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PubMed2004

Reflectance confocal microscopy may differentiate acute allergic and irritant contact dermatitis in vivo.

BACKGROUND: Acute irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD) may be difficult to distinguish by clinical or histologic assessment. Reflectance confocal microscopy (RCM) enables real-time, high-resolution skin imaging in vivo. OBJECTIVE: We sought to image, characterize, and distinguish acute ACD and ICD in vivo. METHODS: Volunteers with ACD were patch tested with an allergen and the irritant, sodium lauryl sulfate. RCM imaging and transepidermal water loss measurements were performed at 24 and 72 hours. Biopsy specimens were correlated with RCM images. RESULTS: Spongiosis, epidermal inflammatory cell infiltrate, and vesicle formation were observed in ACD and ICD. Compared with ACD, ICD showed greater disruption of the stratum corneum, and more parakeratosis. There was a significantly greater increase in transepidermal water loss for ICD compared with ACD. CONCLUSION: RCM is a promising tool for dynamic, noninvasive assessment and may help to differentiate acute ACD and sodium lauryl sulfate-induced ICD.

Adult↗
PubMed1990

Primula contact dermatitis: an easily overlooked diagnosis.

Contact dermatitis to Primula obconica is not uncommon in the United States, yet it is scarcely mentioned in current North American dermatologic textbooks and literature. Affecting mainly women, primula contact dermatitis is often misdiagnosed since its nondescript pattern suggests an endogenous dermatitis. The author summarizes his experience with nine patients encountered in his practice during two years. Patch testing is important since a positive patch test reaction confirms the diagnosis and helps to convince the patient to discard the offending plant(s). A simple technique of patch testing with the primula leaf is described.

Adult↗
PubMed1999

Allergic contact dermatitis to plastic banknotes.

Allergic contact dermatitis to ultraviolet (UV) cured acrylates occurs predominantly in occupationally exposed workers. Two men presented with dermatitis coinciding with the location of banknotes in their pockets. Patch testing confirmed allergic contact dermatitis to multiple acrylates and Australian plastic banknotes. This is the first report of contact allergy to acrylates present in Australian plastic banknotes.

Acrylates↗
PubMed2006

Enhanced expression levels of IL-31 correlate with IL-4 and IL-13 in atopic and allergic contact dermatitis.

BACKGROUND: IL-31 is produced by activated T lymphocytes, preferentially by TH2 cells. Transgenic mice overexpressing IL-31 have a phenotype resembling allergic dermatitis in human subjects. OBJECTIVE: We sought to evaluate the potential importance of IL-31 in the pathogenesis of human T cell-mediated skin diseases. METHODS: We analyzed total RNA taken from 149 skin biopsy specimens from patients with atopic dermatitis (AD), allergic contact dermatitis (ACD), or psoriasis in comparison with specimens taken from patients with healthy skin (n = 13) by using quantitative real-time PCR for the expression of TH1/TH2 cytokines. RESULTS: We found statistically increased mRNA levels of IL-31 in biopsy specimens taken from patients with AD, irrespective of the severity of the disease and serum IgE levels. Moreover, IL-31 mRNA levels were strongly increased in many biopsy specimens taken from patients with ACD. However, no increased transcription of IL-31 could be detected in biopsy specimens taken from psoriatic plaques. A comparison of mRNA levels of IL-31 with TH1 or TH2 cytokines demonstrates a correlation of the expression of IL-31 with IL-4 and IL-13 but not with IFN-gamma. No significant increase of IL-31 receptor mRNA could be detected in any disease, whereas the second receptor subunit of IL-31, the oncostatin M receptor, seems to be enhanced transcribed in patients with psoriasis. CONCLUSION: IL-31 expression is not only increased in patients with AD but also in those with ACD, 2 pruritic skin disorders. In both types of eczema, expression of IL-31 is associated with the expression of the TH2 cytokines IL-4 and IL-13. CLINICAL IMPLICATIONS: IL-31 might contribute not only to the development of AD but also to ACD-provoked skin inflammation.

Dermatitis, Allergic Contact↗
PubMed2003

Detection of occupational allergic contact dermatitis by patch testing.

Occupational allergic contact dermatitis (OACD) is an important medical and occupational health problem. If undiagnosed, the disease may persist and even spread widely, resulting in severe and permanent disability to the worker, who may be deprived of his legal right to compensation. OACD is not uncommon in China, although many dermatologists fail to establish the connection between disease and working conditions, because they think that the diagnosis of OACD is the work of occupational medicine and that special diagnostic methods are required. The Ministry of Health and Ministry of Labour and Social Security of China have issued a new law recently to emphasize the prevention and treatment of occupational disease. It requires physicians to make an accurate diagnosis and report of occupation-related diseases. In this study, we have successfully investigated 14 cases of OACD in our hospital by patch testing the patients with a standard series of allergens and investigating by questionnaire the suspected offending occupational allergens. During a 2-year period (2001-2003), 14 patients with suspected allergic contact dermatitis were investigated and confirmed as having OACD. OACD may develop in many different occupations. In this study, nickel, 4-phenylenediamine, fragrance mix, black rubber mix, colophonium, epoxy resin and thiuram mix were identified by patch testing as the main offending allergens in such patients. These results indicate that patch testing plays a vital role in the diagnosis and identification of occupational allergens, and our study shows that OACD can often be diagnosed by patch testing patients with a standard series. The clinician should be alert to recognize the offending allergens of OACD by referring to patch testing all patients with clinically suspected contact dermatitis, and then educating the sensitized worker in how to avoid further exposure to the causative allergens.

Adult↗
PubMed1977

Contact dermatitis from polyfunctional acrylic monomers.

Five out of 26 men employed formulating radiation drying printing ink developed eczematous dermatitis. Positive patch tests were obtained with two polyfunctional acrylic monomers, pentaerythritol triacrylate and trimethylol propane triacrylate and with formulations containing these in four affected employees. Cross sensitization was observed to dipentaerythritol monohydroxy pentaacrylate in each case. A fifth employee appeared to have developed irritant dermatitis from contact with these materials.

Acrylates↗
PubMed1997

Elevated serum levels of soluble CD30 are associated with atopic dermatitis, but not with respiratory atopic disorders and allergic contact dermatitis.

Type 2 helper T-cell immune responses can be demonstrated in the human atopic disorders atopic dermatitis and allergic asthma/rhinoconjunctivitis. The CD30 (Ki-1) antigen, originally described on Hodgkin and Reed-Sternberg cells, has recently been proposed as a marker of T cells with potent B-cell helper activity producing IL-5 and gamma-IFN, as well as on CD4+ and CD8+ T cells with a Th2 cytokine profile. As a soluble form of CD30 (sCD30) is released by CD30+ cells in vivo, we studied its clinical significance in atopic disorders compared with allergic contact dermatitis and healthy controls. Elevated sCD 30 levels were associated with atopic dermatitis (P < 0.0001), but not with respiratory atopic disorders or allergic contact dermatitis. sCD30 levels in patients with atopic-dermatitis were independent of serum IgE. The particular occurrence of serum sCD30 in patients with atopic dermatitis indicates a special regulatory function of CD30+ cells in this disease.

Adolescent↗
PubMed1986

Industrial airborne irritant or allergic contact dermatitis.

Industrial airborne irritant or allergic contact dermatitis is commonly observed in many factories. Examples of airborne irritants include fibres (such as fibreglass or rockwool), various kinds of dust particles (such as cement, slag, sludge, insulating foam, wood chips), acids and alkalis, gasses and vapours. Airborne contact allergens are unequivocally numerous. The clinical symptoms of both irritant and allergic airborne contact dermatitis are reviewed.

Air Pollutants, Occupational↗
PubMed1998

Occupational protein contact dermatitis caused by meat and fish.

BACKGROUND: Protein contact dermatitis is a form of contact dermatitis possibly triggered by proteinaceous allergens. MATERIALS AND METHODS: We report two patients with a history of erythematous and urticarial skin reactions followed by transformation into prolonged papular symptoms upon contact with proteinaceous material. RESULTS: The symptoms reported by the patients were reproducible by skin testing with meat (cow) and fish (salmon). Both patients experienced extracutaneous manifestations after ingestion of meat and fish, as proven by oral challenge. Specific immunoglobulin E (IgE) antibodies were detected in the patients' blood. CONCLUSIONS: Both cases meet all major criteria of protein contact dermatitis, suggesting IgE-mediated immediate-type hypersensitivity with late-phase cutaneous reactions.

Adult↗
PubMed1997

Airborne allergic contact dermatitis from pine dust.

BACKGROUND: Airborne contact dermatitis is a challenging entity that requires comprehensive patch testing and exposure review to diagnose accurately. OBJECTIVE: Four patients with airborne contact dermatitis and positive patch tests to colophony were evaluated. METHODS: Patch testing was performed on all patients using a modified European standard series plus additional applicable allergens. RESULTS: All patients had positive patch tests to colophony and exposure to pine dust. CONCLUSION: Patch testing is a critical element in the evaluation of patients presenting with an airborne pattern of contact dermatitis.

Adult↗
PubMed1984

Primary and secondary sites of occupational contact dermatitis.

Patterns of distribution of allergic contact dermatitis follow a certain order in time. The disease starts at a given site, most often as a unilateral acrodermatitis and, should it become chronic, spreads locally. The subsequent pattern of distribution varies depending on the primary site and the type--occupational or otherwise--of the disease. In this study data collected two decades ago are confronted with the more recent ones relating to 1055 cases of occupational allergic contact dermatitis. Examination of this material brought to light no essential difference between the older and more recent patterns of distribution of secondary sites. The incidence, however, of certain multiple localizations and of the primary or secondary involvement of the face has diminished.

Dermatitis, Atopic↗
PubMed1996

Occupational contact dermatitis to gold.

A case of occupational contact dermatitis to gold is presented. This is uncommon as gold is relatively insoluble. Allergic contact dermatitis to gold is confirmed by patch testing with gold sodium thiosulfate 0.5% in petrolatum. Occupational contact dermatitis in the gold industry can be reduced by providing workers with more protective gear and better ventilation.

Dermatitis, Allergic Contact↗
PubMed2006

Allergic contact dermatitis among maintenance and clerical workers in a military population.

Contact dermatitis is one of the leading causes of occupational morbidity and absenteeism and has become an intolerable cause of missed workdays and health problems in the Israeli military. The aim of this study was to determine the rate of contact dermatitis in maintenance and clerical workers, the common allergens causing it, and the background of atopy in the subjects in order to design preventive measures. Medical records of all recruits to the Israel Defense Forces from 2000 to 2003 were reviewed for contact dermatitis. The 102 cases found were further assessed for job assignment, atopic background, and allergens. Of the 102 cases, 60 had irritant contact dermatitis and 42 had allergic contact dermatitis, of which 33 (78.6%) were maintenance workers, mainly mechanics. 13 soldiers in the maintenance job category (39%) and 2 soldiers in the clerical group (22.2%) had atopic background. There were 55 positive reactions in patch tests, 25 of them to oil and cooling fluids, with 14.5% attributed to methylchloroisothiazolinone/methylisothiazolinone) (Kathon CG). Atopy was found to be a risk factor for allergic contact dermatitis in our study and should be screened for in job assignment procedures in the military. Oil and greases contain significant allergens, especially their preservatives.

Adolescent↗
PubMed2004

Allergic contact dermatitis: pathophysiology applied to future therapy.

Contact dermatitis is a common reason for patient visits to primary-care clinics and represents up to 7% of all dermatologic consultations in the US. Substantial progress has been made in elucidating the pathophysiology of contact dermatitis, particularly the allergic form. A better understanding of pathologic mechanisms has led to improved management of cases and will continue to advance treatment modalities. The present paper reviews the pathogenesis and current treatment of allergic contact dermatitis and speculates on the prospects for improved future therapy.

Dermatitis, Allergic Contact↗