| 1. |
- Eriksson, Thomas, et al.
(författare)
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The use of photos from patch-test reactions on day 7 taken by mobile phones by professional ice hockey players in Sweden investigated for the presence of occupational dermatoses
- 2016
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Ingår i: Contact Dermatitis. - 0105-1873 .- 1600-0536. ; 75:Suppl. 1, s. 39-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- survey was undertaken in all ice hockey players in 26 professional teams in Sweden representing the two highest divisions. All players answered a questionnaire and the players from six teams, three from each of the two divisions, were patch tested with 72 test preparations in a baseline series supplemented with a series representing the work environment of the players. For practical reasons, the patch testing and test reading on day 3 took place in the arenas of the teams. As a traditional dermatologist reading on day 7 was impossible to perform in all but one team, the players and coaches were asked to use their mobile phones to take photos of the tested backs of the players on day 7 and to send them to the investigative team. In one team a dermatologist reading took place on day 7 independently of the mobile phone photos. In total, 107 players in the six teams were patch tested, and a reading on day 3 was performed in 103. Fifty contact allergic reactions were noted in 26 players. When comparing the reactions present on day 3 with the photos from day 7, seven (14%) more positive reactions were registered. The seven additional reactions were noted to seven different sensitizers: hexavalent chromium, oxidized linalool, thiomersal, mercapto mix, mercaptobenzothiazole, PFR-2 (a resol resin based on phenol and formaldehyde) and methylenedianiline. In summary, 14% more contact allergic reactions were diagnosed when using photos of the tested backs to replace the traditional dermatologist reading.
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| 2. |
- Hamnerius, N., et al.
(författare)
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Hand eczema in healthcare workers : a questionnaire survey of risk factors and work-related exposures
- 2016
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 75:S1
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Recent data on the prevalence and causes of hand eczema among healthcare workers in Sweden are lacking. Multidrug-resistant bacteria have necessitated improved hand hygiene and preventive measures. This has led to an increase in the use of disposable rubber gloves and hand disinfectants, which might influence the risk of hand eczema. Our aims were to identify healthcare workers with hand eczema; to estimate quantitative and qualitative exposure to rubber gloves, hand disinfectants and other exposures; and to survey constitutional factors. An electronic questionnaire was distributed to all employees at the hospitals in southern Sweden. The results were statistically analysed using χ2-tests and binary logistic regression. The 1-year prevalence of self-reported hand eczema was 20% among the responding 9051 nurses and physicians. On a daily basis, 30% reported hand washing >20 times at work, 45% reported using hand disinfectants >50 times, and 28% used >20 pairs of nonsterile rubber gloves. The prevalence of hand eczema was significantly higher among the employees reporting a higher exposure to hand washing, hand disinfectants and rubber gloves than in those reporting a lower exposure. The prevalence of hand eczema was also significantly higher among respondents with a history of childhood eczema, who were smokers, who had a body mass index >30 kgm-2, who spent >30 min per day working in the kitchen or who had children aged
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| 3. |
- Balato, A., et al.
(författare)
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The role of the dermatologist in the immune-mediated/allergic diseases – position statement of the EADV task force on contact dermatitis, EADV task force on occupational skin diseases, UEMS-EBDV subcommission allergology and European Dermatology Forum
- 2019
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 33:8, s. 1459-1464
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Tidskriftsartikel (refereegranskat)abstract
- Background: The members of the Task Force on Contact Dermatitis and the Task Force on Occupational Dermatoses of the European Academy of Dermatology and Venereology (EADV), of the European Dermatology Forum (EDF), and the members of the UEMS Section of Dermatology-Venereology (UEMS-EBDV) we want to vindicate the fundamental role that the specialist in Dermatology has in the diagnosis and management of Immuno-mediated /allergic Diseases. Objective: In disagreement with the blueprint paper of the UEMS section of Allergology (2013), in which dermatologists are excluded from one of their core activities it was decided to write this consensus paper. Discussion: The skin occupies a crucial place in the broad spectrum of allergic diseases; there is no other organ with such a multitude of different clinical conditions mediated by so many pathogenetic immune mechanisms. Subsequently, dermatologists play a fundamental role in the management of immune-mediated diseases including among others contact dermatitis, atopic dermatitis, urticaria and angioedema or cutaneous adverse drug, food and arthropod reactions. The essential role of dermatology in the diagnostic, therapeutic and preventive management of immune mediated /allergic diseases which is crucial for patient management is justified from both the academic and professional point of view. Conclusion: Based on the best care of the patient with cutaneous immune allergic disease a multidisciplinary approach is desirable and the dermatologist has a pivotal role in patient management. Be so good and no one will not ignore you, dermatologist. Ideally Dermatology should be governed according the following Henry Ford statement: “Arriving together is the beginning; keeping together is progress; working together is success.”.
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| 4. |
- Bruze, M., et al.
(författare)
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Validation of a questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix I
- 2020
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 182:4, s. 955-964
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Tidskriftsartikel (refereegranskat)abstract
- Background: In a European study on contact allergy in the general population, it was hypothesized that the combination of contact allergy to a fragrance together with a history indicating dermatitis at exposure, and thereafter subsequent avoidance of scented products, implied a diagnosis of allergic contact dermatitis. Objectives: The primary aim of this study was to validate this hypothesis and algorithm. The secondary aim was to investigate whether there was any association between the outcome of the repeated open application test (ROAT) and the patch test reactivity. Methods: In total, 109 patients with and without contact allergy to fragrance mix (FM) I were recruited. Volunteers from six European dermatology clinics participated in the study including a patch test and a ROAT. Results: Positive ROAT reactions were noted in 26 of the 44 volunteers with contact allergy to FM I. None of the volunteers reacted to the vehicle (P < 0·001). More individuals with a positive algorithm had positive ROATs than those with a negative algorithm. However, the difference was not statistically significant. The lower the patch test concentration eliciting a positive test reaction, the more likely a positive ROAT and the more likely that the positive ROAT appeared early during the investigative period. Conclusions: The algorithm used in this study was not substantiated in this ROAT set-up. The stronger the patch test reactivity the more likely was a positive ROAT and the more likely it was that the positive ROAT appeared early during the application period. What's already known about this topic?. To the best of our knowledge, a scientifically designed and conducted repeated open application test (ROAT) has never been performed before to validate a diagnosis of allergic contact dermatitis partly based on a questionnaire. What does this study add?. This is the largest controlled, randomized and blinded ROAT performed to date. Higher patch test reactivity to fragrance mix I indicated a greater likelihood of a positive ROAT. What are the clinical implications of this work?. Further refinement of the questions is required in order to diagnose allergic contact dermatitis from fragrances based on a questionnaire.
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| 5. |
- Bruze, M., et al.
(författare)
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Validation of questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix II : the EDEN Fragrance Study
- 2021
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 35:8, s. 1692-1701
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Tidskriftsartikel (refereegranskat)abstract
- Background: In a European study on contact allergy in the general population, it has been hypothesized that the combination of contact allergy to a fragrance together with a history indicating dermatitis at exposure and thereafter subsequent avoidance of scented products implied a diagnosis of allergic contact dermatitis. Objectives: The primary aim of this study was to validate this hypothesis/algorithm. The secondary aim was to investigate whether there was any association between the outcome of the recent repeated open application test (ROAT) and the patch test reactivity. Methods: One hundred nine subjects with and without contact allergy to fragrance mix II (FM II) were recruited. Volunteers from six European dermatology clinics participated in the study including a patch test and a ROAT. Results: Twenty-four positive ROAT reactions were noted in total including 20 of those 32 with contact allergy to FM II. None of the volunteers reacted to the vehicle (P < 0.001). More individuals with a positive algorithm had positive ROATs when compared with those with a negative algorithm. However, the difference was not statistically significant (P = 0.12). The lower the patch test concentration eliciting a positive test reaction, the more likely was a positive ROAT and the more likely that the positive ROAT appeared early during the investigative period. Conclusions: The algorithm used in this study was not validated but it was indicated in this ROAT setup. The stronger the patch test reactivity the more likely was a positive ROAT and the more likely it was that the positive ROAT appeared early during the application period.
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| 6. |
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| 7. |
- Hamnerius, N, et al.
(författare)
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Wet work exposure and hand eczema among healthcare workers - a cross-sectional study
- 2018
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 178:2, s. 452-461
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hand eczema is more common in healthcare workers compared to the general population. The hands are subject to changing occupational exposures due to mandatory hygiene regulations for health care workers.OBJECTIVES: To describe the exposure due to hygiene procedures and investigate the associations between occupational hand washing, use of non-sterile gloves, and hand disinfectant and self-reported hand eczema.METHODS: Cross-sectional study with an electronic questionnaire distributed to 28 762 hospital employees in southern Sweden. Respondents working as nurses, assistant nurses or physicians constituted the group of healthcare workers analysed. Adjustments were made for gender, age, wet work at home, life-style factors and atopic dermatitis.RESULTS: 12 288 (43%) responded including 9051 healthcare workers. In this group the 1-year prevalence of self-reported hand eczema was 21%. On a daily basis, 30% reported hand washing with soap >20 times at work, 45% used hand disinfectants >50 times, and 54% used non-sterile gloves > 2 hours. After adjustment for confounding factors, a dose-dependent association with self-reported hand eczema was found for the daily number of hand washes with soap at work and time working with disposable gloves, but not for alcoholic disinfectant use. Hand washing outside work was not associated with self-reported hand eczema in the adjusted multivariate analysis.CONCLUSIONS: In this study, we found a higher 1-year prevalence of self-reported hand eczema among Swedish healthcare workers than reported in the general population. Hand washing with soap and use of disposable gloves were associated with the occurrence of self-reported hand eczema in a dose-dependent way. Use of hand disinfectant was not associated with self-reported hand eczema. This article is protected by copyright. All rights reserved.
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| 8. |
- Passlov, H. M., et al.
(författare)
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Hand strength and dexterity in individuals with hand eczema
- 2020
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 34:12, s. 2856-2862
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with hand eczema often describe symptoms such as pain, clumsiness and difficulty flexing their fingers, thus impairing the function of the hand. Objective: The aim of this study was to investigate whether hand eczema is associated with a measurable impairment of hand strength and dexterity. We also studied the relationship between hand function and the ability to perform activities of daily living (ADL), pain level and quality of life measured with the Dermatology Life Quality Index (DLQI). Methods: Twenty-one participants with ongoing hand eczema were examined with well-established methods for measuring hand grip strength, pinch strength and dexterity. A questionnaire was designed to investigate perceived ability to perform ADL. The participants were also asked to grade their current pain level, and the DLQI was used to assess the participants' quality of life. A group of 12 participants was reinvestigated when healed. Results: The participants demonstrated a significant improvement in all functional tests when healed. There was a strong correlation between ADL and both dexterity and hand grip strength. There was also a strong correlation between ADL and pain. All participants reported some difficulty performing ADL. Conclusions: Our results suggest that ongoing hand eczema may lead to a measurable decrease of strength and dexterity of the hand, leading to an impairment of the ability to perform ADL and consequently to a poorer quality of life.
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| 9. |
- Siemund, I., et al.
(författare)
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Penetration of aluminium salts through pig skin in vitro
- 2012
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 66:s2, s. 52-52
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Recently it was suggested to use aluminium chloride hexahydrate in petrolatum at 10% to detect aluminium contact allergy. Patch testing with aluminium chloride hexahydrate at 20% did not demonstrate a higher number of positive test reactions. It was speculated that the constricting effect of aluminium salts might impair skin penetration. Objectives: The purpose of the present study is to estimate the concentration of aluminium in various skin layers and in the recipient phase using different aluminium test preparations on pig skin in an in vitro diffusion cell system. Methods: Full-thickness (7sim; porcine ear skin was mounted in Franz-type diffusion cells. The diffusional area was 0.64 cm2 and recipient volume 4 ml. The dermal side was exposed to a recipient solution consisting of PBS (phosphate buffer saline, pH 7.4). Aluminium chloride hexahydrate preparations in petrolatum and in water at 10% were applied to the donor compartment facing the epidermis for 24 hr. All samples were analysed for total aluminium by atomic absorption spectrometry. The limit of detection was 0.01 μg/ml. Results: No aluminium could be detected in the recipient phase in the six diffusion cells. Conclusions: Neither aluminium in petrolatum nor in water gave detectable amounts of penetrating aluminium in 24 h. The lipophilicity of the vehicle was not decisive.
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| 10. |
- Svedman, C., et al.
(författare)
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Continuous glucose monitoring systems give contact dermatitis in children and adults despite efforts of providing less ‘allergy- prone’ devices : investigation and advice hampered by insufficient material for optimized patch test investigations
- 2021
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 35:3, s. 730-737
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Tidskriftsartikel (refereegranskat)abstract
- Background: Medical devices are increasingly being reported to cause contact allergic dermatitis reactions. Objective: Review of patients with diabetes type I referred for suspected allergic contact dermatitis to insulin pump or glucose sensor systems. Method: We have reviewed 11 referred diabetes mellitus patients investigated for allergic contact dermatitis reactions to medical devices and specifically Dexcom G6®. Extracts from the medical devices were analysed. Results: The majority of patients was children, the majority had relevant allergies and particularly allergy to isobornyl acrylate which was also found in the glucose sensor system Dexcom G6®. Conclusions: The following case reports bring in focus the fact that patients sensitized through use of one medical device and being advised the use of another, or find another product for a while useful, are not by necessity free from future episodes of allergic contact dermatitis. The case reports emphasize the need for collaboration since it is impossible for even well-equipped laboratories to properly investigate the medical devices when information on the substances used in production is not uniform and complete and material to investigate are scarce. The importance of adequate patch test series and testing with own material and furthermore the importance to re-analyse medical devices and re-analyse test data are emphasized.
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