1/599. Irritant contact dermatitis due to 1-bromo-3-chloro-5,5-dimethylhydantoin in a hydrotherapy pool. Risk assessments: the need for continuous evidence-based assessments. A physiotherapist working in hydrotherapy presented to occupational health with irritant contact dermatitis. Subsequent investigation revealed that the likely causative agent was 1-bromo 3-chloro 5,5 dimethylhydantoin which was used to disinfect the hydrotherapy pool. A COSHH risk assessment had been performed which failed to take full account of current knowledge and this agent had been introduced into the workplace. The development of adverse health effects among staff and other pool users lead to a review of this risk assessment and eventually a return to less hazardous chlorine-based disinfection. Had an evidence-based approach been combined with an appropriate COSHH assessment prior to and following changes in the workplace then unnecessary risk to employees would not have occurred. ( info) |
2/599. Allergic contact dermatitis from propellants in deodorant sprays in combination with allergy to ethyl chloride. Allergic contact eczema from the use of deodorant sprays is sometimes caused by sensitization to the propellants. Positive reactions were seen in three patients when patch testing to Freon 11 (trichloromonofluoromethane). One patient also reacted to Freon 12 (dichlorofluoromethane). Another patient had an eczematous eruption after ethyl chloride was sprayed on the skin prior to taking biopsy. The two other patients showed strongly positive patch tests with this compound. Further investigations of the sensitizing capacity propellants with chemical resemblance have to be carried out to solve the problem of cross-sensitization. ( info) |
3/599. Squaric-acid-diethylester - a strong sensitizer. A patient developed a circumscribed contact dermatitis after a single contact with squaric-acid-diethylester (SADE). patch tests with low concentrations of SADE were positive. Based on these observations, experimental studies on the sensitizing capacity of SADE were performed on guinea-pigs. The results disclosed that this compound is a strong sensitizer. Derivatives of SADE, such as the nearly insoluble squaric acid, squaric acid-1,2-diamide and dithio-N,N'-dicyclohexyle-1,2-diamide were not able to produce allergic skin reactions in the sensitized patient nor in guinea pigs. The chemistry and the range of uses of squaric acid and its derivatives are briefly mentioned. A hypothesis on the molecular mechanism of conjugation of SADE to human proteins and thereby on sensitization is discussed. A warning is given for taking precautionary measures before handling this substance. ( info) |
4/599. Allergic contact dermatitis to a salicyclic acid plaster. We report two patients who developed allergic eczematous contact dermatitis to a salacid plaster used to treat plantar warts. Both patients were subsequently shown to be allergic to dehydroabietic acid, a resin contained in the plaster. ( info) |
5/599. Allergic contact blepharoconjunctivitis due to phenylephrine eye drops. We present two cases of sensitization to phenylephrine hydrochloride with clinical manifestation of blepharoconjunctivitis in the course of an ophthalmologic examination. Patch testing with available commercial preparations containing phenylephrine hydrochloride was positive in both patients. The other eye drops tested during the ophthalmologic examination were negative for both cases. ( info) |
6/599. Lymphomatoid contact dermatitis: a syndrome produced by epicutaneous hypersensitivity with clinical features and a histopathologic picture similar to that of mycosis fungoides. Four cases have been studied which were clinically suggestive of mycosis fungoides because of their infiltrated plaque-like lesions, but in which the suspicion of a topical hypersensitivity arose when a positive patch test was obtained with the striker part of a box of matches. ( info) |
7/599. The effect of perfume "ageing" on the allergenicity of individual perfume ingredients. An ingredient of a perfume which is a sensitizer may become hypoallergenic by interacting with other ingredients during the ageing process of the perfume. Thus, a patient with an exquisite allergic sensitivity to cinnamic aldehyde tolerates two perfumes containing cinnamic aldehyde without acquiring a dermatitis. There are several theories of why cinnamic aldehyde can become a non-sensitizer in a perfume mixture. Testing with a mature perfume may be much more significant than testing with individual ingredients. ( info) |
8/599. Quinazoline Yellow SS in cosmetics. Five cases of allergic contact dermatitis from Quinazoline Yellow SS (D and C Yellow 11) in cosmetics are described, three from a lipstick and two from a rouge stick. Four of them showed marked oedema spreading to the eyelids and down to the neck. Two of them required systemic steroids. All four had strongly positive patch tests to the dye and to the cosmetic used. ( info) |
9/599. T cell involvement in persulfate triggered occupational contact dermatitis and asthma. BACKGROUND: Ammonium and potassium persulfates may induce a variety of cutaneous and respiratory diseases. The precise underlying mechanisms, however, are unclear. OBJECTIVE: To describe a hairdresser, who developed contact dermatitis, rhinoconjuntivitis, and bronchial asthma of delayed onset after occupational exposure to hair bleaches containing persulfate salts and to provide evidence for a common T-cell mediated mechanism responsible for the clinical manifestations. methods: We performed skin testing, routine histologic and immunohistochemical examination of the skin reaction after prick testing, lymphocyte proliferation analysis, nasal challenge test, and pulmonary function testing. RESULTS: The causative role of bleaching powder and ammonium persulfate was demonstrated by case history, skin tests, and a nasal challenge test. patch tests produced a delayed cutaneous reaction to ammonium persulfate confirming contact sensitization. Prick tests with bleaching powder and ammonium persulfate were negative at 15 minutes but revealed a late skin reaction with a papule at the prick sites after 24 hours. Histologic examination of this late reaction demonstrated a perivascular infiltration comprising predominantly T lymphocytes. Further, a significant proliferation of T cells to bleaching powder was reproducibly found by a lymphocyte proliferation analysis. Nasal challenge test with bleaching powder showed a significant reduction of air flow after 24 hours. CONCLUSION: Our findings suggest that immunologic mechanism with direct involvement of T cells may not only play an important role in the pathogenesis of the cutaneous but also in the respiratory and rhinoconjunctival reactions. ( info) |
10/599. Occupational contact dermatitis due to 2-chloracetophenone tear gas. 2-Chloracetophenone (CN) is widely used as tear gas by police and civilians for self-defence. It may affect the eyes, respiratory system and skin, sometimes causing serious injuries. Both irritative and allergic contact dermatitis have been described. We report three police officers who experienced accidental escape of CN from their professional tear gas canisters. All of them showed localized dermatitis at the site of contact to CN, while widespread lesions appeared after 4 days in one case. patch tests with the original involved tear gas dissolved in acetone (at 0.1-0.0001%) indicated an allergic reaction in two patients and an irritative reaction in the third. Occupational contact dermatitis due to CN seems to occur among police officers more often than is generally known. Infrequently, extensive health problems may be caused by CN when lesions spread over the integument. Therefore, an improvement of safety measures in occupational CN gas use is needed, especially aiming at avoidance of accidental leakage of canisters. ( info) |