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  • 1
    Electronic Resource
    Electronic Resource
    Occupational allergic contact dermatitis and Type I sensitization caused by Gerbera in a greenhouse worker (2002)
    Oxford, UK : Blackwell Science, Ltd
    Contact dermatitis 46 (2002), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1600-0536.2002.460215.x
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  • 2
    Electronic Resource
    Electronic Resource
    Contact allergy to calcipotriol does exist (1999)
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 40 (1999), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A 64-year-old woman developed an itchy papulovesicular dermatitis at the periphery of psoriatic plaques on the lower legs after the daily application of calcipotriol ointment (Psorcutan® Salbe) for 2 weeks. She had used the same ointment for 4 weeks 6 months before. Patch testing revealed strongly positive reactions to the marketed product and to the active ingredient calcipotriol in a concentration series (2.0, 10.0 and 50.0 μg/ml in isopropyl alcohol). A repeated open application test (ROAT) on the forearms showed a vesicular dermatitis after 4 days on the side that received the calcipotriol ointment, whereas the control with the placebo ointment remained completely negative. Histologic examination of the ++ patch test reaction was in line with the picture of contact allergy. Retesting after 6 months confirmed the hyper sensitivity, with a positive reaction even at 0.4 μg/ml. For comparison, the ROAT with calcipotriol ointment was performed for 2 weeks on both forearms of 15 volunteers never exposed to calcipotriol before. Only 2 subjects developed a slight reaction on days 5 and 11, respectively. Based on this case and on previous reports in the literature, calcipotriol must now be regarded as both a contact allergen and an irritant. For patch testing, a concentration of 2 μg/ml in isopropyl alcohol is the most suitable. If the reaction is only weakly positive and not reproducible after some time, it might be of the irritant type. In unclear cases, a ROAT should be performed. A severe papulovesicular dermatitis within 1 week will confirm the presence of contact allergy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0536.1999.tb05993.x
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  • 3
    Electronic Resource
    Electronic Resource
    Airborne irritant contact dermatitis due to synthetic fibres from an air-conditioning filter (2005)
    Oxford, UK; Malden, USA : Munksgaard International Publishers
    Contact dermatitis 52 (2005), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 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.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0105-1873.2005.00526.x
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  • 4
    Electronic Resource
    Electronic Resource
    FS10.5
Occupational allergic contact dermatitis from isothiazolines (2004)
    Oxford, UK; Malden, USA : Blackwell Publishing Ltd/Inc.
    Contact dermatitis 50 (2004), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Several employees of a construction adhesives-producing plant developed skin problems. Within few weeks, 4 out of 12 workers got itchy eczematous lesions at the face, lower arms and hands. All of them reported on a work-relationship with recoveries during holidays and sick-leaves. This prompted the responsible occupational physician to contact our occupational dermatological clinic for further examination. First, we got an overview of the chemicals and pathways used for the production of the highly specialized plastic products. After working place examination, extended medical histories of the employees were taken. All affected workers were patch tested with the European Standard series, epoxy resins, preservatives and own working materials. After an occlusion time of 48 hours, skin tests were read at day 2 and 4 according to the ICDRG guidelines. Examination of the plant revealed that all affected workers were employed at the blending unit where, in particular dusty, ingredients were mixed. Few months prior to the development of skin problems, 2-n-octyl-4-isothiazolin-3-one (OIT) preservative had been introduced in the production pathway in partial exchange for chloro/methylisothiazolin-3-one (CIT/MIT). Personal protection measures were rarely provided.All 4 tested workers were found patch test positive to CIT/MIT, 3/3 positive to OIT and 1/3 positive to 1,2-benzisothiazoloin-3-one (BIT) and methyldibromoglutaronitril. Industrial usage of preservatives can result in frequent sensitisation of exposed employees. Adequate protection and prevention advices are required. This study highlights the need for extended (occupational) medical histories and working place examination to identify individual risk factors and to trace potential hazards at the working place.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0105-1873.2004.0309cp.x
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  • 5
    Electronic Resource
    Electronic Resource
    Improved detection of allergen-specific T-cell responses in allergic contact dermatitis through the addition of ‘cytokine cocktails’ (2005)
    Oxford, UK; Malden, USA : Munksgaard International Publishers
    Experimental dermatology 14 (2005), S. 0 
    Details
    ISSN: 1600-0625
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract:  The gold standard for the diagnosis of allergic hypersensitivity is skin patch testing with the suspected allergens. This diagnostic tool, however, has distinct disadvantages, and therefore the development of alternative or complementary in vitro tests is of great importance. In this study, we evaluate the applicability of an in vitro test method, as developed earlier for nickel allergy, to detect allergen-specific T cells in the blood of patients allergic to frequent sensitizers (chromate, cobalt, paraphenylenediamine, fragrances and chloromethyl-isothiazolinone). Peripheral blood mononuclear cells (PBMCs) of allergic patients and healthy controls were cultured in the absence or presence of allergen. Additionally, type 1 (IL-7 and IL-12) or type 2 (IL-7 and IL-4) stimulating cytokines were added; after 6-day proliferation, IFN-γ and IL-5 secretions were determined. Without the addition of cytokines, consistent allergen-induced proliferation was observed in PBMCs of nickel-allergic patients only. By contrast, the addition of type 1 or type 2 stimulating cytokines resulted in a significantly enhanced allergen-specific proliferation for all allergens tested (sensitivity increased from 26 to 43% or 38%, respectively, P 〈 0.05). In these cultures, allergen-induced IFN-γ and IL-5 secretion was also significantly increased, compared to healthy controls (P 〈 0.05, for IFN-γ sensitivity 79%, specificity 93%; for IL-5 sensitivity 74%, specificity 81%). In conclusion, these results demonstrate an increased proliferative capacity and cytokine production by allergen-specific T cells from allergic patients, but not of healthy individuals upon stimulation with allergens in combination with type 1 or 2 skewing cytokines. The present data warrant further exploration of the application of this test to a broader set of allergens.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0906-6705.2005.00344.x
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  • 6
    Electronic Resource
    Electronic Resource
    Assessment of contact allergen cross-reactivity by retesting (2002)
    Oxford, UK : Munksgaard International Publishers
    Experimental dermatology 11 (2002), S. 0 
    Details
    ISSN: 1600-0625
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: At former allergic contact dermatitis reaction sites retesting causes augmented hyper-reactivity, characterized by an accelerated onset within a few hours. This expression of ‘local skin memory’ has been ascribed to locally persisting allergen-specific effector/memory T cells. To verify this hypothesis, we investigated whether accelerated retest reactivity also occurs with cross-reactive allergens. Guinea pigs were immunized with either or both 2,4-dinitrochlorobenzene (DNCB) and 2-hydroxyethyl methacrylate (HEMA), and primary skin tests to these and cross-reactive methacrylic compounds were performed 12–21 days later. Subsequently, new skin tests were conducted 3 weeks later both at the former test (‘retest’) and contralateral, non-pretreated test (‘control’) sites, and skin test readings started 2 h later. Retest reactivity was evaluated by comparing retest and contralateral control reactions. Both contact sensitizers, HEMA and DNCB, induced strong retest reactivity, peaking at 4–6 h. Fully allergen-specific retest reactivity was observed when primary skin tests had been postponed until 21 days after immunization, most probably reflecting loss of accumulation of irrelevant allergen-primed T cells at that time. As hypothesized, retesting with various methacrylate congeners at primary HEMA, but not DNCB, skin test sites showed early hyperreactivity strengths in line with those observed earlier in conventional cross-reactivity studies. These results, therefore, support the view that local skin memory exhibits allergen specificity through residual allergen-primed T cells. Because the retesting procedure is readily applicable in clinical practice, it provides a tool not only for confirmation of doubtful contact allergic skin reactions, but also for distinguishing between true cross-reactivity and coincident multiple sensitization in man.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1600-0625.2001.110309.x
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  • 7
    Electronic Resource
    Electronic Resource
    FS02.2
CD4+ CCR10+ effector T cells reside at former allergic contact dermatitis sites (2004)
    Oxford, UK; Malden, USA : Blackwell Science Ltd/Inc.
    Contact dermatitis 50 (2004), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Local skin memory (LSM) describes the clinical phenomenon of an accelerated and increased inflammatory allergic contact dermatitis (ACD) response upon renewed allergen exposure. This has been ascribed to the local persistence of few, but allergen-specific, T cells. Here, firstly, we characterized effector T cells, and, subsequently, studied which of these cell populations are present at former challenge sites and might contribute to LSM. Peripheral blood T cells were stimulated with nickel sulphate. Cellular phenotypes and chemokine receptor expression profiles were analysed by FACS-staining: CLA together with CD4/CD8, CD45R0/RA, CXCR3, CCR4, CCR6 and CCR10. Skin biopsies were taken at 0, 3 and 21 days after allergen application and analysed for the same markers. Upon nickel-stimulation, amount of CD4+ CLA+ CD45R0+ T cells was increased. Together with CLA, CXCR3, CCR4 and, mainly, CCR10 expression was augmented. CCR6 expression was negative on CLA+ cells. In biopsies from patch tests, cellular infiltrates were present at 3 and 21 days after allergen application. Interestingly at day 21, residing cells were localized at the perivascularity and were characterized as CD4+ CD8− CCR10+ T cells. In conclusion, nickel-activated effector T cells can be characterised as CD4+ CD8− CLA+ memory T cells. They express CXCR3, CCR4 and, in particular, CCR10. After clinical recovery from an ACD reaction, CD4+ CCR10+ memory T cells apparently reside locally. The persistence of these CCR10+ T cells, expressing the appropriate receptor of the skin specific chemokine CCL27, can explain clinically important phenomena such as LSM and flare up reactions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0105-1873.2004.0309t.x
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  • 8
    Electronic Resource
    Electronic Resource
    Kontaktallergien in medizinischen Berufen (1994)
    Springer
    Der Hautarzt 45 (1994), S. 834-844 
    Details
    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
    URL: http://dx.doi.org/10.1007/s001050050182
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