinforcements, and 1 to formaldehyde in a urea-formaldehyde glue and a lacquer. 4 workers had irritant contact dermatitis from epoxy resin compounds, lacquers, sanding dust, or glass-fiber dust. 3 had contact allergy from a new sensitizer, diethyleneglycol diglycidyl ether, in a reactive diluent. Immediate transfer of workers sensitized to epoxy resin from epoxy exposure prevents aggravation of their dermatitis and broadening of the sensitization to epoxy hardeners, diluents and other compounds.

Adhesives↗
PubMed1996

Occupational allergic contact dermatitis from spices.

About 1000 patients were investigated at our clinic during 1991-1995 for occupational skin disease, and 5 had occupational allergic contact dermatitis from spices. The patients were chefs, or kitchen, coffee room, and restaurant workers. All patients had hand (or finger) dermatitis. The causative spices were: garlic, cinnamon, ginger, allspice and clove. The same patients also had allergic patch test reactions to foods: tomato, lettuce and carrot. Paprika elicited a weak allergic patch test reaction in 2 patients. Occupational allergic contact dermatitis from spices is relatively rare, but needs to be taken into consideration in patients who have hand dermatitis, and work with spices and foods. Patch testing with spices as is is useful, but testing with dilutions in pet, may be needed to confirm that the patch test reactions are allergic. Patients also need to be prick tested with spices and foods.

Adult↗