11/599. Contact urticaria to the MCU-2A/P gas mask. A case of contact urticaria to the silicone rubber in the MCU-2A/P gas mask is presented. Contact urticaria is a type I hypersensitivity reaction mediated by immunoglobulin e that usually manifests as localized erythema, edema, pruritus, and urticarial plaques. It can also cause systemic reactions, including anaphylaxis. Allergic reactions to silicone rubber have been increasingly reported and are of importance in medical and military personnel. The implication of such a diagnosis in an active duty military member is significant because the individual cannot be worldwide-qualified. The correct diagnosis of allergic skin reactions to personal protective gear is critical to maintaining a strong fighting force and protecting military personnel from potentially life-threatening allergic reactions. ( info) |
12/599. dermatitis causada por Hylesia metabus (lepidoptera: Hemileucidae) en la region costera del Estado del Delta del Amacuro, venezuela [dermatitis caused by Hylesia metabus (lepidoptera: Hemileucidae) in the costal region of the state of Delta Amacuro, venezuela] 2 cases of acute dermatitis caused by butterfly Hylesia metabus in an area that so far has not been considered as endemic for this species were presented. The dermatitis observed in these individuals may be described as very circumscribed, pruriginous, erythematous generalized protruding papules that may be compared with urticaria, and with a variable degree oedema. Monomorphic eruption consisting in small hard papules crowned by a little vesicle was also present. The lesions of these 2 patients evolved with intensely pruriginous papules for a week and after that they healed without dermatological sequelae. ( info) |
| We report 2 cases of elicitation of allergic contact dermatitis to acrylates from disposable blue diathermy pads used on patients who underwent routine surgery. Their reactions were severe, and took approximately 5 weeks to resolve. Both patients gave a prior history of finger tip dermatitis following the use of artificial sculptured acrylic nails, which is a common, but poorly reported, cause of acrylate allergy. Patch testing subsequently confirmed allergies to multiple acrylates present in both the conducting gel of disposable blue diathermy pads, and artificial sculptured acrylic nails. We advocate careful history taking prior to surgery to avoid unnecessary exposure to acrylates in patients already sensitized. ( info) |
14/599. Protein-contact eczematous reaction to cornstarch in clothing. Protein contact dermatitis is an eczematous reaction to antigens often associated with immediate hypersensitivity. A patient with a history of atopic eczema and multiple immediate sensitivities was seen for a persistent dermatitis of the face, hands, and clothing areas of the trunk and arms. Investigation showed a positive prick test to cornstarch, and avoidance of glove powder and starch in her clothing cleared what had been a recalcitrant problem. ( info) |
15/599. Occupational asthma and contact dermatitis in a spray painter after introduction of an aziridine cross-linker. A 23-year-old spray painter developed contact dermatitis and respiratory difficulty characterized by small airways obstruction shortly after the polyfunctional aziridine cross-linker CX-100 began to be used in his workplace as a paint activator. The symptoms resolved after he was removed from the workplace and was treated with inhaled and topical steroids. Painters may have an increased risk of asthma due to exposure to a variety of agents, such as isocyanates, alkyd resins, and chromates. This case illustrates the importance of using appropriate work practices and personal protective equipment to minimize exposure. Occupational asthma is diagnosed by a history of work-related symptoms and exposure to known causative agents. The diagnosis is confirmed by serial pulmonary function testing or inhalational challenge testing. The risk of asthma attributable to occupational exposures is probably underappreciated due to underreporting and to inappropriate use of narrow definitions of exposure in epidemiologic studies of attributable risk. ( info) |
16/599. A baboon syndrome induced by intravenous human immunoglobulins: report of a case and immunological analysis. Following the second series of intravenous human immunoglobulins (IVIg; 0.4 g/kg) prescribed to treat a sensorimotor polyneuritis, a 28-year-old woman developed pompholyx that recurred after each of the following monthly treatments with IVIg. During the administration of the 10th series, the patient developed a typical baboon syndrome. Immunohistochemical studies of a skin biopsy revealed an unexpected epidermal expression of p-selectin, usually expressed by endothelial cells. Patch, prick and intradermal tests performed with IVIg on the back, arms and buttocks gave negative results on immediate and delayed readings. IVIg were re-administered, with the informed consent of the patient, and induced a generalized maculopapular rash. This is the first reported case of baboon syndrome induced by IVIg. Although extensive skin testing was performed, all test sites remained negative. We wonder whether IVIg could reproduce immunological mechanisms involved in the 3 types of systemic contact dermatitis (pompholyx, baboon syndrome and maculopapular rash), including the epidermal expression of p-selectin. ( info) |
17/599. face dermatitis from contaminants on a mask for anaesthesia. Allergic and irritant contact reactions to face masks for anaesthesia have rarely been reported. We present a 55-year-old female patient who developed facial allergic contact dermatitis after an operation requiring general anaesthesia. patch tests showed positive reactions to cocospropylenediamin-guanidinium-diacetate (trivial name Dodigen 3558), a preservative used in disinfectants for medical instruments. It could be proven that residues of the causative allergen in the disinfectant adhered to the mask. This is the first report of a clinically relevant sensitization to this increasingly widely used agent. ( info) |
18/599. Allergic response to stainless steel wire. A review of the literature indicates that an allergic response to stainless steel is rare, although nickel is a common allergen and is encountered continually in daily life. An allergic reaction could occur at a most inopportune time. Rational approaches in management of an allergic response to stainless steel appear to be either: (1) wire removal and symptomatic therapy, (2) application of fixation with other substances, or (3) administration of steroids with necessary stainless steel immobilization left in place. The report suggests the need for research to determine the chromium content or chromium-nickel ratio that would eliminate allergic manifestations to the nickel component in wrought or cast base metal dental appliances. ( info) |
19/599. Systemic contact dermatitis caused by oral chromium picolinate. Although nickel is the metal most commonly implicated in systemic contact dermatitis, other metals such as chromate have also been known to cause dermatitis when ingested. chromium picolinate has been espoused as a nutritional supplement. Allegedly, it helps control blood sugar in diabetes and may reduce cholesterol and blood pressure levels. ( info) |
20/599. Too hot to handle: an unusual exposure of HDI in specialty painters. BACKGROUND: Hexamethylene Diisocyanate (HDI) is a color stable aliphatic isocyanate that is used in specialty paints as a hardener. Due to the lower vapor pressure of its commercial biuret form, it is considered a relatively "safe" isocyanate from an exposure standpoint. This case series reports on an unusual toxic exposure to HDI. Between November 1993 and May 1994, seven specialty painters and one boiler maker who were working at three different power plants were examined at the Institute of Occupational and environmental health at west virginia University. At their respective work sites, HDI was applied to the hot surfaces of boilers that were not shut down, and allowed sufficient time to cool. Consequently, these workers were exposed to volatile HDI and its thermal decomposition products. methods: All of these workers underwent a complete physical examination, spirometry, and methacholine challenge testing. RESULTS: All 8 workers complained of dyspnea, while 4 of the 8 also complained of rash. On examination 3 workers were methacholine challenge positive and 2 had persistent rash. At follow-up 4 years later, 5 workers still had to use inhalation medication and one had progressive asthma and dermatitis. All 8 workers, by the time of the follow-up, had gone through economic and occupational changes. CONCLUSIONS: This case series reports on an unusual exposure to HDI. It is unusual in that: 1) There were two simultaneous sentinel cases with two different material safety data sheets (MSDS) for the same product, 2) Exposure was to volatile HDI and its decomposition products and 3) Hazardous conditions of exposure occurred at three different sites. ( info) |