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A multicenter study was performed in 9 Italian centers by members of the GIRDCA, to evaluate the frequency and source of contact sensitization in a group of 302 hairdressers with dermatitis. Occupational habits and use of preventive measures were specifically investigated both in these 302 hairdressers and in a further group of 240 hairdressers who answered a questionnaire. The results showed the presence of an occupationally relevant sensitization in 60.9% of the 302 hairdressers. This proportion included 52 hairdressers who had negative patch tests to the hairdressers series but showed positive reactions to other allergens, such as nickel, rubber additives. preservatives and fragrances. which were judged relevant to their occupation. Among hair dyes, PPD caused 73 reactions (24.2%), PAP 32 reactions (10.6%), ONPPD 24 reactions (7.9%), and PTD 40 reactions (1 3.2%), A low incidence of sensitization was detected in our hairdressers to resorcinol and pyrogallol (1.3% for each substance). Among permanent wave allergens, positive reactions to GMTC were found in 11.3% of patients. while ATG gave a lower rate of positive reactions (5.0%), Allergic contact dermatitis due to APS was also relatively common (11.3%), 4 hairdressers in this study gave a positive reaction 30 min after a provocative test with latex gloves, patch testing to the rubber series being negative. Enquiry regarding preventive measures revealed chat the majority of hairdressers use gloves when doing hair dyeing. but rarely use them for washing dyed hair or for doing permanent waving. The infrequent use of preventive measures by Italian hairdressers was confirmed by the results of the questionnaire, and possibly explains the high frequency of skin problems (12.5%) in the hairdressing population that was specifically interviewed. [ABSTRACT FROM AUTHOR]

737 patients with suspected cosmetic- or medicament-related contact dermatitis were patch tested with 6 emulsifier agents: triethanolamine, cetyl stearyl alcohol, sorbitan sesquioleate, polyoxyethylene sorbitan monopalmitate, polyoxyethylene sorbitan monooleate, and Amerchol L 101. 39 patients (5.3%) gave 1 or more positive patch tests to emulsifiers. A total of 54 positive reaction were found, 23 of which were clinically relevant, triethanolamine being the most frequent sensitizer. Patients with emulsifier sensitivity generally give a high prevalence of positive patch tests to other common ingredients of topical preparations, such as preservatives or active ingredients. Cosmetics and topical medicaments were detected as the source of sensitization in an equal number of patients. Patch tests with patients' own causative preparations were frequently negative. To avoid overlooking emulsifier sensitivity, it is advisable to test these compounds in patients with contact dermatitis that is possibly due to topical preparation, regardless of whether they have other clinically relevant positive reaction or whether patch tests with their own products are negative. [ABSTRACT FROM AUTHOR]

The frequency of thimerosal sensitization was determined in 5 groups of subjects: military recruits; healthy subjects; patients with asthma or rhinitis undergoing hyposensitizing therapy with thimerosal- preserved antigenic extracts; patients with allergic contact dermatitis; patients with allergic contact conjunctivitis. Our patients with allergic contact dermatitis have a higher incidence of positive patch tests to thimerosal than healthy subjects. The source of thimerosal sensitization in this group remains obscure, their history of exposure to this or to other mercury derivatives being comparable to that of the healthy population. Patients with allergic contact conjunctivitis and patients receiving immunotherapy for asthma or rhinitis present a significantly higher frequency of thimerosal sensitization than the other groups, indicating that ophthalmic solutions and thimerosal-preserved allergen extracts are an important source of thimerosal sensitization. The clinical relevance of thimerosal sensitization was definitively established only in patients with allergic contact conjunctivitis, even though patients receiving immunotherapy frequently presented local reactions at the site of allergen inoculation. [ABSTRACT FROM AUTHOR]

This article presents a case study of a 9 year old child afflicted with redness, swelling and itching on finger of her right hand and on her right cheek patch testing was performed on the patient as part of the treatment. This study has led researchers to sum up that contact allergy to metallic mercury arise from topical medicaments, broken thermometer and dental amalgam. The case, however, illustrates mercurochrome cross-sensitization with organic compounds. Even though, this compound is widely used as a skin antiseptic, sensitization to mercurochrome has infrequently been reported.

Prick tests with common food and inhalant allergens showed a positive reaction to Tyrophagus putrescens. In 1985, a 45-year-old entomologist presented with a seven year history of recurrent itchy papulovesiculur eruptions. The patient reported that these symptoms improved while he was away from work. Food mites can migrate under the scales of the stratum corneum or into fissures in the epidermis. Repeated exposure to such food mites may lead to sensitization, with production of urticaria or bronchial asthma.

This article presents a case study of 70 year old man presented with sever facial dermatitis. His symptoms had appeared five months after starting on an ophthalmic preparation for the treatment of cataracts. This study has led to sum up that contact allergy to ophthalmic preparations is a common problem, preservatives being the most frequent sensitizes. The above case study also illustrates the importance of patch testing with the individual constituents of ophthalmic preparations. Negative patch test reactions to eye-drops don't exclude the possibility of contact sensitization to one or more of the ingredients of those eye-drops.

The article discusses contact dermatitis due to antioxidants. Generally, antioxidants added to foods, cosmetics and pharmaceuticals are phenols, including esters of gallic acid. Contact dermatitis due to antioxidants is rarely reported and most published cases concern BHA sensitization. Although antioxidants are probably rare sensitizers, they may sensitize at very low concentrations and their wide dissemination in topical preparations and foods makes it difficult for patients to avoid further exposure.

Erythema multiforme-like lesions have rarely been associated with allergic contact dermatitis due to various allergens. Although the association of a type-III reaction with a type-IV allergic reaction has been proposed as a possible explanation, the pathogenesis of secondary polymorphic reactions remains obscure. The article reports a case of erythema multiforme associated with contact dermatitis to hair dyes. A 70-year-old woman was admitted with an acute dermatitis involving the scalp, ears and limbs which had lasted for one week. She had he hair dyed one day before the onset of the rash which began with irritation and itching on the scalp and behind the ears.

Butylated hydroxyanisole (BHA), an antioxidant widely used for food, pharmaceutical and cosmetic manufactures, has been reported as a rare cause of contact dermatitis. In the article, two cases of contact dermatitis due to BHA in topical preparations has been reported. Both the patients are suffering from skin diseases and applying topical ointments, having BHA as an active ingredient. Patch tests showed strong positive reactions with BHA. Since antioxidants are not included in the standard test series, the frequency of BHA sensitivity is unknown.

Phenylephrine is an adrenergic agent which mainly stimulates alpha-adrenergic receptors. It is widely used in ophthalmology for administration as eye drops as a ten percent solution in association with atropine-like para-sympathetic blockers to obtain maximum pupillary dilation for diagnostic or therapeutic purposes. In addition, this drug is present at lower concentration in several ophthalmic solutions. Despite its wide use, it is a rare cause of contact dermatitis and one case of contact dermatitis has been confirmed by patch testing.

Glutaraldehyde is dialdehyde mostly used in solution for sterilization and disinfection. Investigation of 541 hospital cleaning woman showed a very low prevalence of sensitization to glutaraldehyde, but several cases of dermatitis have been reported in hospital staffs. A twenty five year old surgical instruments nurse developed chronic dermatitis of both hands with marked dryness, redness, infiltration and fissures. Patch testing showed a strong positive to Cidex, a disinfectant agent containing glutaraldehyde. Glutaraldehyde must now be considered as an important cause of contact dermatitis in hospital employees working on the disinfection and sterilization of endoscopes and other surgical instruments.

The article focuses on contact dermatitis due to minoxidil. It is a potent vasodilator, used for resistent hypertension, which has recently been claimed to be useful as a topical agent in the treatment of alopecia. Systemic allergic reactions have rarely been reported from oral Minoxidil. Allergic contact dermatitis has been observed in 2 patients using topical Minoxidil for hair regrowth. In the last 2 years, treatment with 1% Minoxidil lotion in 465 patients with androgenic alopecia caused 2 cases or allergic contact dermatitis and 1 of photoallergic contact dermatitis.

Topical non-steroidal anti-inflammatory drugs (NSAIDs) have become commonly used in certain countries for muscular pain, mild rheumatic disease and lower leg venous insufficiency. A 61-year-old woman had severe dermatitis of her face and limbs that required systematic steroids. The anamnesis revealed that she developed severe oedema on her face and limbs after using an anti-inflammatory cream for the treatment of lower limb rheumatic pain. Various researchers have described contact allergy to oxyphenbutazone with cross-sensitivity to phenyl butazone.

The occurrence of aIIergic contact dermatitis due to povidone-iodine which is one of the most widely used iodophor. An iodophor is a complex of iodine and a carrier molecule which prolongs the effect of iodine solubility and its release when the latter is used as a germicide along with some ingredients. Povidone-iodine is also known as polyvinylpyrrolidone-iodine. The case was studied with two different patients who had chronic hand dermatitis and acute dermatitis respectively. In both cases patch tests were reported to be positive.

The article presents cases of contact allergy to ketoprofen in patients with contact dermatitis. Allergic contact dermatitis was diagnosed in 11 cases and allergic photocontact dermatitis in 12 cases. The occurrence of positive patch test reactions to ketoprofen gel, in patients with a positive photopatch test but a negative patch test to the drug itself, suggests that petrolatum might not be the optimal vehicles. An optimal vehicle may clearly enhance the sensatizing properties of any allergen. The vehicle plays a crucial role in the development of ketoprofen allergy.

The article cites case reports of various patients to show that contact urticaria (CU) is generally a rare side-effect during topical immunotherapy, diphenylcyclopropenone (DFC) being the major allergen responsible. Contact allergens, such as dinitrochlorobenzene (DNCB), squaric acid dibutylester and DFC, have been advocated in the treatment of both alopecia areata and recalcitrant warts. Side-effects include local adenopathy, generalized eczema, depigmentation and CU. The risks of long-term immunostimulation and mutagenesis must also be considered. DNCB has been responsible for most reported cases of CU.

Allergic contact dermatitis due to permanent waves is quite rare and most reported cases have occurred in hairdressers who were occupationally sensitized. Acid permanent waves containing glyceryl monothioglycolate are responsible for most of these reactions. In this article, the authors report 6 cases of allergic contact dermatitis due glyceryl monothioglycolate in permanent waves. The contact dermatitis in these patients involved the back of the hands and in 2 cases, the lateral sides of the fingers. Patch tests through vinyl gloves were positive in the glyceryl monothioglycolate-sensitized hairdressers.

This article reports on case studies of patients suffering from systematic reactions caused due to the preservative vaccine "thiomersal." The first case study reports on a 66 year-old woman who was admitted with acute urticaria 3 days after she had been vaccinated against influenza with a vaccine containing 0.01% thiomersal concentration. The rash disappeared within a few days without the treatment. The second case study presents information of a 31-year-old doctor, who developed acute urticaria one day after vaccination against hepatitits B with a vaccine containing 0.05% of thiomersal. Both patients presented a sytematic cutaneous reaction after injection of parenteral solutions containing thiomersal as preservative. Since the patch tests revealed sensitization it was believed that systematic reactions was caused due to the presence of Thiomersal.

This article presents a case study related to contact dermatitis to anti-inflammatory agent ibuprofen. A 69-year-old man with cervical arthritis applied an ointment containing ibuprofen whenever pain occurred. Recently, after a week of therapy, he developed an eczematous eruption with red vesicular lesions on the neck and over the back. Personal and family history of contact dermatitis and atopy were negative. Patch testing was performed. Cutaneous reactions due to indigestion of ibuprofen was confirmed.

This article presents information on propolis contact dermatitis. Propolis is a resinous compound which bees collect, transform and use inside the hives to smooth the surface, seal crevices and protect the entrance from intruders. Propolis contact dermatitis has been reported mainly in beekeepers or from cosmetic or medical preparations. The allergen in propolis is still unknown. Since propolis is widely used by the cosmetic and pharmaceutical industries, it should be included in the patch test series for patients with drug or cosmetic dermatitis.

The article focuses on contact stomatitis caused due to NN-dimethyl-para-toludine. Allergic resins are among the most widely used compound in dental practice for construction of prostheses. These resins are produced by inducing polymerization of a mixture of methyl methacrylate monomer and polymethyl methacrylate powder with benzyl peroxide and an accelerator. In this process of polymerization is rarely complete. The article presents information on a case study of a 62 year old house wife with a problem of burning and soreness of the mouth which lasted for 1 month.

Although topical antihistamines are a frequent cause of contact dermatitis, contact sensitization to chlorpheniramine maleate, an antihistamine group, is reported to be rare. A 45-year old housewife had a chronic eczema of the face for 4 years. She had not been using topical medicaments or cosmetics there, with the exception of eyedrops used in the treatment of chronic conjunctivitis. Patch tests with the GIRDCA standard series and photopatch tests were negative. The patient had sporadically used an antihistamine cream containing chlorpheniramine maleate for the treatment of insect bites.

This article presents a case study of 36-year-old woman suffering from patchy alopecia areata. It was found out that she was sensitized to acetone for a therapy. After handling acetone at work the patient developed an acute contact dermatitis of the face and upper limbs. The patient was patch tested and it was observed that she showed positive reactions to acetone which persisted for 7 days. the problem of subsequent occupational hazards in patients submitted to sensitizing therapies seemed to have been definitely resolved when squaric acid dibutylester and diphencyprone were introduced to substitute for dinitrochlorobenzene.

This article focuses on a case study of a 57 year old female, who had developed contact dermatitis due to Bufexamac. She was treated with an ointment Bufexamac 5% on itchy seborrhoeic dermatitis of the face and scalp. After 2 months of therapy, she developed a dermatitis on the face. She was patch tested to the ICDRG standard series and her own products including Viafen ointment.

This article focuses on the case study of two women, who had developed contact dermatitis with rosacea. A 68-year-old woman with rosacea for 5 years had a severe relapse. Since erythema and scaling were intense and she complained of severe itching, patch tests were then performed. Although the standard ICDRG series was negative, a strong positive reaction was observed to her eye drops. A 40-year-old woman with rosacea for 2 years complained of an acute worsening of the dermatosis.

This article presents a case study of a woman suffering from contact dermatitis caused due to cerumenex, a widely used ear wax remover. A 67-year-old woman developed severe redness, swelling and edema of the left ear, left cheek, neck and left eyelids. It was found out that on the previous day she had used cerumenex ear drops. On patch testing with contact dermatitis research group standard series the patient showed negative response to all the ingredient except for oleyl polypeptide. The doctors suggested that since oleyl polypeptide is widely used as a surfactant and stabilizer in cosmetics and drugs, the sensitization may have occurred through the use pf this product.

Since January 1987, 63 food handlers affected by chronic hand eczema were studied. A large variety of foods including fruits, vegetables, fish and meat elicited the positive vesicular reaction in different patients. The histological and immunohistochemical study of apparently normal hand skin showed focal parakeratosis and an increased number of Langerhans cells. Biopsies of the immediate vesicular reactions induced by foods showed spongiotic vesicles within the epidermis and a moderate to dense mononuclear dermal perivascular infiltrate.

The article cites case studies related to flare-up reaction from para-amino-diphenylamine. 10 patients developed a flare-up reaction after 10 to 15 days induced by para-amino-diphenylamine. A biopsy was taken of the reaction. Each sample was divided into 2 parts, one was processed for routine histology and the other sectioned in a cryostat employing the ABC technique and applying monoclonal antibodies to characterize lymphoid and reticular cell lines. The results of the test showed that the epidermis was infiltrated with mononuclear cells and showed slight spongiosis.