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Objective: To identify the concentration of the fragrance compound hydroxyisohexyl 3-cyclohexene carboxaldehyde (INCI) (HICC) that is sufficiently low not to cause an allergic reaction in patients with proven sensitization. Methods: Repeated open application testing (ROAT) in 64 subjects with 2 preparations (perfume and cream) in different concentration (0.005–2.5%). Confirmatory patch testing with four preparations in two different concentrations (2.5% and 5%). Results: The concentrations of HICC being tolerated by 90% of those sensitized to HICC are estimated as <88.2 ppm (cream) and <270 ppm (perfume) equivalent to 1.2 μg/cm2 (perfume) and 4.9 μg/cm2 (cream). Patch test preparations differed with regard to sensitivity (88.5–98.1%) and specificity (37.5–87.5%) against the ROAT result as external criterion. ROAT concentrations and the reaction strength in patch testing were inversely correlated (Kendall's tau-b: 0.69), both indicating the existence of different degrees of susceptibility. Conclusion: To protect 90% (50%) of people sensitized, the use concentration should be in the range of 0.009–0.027% (0.18–0.34%), depending on the product type. Taking into account these results, excessive concentrations should be avoided, as this would continue to sensitize people. Close monitoring is indispensable to prove the efficacy of any recommendations aiming to prevent induction. [ABSTRACT FROM AUTHOR]

Background: Occupational hand dermatitis (OHD) is a common and often chronic condition. Usage of topical corticosteroids is limited in long-term therapy because of potential side-effects. New treatment options are highly appreciated. Objective: To study efficacy and safety of tacrolimus in patients suffering from OHD. Patients and Methods: In a prospective, open, multicentre study, 29 patients with OHD of predominantly mild-to-moderate severity were treated with tacrolimus ointment (Protopic® 0.1%) during a 4-week active treatment period with twice daily application followed by a 2-month optional treatment period. Efficacy was evaluated by the use of a standardized hand eczema score and by clinical severity rating, conducted on all study visits (screening, baseline and weeks 2, 4, 6, and 12). Adverse events were recorded for safety evaluation. Results: The hand eczema score declined significantly after 2 weeks of treatment compared with baseline and further declined until the end of the study. Finally, 12 (44%) patients were clear of hand eczema. Worsening of the dermatitis occurred in 2 patients (7%). Clinical grading indicated improvement too. Overall tolerability was good. Conclusion: Topical tacrolimus might be an efficacious treatment option for chronic OHD. Blinded and randomized controlled studies are necessary to confirm the results of this pilot study. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 24-year-old women who developed hand eczema after six months of full-time cleaning of hospital operating theatres. She underwent patch testing with the baseline series, a series of disinfectants, and fragrances. It indicates that the remaining sensitizations were not related to occupational exposure and not considered to be clinically relevant. It suggests that disinfectants based on quarternary ammonium compounds should be considered.