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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 29 (1993), S. 0 
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 2 barrier creams (BC) were evaluated against the anionic detergent sodium lauryl sulphate (SLS) using a new human test model. In the repetitive irritation test (RIT) on human skin, the irritant SLS is applied to the ventral forearm of Healthy volunteers daily for 2 weeks. 1%, 5%, and 10% SLS is exposed to the skin for 30 min. using a glass cup 2.5 cm in diameter. The BC is applied 30 min before the irritant. Cutaneous irritation is assessed on a score for erythema (0 to 5+), and quantified by various biophysical techniques: transepidermal water loss (TEWL) by evaporimetry, skin blood flow volume (BFV) by laser-Doppler velocimetry, and -skill colour bi colorimetry (La* value). 10 subjects were tested with SLS on one forearm without pretreatment (control) and with Taktosan Salbe as BC on the other forearm. A 2nd panel of 10 subjects was tested in the same way with SLS and Marly skin as BC. Taktosan Salbe was extremely effective in reducing the irritation by SLS: there were significant differences regarding all lest parameters for 10% SLS in the 2nd week. The most differentiating parameter was TEWL, revealing statistical differences as early as the 1st week for 10%. SLS and Taktosan Salbe, while the least differentiating sensitivity was found for La*. In contrast, there was no significant suppression of irritancy in any parameter with Marly skin, either in the 1st week or in the 2nd week with any concentration of SLS. The results show the differentiating potential of the model developed. Results obtained with the previously described animal model are confirmed- Noninvasive biophysical techniques, particularly TEWL measurements, might be extremely valuable in identifying new active ingredients of BC.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The objective of this study was to determine the frequency of reactivity to a series of commonly fragrances in dermatological patients. A total of 48 fragrances (FF) were chosen, based on the publication of Fenn in 1989 in which the lop 25 constituents of 3 types (1. perfumes, 2. household products, 3. soaps) of 400 commercial products on the US market had been determined. In a pilot study on a total of 1069 patients in 11 centres, the appropriate test concentration and vehicle were examined. For most fragrances, 1% and 5% were chosen, and petrolatum proved to be the best vehicle in comparison to isopropyl myristate and diethyl phthalate. In the main study, a set of 5 to 10 fragrances at 2 concentrations was patch tested in each centre on a minimum of 100 consecutive patients seen in the patch test clinic. These patients were also patch tested to a standard series with the 8% fragrance mix (FM) and its 8 constituents. In patients with a positive reaction to any of the 48 FF, a careful history with regard to past or present reactions to perfumed products was taken. A total of 1323 patients were tested in 11 centres. The 8% FM was positive in 89 patients (8.3% of 1072 patients). Allergic reactions to the constituents were most frequent to oak moss (24), isoeugenol (20), eugenol (13), cinnamic aldehyde (10) and geraniol (8). Reactions read as allergic on day 3/4 were observed only 10 × to 7 materials of the new series (Iso L: Super® (2), Lyral® (3), Cyclacet® (1), DMBCA (1), Vertofix® (1), citronellol (1) and amyl salicylate (1)). The remaining 41 fragrances were negative. 28 irritant or doubtful reactions on day 3/4 were observed to a total of 19 FF materials (more than 1 reaction: 5% citronellol (2), 1%amyl salicylate (2), 1%isononyl acetate (3), 0.1% musk xylol (2). 1%citral (2), and 1% ionone beta (2)). Clinical relevance of positive reactions to any of the FF series was not proved in a single case. This included the 4 reactions in patients who were negative to the 8% FM. In conclusion, the top 25 fragrances commonly found in various products caused few reactions in dermatological patients and these few appeared to be clinically irrelevant, with the possible exeption of Lyral®. However, this data should be interpreted in the light of the relatively small number of patients tested (only 100 in most centres).
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 32 (1995), S. 0 
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In a multicentre study, the value of adding sorbitan sesquioleate (SSO) to the constituents of the 8% fragrance mix (FM) was investigated. In 7 centres, 709 consecutive patients were tested with 2 types of FM from different sources, its 8 constituents with 1% SSO, its 8 constituents without SSO, and 20% SSO. 5 patients (0.71%) reacted to the emulsifier SSO itself, read as definitely allergic on day 3/4. 53 patients reacted to either one of the mixes with an allergic type of reaction. When tested with the constituents without SSO, 41.5% showed an allergic reaction versus 54.7% with SSO. If both types of reactions were considered (allergic and irritant) 38.3% of 73 patients showed a positive “breakdown” result without SSO, versus 54.8% with SSO. The differences were statistically significant. Reactivity to FM constituents was changed in a specific pattern by addition of SSO-irritant reactions increased, particularly for cinnamic alcohol, eugenol, geraniol, oak moss and hydroxycitronellal, whereas others showed only a slight change. Allergic reactions were also increased by SSO, but the rank order of the top 3 sensitizers (isoeugenol, oak moss and eugenol) did not change. Cinnamic alcohol was the only constituent with decreased reactivity after addition of SSO. A positive history of fragrance sensitivity (HFS) was clearly associated with a positive allergic reaction to either the mix or 1 of its constituents (51% versus 28.6% with a negative HFS). Irritant reactions were linked to a negative HFS in a high proportion (64.3%). In 17 patients, a repeated open application test (ROAT) was performed with a total of 43 patch-test-positive materials. The ROAT was positive in 20/31 (64.5%) tests in 11 patients with a positive HFS, but negative in all 6 patients with a negative HFS (0/12 tests). In conclusion, addition of SSO to the constituents of FM increases both irritant and allergic reactions, though the difference from the results obtained without SSO is not as high as previously reported. The ROAT is a valuable tool in validating such patch test results.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Der Hautarzt 45 (1994), S. 834-844 
    ISSN: 1432-1173
    Keywords: Schlüsselwörter: Berufsdermatosen – Kontaktallergie – Medizinische Berufe – Gummi – Latex-Kontakturtikaria – Prävention ; Key words: Occupational dermatitis – Contact allergy – Medical and paramedical professions – Rubber – Latex contact urticaria – Prevention
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. Based on reports in the literature, data from the information network of German dermatology centres (Informationsverbund Dermatologischer Kliniken) and the authors own findings, a review is presented on prevalence, clinical picture and causative agents of contact allergic dermatoses, in health care professions. In 1991 the proportion of suspected occupational diseases in the health care professions (including hairdressers) represented by cases of dermatitis, as reported to the responsible insurance institution, reached 72% of the total for the year (7287 out of 10 127). Every 20th to 40th case was recognized as an occupational dermatosis according to German law. Accurate figures on incidence are scarce; for dentists an incidence of 0.11‰ has been calculated. The risk of developing occupational hand eczema has been shown to be at least three times higher for nurses than for other so-called dry professions. For persons engaged in the personal care of the ill and the elderly, relevant occupational allergens were found to be benzalkonium chloride and aldehydes in disinfectants, as well as rubber accelerators such as thiuram mix. Latex contact urticaria has increasing significance for medical personnel, with prevalence rates of sensitization between 4.5% and 10.7%. Among physicians, contact allergies to thiuram mix were found to be dominant (12.9%). For surgeons and orthopaedic surgeons, methyl metacrylate as a constituent of bone cement is of great importance. Various esters of acrylic acid and methacrylic acid are important sensitizers in the dental professions, particularly in heavily exposed dental laboratory technicians. Only a few gloves protect against these types of sensitizers. Sensitizations by medicaments can be avoided in most cases by reducing direct skin contact, as practiced with penicillin or ispaghula powder. Strategies of prevention include information of atopics regarding the increase in occupational dermatitis, the regular use of barrier creams, intensive skin care after work and avoidance of irritants and allergens wherever possible.
    Notes: Zusammenfassung. Aufgrund von Literaturmitteilungen, Daten des Informationsverbundes der Dermatologischen Kliniken (IVDK) und eigenen Untersuchungsergebnissen wird eine Übersicht über Häufigkeit, Klinik und auslösende Ursachen von kontaktallergischen Dermatitiden in medizinischen Berufen gegeben. 1991 erreichte bei der zuständigen Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW) der Anteil über die "Ärztliche Anzeige" gemeldeter Hauterkrankungen in medizinischen Berufen (inkl. Friseure) 72% (7287 von insgesamt 10 127 Verdachtsmeldungen an die BGW) bei Krankenschwestern besteht ein 3fach erhöhtes Risiko für die Entwicklung eines Handekzems. Für den Pflegebereich konnten als relevante berufliche Allergene neben Aldehyden und Benzalkoniumchlorid in Desinfektionsmitteln, die Gummiakzeleratoren des Thiuram-Mix eruiert werden. Große Bedeutung für medizinisches Personal hat die Latex-Kontakturtikaria mit Sensibilisierungsraten zwischen 4,5% und 10,7%. In ärztlichen Bereichen dominiert dagegen die Kontaktallergie auf Thiuram-Mix mit 12,9%. Für Chirurgen und Orthopäden hat Methylmethacrylat als Bestandteil des Knochenzements eine große allergologische Bedeutung. Verschiedene (Meth-)-Acrylsäureester sind auch im zahnärztlichen Bereich wichtige Sensibilisatoren, vor allem bei den stark exponierten Zahntechnikern. Präventiv sollten Atopiker bei ihrer Berufswahl auf das erhöhte Risiko für berufliche Ekzeme bei hautbelastenden Tätigkeiten hingewiesen werden.
    Type of Medium: Electronic Resource
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