[PHOTO-CONTACT DERMATITIS. THE PHOTO-PATCH TEST AS A VERIFICATION OF THE PHOTO-ALLERGIC NATURE].
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Depigmentation due to contact dermatitis, presents itself in most of the cases as a professional disease, and in only few reports it is shown to be caused by the use of personal items. From June 1982 to March 1983, six patients were observed with a symmetrically distributed contact dermatitis, located on the upper side of the feet, showing the marks of rubber sandal straps, know as "Hawaiian sandals". All patients were exposed to standard patch tests, containing 31 elements among which, there are seven substances that are related to the rubber manufacturing process, such as: potassium dichromate, mercaptobenzothiazole, diphenylguanidine, thiuram-rubber-mixture, colophony, p-phenylenediamine, hydroquinone. The interpretation of the patch tests was done after 48 an 72 hours, following the criteria that were established by the International Contact Dermatitis Research Group (ICORG). Five patients showed sensitiveness to at least, two of the suspected substances. Mercaptobenzothiazole and/or thiuram rubber mixture were the substances most frequently related to these cases of depigmentation. Two patients who had a positive patch test for the thiuram-mix, developed a depigmentation area on the site of the test after two weeks. Depigmentation produced by the thiuram-mix had not been related formerly and though our study it became evident that this substance can lead to it.
The high risk of occupational contact dermatitis in dental personnel are well accepted throughout the world. There are few reports concerning occupational skin disease in dental personnel in Korea. The purposes of this study were to investigate the frequency, characteristics and causative factors of contact dermatitis in Korean dental technicians. Recording of personal history, physical examination and patch tests with the Korean standard series and dental screening series were performed in 49 dental technicians. Most of the subjects were exposed to a variety of compounds, including acrylics, metals, plaster, alginate, etc. 22 (44.9%) subjects had contact dermatitis, present or past, and the site involved was the hand in all 22. The most common clinical feature of hand dermatitis was itching (77.3%); scaling, fissuring and erythema were other common clinical features. Metals, including potassium dichromate (24.5%), nickel sulfate (18.4%), mercury ammonium chloride (16.3%), cobalt chloride (12.2%) and palladium chloride (10.2%), showed high positive rates in patch test results of 49 dental technicians. 7 positive reactions to the various acrylics were found in 3 subjects. In our study, the frequency and clinical features of the contact dermatitis showed a similarity to other reports, though the patch test results were somewhat different; a higher patch-positive reaction to metals and a relatively lower patch-positive reaction to acrylics than the patch test results reported in Europe.
A total of 507 (M 121, F 386) cases of facial dermatitis were investigated, of whom 308 (M 49, F 259) had eczema confined to the face. The prevalence of positive patch tests was 45% (229/507). Among all the patients, the 2 most frequent allergens were nickel (15.2%) and ammoniated mercury (6.1%), with the incidence of nickel sensitivity in men (20%) being greater than in women (13.7%). 56% of the nickel-positive cases were caused by metal spectacle frames. Taiwan's high number of spectacle-wearers, its subtropical climate and the characteristic oriental facial structure are possibly major contributing factors. Most ammoniated mercury (AM)-sensitive cases resulted from cosmetics. Skin-lightening creams are widely used in Taiwan, but their content is poorly controlled. According to consumer reports, 14.9% (48/322) had applied AM-containing cosmetics. Of all the cosmetics tested for mercury, 2.2% (60/2711) were positive.
Two cases of contact dermatitis from electroplating solutions were attributed to irritation from cyanide salts. Both demonstrated similar clinical features. In neither could concomitant contact allergy to other constituents of the plating solutions be demonstrated. In one case, irritation could not be attributed to the alkalinity of the plating solution. Contact dermatitis from cyanide plating solutions may be associated with systemic symptoms, since cyanide is rapidly absorbed through the skin. Poor handling and hygiene techniques in the workplace should be corrected immediately.
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We report two atopic boys with allergic contact dermatitis to nickel. Both children had early onset of atopic dermatitis and subsequently presented with infraumbilical dermatitis corresponding to the site of contact with metal snaps. A positive patch test response to 2.5% nickel sulfate in petrolatum was observed in both boys. Allergic contact dermatitis in patients with atopic dermatitis is not uncommon and probably occurs more often than recognized.
Allergic contact dermatitis from the topical use of essential oils is not widely recognized as an occupational hazard. Four cases of allergic contact dermatitis to essential oils occurring in three aromatherapists and one chemist with a particular interest in aromatherapy are described. All presented with predominantly hand dermatitis and demonstrated sensitization to multiple essential oils. One patient developed a recurrence of cutaneous symptoms following ingestion of lemongrass tea. Workers within this industry should be aware of the sensitization potential of these products and the risk of limiting their ability to continue employment.
Although chlorhexidine is a widely used substance, allergic contact dermatitis from chlorhexidine has rarely been reported. Our objective was to study all cases of allergic contact dermatitis from chlorhexidine that were seen at St John's Institute of Dermatology from January 1983 to June 2002. The case records of all patients with positive patch-test reactions to chlorhexidine during the study period were retrieved. The clinical presentation, strength, and relevance of the positive patch-test results as well as possible sources of exposure were studied. There were five cases of allergic contact dermatitis from chlorhexidine during the study period; three of these patients had positive patch-test reactions to chlorhexidine that were of current relevance. The possible sources of exposure included Hibisol, Hibiscrub, a chlorhexidine spray, and peri- and postoperative antiseptic solutions. We concluded that allergic contact dermatitis from chlorhexidine is rare. However, when it occurs, it may cause a severe dermatitis reaction.
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Dermatitis accounts for about 30 percent of all illnesses in the workplace. A thorough exposure history is the most important element in accurate diagnosis of skin lesions. In certain cases, skin lesions may be valuable diagnostic clues to the presence of systemic toxicity. Irritant and allergic contact dermatitis, photosensitivity contact dermatitis, and contact urticaria are examples of skin lesions that may be caused by exposure to an environmental agent.
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BACKGROUND AND DESIGN: Topical antibiotics are one of the most common causes of allergic contact dermatitis and are frequently used in postoperative wound care. We prospectively followed up patients having cutaneous surgery to determine the frequency of allergic contact dermatitis to topical antibiotics used on postoperative wound care. RESULTS: Nine (4.2%) of 215 patients who had undergone surgery who were using a topical antibiotic had an eruption develop postoperatively that was consistent with an allergic contact dermatitis from the topical antibiotic. Seven of the nine patients agreed to patch testing with the standard tray and selected topical antibiotics. Five patients had a positive patch test to neomycin sulfate and four had a positive patch test to bacitracin. The frequency of allergic contact dermatitis proved by patch testing to neomycin and bacitracin is five (5.3%) of 94 and four (2%) of 198, respectively, in the patients who used these antibiotics. All proved sensitivities to bacitracin occurred in patients using a topical antibiotic that also contained neomycin and were patch tested positive to the neomycin. No patients using only pure bacitracin had allergic contact dermatitis. CONCLUSIONS: Allergic contact dermatitis to a topical antibiotic, especially neomycin, should be considered in any patient who has development of a dermatitis after cutaneous surgery. Because of the frequency of allergic contact dermatitis, neomycin-containing antibiotics should be avoided in postoperative wound care.
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