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Para-tertiary-butylcatechol (PTBC) has been patch tested in Europe at 1% in petrolatum (pet.) and is now suspected of induction of patch test sensitization. A prospective study was initiated to obtain detailed data on this undesirable risk. A dilution series of PTBC (1%, 0.5%, 0.25%, 0.1% pet.) was used. Patch tests were read on days (D) 1-3, 7, 14 and 21 after application. Patients who were unable to return for late readings were telephoned and asked to report any reaction at the patch test sites. 40 out of 46 patients included completed the study. Patch tests were negative in 35 patients. 4 patients showed a positive patch test at later readings only (D7-D21); 2 patients reacted to a concentration as low as 0.1%. Rechallenge was performed in 2 of these patients, revealing a clearly positive reaction as early as D2 after patch test application. PTBC clearly induced patch test sensitization in 10% of the patients. It cannot be excluded that patch testing with 0.25% PTBC or with even lower concentrations might induce patch test sensitization. The optimal patch test concentration still has to be determined but may be within the range of 0.01% to 0.25% PTBC.

The relative alkylation index (RAI), a theoretically derived parameter intended to quantify the relative extent of carrier haptenation resulting from a given dose of a given sensitizer, has previously been successfully applied to the analysis of relative sensitization potential and dose-response data for a variety of contact allergens which are directly electrophilic. Here the RAI concept is applied to analysis of data on compounds related to urushiol (i.e., 3-substituted catechols), the naturally occurring mixture of allergens responsible for contact allergy to poison ivy and poison oak. These allergens are believed to act as pro-electrophiles, being oxidized to electrophilic orthoquinones in vivo. It is found that the various types of urushiol derivatives fit the same sort of RAI-sensitization relationships as expected theoretically and as found previously with direct acting electrophiles. There is evidence that in many cases, the test conditions were such that overload effects, whereby the degree of sensitization induced decreases with increasing carrier haptenation, applied. It is also concluded that the question as to the relative sensitization potencies of the naturally occurring urushiols remains open. The commonly held view that with these materials, sensitization potential increases with increasing unsaturation in the 3-hydrocarbyl chain of the 3-hydrocarbyl catechols, is based on evidence that is capable of alternative interpretation.

8 subjects learning the art of lacquerware were patch tested to urushiol before and after contact with lacquer, in order to document whether hyposensitization to urushiol occurred among Japanese lacquer craftsmen. Simultaneously, we performed patch tests on 2 urushiol-sensitized controls who had no contact with lacquer during the investigation. Lacquer is made from the sap of the Japanese lacquer tree and raw lacquer is composed of 60-65% urushiol and its oligomer. 5 of the 8 subjects showed positive reactions to urushiol 1 month after their first contact. They became negative or less positive after prolonged (9 or 10 months) exposure to lacquer. As reactions to urushiol decreased, dermatitis became less severe. Controls showed consistently high reactions. However, 1 subject showed persistently strong reactions to urushiol. Unlike the other 7 subjects, he was previously sensitized to urushiol before the first contact with lacquer. The remaining 2 subjects showed no reaction throughout our investigation. These results strongly suggest that hyposensitization to urushiol does occur among Japanese lacquer craftsmen.

Tertiary butyl catechol (TBC), an antioxidant in phototypesetting paper, caused allergic contact dermatitis in several newspaper production workers. Five of eight tested workers had strong positive tests to the paper and to 0.1 percent TBC. Only one had subsequent hypopigmentation. The newspaper agency where they work now uses a product which contains no TBC. Sensitized workers have remained free of dermatitis unless exposed to advertising copy from outside sources.

Case reports are described of individuals who developed acute contact dermatitis after contact with the resin from the Rhus verniciflua (Toxidendron vernicifluum). Potential problems from possible extensive urban planting of this species are discussed.

In a search for contact sensitivity to antioxidants we patch tested consecutive patients referred with eczematous dermatitis. Six cases of allergic contact sensitivity to nordihydroguairetic acid (NDGA) were observed. Three had been sensitized by one brand of cream containing 0.1% NDGA, in three patients the source of sensitization could not be traced. In four patients we found positive patch tests to butylated hydroxyanisole and/or to butylated hydroxytoluene. In two cases the positive patch tests were relevant, since both patients remained asymptomatic when antioxidants were avoided in food. They both had acute flares of vesicular eczema on the fingers after oral administration of small amounts. Gallate esters and Vitamin E (d,l-alpha-tocopherol) each gave one unexplained positive patch test. The present data suggest that further search for hidden sensitizers in topical medicaments and cosmetics is warranted. A declaration of all ingredients in industrial products should be placed on the label.