Occupational skin diseases (OSDs) often have considerable medical and occupational consequences. Previous data on prognostic factors have been derived from studies with fairly small sample sizes.
To determine the medical and occupational outcome in 1048 patients diagnosed with OSD at the Finnish Institute of Occupational Health and to identify the prognostic risk factors for the continuation of OSD.
Patients examined in 1994-2001 filled out a follow-up questionnaire 6 months after the diagnosis. Data on atopy, contact allergies, and occupation were analysed.
Six months after the diagnosis the skin disease had healed in 27% of the patients. The OSD had cleared up in 17% of those with no changes at work, and in 34% of those who had changed their job/occupation. The best clearing had occurred in the patients with contact urticaria (35%), whereas the healing of allergic (27%) and irritant (23%) contact dermatitis was similar. The risk factors for continuing occupational contact dermatitis (OCD) were no changes in work, age > 45 years, food-related occupations, respiratory atopy, and male sex.
The healing of OSD was associated with discontinuation of the causative exposure. A change in work and the presence of easily avoidable work-related allergies were associated with a good prognosis.
Since 1990 7 sunscreen allergens have been included in the standard photopatch protocol at 2 Swedish dermatology clinics. 355 consecutive patients with suspected photosensitivity were tested, and in 28 of these (7.9%), a total of 42 allergic reactions were found. 80% of the reactions were of photocontact origin. The most common allergen was benzophenone-3 (Eusolex 4360), with 15 photocontact and 1 contact allergic reactions, followed by isopropyl dibenzoylmethane (Eusolex 8020) (8 photocontact, 4 contact) and butyl methoxydibenzoylmethane (Parsol 1789), with 6 photocontact reactions. There were 2 cases of photocontact allergy to phenylbenzimidazole sulfonic acid (Eusolex 232), which has not been reported previously. 1 case of contact urticaria from benzophenone-3 was accidentally found. In addition, 21 + reactions of doubtful relevance were noted in 14 patients: 16 on irradiated and 5 on non-irradiated test sites. Among these, irritant and phototoxic reactions may be included. These results indicate that the inclusion of UV filters in the standard photopatch protocol is important. Immediate-type testing for urticaria could also be of value.
The prevalence of contact allergy in the general population has traditionally been investigated through population-based epidemiological studies. A different approach is the combination of clinical epidemiological (CE) data and the World Health Organization-defined drug utilization research (DUR) method. The CE-DUR method was applied in Denmark to estimate the prevalence of contact allergy in the general population and compare it with the prevalence estimates from the Glostrup allergy studies. Contact allergy prevalence estimates ranging from very liberal ('worst case') to conservative ('best case') assumptions were based on patch test reading data in combination with an estimate of the number of persons eligible for patch testing each year based on sales data of the 'standard series'. The estimated 10-year prevalence of contact allergy ranged between 7.3% and 12.9% for adult Danes older than 18 years. The 10-year prevalence of contact allergy measured by CE-DUR was slightly lower than previous prevalence estimates from the Glostrup allergy studies. This could probably be explained by a decrease in nickel allergy. The CE-DUR approach holds the potential of being an efficient and easy monitoring method of contact allergy prevalence.
p-Phenylenediamine (PPD) is an important allergen; 5.0% of patients tested positive to PPD when patch-tested, according to the North American Contact Dermatitis Group. Hair dyes are the main source of exposure.
To assess the significance of PPD allergy at the Ottawa Patch Test Clinic.
We assessed the epidemiology of PPD allergies and determined the cross-reactivity with other para-amino compounds. Charts of patients visiting the Ottawa Patch Test Clinic between May 1997 and July 2009 were reviewed.
One hundred thirty-four patients were found to have a contact allergy to PPD; 75.4% were female, 24.6% were male, 13.4% were hairdressers, 18.7% had a history of atopy, 90.3% were sensitized by hair dye, 2.2% were sensitized by henna tattoos, and 7.5% were sensitized by other sources. Positive patch-test reactions to textile dyes were seen in 24.6%, 7.5% reacted to benzocaine, 6.0% reacted to sulfa drugs, 1.5% reacted to isopropyl-para-phenylenediamine, and 1.5% reacted to para-aminobenzoic acid.
PPD is an important source of allergic contact allergy. Our results show a significant relationship of PPD with other related para-amino compounds.
Results of standard patch tests performed with the same methodology in one centre are rarely available over a large time span. This gives the unique opportunity to study not only prevalence but also persistency of contact allergy and characterize subpopulations. The objectives were to investigate sensitivity rates and persistencies of patch test results and characterize patients with multiple contact allergies. A 20-year retrospective database-based study of 14 998 patients patch tested with the European Standard Series was performed. 34.5% were sensitized, primarily women. Sensitivity to nickel was most frequent and least frequent to mercaptobenzothiazole, N-isopropyl-N-phenyl-p-phenylenediamine and benzocaine. Yearly proportion of negative, mono/double-allergic, and multiple-allergic cases remained stable. Persistency of positive reactions was high for para-phenylenediamine, Cl(Me)isothiazolinone, and primin and poor for paraben mix. 5.1% were multiple allergic, primarily women, and 90% got diagnosed by the first test. Frequency of multiple allergies increased with age. More multiple- than mono/double-allergic patients were tested multiple times. Persistency and sensitivity rates in a Danish eczema population are provided and are useful for decisions regarding the standard series. Patients with multiple contact allergies are typically elderly women who might have long-lasting and hard-to-treat eczema. Cumulative environmental exposure seems necessary to develop multiple allergies.
BACKGROUND: Methyl 2-octynoate is a synthetic fragrance which was first described to have sensitizing properties in 1935. It is one of the 26 fragrances to be labelled on the ingredient list according to current European cosmetics regulation. OBJECTIVES: To report the experience with patch testing with methyl 2-octynoate 1% and 2% in pet. METHODS: 230 eczema patients were consecutively patch tested with 1% methyl 2-octynoate at department of Dermato-allergology Gentofte Hospital, Denmark and 120 eczema patients were consecutively patch tested with 2% M2O in Finn Chambers at the Départment de Dermatologie, CHU Saint Jacques, France. RESULTS: Three cases of active sensitization were observed. 2 (0.87%) of the 230 Danish subjects tested with 1% in pet. and of the 120 French subjects patch tested with 2% in pet. 1 (0.83%). There was no statistical difference in active sensitization between the two groups (P = 0.72). Allergic contact dermatitis was observed in two patients (1.67%) in the French group and none in the Danish group. CONCLUSION: Contact allergy to methyl 2-octynoate was frequently seen when patch testing with 2% in pet. However, active sensitization was also observed, when patch testing with concentrations of 1% and 2% methyl 2-octynoate. The patch test concentration should be below 1% in pet., but a safe concentration remains to be defined.
Para-tertiary-butylcatechol (PTBC) is a rare allergen which is used in the rubber, paint and petroleum industries. We present 9 patients who were sensitized to PTBC and examined at the Finnish Institute of Occupational Health (FIOH) between 1974 and 1995. 3 of the patients had been exposed to PTBC in their work. 2 of them also had allergic reactions to para-tertiary-butylphenol (PTBP)-formaldehyde resin and to PTBP. 5 of the patients became sensitized to PTBC from patch testing. PTBC was found to be one of the most common causes of active sensitization in our clinic. Accordingly, at the FIOH, the patch test concentration of PTBC was lowered to 0.25% and this lower concentration is recommended for general use.
OBJECTIVE: Drinking patterns and flushing response were investigated among indigenous natives of Chukotka, Siberia (162 women, 139 men). The quantification of drinking behavior could be used for comparison with other northern peoples and as a baseline for future intervention. METHOD: Interviews, physical examinations and blood tests were performed in the Chukotka region of Siberia. RESULTS: 28% of the men and 4.5% of the women drank at least once per week. High doses per typical drinking occasion, which averaged 177.6 g of pure alcohol in men and 74.3 g in women, were reported; 10.3% of the men and 25.5% of the women reported that they experienced facial flushing after drinking. In most cases more than 20 g of alcohol was necessary to induce flushing, and two-thirds of the flushers were able to continue drinking after flushing began. No significant relationship between flushing and frequency and quantity of drinking and the prevalence of alcohol-related symptoms was found. There was a significant association between flushing by women and reports by them of their parent's flushing. CONCLUSIONS: Flushing by Chukotka natives and its relationship to drinking behavior is different from Oriental ALDH2-deficient flushing.
Available upon request at the Alaska Medical Library, located on the second floor of UAA/APU Consortium Library. Ask for accession no. 11443.
Photoallergic contact dermatitis (PACD) is a hypersensitivity reaction that occurs when a previously photosensitized exogenous agent comes into contact with UV radiation. Currently, there are no studies profiling photoallergic reactions in Canada. Because the photoallergen profile changes over time, it is necessary to continually update our knowledge to ensure proper recognition of allergens and appropriate treatment of patients.
This study aimed to profile photoallergic reactions in Canada.
A retrospective chart review of all patients who underwent photopatch testing at Toronto Western Hospital between January 2001 and December 2010 was completed. Photoallergic, allergic, and irritant reactions were recorded for 26 common allergens.
Ninety-nine patients (61.9%) had at least 1 positive reaction to the test allergens. Fifty-four patients (33.8%) had at least 1 photoallergic reaction. All 26 allergens produced at least 1 allergic or photoallergic reaction. The most common relevant photoallergens were benzophenone-3, octyl dimethyl para-aminobenzoic acid (PABA) in 5% alcohol, and butylmethoxy-dibenzoylmethane.
This study is the first to profile photoallergic contact reactions in Canada. It is clear that the culprit photoallergen in PACD can often be identified in a properly selected population. Future surveillance is necessary to continue to characterize PACD trends in Canada and to help better treat and screen this patient population.