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T Menné

Publications and source records attributed to T Menné.

At least 19 recordsLinked to original sources

Inverse relationship between allergic contact dermatitis and type 1 diabetes mellitus: a retrospective clinic-based study.

AIMS/HYPOTHESIS: Contact allergy (CA) is a disease induced and maintained by environmental factors, which mainly has a Th2 pattern in its chronic form. Environmental factors play a major role in CA, while genetic factors are of minor importance. Type 1 diabetes is an autoimmune disease of the islets of Langerhans, which has a Th1 cytokine pattern and in which modulators of risk are both genetic and environmental. To investigate whether environmental exposure to chemicals leading to CA could influence the risk of type 1 diabetes, we conducted a retrospective clinic-based study of patients subjected to diagnostic patch testing of CA. METHODS: We undertook a retrospective clinic-based study of 13,315 patients who were patch-tested between 1985 and 2003, and linked it with the Danish National Patient Registry containing diabetic mellitus discharge diagnoses from 1987 to 2003. The 13,315 patch-tested patients gave rise to 4,848 CA patients. Using logistic regression, we calculated odds ratios for persons with CA of having type 1 diabetes. RESULTS: Type 1 diabetes was diagnosed in 229 of the patch-tested patients. CA patients had a reduced risk of having type 1 diabetes, with an odds ratio 0.62 (95% CI 0.46-0.86). After adjusting for sex and age, the odds ratio was 0.63 (95% CI 0.47-0.86). CONCLUSIONS/INTERPRETATION: An inverse relationship between CA and type 1 diabetes was found. Thus there may be a protective effect of having CA in relation to the risk of type 1 diabetes, or vice versa type 1 diabetes may lead to tolerance rather than hypersensitivity. Alternatively, these two diseases may share common genetic factors, although at present these are unknown.

Adolescent↗

Contact dermatitis from methylisothiazolinone in a paint factory.

Introduction of new potential contact-sensitizing chemicals have in the past led to epidemics of contact dermatitis. A new preservative containing only methylisothiazolinone (MI) and not methylchloroisothiazolinone (MCI) has recently been introduced in the European Union for use in products, such as paint, glue and cosmetics. The objective of this article is to describe a factory outbreak of contact allergy to MI and MCI preservatives. This factory outbreak describes allergic contact dermatitis towards MI in 4 patients of 14 persons working at a paint manufacturer. Patch test results from all patients showed positive reactions for MI and MCI/MI. The reactions were stronger for MI than MCI/MI indicating a primary sensitization to MI. The combination of MCI/MI remains widely used, and therefore various patterns of exposure and sensitization could be seen in the future. Our data show that MI holds a potential for eliciting and propably inducing contact allergy in humans. Whether this preservative is safe to use in cosmetics where billions of consumers are exposed needs a care full monitoring.

Adult↗

Allergic reactions in anaesthesia: are suspected causes confirmed on subsequent testing?

BACKGROUND: The aim of this retrospective survey of possible allergic reactions during anaesthesia was to investigate whether the cause suspected by anaesthetists involved corresponded with the cause found on subsequent investigation in the Danish Anaesthesia Allergy Centre (DAAC). METHODS: Case notes and anaesthetic charts from 111 reactions in 107 patients investigated in the DAAC were scrutinized for either suspicions of or warnings against specific substances stated to be the cause of the supposed allergic reaction. RESULTS: In 67 cases, one or more substances were suspected. In 49 of these (73%) the suspected cause did not match the results of subsequent investigation, either a different substance being the cause or no cause being found. Only five cases (7%) showed a complete match between suspected cause and investigation result. In the remaining 13 cases (19%) there was a partial match, the right substance being suspected, but investigations showed an additional allergen or several substances, including the right substance being suspected. CONCLUSIONS: An informed guess is not a reliable way of determining the cause of a supposed allergic reaction during anaesthesia and may put a significant number of patients at unnecessary risk. Some patients may be labelled with a wrong allergy, leading to unnecessary warnings against harmless substances, and some patients may be put at risk of subsequent re-exposure to the real allergen. Patients with suspected allergic reactions during anaesthesia should be referred for investigation in specialist centres whenever possible.

Allergens↗

Allergic contact dermatitis from methyldibromo glutaronitrile--clinical cases from 2003.

Of the 766 patients with eczematous skin disease patch tested in 2003 at the Department of Dermatology, University Clinic Gentofte, 38 (4.9%) showed a positive reaction to methyldibromo glutaronitrile (MDBGN), and in an additional 2 patients, a doubtful positive patch test reaction was found to be of relevance. Among these, 27 had hand eczema, with a relevant exposure predominantly from wash-off products, either liquid soaps or shampoos, in 24 patients. Following identification of the allergen by patch testing and subsequent avoidance of products containing MDBGN, the hand eczema either improved or cleared in 19 patients. Chemical analysis showed 11 p.p.m. to 473 p.p.m. MDBGN in products used by the patients. Based on the present clinical study and accumulated evidence in the literature, it is concluded that MDBGN is not suitable for use in any type of cosmetic product.

Allergens↗

Patch testing with methyldibromo glutaronitrile, a multicentre study within the EECDRG.

Contact allergy to and allergic contact dermatitis from methyldibromo glutaronitrile (MDBGN) have frequently been reported. As there has been no agreement on which MDBGN test preparation to use, a study was initiated to help determine the optimal patch test preparation for MDBGN. 2661 consecutively patch tested patients at 11 test clinics representing 9 European countries participated. Petrolatum preparations with MDBGN at 1.0%, 0.5%, 0.3% and 0.1% were inserted in the standard series. Contact allergy rates were noted in the range 4.4-1.1% following decreasing test concentrations. Reactions not fulfilling all criteria to be classified as allergic reactions could represent either weak allergic or irritant reactions, and such reactions were noted in the range 8.2-0.5% with decreasing concentrations. A significant number of these reactions represented weak allergic reactions, as allergic reactions were obtained to higher patch test concentrations in the same individual. Morphologically irritant reactions were noted only for the highest test concentrations. In summary, the contact allergy rates and frequencies of doubtful and irritant reactions vary with the patch test concentration. The final decision on patch test concentration for MDBGN should not only rely on these factors but also include information on patch test concentrations required to diagnose individual cases with allergic contact dermatitis from MDBGN as well as results of repeated open application tests.

Allergens↗

Repeated open application test with methyldibromo glutaronitrile, a multicentre study within the EECDRG.

Contact allergy to and allergic contact dermatitis from methyldibromo glutaronitrile (MDBGN) have frequently been reported. This study was initiated to help determine the optimal patch test preparation for MDBGN. In 51 patients with a doubtful or a positive patch test reaction to at least 1 of 4 test preparations with MDBGN in petrolatum at 1.0% w/w, 0.5%, 0.3% and 0.1%, a repeated open application test (ROAT) with moisturizers with and without MDBGN at 0.03% w/w was performed on the upper arms for 2 weeks. 18 of the 51 (35.3%) patients developed a positive ROAT. In all patients, there was a positive ROAT only to the moisturizer with MDBGN (P < 0.001). A statistically significant association was also found between the patch test reactivity (PTRL) and the outcome of the ROAT (P < 0.001). If only considering those with a PTRL above 0.3%, thus with negative or doubtful test reactions to 0.1% and 0.3%, there were still statistically significantly more patients with a positive ROAT to the moisturizer with MDBGN than to the moisturizer without MDBGN. The study demonstrates that patch testing with MDBGN at 0.3% and 0.1% will miss clinically relevant patch test reactions to MDBGN.

Adult↗

Methyldibromo glutaronitrile contact allergy: effect of single versus repeated daily exposure.

Some types of cosmetic products such as hand soaps and creams are commonly used several times a day, especially in occupational use situations. Little has experimentally been shown of how the daily frequency of the application of an allergen in a product influences the allergic response. This study investigates the allergic responses elicited in presensitized individuals when exposed to a specific amount of allergen applied either in 1 application per day or distributed over 4 applications per day. As model allergen, the cosmetic preservative methyldibromo glutaronitrile (MDBGN) is used. 19 contact allergic individuals and 12 controls participated in a double-blind, randomized use test. To areas on the forearms were applied 2 drops either once daily of a solution containing 0.04% MDBGN or 4 times a day of a solution containing 0.01% MDBGN. 14 of 19 patients developed dermatitis following the application of approximately equal amounts of MDBGN on both arms. Controls were negative. In this experiment, applications of 0.04% MDBGN once daily or 0.01% MDBGN 4 times daily had, in a use test, approximately equal capabilities of provoking allergic contact dermatitis. This adds new knowledge to the risk assessment and regulation of cosmetic allergens. However, these results may be highly allergen dependent, and further studies are needed before more general conclusions can be made.

Adult↗

Airborne chemicals cause respiratory symptoms in individuals with contact allergy.

Exposure to fragrance chemicals causes various eye and airway symptoms. Individuals with perfume contact allergy report these symptoms more frequently than individuals with nickel allergy or no contact allergies. However, the associations between contact allergy and respiratory symptoms elicited by airborne chemicals other than perfumes are unclear. The study aimed to investigate the association between eye and airway symptoms elicited by airborne chemicals (other than perfumes) and contact allergy in a population-based sample. A questionnaire on respiratory symptoms was posted, in 2002, to 1189 individuals who participated in 1997/1998 in a Danish population-based study of allergic diseases. Questions about eye and airway symptoms elicited by different airborne chemicals and airborne proteins were included in the questionnaire. Data from the questionnaire were compared with data on patch testing and prick testing. Having at least 1 positive patch test (adjusted odds ratio 1.7, 95% CI 1.2-2.5) was associated with the symptoms, and the odds ratio increased with the number of positive patch tests (P-value for test for trend <0.05). Bronchial hyperreactivity, female sex and psychological vulnerability were independently associated with symptoms, but no association was found between prick test reactivity to proteins and the symptoms elicited by airborne chemicals.

Adult↗

Monitoring the European standard series in 10 centres 1996-2000.

A 5-year retrospective study of the frequency of sensitization to the 25 allergens of the European standard series (ESS) was conducted in 10 centres in 8 European countries. Included were the results of 26 210 patients. The range in sensitivities differed moderately between the centres. Combining results of different centres and drawing conclusions on incidences can be done only with great care. The information on the ranking of the allergens and their sensitization incidence in the clinics are useful for decisions on the future composition of the standard series. The ESS is still a valid screening tool, and no substances should be deleted.

Allergens↗

The European standard series in 9 European countries, 2002/2003 -- first results of the European Surveillance System on Contact Allergies.

Since January 2001, the European Surveillance System on Contact Allergies (ESSCA), supported by European Union funding (contract QLK4-CT-2001-00343), has started to collect patch-test data. This comprises a standardized clinical history and the patch-test results using the European standard series, from 17 centres in 9 European countries listed above. In 2002 and 2003, 10 511 patients' test results have been pooled and analysed. The anamnestic data partly reflect the subspecialties of some centres. The most common allergen was nickel sulfate (17.3%); however, large international variations were observed. The prevalence of contact allergy to Myroxylon pereirae resin (balsam of Peru) (5.8%) is coming close to the frequency found with the fragrance mix (6.4%). Regarding contact allergy to chromium compounds, different frequencies were noted in the 2 centres focused on occupational dermatitis (2.3% in the FIOH versus 7.4% in the Nofer Institute). These most likely reflect the beneficial effect of addition of ferrous sulfate in one, but not the other country. As differences may partly be due to different patch-test reading, standardization may need to be refined further. By providing post-marketing surveillance in the field of contact allergy, ESSCA will meet its objective of increased consumer safety across Europe.

Adult↗

Experimental elicitation of contact allergy from a diazolidinyl urea-preserved cream in relation to anatomical region, exposure time and concentration.

The elicitation potential of the cosmetic preservative diazolidinyl urea was studied in formaldehyde- and diazolidinyl urea-sensitized volunteer patients using a stepwise controlled exposure design. The test product was a facial moisturizer, preserved with varying concentrations of diazolidinyl urea, ranging from 0.05% to 0.6%. A repeated open application-like exposure test was performed on volunteers and a control group with the test product containing increasing preservative concentrations, on arm, neck and face, sequentially, for 2 weeks or until dermatitis developed. The preservative action in the cream at different test concentrations was tested in microbial challenge tests and was found effective at all concentrations tested. The study established a non-eliciting concentration of diazolidinyl urea of 0.05% in formaldehyde-sensitive patients and showed that the skin reactivity depends on the anatomical region, increasing from the upper arm to neck and, possibly, to the face. The study design, beginning on the upper arm and moving on to the neck and face seems to be relevant for the study of reactions to cosmetic products. A clear dose-response relationship was seen regarding preservative concentration in the product.

Adolescent↗

Contact dermatitis to hair dyes in a Danish adult population: an interview-based study.

BACKGROUND: Contact allergy to hair dye ingredients is a well-known entity seen both in consumers using hair dyes and among hairdressers with occupational contact dermatitis. Surveys show that consumers with even severe adverse skin reactions to hair dyes only rarely contact the healthcare services. The frequency of hair dye-induced skin reactions in the consumer population is unknown. OBJECTIVES: An epidemiological investigation with the aim of establishing the proportion of hair dye-induced skin reactions was performed in a population-based sample. METHODS: A representative random sample (n = 4000) was taken of the Danish adult population. Personal interview questions were asked regarding adverse skin reactions to hair dyes, either compatible with a classical allergic eczematous reaction with redness, scaling and itching or a severe allergic reaction with oedema of the forehead and face. The response rate was 65.2%. RESULTS: A total of 18.4% of the male respondents and 74.9% of the female respondents had at some point dyed their hair. The median age at first hair dyeing was 16 years (range 1-80). Adverse skin reactions to hair dyes compatible with an allergic reaction were reported in 5.3% of individuals who had ever used hair dye. Of these, only 15.6% had been in contact with healthcare services after the hair dye reaction. Having had a temporary tattoo was not a significant risk factor for an adverse reaction to hair dyes. CONCLUSIONS: The rate of adverse allergic skin reactions to hair dyes was higher than expected from patch-test studies. Only by studying the clinical types of adverse reactions to hair dyes will it be possible to gather a complete epidemiological picture of the nature and extent of the problems related to hair dye ingredients.

Adolescent↗

Methyldibromoglutaronitrile in rinse-off products causes allergic contact dermatitis: an experimental study.

BACKGROUND: The frequency of sensitivity to the cosmetic preservative methyldibromoglutaronitrile (MDBGN) has increased significantly in Europe. Most cases of allergic contact dermatitis from MDBGN are caused by leave-on cosmetic products. The risk of developing allergic contact dermatitis from rinse-off products has been less studied. OBJECTIVES: To investigate the allergic response elicited in presensitized individuals from exposure to a rinse-off product preserved with the maximum permitted level of MDBGN. METHODS: Nineteen contact allergic individuals and nine controls participated in a double-blind, randomized repeated open application test (ROAT) using two coded liquid soaps with and without MDBGN. Areas of 50 cm2 on the lower arms were washed with the soaps twice a day for up to 28 days; two of the subjects continued for 34 days. The subjects were also patch tested with a dilution series of MDBGN to determine their patch test threshold values. RESULTS: Seven presensitized individuals (37%) developed allergic contact dermatitis from the soap containing MDBGN. The mean dose of MDBGN per application was 2.2 micro g cm-2 and the reactions appeared between days 6 and 34. All nine controls had negative ROATs. The difference in reactivity between test subjects and controls was significant (one-sided Fisher's exact test, P = 0.04). Patch test threshold values ranged from < 0.001% to 0.2% MDBGN in ethanol/water. CONCLUSIONS: This study shows that the exposure to a rinse-off product containing the maximum permitted level of MDBGN can easily elicit an allergic response in presensitized individuals. Along with reported cases of induction and elicitation caused by MDBGN in rinse-off products the study indicates that the permitted level of MDBGN in rinse-off products is too high. We recommend that this level should be re-evaluated.

Adult↗

Routine patch testing with frullanolide mix: an European Environmental and Contact Dermatitis Research Group multicentre study.

Contact sensitivity to plants containing 1 or more sesquiterpene lactones (SLs) is difficult to diagnose. The mixture of SLs (SL mix) has been shown to detect only about 60% of sensitized individuals. In order to improve the diagnosis of sensitization to plants containing SLs, we have tested a mixture of frullanolides contained in Frullania dilatata and Frullania tamarisci at 3 different concentrations (0.01%, 0.033% and 0.1% in petrolatum). 8605 consecutive eczema patients in 1 North American and 15 European dermatology departments were tested with this mix, and 0.35% of positive cases to the different concentrations were found. Routine use of this mix permitted detection of only a small percentage of extra cases and did not improve the SL mix score. The frullanolide mix should therefore be restricted to investigations in particular geographical zones and/or in particular occupations.

Allergens↗

Deodorants: an experimental provocation study with hydroxycitronellal.

Axillary dermatitis is a common problem, particularly in individuals with contact allergy to fragrances. Many individuals suspect their deodorant to be the causal product of their fragrance allergy. It has been shown that deodorants containing cinnamic aldehyde (cinnamal) can elicit axillary dermatitis in patients sensitized to this substance. The aim of the present investigation was to evaluate the importance of hydroxycitronellal used in deodorants for the development of axillary dermatitis, when applied by individuals with and without contact allergy to this fragrance chemical. Patch tests with deodorants and ethanolic solutions containing hydroxycitronellal, as well as repeated open application tests (ROAT) with roll-on deodorants with and without hydroxycitronellal at different concentrations, were performed in 14 dermatitis patients, 7 with and 7 without contact allergy to hydroxycitronellal. A positive ROAT was noted only in the patients hypersensitive to hydroxycitronellal (P < 0.001) and only in the axilla to which the deodorants containing hydroxycitronellal had been applied (P < 0.001). Deodorants containing hydroxycitronellal in the concentration range of 0.032-0.32% used twice daily on healthy skin in individuals hypersensitive to hydroxycitronellal can elicit axillary dermatitis in a few weeks.

Adolescent↗