1/14. Occupational IgE-mediated allergy to tribolium confusum (confused flour beetle).BACKGROUND: We report on IgE-mediated allergy in a worker caused by tribolium confusum (confused flour beetle). These beetles lived in the "old" flour to which he was exposed in his work. CASE REPORT: A 35-year-old, nonatopic mechanic in a rye crispbread factory developed rhinitis, conjunctivitis, and asthmatic symptoms, as well as urticaria on his wrists, lower arms, hands, neck, and face, during the maintenance and repair of machines contaminated by flour. This flour had been in and on the machines for a long time, and it contained small beetles. The patient did not suffer any symptoms when handling fresh, clean flour. RESULTS: skin prick tests with standard environmental allergens, storage mites, enzymes, flours, and molds were negative. A prick test with flour from the machines gave a 10-mm reaction. An open application of the same flour caused urticarial whealing on the exposed skin. Prick tests with fresh flour from the factory were negative. A prick test with minced T. confusum from the flour in the machines gave a 7-mm reaction. histamine hydrochloride 10 mg/ml gave a 7-mm reaction. Specific serum IgE antibodies to T. confusum were elevated at 17.2 kU/l. Prick tests with the flour from the machines were negative in five control patients. CONCLUSIONS: The patient had occupational contact urticaria, rhinitis, conjunctivitis, and asthmatic symptoms from exposure to flour. His symptoms were caused by immediate allergy to the beetle T. confusum. Immediate allergy to this beetle has rarely been reported in connection with respiratory symptoms, but it may be more common. Contact urticaria from this source has not been reported before.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/14. Occupational allergic contact dermatitis in a company manufacturing boards coated with isocyanate lacquer.Over a short period of time, there was an outbreak of work-related skin lesions among workers at a company producing flooring laminate boards, after the introduction of a water-repellent lacquer based on diphenylmethane-4,4'-diisocyanate (MDI). In 5 workers, patch testing was performed with a standard series, an isocyanate series and work-environmental products when indicated. 3 of the workers were tested with the lacquer, and contact allergy was found with concurrent reactions to 4,4'-diaminodiphenylmethane (MDA). 1 of the 3 workers also showed a simultaneous reaction to MDI, whereas 1 showed a positive reaction to dicyclohexylmethane-4,4'-diisocyanate (HMDI). Of the 2 individuals not tested with the lacquer, 1 reacted to both MDI and MDA, whereas the other reacted to a soap used at work. In 3 of 4 cases, the isocyanate reactions appeared after D3. Occupational contact with isocyanates should not exclusively be focused upon respiratory hazards, as this report shows that skin contamination probably increases the risk of developing contact allergy to isocyanates and isocyanate-related substances. When aiming at diagnosing contact allergy to isocyanates, it is desirable to perform a late reading, as positive reactions appear late. MDA appears to be a good marker for isocyanate hypersensitivity.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
3/14. Cyanoacrylate dermatitis.An outbreak of irritant dermatitis from a cyanoacrylate glue among a group of electronic assembly workers is described. It was caused by vaporization of monomer under conditions of low relative humidity. No further outbreak occurred when the humidity of the working environment was raised above 55%.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/14. Airborne irritant contact dermatitis due to synthetic fibres from an air-conditioning filter.We describe 8 cases of occupational airborne irritant contact dermatitis in intensive care unit (ICU) employees caused by synthetic (polypropylene and polyethylene) fibres from an air-conditioning filter. Not until a workplace investigation was conducted, was it possible to clarify the unusual sequence of events. High filter pressure in the intensive care air-conditioning system, maintained to establish an outward airflow and prevent microorganisms from entering the ward, probably caused fibres from the filter to become airborne. Upon contact with air-exposed skin, fibres subsequently provoked skin irritation. Test periods in the ICU with varying filter pressures, in an attempt to improve environmental conditions, led to even higher filter pressure levels and more complaints. The sometimes-very-low humidity might have contributed to development of skin irritation. The fact that most patients recovered quickly after treatment with emollients and changing the filters made it most likely that the airborne dermatitis was of an irritant nature.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/14. philodendron-induced dermatitis: report of cases and review of the literature.plants of the genus philodendron, and the family araceae, were reported as causing dermatitis as early as 1923. The allergenic compounds in philodendrons are resorcinols, which share common chemical side chains with the allergenic catechols of toxicodendron members of the family anacardiaceae. I report here two cases of allergic contact dermatitis to philodendron species commonly found in the Hawaiian islands. philodendron dermatitis, however, is not confined to tropical or subtropical areas. Exposure may occur in nursery workers in temperate climates and in the home environment worldwide.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/14. Dithiocarbamate therapy for nickel dermatitis.Increased internal exposure to nickel can cause an exacerbation of nickel contact dermatitis. nickel ions are chelated by diethyldithiocarbamate (DDC) and thereby inactivated. An oral dose of about 1 g DDC/day was given to a patient. The nickel excretion in the urine increased about tenfold; the nickel elimination in scalp hair did not increase. The slightly negative nickel balance did not exhaust the nickel content of the organs appreciably with a dose of 1.2 g DDC/day for 2 months. At the end of this experiment patch tests with nickel sulphate were still positive though less local therapy was needed, and the cross correlation between the activity of the eczema and the nickel concentration in the urine had lost its former periodicity. It is therefore not yet possible to conclude whether or not DDC may be really of help in the very nickel hypersensitive patient by reducing the exposure to nickel originating in food and other environmental sources.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/14. Contact dermatitis to anaerobic sealants.High-performance polymerizable anaerobic sealants originated in 1953 and are used to lock metal parts together chemically. A case of hand contact dermatitis from Loctite RC/601, 242, and 504 is reported in a 60-year-old machine assembler. This diagnosis was documented by positive patch tests of the product and of three of the components: polyethylene glycol dimethacrylate, hydroxypropyl, and hydroxyethyl methacrylate. This is the third report of contact dermatitis caused by these sealants in the united states, is the second in the world on hydroxypropyl methacrylate, and is another example of the wide environmental use of potentially sensitizing acrylic resins.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
8/14. Pulling boat hands: a unique dermatosis from coastal new england.We report a previously unrecognized hand dermatosis, pulling boat hands (PBH), occurring in thirteen participants at the Outward Bound School on Hurricane Island, maine. Painful and pruritic macules, plaques, and vesicles developed exclusively while subjects lived aboard a pulling boat, the school's open rowing/sailing craft. Nine of those affected were women and eight had Raynaud's phenomenon or vasospasm. These subjects experienced thirty episodes of PBH during May through October, 1978 to 1982. Histopathology revealed a superficial and deep lymphohistiocytic perivascular infiltrate, subepidermal blister formation, red blood cell extravasation, and dermal capillary thrombosis compatible with cold injury to the skin. All patients experienced prolonged percussion to their hands while rowing as well as a continuous environmental exposure to cold air, wind, humidity, ocean spume, and precipitation. These clinical, histopathologic, and environmental findings suggest a unique syndrome that combines the vascular effects of mechanical trauma from rowing with those of nonfreezing cold injury.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
9/14. Airborne contact dermatitis caused by tulip bulbs.A case of airborne contact dermatitis in a seedsman due to tulip bulbs is reported. The eczema finally involved the whole integument. It was caused by small particles from the outer layers of the bulbs, which arise when the bulbs are rubbed together. These particles, which contain the sensitizer tuliposide-A, contaminated the whole environment of the seed shop and the car and clothes of the patient. Epicutaneous tests were strongly positive with tuliposide-A as well as with an extract of the dust taken from the patient's office.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
10/14. Allergic contact dermatitis in two machinists.Two machinists were seen whose chronic hand dermatitis was explained by allergic sensitivity to a biocide, Tris Nitro (2-[hydroxymethyl]-2-nitro-1,3-propanediol), which was added to their metalworking fluids (cutting oils) to prevent rancidity. The cause of the men's difficulty was first suspected when they had positive patch test reactions to a related biocide, Bronopol (2-bromo-2-nitropropane-1,3-diol), which we added to our standard screening tray because of its presence in more than 500 cosmetic formulations. The detective skills of the patients uncovered the chemical, Tris Nitro, related to Bronopol in their work environment. Most cases of dermatitis seen in machinists are irritant in origin. As we achieve better cooperation from the metalworking fluid industry, perhaps an increasing number of allergens will be identified. When this occurs, a cooperative manufacturer can be invaluable in directing a machinist to a replacement--a well-preserved cutting fluid free of the allergen.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
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