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A case study is presented for a 24-year-old male patient with acute dermatitis. It states he was a marine engineer on a container ship who developed severe oozing dermatitis on the forearms, dorsa of the hands, and thighs after he was exposed to warm oil from a centrifuge he was cleaning. It mentions that clinical presentation and patch testing results gave a suspicion of cobalt contamination and suggests the machine oils acted as a surfactant to allow the skin absorption of cobalt contaminants.

Background Chromium is an important skin sensitizer. Exposure to it has been regulated in cement, and recently in leather. Studies on the deposition of chromium ions on the skin as a result of handling different chromium-containing materials are sparse, but could improve the risk assessment of contact sensitization and allergic contact dermatitis caused by chromium. Objectives To determine whether the handling of chromium-containing samples of leather and metal results in the deposition of chromium onto the skin. Methods Five healthy volunteers participated. For 30 min, they handled samples of leather and metal known to contain and release chromium. Skin deposition of chromium was assessed with the acid wipe sampling technique. Results Acid wipe sampling of the participants' fingers showed chromium deposition on the skin in all participants who had been exposed to leather (range 0.01-0.20 µg/cm2) and in 3 of 5 participants after they had manually handled metal discs (range 0.02-0.04 µg/cm2). Conclusions We found that samples of leather and metal had the ability to deposit chromium on the skin at significant levels, in spite of a short duration of exposure. [ABSTRACT FROM AUTHOR]

The history of chromium as an allergen goes back more than a century, and includes an interventional success with national legislation that led to significant changes in the epidemiology of chromium allergy in construction workers. The 2015 EU Leather Regulation once again put a focus on chromium allergy, emphasizing that the investigation of chromium allergy is still far from complete. Our review article on chromium focuses on the allergen's chemical properties, its potential exposure sources, and the allergen's interaction with the skin, and also provides an overview of the regulations, and analyses the epidemiological pattern between nations and across continents. We provide an update on the allergen from a dermatological point of view, and conclude that much still remains to be discovered about the allergen, and that continued surveillance of exposure sources and prevalence rates is necessary. [ABSTRACT FROM AUTHOR]

Background Along with chromium, nickel and cobalt are the clinically most important metal allergens. However, unlike for nickel and cobalt, there is no validated colorimetric spot test that detects chromium. Such a test could help both clinicians and their patients with chromium dermatitis to identify culprit exposures. Objectives To evaluate the use of diphenylcarbazide ( DPC) as a spot test reagent for the identification of chromium( VI) release. Methods A colorimetric chromium( VI) spot test based on DPC was prepared and used on different items from small market surveys. Results The DPC spot test was able to identify chromium( VI) release at 0.5 ppm without interference from other pure metals, alloys, or leather. A market survey using the test showed no chromium( VI) release from work tools (0/100). However, chromium( VI) release from metal screws (7/60), one earring (1/50), leather shoes (4/100) and leather gloves (6/11) was observed. We found no false-positive test reactions. Confirmatory testing was performed with X-ray fluorescence ( XRF) and spectrophotometrically on extraction fluids. Conclusions The use of DPC as a colorimetric spot test reagent appears to be a good and valid test method for detecting the release of chromium( VI) ions from leather and metal articles. The spot test has the potential to become a valuable screening tool. [ABSTRACT FROM AUTHOR]

Background Cobalt is a strong skin sensitizer and a prevalent contact allergen. Recent studies have recognized exposure to leather articles as a potential cause of cobalt allergy. Objectives To examine the association between contact allergy to cobalt and a history of dermatitis resulting from exposure to leather. Methods A questionnaire case-control study was performed: the case group consisted of 183 dermatitis patients with a positive patch test reaction to cobalt chloride and a negative patch test reaction to potassium dichromate; the control group consisted of 621 dermatitis patients who did not react to either cobalt or chromium in patch testing. Comparisons were made by use of a χ2-test, Fisher's exact, and the Mann-Whitney test. Logistic regression analyses were used to test for associations while taking confounding factors into consideration. Results Leather was observed as the most frequent exposure source causing dermatitis in the case group. Although the case group significantly more often reported non-occupational dermatitis caused by leather exposure ( p < 0.001), no association was found between cobalt allergy and dermatitis caused by work-related exposure to leather. Conclusions Our study suggests a positive association between cobalt allergy and a history of dermatitis caused by non-occupational exposure to leather articles. [ABSTRACT FROM AUTHOR]

Background A patient who had suffered from persistent generalized dermatitis for 7 years was diagnosed with cobalt sensitization, and his leather couch was suspected as the culprit, owing to the clinical presentation mimicking allergic chromium dermatitis resulting from leather furniture exposure. Materials and methods The cobalt spot test, X-ray fluorescence, inductively coupled plasma mass spectrometry and scanning electron microscopy were used to determine cobalt content and release from the leather couch that caused the dermatitis and from 14 randomly collected samples of furniture leather. Results The sample from the patient's leather couch, but none of the 14 random leather samples, released cobalt in high concentrations. Dermatitis cleared when the patient stopped using his couch. Conclusions Cobalt is used in the so-called pre-metallized dyeing of leather products. Repeated studies have found high levels of cobalt sensitization, but not nickel sensitization, in patients with foot dermatitis. We raise the possibility that cobalt may be widely released from leather items, and advise dermatologists to consider this in patients with positive cobalt patch test reactions. [ABSTRACT FROM AUTHOR]

Despite an increasing knowledge of dandruff and seborrbeic dermatitis (D/SD), the pathophysiological understanding is still incomplete but suggests a role of Malassezia yeasts in triggering inflammatory and hyper-proliferative epidermal responses. The objective of this report is to review published literature from in vivo studies of D/SD populations to provide a more complete description of overall scalp health. New biomolecular capabilities establish a depth of pathophysiological understanding not previously achievable with traditional means of investigation. Biomarkers representing inflammation, hyper-proliferation and barrier function are all perturbed by the D/SD condition and robustly respond to therapeutic resolution. These biomarkers can be sampled noninvasively, enabling their use in routine clinical evaluations as either surrogate endpoints or complementary ones to classical signs/symptoms to broaden the etiological learning. [ABSTRACT FROM AUTHOR]

Background. Painters are among the occupational groups that most commonly experience occupational contact dermatitis, but few investigations exist concerning this occupation. Objectives. To characterize painters with contact dermatitis and identify the most common allergens associated with the occupation. Materials and methods. All patch test results of 219 painters and 1095 matched controls registered by the Danish Contact Dermatitis Group between 2001 and 2010 were analysed. Results. Hand eczema ( p < 0.0001) and occupational contact dermatitis ( p < 0.0001) were observed significantly more often in the painters than in the group of controls. Sensitizations to the following allergens from the European baseline series were associated with the occupation and were statistically significant: methylchloroisothiazolinone/methylisothiazolinone, epoxy resin, formaldehyde, and quaternium-15. Three different isothiazolinones emerged as the most frequent sensitizers of the allergens tested in addition to the baseline series. Conclusions. The results indicate that painters have an increased risk of developing occupational hand eczema. Isothiazolinones and epoxy resin proved to be the two most frequent sensitizers in painters. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the validity of a Danish adaptation of the Itch Severity Scale (ISS) by exploring the associations between pruritus severity, psychological symptoms, and quality of life in a consecutively recruited sample of 20 patients with atopic dermatitis, 20 with psoriasis, 20 with urticaria, 12 with genital pruritus, 11 with nephrogenic pruritus, and 20 controls with vascular malformations. Convergent and discriminative validity was explored by analysing the associations of the ISS total score and the individual ISS component scores with age, sex, diagnosis, disease severity, sleep quality, de-pressive symptoms, anxiety, non-specific somatic symptoms, and pruritus-related quality of life impairment. Patients with urticaria reported significantly (p><0.05) greater pruritus severity scores than the remaining pa-tient groups, and pruritus severity was significantly as-sociated with impaired sleep quality, more depressive symptoms, higher levels of anxiety, more non-specific somatic symptoms, and impaired quality of life. The results also confirmed the multidimensional nature of pruritus, with the affective dimension of pruritus being a better predictor of depressive symptoms, anxiety, and quality of life impairment than the sensory dimension. Finally, our results confirmed previous findings that the associations between pruritus severity and depressive symptoms and somatic symptoms were partly mediated by the effect of pruritus on sleep quality. [ABSTRACT FROM AUTHOR]

Abstract: Psoriasis is a common inflammatory skin disease and obesity constitutes a risk factor for the disease. Obese patients with psoriasis are often more difficult to treat and are at increased risk for dyslipidemia, diabetes, hypertension and cardiovascular disease. Case reports suggest that gastric bypass surgery in patients with psoriasis may result in complete remission of the disease. A substantial weight loss is achieved in the months following surgery, which is likely to reduce psoriasis symptoms and risk of comorbidities. Interestingly, however, it has been described that improvement of psoriasis is initiated immediately following surgery before any weight loss could have happened. We hypothesize that the glucose-lowering gut incretin hormone glucagon-like peptide-1 (GLP-1) is responsible for this effect. The levels of GLP-1 have been shown to increase up to 20 times after gastric bypass surgery. This most likely contributes importantly to the acute remission of type 2 diabetes, which is often induced by gastric bypass operations. The hormone is not hypersecreted after the purely restrictive bariatric procedure gastric banding and no case reports exist on improvement in psoriasis following gastric banding. Intriguingly, recent studies describe that GLP-1 may convey anti-inflammatory effects in addition to its effects on glucose homeostasis. Also, GLP-1 reduces appetite and gastrointestinal motility including gastric emptying, which reduces food intake and leads to weight loss. Thus, both a direct anti-inflammatory effect of GLP-1 as well as an indirect effect through weight loss could contribute to improvement in psoriasis. A potential involvement of GLP-1 in the remission of psoriasis observed after bariatric surgery offers exciting possibilities for research and eventually perhaps new ways of anti-psoriatic treatment. [Copyright &y& Elsevier]

Methylisothiazolinone (MI) used alone is a new preservative causing a high prevalence of contact allergy. The eliciting threshold of MI is unknown. The combination of MI and phenoxyethanol enhances the antimicrobial efficacy of MI. The eliciting doses of MI contact allergy in a patch test and a repeated open application test (ROAT) were investigated. In the patch test, it was determined whether phenoxyethanol influenced the reactivity to MI. Eleven MI-allergic individuals were patch tested with two dilution series of 12 doses of MI and the same 12 doses with phenoxyethanol. The ROAT mimicked the use of a cream preserved with 100, 50 and 5 ppm MI (corresponding to 0.21, 0.105 and 0.0105 µg MI/cm). Phenoxyethanol had no influence on the reactions to MI. The lowest eliciting dose in the patch test was 1.47 µg MI/cm. In the ROAT, 7 patients (64%) reacted to 0.21 and 0.105 µg MI/cm and 2 patients (18%) reacted to 0.0105 µg MI/cm, corresponding to a cream preserved with 5 ppm MI. A maximum of 100 ppm MI is permitted in cosmetic products. Eighteen per cent of MI-allergic patients reacted to a concentration 20 times lower in a ROAT. The amounts used in cosmetics should be reduced, and the development of MI contact allergy should be monitored closely. [ABSTRACT FROM AUTHOR]

Background: Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) has been one of the most frequent sensitizers since the 1980s. In 2005, the use of MI alone was approved for the preservation of cosmetic and household products in the EU. Before that, MI was used in industrial products, and the first cases of isolated MI contact allergy were published. Objectives: To present the prevalence and causes of MI contact allergy. Materials and methods: Patch test results from 2536 dermatitis patients tested with MI at Gentofte University Hospital between May 2006 and February 2010 were analysed. A retrospective investigation of medical records from MI-allergic patients was performed to reveal the causes of their MI contact allergy. Results: Of patch-tested patients, 1.5% had MI contact allergy. It was associated with occupational dermatitis, hand eczema and age above 40 years. Exposure to MI in cosmetic products was found in 12 (32%) cases, and exposure to MI in occupational products was found in 11 (30%) cases; 5 of the 11 were painters. Conclusions: The prevalence of MI contact allergy is already at the same level as that of other sensitizing preservatives, which have been on the market for several years, but no rising trend was identified. MI contact allergy was associated with both occupational and consumer products. [ABSTRACT FROM AUTHOR]

Methylchloroisothiazolinone and methylisothiazolinone (MCI/MI) contact allergy affects 1–3% of patch-tested patients in European centres. The aim of the present study was to evaluate the importance of the factors – time and concentration (dose/per unit area) – in the elicitation capacity by means of a repeated open application test (ROAT) experimental design. The study was designed as a double-blind, placebo-controlled, dose–response ROAT preceded by a diagnostic patch testing. 25 subjects with confirmed MCI/MI allergy and 10 healthy, non-MCI/MI allergic control subjects were exposed to 0.025 μg/cm2 (2 p.p.m.) of MCI/MI/unit area of the skin for 4 weeks. After a wash-out period of at least 4 weeks, the subjects were exposed to 0.094 μg/cm2 (7.5 p.p.m.) of MCI/MI/unit area of the skin for 4 weeks. The study showed the importance of both time and exposure in the elicitation process. It demonstrated that the elicitation threshold for MCI/MI is expected to be in the proximity of 0.025 μg/cm2 although it was not possible to establish a definitive elicitation threshold for MCI/MI in this study. [ABSTRACT FROM AUTHOR]

The morphology of early allergic contact dermatitis reactions was studied in formaldehyde allergic individuals exposed to a cream product preserved with 4 different concentrations of diazolidinyl urea. The study was made using a dose-escalating design in 3 different anatomical regions, the upper arm, neck and face. On the arm and neck, the dominant initial morphology was an eczematous papular eruption. In the face, the initial skin changes were more homogeneous and infiltrated erythema. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 24-year-old woman who is suffering from atopic dermatitis that is presented with chronic hand eczema. It details the results of the patient's patch testing which revealed an allergic reaction to sorbitan sesquioleate that was found on the vinyl rubber gloves that the patient wore when doing tasks that involves prolonged contact with water. It offers information on sorbitan sesquioleate which is considered as a weak allergen.

Primin was included in the European standard series (ESS) in 1984. In 2000, a primin-free variant of Primula obconica, the main source of contact allergy to primin, was introduced in the market. The aim of this study was to analyse the trends of primin allergy in 13 986 consecutively patch-tested eczema patients over a 20-year period from 1985 to 2004. 151 patients gave a positive patch test to primin. The majority were women, in two-third of patients the patch test was relevant and most presented with hand eczema. Only few of the cases (4.7%) were occupational. A significant decline of contact allergy to primin was seen ( P < 0.001) over the years affecting all age groups. The frequency was 0.5% during 2000–2004. Contact allergy has been rare since 2000. The low frequency of positive patch test to primin does not support inclusion in the ESS in our region. [ABSTRACT FROM AUTHOR]

A case study of 9-year-old non-atopic boy developed eczema on his face, chest, arms and legs, after his bedroom had been painted with Flügger Flutex. is presented. It discusses importance of a complete declaration of isothiazolinones in products beyond cosmetics. It further discusses risk of sensitization for contact allergens.

The article presents a case study of a 53-year-old man presented with pain and bleeding during defecation. Topics include general practitioner suspected with haemorrhoids and began treatment with doloproct and proctosedy and then treated with a gel containing the calcium channel blocker diltiazem by gastrointestinal surgeon, systemic allergic dermatitis due to application of diltiazem and neomycin in the gel used to treat anal fissures and dermatitis from other agents such as amlodipine.

The article discusses the findings of a study to assess the release of chromium (VI) in 848 jewellery items using the diphenylcarbazide (DPC) spot test. It notes that the jewellery items were purchased from different locations including Denmark, Poland, and Great Britain. The results of the DPC spot test confirm that the jewellery items failed to release more than 0.5 parts per million (ppm) of chromium (VI) which is less than the amount needed to elicit dermatitis in allergic patients.

The article presents a case study of a 28-year-old male baker who experienced persistent hand dermatitis for the past 6 months. It states that due to the nature of the patient's work, performing different tasks including the mixing of food ingredients and placing those onto baking sheets, skin contact took approximately 80-100 times in every working day. It also points out the impact of cobalt on the condition of the patient.

The article presents a case study of a 60-year-old man with dermatitis. The patient was involved in maintenance of exotic birds and didn't wear gloves while working. He developed vesicular hand eczema which later spread to his entire body. Tests revealed that dermatitis was caused by animal feed like crickets.