Low incidence of occupational dermatitis from chromate.
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10 of 20 workers in an envelope-making factory developed contact dermatitis. The cause was dibutyl maleinate, which was added to a polyvinylacetate glue. Dibutyl maleinate is a strong sensitizer and should be withdrawn from industrial use.
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4 workers developed hand dermatitis in an automated starch modification process plant. 2,3-epoxypropyl trimethyl ammonium chloride (EPTMAC), a quaternary ammonium compound used as a cationizing chemical, produced allergic reactions in all 4 patients. They had only been in contact with EPTMAC for a short time before developing dermatitis, which indicates that EPTMAC is a strong sensitizer. Immunohistochemistry and electron microscopy showed the features of an allergic patch test. An industrial hygiene project was initiated at the factory to prevent new cases. It revealed many risks of skin contact with the process chemicals. Thus an automated process does not guarantee protection.
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A dental assistant developed sensitivity to dental restorative materials within 3 months of starting to use them. They contained the epoxy acrylate BIS-GMA, which is the most commonly used dimethacrylate monomer in dental composite restorations. She was positive to a patch test with BIS-GMA, which was the probable allergen, and epoxy resin, but this substance was not present in the materials used, as shown by high performance liquid chromatography. The patient was also allergic to the disinfectant Desimex i containing dodecyl diaminoethyl glycine.
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A 42-year-old woman had recurrent dermatitis on the hands, arms, face and trunk for 5 years. She was allergic to chrysanthemum, with positive patch tests. She also had contact urticaria to chrysanthemum, with a wheal-and-flare reaction 15 min after application of chrysanthemum juice to a scratch test site. This was not seen in control subjects. The co-existence of allergic contact dermatitis and contact urticaria from chrysanthemum might play a rôle in the development of dermatitis, especially severe chronic dermatitis of her hands.
6 patients are described who developed contact dermatitis after cereal contact on atopic skin for periods of 2 to 20 years. 2 patients were wheat flour patch-test-positive. They had punch biopsies taken for standard histological and immunohistochemical investigation by labeling with monoclonal antibodies, anti-DR and anti-IgE. Sections showed features of contact dermatitis. There were many dendritic cells located perivascularly in the papilla and in the epidermidis, intensely positive for monoclonal anti-IgE antibody. In control atopic subjects, there were a few perivascular IgE positive cells, probably mastocytes. This study shows that there may be a relationship between some allergens and atopic eczema in patients exposed to them in the course of their work. In some cases, there was a true allergic contact dermatitis, seen through the clinical and histological characteristics, and the results of immunohistochemical study.
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