[Occupational dermatitis in physicians].
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Biomedical subjects
Publications and source records attributed to Z Grzywa.
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3 patients with contact urticaria as the only pathological symptom are described, 2 with contact urticaria and other manifestations of hypersensitivity and 3 with immediate reaction to patch-test allergens.
In the report new contact allergens and allergen sources detected in Warsaw in the period 1975-1977 are described. They are divided into 3 groups: industrial allergens, remaining occupational allergens and cosmetics. There are given some data concerning the substances present in industrial oils, hardeners and epoxy resin solvents, drugs sensitizing nurses, several new sources of chromium allergens, essential oils and synthetic flavours. Results obtained with various star anise oil samples are described. Essential oils and synthetic flavours. Results obtained with various star anise oil samples are described. Essential oils and synthetic flavours are discussed as the main allergens in cosmetics.
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The standard series and 35 essential oils were tested on 450 patients with dermatitis. It was found that those simultaneously sensitive to essential oils are more frequently negative than positive to balsam of Peru. The remaining 3 balsams, however (colophony, turpentine and wood tars), are also screening agents for essential oils. All four balsams reveal sensitivity to essential oils in most of the subjects tested. In patients negative to all 4 balsams of the standard series, attempts to find an essential oil with which tests would be simultaneously frequently positive with those for other essential oils failed.
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Primary contact sensitivty to m-phenylenediamine was noted in 8 of 182 workers handling this substance as hardener. In these patients the period between the beginning of this work and the appearance of dermatitis was shorter if they became simultaneously sensitive to epoxy resin and/or triethylenetetramine. Moreover from among 150 consecutive patients one was positive to m-phenylenediamine and negative to p-phenylenediamine. From among the selected patients positive to p-phenylenediamine more than 40 per cent were also positive to m-phenylenediamine. A large number of the latter patients were as well positive to o-phenylenediamine. No patients were found who would be positive to o-phenylenediamine and negative to m-phenylenediamine. Nearly all those positive to m- and p-phenylenediamine were also positive to the meta isomers of other aromatic amines.
The frequency of positive patch tests to 13 rubber accelerators in Poland was recorded. Of particular interest was the relatively large group of patients positive to several, mostly chemically unrelated, accelerators. The mechanism of this multiple sensitivity is discussed. Positive tests to N-isopropyl-N-phenyl-p-phenylenediamine were observed in more than half of the patients reacting to several aromatic amines. Anamnesis indicated that in the case of cross-reactions to many aromatic amines, none of the patients positive to N-isopropyl-N-phenyl-p-phenylenediamine had complained of a reaction to rubber products.
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Two hundred consecutive patients and 50 subjects positive to balsams were tested with the 35 essential oils most frequently used in Polish cosmetics. The frequency of sensitivity to the particular oils is noted and the index of sensitization calculated as the amount of oil/kg used annually for the production of Polish cosmetics per one patient positive to this oil. The correlation of positive tests to essential oils with positive tests to four balsams of the standard series is shown.
Star anise oil in 2 and 1% concentrations produced active sensitization in 5% of test subjects, and positive patch tests in 36 and 34%, respectively, of consecutive patients with dermatitis. A comparison of the results of tests with balsams and other essential oils showed that star anise oil does not give cross-reactions and pseudo cross-sensitivity. Patients positive to this oil are frequently positive to anethole and to other constituents of this oil: alpha-pinene, limonene and safrole. In tests with star anise oil it is noteworthy that a 1% concentration is strongly irritant, and 0.5% reveals sensitivity in only one fifth of the actively sensitized subjects. It is possible that the cause of false negative patch tests might be similar in the case of some other allergens.
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With the exception of certain drugs, some contactants give positive patch test reactions less frequently in patients with atopic dermatitis than in all patients with dermatitis. Both among atopics and other dermatitis patients, women reacted positively to most drugs more frequently than men did. In Poland, positive patch tests to balsams are rare in atopics.