| 1. |
- Bruze, Magnus, et al.
(författare)
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Recommendation of appropriate amounts of petrolatum preparation to be applied at patch testing.
- 2007
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 56:5, s. 281-285
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Tidskriftsartikel (refereegranskat)abstract
- Background: No recommendation exists on the amount of petrolatum (pet.) preparation to be applied in a Finn Chamber (R) or van der Bend Chamber. Objectives: The aim of this study was to determine the appropriate amount of pet. preparation to apply in the Finn and van der Bend chambers. Methods: 12 volunteers were patch tested with green-coloured pet. in Finn and van der Bend chambers on the back on 3 occasions. Doses were 10, 15, 20, 25, and 30 mg initially and on second and third occasion, 10 mg was removed in van der Bend Chambers and 35 mg was added. On day 2, the test sites were scored. A negative test equalled a test area not covered to 100%. A positive test meant a completely green-coloured test area. Minor and major spreading was noted. The amount of pet. preparation yielding at most 5% negative reactions and having the least number of reactions with major spreading equalled the appropriate amount. Results: For van der Bend Chambers, all doses yielded more than 5% negative reactions. For the Finn Chamber (R), 30, 25, and 20 mg pet. yielded less than 5% negative reactions and with major spreading in 60%, 40%, and 25% of test sites. Conclusions: 20 mg pet. preparation was the optimal dose for the Finn Chambers (R).
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| 2. |
- Bruze, Magnus, et al.
(författare)
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Variation in the amount of petrolatum preparation applied at patch testing.
- 2007
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 56:1, s. 38-42
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Tidskriftsartikel (refereegranskat)abstract
- The elicitation of a positive patch test reaction in a given individual depends upon the dose of the sensitizer applied, the patch test technique and the occlusion time. The dose is determined by the concentration and volume/amount of test preparation applied. If the same amount/volume of a test preparation is applied all the time with the same test technique (same area of skin) and occlusion time, it is appropriate to use concentration as a dose parameter. Most contact sensitizers are incorporated in petrolatum (pet.). With pet. as vehicle, it is impossible to repeatedly apply an exact volume/amount. This study was performed to investigate the inter- and intra-individual variation of pet. preparation applied at patch testing by 3 technicians. Weighing demonstrated that the 3 technicians had about the same precision in their pet. application. The investigation demonstrates that there is both an inter-individual (statistically significant) and intra-individual variation in the amounts of pet. applied at patch testing for the 3 technicians. Presently, there is no recommendation on what amount of pet. preparation to apply, which merits a decision to be taken based on thorough investigations on the appropriate volumes of pet. preparation to be applied in various patch test systems.
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| 3. |
- Carstensen, Ole, et al.
(författare)
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The validity of a questionnaire-based epidemiological study of occupational dermatosis
- 2006
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 55:5, s. 295-300
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the validity of a questionnaire and medical anamnesis to identify persons with dermatitis in an occupational setting. The design was a clinical epidemiological cross-sectional study. The study was performed between the second and fourth week of January 2001. A questionnaire was followed a week later by a medical occupational interview and a clinical dermatological examination, including a comprehensive patch test with potential workplace chemicals. The anamnesis and the clinical examination were made independently by occupational and dermatological physicians, and the skin examination was performed blinded to anamnestic data. The setting was the mother plants of a Danish-based international company producing wind turbine systems. The study population was a workplace cohort, highly exposed to epoxy resin systems and other chemicals, and totalled 724 production workers at 4 facilities. The rate of participation was 84.7%. Using enquete questions of current skin rash against the clinical presence of dermatitis, we found a sensitivity of 22% and a specificity of 89%, compared to 45% and 87%, respectively, when the anamnestic work history, taken by an occupational physician, was the screening parameter. Using 'workplace periodic prevalence' of dermatitis, we found sensitivities in the range of 63-76% by a questionnaire and 70-83% by medical anamnesis. Questionnaire screening by skin symptoms gave the highest values for redness, a sensitivity of 33% and a specificity of 76%, and decreasing validity parameters as more symptoms were added to the list of screening questions. We found that the use of a questionnaire and medical anamnesis were problematic, when the purpose was screening for contact dermatitis and allergy, in this industrial cohort manufacturing reinforced plastic products. But these instruments might be useful for epidemiological surveillance, when the questionnaire has been validated in the given occupational setting.
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| 4. |
- Engfeldt, Malin, et al.
(författare)
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Chemical analysis of 2,4-toluene diisocyanate, 1,6-hexamethylene diisocyanate and isophorone diisocyanate in petrolatum patch-test preparations.
- 2005
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Ingår i: Dermatitis. - 1710-3568. ; 16:3, s. 130-135
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Tidskriftsartikel (refereegranskat)abstract
- Background: Isocyanates with the general formula R-(N=C=O) are theoretically contact sensitizers. However, allergic contact dermatitis (ACD) from isocyanates is seldom reported. In previous reports, patients reacted to their isocyanate-based work materials but not to commercial patch-test preparations of isocyanates. Therefore, we suspected that the low frequency of reported ACD from isocyanates was partly due to inadequate commercial preparations. A past study also showed the concentrations of diphenylmethane-4,4'-diisocyanate (4,4'-MDI) in petrolatum preparations to be much lower than declared. Objective: In this study, 2,4-toluene diisocyanate (2,4-TDI), 1,6-hexamethylene diisocyanate (1,6-HDI), and isophorone diisocyanate (IPDI) were investigated in a similar fashion. Methods: In preparations from 12 dermatology departments and two suppliers of patch-test allergens, we determined the isocyanate content as the isocyanate-dibutylamine derivative, using liquid chromatography and mass spectrometry. The preparations were considered stable if the ratio between the stated and found concentrations was within the range of 0.8 to 1.2. Results: Although 28 of 36 investigated preparations had ratios outside of the stable range, they were in its vicinity, which indicates that preparations of 2,4-TDI, 1,6-HDI, and IPDI are more stable than are preparations of 4,4'-MDI where previously reported results showed ratios far outside of stable range. Conclusion: As opposed to preparations of 4,4'-MDI, preparations of 2,4-TDI, 1,6-HDI, and IPDI can be considered to be stable.
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| 5. |
- Engfeldt, Malin, et al.
(författare)
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How to optimize patch testing with diphenylmethane diisocyanate
- 2007
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 57:3, s. 138-151
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Tidskriftsartikel (refereegranskat)abstract
- We have previously shown that patch test preparations of polymeric diphenylmethane diisocyanate (PMDI) are more stable than preparations of diphenylmethane-4,4'-diisocyanate (4,4'-MDI). This study was conducted to (i) investigate whether PMDIs yield as many positive reactions as 4,4'-MDI, (ii) study concurrent reactions to 4,4'-MDI and 4,4'-diaminodiphenylmethane (4,4'-MDA), and (iii) follow the course of positive reactions during 4 weeks. It was shown that PMDIs detect as many positive reactions as 4,4'-MDI. Thus, they are better patch test agents being more stable than preparations of 4,4'-MDI. We recommend that PMDIs with a monomer content of at least 35% is used in 2.0% petrolatum (pet.) (i.e. monomer patch test concentration approximately 0.7%). It was shown that reactions to 4,4'-MDI and PMDIs appear late and we recommend readings on both day (D) 3/4 and D7. 4,4'-MDA was shown to be a good marker for 4,4'-MDI and patch testing with 4,4'-MDA in 0.25% pet. can be used instead of PMDI. Concomitant reactions to 4,4'-MDI and 4,4'-MDA are probably not caused by conversion of 4,4'-MDI into 4,4'-MDA by reaction with water. Another explanation is a path of reactions leading to ureas and MDI conjugates with skin constituents, which are hydrolysed into 4,4'-MDA. This complex process depends upon several factors and might explain why positive MDI reactions appear after D7.
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| 6. |
- Engfeldt, Malin, et al.
(författare)
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Is it possible to improve the patch-test diagnostics for isocyanates? A stability study of petrolatum preparations of diphenylmethane-4,4'-diisocyanate and polymeric diphenylmethane diisocyanate.
- 2007
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 56:1, s. 27-34
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Tidskriftsartikel (refereegranskat)abstract
- We have previously shown that the concentration of diphenylmethane-4,4'-diisocyanate (4,4'-MDI) in commercial test preparations was so low that patch testing with the same was not reliable. The stability of 4,4'-MDI in petrolatum (pet.) was compared with pet. preparations of polymeric diphenylmethane diisocyanate (PMDI), which consists of a complex mixture of monomeric isomers and oligomers of MDI. Preparations of 4,4'-MDI and PMDI were stored under 3 different conditions, i.e. at room temperature, refrigerated and frozen. They were analysed continuously during 1 year with regard to the content of 4,4'-MDI, 3-ring oligomers and 4-ring oligomers using liquid chromatography-mass spectrometry. PMDI preparations kept frozen were stable for a year. All other preparations failed to fulfil the requirements of stability, i.e. +/- 20% of the initial concentration. Storage in a freezer prolonged the lifetime for 4,4'-MDI. The decrease in concentration for preparations kept at room temperature and refrigerated was less rapid in PMDI preparations than in 4,4'-MDI preparations. PMDI preparations are better suited for patch testing patients exposed to MDI because they are more stable and homogeneous than 4,4'-MDI preparations. They better reflect possible allergens that workers are exposed to because products used in industry contain both monomers and oligomers.
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| 7. |
- Goon, Anthony Teik-Jin, et al.
(författare)
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Contact allergy to acrylates/methacrylates in the acrylate and nail acrylics series in southern Sweden: simultaneous positive patch test reaction patterns and possible screening allergens
- 2007
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 57:1, s. 21-27
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Tidskriftsartikel (refereegranskat)abstract
- In a recent study we showed that all our dental personnel/patients were detected with 2-hydroxyethyl methacrylate (2-HEMA) and 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy)phenyl]propane (bis-GMA). We studied 90 patients tested to the acrylate and nail acrylics series at our department over a 10 year period to see whether screening allergens could be found. Patch testing with an acrylate and nail acrylics series was performed. Among the 10 acrylate/methacrylate-allergic occupational dermatitis patients tested to the acrylate series, the most common allergens were triethyleneglycol diacrylate (TREGDA, 8), diethyleneglycol diacrylate (5), and 1,4-butanediol diacrylate (BUDA, 5). All 10 of these patients would have been picked up by a short screening series combining TREGDA, 2-hydroxypropyl methacrylate (2-HPMA), and BUDA or 1,6-hexanediol diacrylate (HDDA). Among the 14 acrylate/methacrylate-allergic nail patients, the most common allergens were ethylene glycol dimethacrylate (EGDMA, 11), 2-HEMA, (9), and triethyleneglycol dimethacrylate (9). Screening for 3 allergens i.e. 2-HEMA plus EGDMA plus TREGDA, would have detected all 14 nail patients. A short screening series combining 2-HEMA, EGDMA, TREGDA, 2-HPMA, bis-GMA, and BUDA or HDDA would have picked up all our past study patients (dental, industrial, and nail) with suspected allergy to acrylate/methacrylate allergens.
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| 8. |
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| 9. |
- Goon, Anthony Teik-Jin, et al.
(författare)
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Screening for acrylate/methacrylate allergy in the baseline series: our experience in Sweden and Singapore
- 2008
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 59:5, s. 307-313
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Tidskriftsartikel (refereegranskat)abstract
- Background: No studies to specifically determine the prevalence of contact allergy to acrylates/methacrylates in patch tested populations have been published. Objectives: To determine the prevalence of acrylate/methacrylate allergy in all patients tested to the baseline patch test series. Methods: Five acrylate/methacrylate allergens (2-hydroxyethyl methacrylate, methyl methacrylate, ethylene glycol dimethacrylate, triethylene glycol diacrylate, and 2-hydroxypropyl acrylate) were included in the baseline series for at least 2 years in Malmo and Singapore. Results: Thirty-eight patients in total had reacted to acrylate/methacrylate allergens in the baseline series during the study period in both populations. In Malmo, there were 26 (1.4%) patients with positive patch tests to acrylate/methacrylate allergens, 14 of whom had relevant reactions. In Singapore, there were 12 (1.0%) patients with positive patch tests to acrylate/methacrylate allergens, but only 1 had relevant reactions. If we had not added acrylate/methacrylate allergens to the baseline series, we would not have patch tested 13/26 (50%) of the positive reactors in Malmo and 11/12 (92%) of the positive reactors in Singapore. The overall proportion of missed positive reactors would have been 24/38 (63%). Conclusions: The prevalence of acrylate/methacrylate allergy in our patch tested dermatitis populations is 1.4% in Malmo and 1.0% in Singapore.
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| 10. |
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