Optician's occupational allergic contact dermatitis, paresthesia and paronychia caused by anaerobic acrylic sealants.
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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.
BACKGROUND: Unsaturated polyester (UP) resins are widely used as cements in car repair painting to produce a smooth surface before the final painting. We report two car painters with hand and face dermatitis who were sensitized to a UP resin used for car repair cements. METHODS: Patch testing with commercial substances and ingredients and extracts from UP resins was used to verify the sensitivity. RESULTS: Both patients showed an allergic patch test reaction to a UP resin. They also had an allergic patch test reaction to diethyleneglycol maleate (DEGM), an extract of a UP resin. CONCLUSIONS: Both patients had been patch tested elsewhere with negative results because UP resins had not been used for patch testing. Accordingly, patients with dermatitis who have been exposed to UP resins need to be patch tested with UP resins. The specific chemical causing allergic contact dermatitis in our patients was DEGM.
Protein contact dermatitis (PCD) is a chronic recurrent dermatitis caused by contact with a proteinaceous material. PCD may also present as paronychia. Here a case of PCD and paronychia from natural rubber latex (NRL) is presented. The correct diagnosis would not have been established if prick testing with NRL had not been performed. This case shows that contact allergy presenting as dermatitis may occur despite negative patch test results. PCD from NRL may be relatively common, although very few cases have been published. This is probably due to the fact that the term contact urticaria is so closely connected to NRL that automatically all cases of type I allergy to NRL are considered contact urticaria, although the clinical picture is a dermatitis, i.e. PCD.