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Cosmetics contain numerous potential allergens. In addition to fragrances, which are the most common cause of contact allergy because of their presence in many skin care products, preservatives are often [...]

In the past 10 years, IgE-mediated allergy to natural rubber latex has become a significant health problem in industrialized countries, especially among health care workers, patients with congenital malformations, and children with a history of multiple surgical interventions. Curative treatment inducing immunological tolerance in formerly sensitized patients is experimental and not yet generally available. Therefore, it is important to be aware of the seriousness of latex allergy and to understand the risk factors leading to this allergy. Preventive measures are needed to decrease the incidence of natural rubber latex sensitization. This article gives a brief review of the current state of knowledge concerning latex allergy, including a definition of latex, epidemiological data, identified allergens, the clinical spectrum, diagnostic procedures, cross-reactions, preventive measures, the legislative background, and economics. Arch Intern Med. 2001;161:105 7-1064

A review of literature suggests that metal compounds can be unsuspected allergens present in cosmetic products This article is part one of a three-part review that draws attention to the [...]

Dimethyl cyanocarbonimidodithioate (CAS No. 10191-60-3) a raw material for cimetidine synthesis, is labelled as an irritant on its storage tank. There is no information available regarding the toxic effects of [...]

Eczema is an inflammatory skin disease characterized by the skin redness and the formation of various types of lesions that may be solid and round, fluid- or pus-filled, scaly, crust-like, or scabby. This skin condition may result from contact with an allergen, or allergy-causing substance, and may recur upon repeated exposure to the allergen. A case is described of a 48-year-old woman with recurrent hand eczema resulting from an allergy to coins. The patient had worked as a grocery store cashier for 18 years, and routinely handled coins. When the patient took a three-week sick leave, the hand eczema healed, but recurred after she returned to work. Various skin tests involving exposure to nickel-containing coins and ingestion of a nickel-containing solution revealed that the patient was allergic to nickel. Allergy to nickel affects 10 percent of the population, and most often occurs in women. Moisture, such as sweat, high temperature, pressure, and friction can enhance the release of nickel ions from metals. The likelihood of allergy is increased with prolonged contact with nickel. Allergy to nickel is common among patients with hand eczema. The risk of nickel allergy is increased by ear piercing at an early age; work in a wet environment; purplish discoloration of skin in the extremities due to low oxygen levels; or abnormal function of the sweat glands. The incidence of hand eczema among nickel-sensitive persons is particularly increased in cashiers and hairdressers, possibly due to increased frequency of contact with nickel-containing materials. The methods for testing for nickel sensitivity are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

When topical drugs (skin ointments or creams) are used to treat skin diseases on a long-term basis, allergic contact dermatitis (skin inflammation) may develop in response to certain compounds in the cream. Hydrocortisone, however, is an often-prescribed agent that is identical to a hormone produced by the adrenal glands (cortisol, a corticosteroid). To evaluate whether patients with allergic reactions to hydrocortisone are also allergic to that drug (and related agents) given systemically, six patients were studied. The patients had developed allergic contact dermatitis from topical corticosteroids (four used hydrocortisone, two used hydrocortisone-17-butyrate). They were then tested (provoked) with oral hydrocortisone (a systemic drug). One patient received, in addition, a drug similar to ACTH (adrenocorticotropic hormone, which stimulates the production of cortisol by the adrenal glands). A placebo (inactive) drug was administered the day before the ACTH-like drug was given. Results showed that the four patients who were sensitive to topical hydrocortisone developed skin reactions in response to the systemic provocation, while the two who were not allergic to hydrocortisone developed no such reactions. The patients whose adrenal glands were stimulated also developed a skin reaction; the placebo drug was not associated with a reaction. The results show that patients with sensitivity to topical hydrocortisone can develop skin reactions to the drug when it is given systemically, and when their production of cortisol is stimulated. These findings may have clinical importance. (Consumer Summary produced by Reliance Medical Information, Inc.)

Propylene glycol is a solvent that is used in many commercial products. It is used in the preparation of medications, cosmetics, shampoos, antiperspirants, and lubricant jelly, as well as in varnishes and synthetic resins. The automotive industry uses propylene glycol in antifreeze and brake fluid. Propylene glycol is so versatile because it can be mixed with water, alcohol, acetone, chloroform or ether. Propylene glycol is an ideal medium and vehicle for the preparation and delivery of topical medicines (creams and ointments). This is because many compounds can be dissolved in it, it retains moisture very well and will not dry out, and it is inexpensive. The concentration of propylene glycol in medications can vary from 2 percent to 60 percent depending on the type of medication. Propylene glycol is used in antibiotics, antifungal agents, benzoyl peroxide preparations, emollients and corticosteroid preparations. Some people develop an allergic reaction and skin irritation (contact dermatitis) after contact with propylene glycol. If skin sensitivity to propylene glycol is suspected, then a skin patch test should be performed. The North American Contact Dermatitis Group recommends using a 10 percent aqueous solution of propylene glycol for skin patch tests. The solution is applied to the skin and the skin is observed for signs of irritation. If a person is sensitive to propylene glycol, then efforts should be made to avoid medicines and products that contain propylene glycol. (Consumer Summary produced by Reliance Medical Information, Inc.)

Examination gloves are commonly used in the health care profession. They are worn by doctors, laboratory scientists, nurses, and aides. The gloves are manufactured by several different companies, are made from a variety of different synthetic rubbers, and may contain different kinds of powder inside the glove to absorb perspiration and prevent sticking. Some people have skin that is sensitive to one or more of the materials in the glove. These people can have an allergic response to the glove material that results in a skin rash. This type of rash is called allergic contact dermatitis. The most common allergens in the gloves are the antioxidants that are added to the rubber during the manufacturing process. This article describes two cases of contact dermatitis that developed following skin contact with the antioxidant 4,4'-thiobis(6-tert-butyl-meta-cresol), also called Lowinox 44S36, in Perry latex examination gloves. The first case involved a nurse's aide who developed a rash on her hands, forearms, cheeks and neck. The rash developed on a hot sunny day, and so it was thought that the rash was related to light. The rash disappeared when she was away from work, but reappeared when she returned. When skin patch tests were performed to test potential allergens, an allergic response to Perry latex examination gloves occurred. However, the woman did not have an allergic response to 10 other brands of latex or vinyl examination gloves. The allergen in the Perry gloves was identified as Lowinox 44S36. The second case involved a female patient who developed a face rash after visiting a dentist's office where the dentist wore Perry latex gloves. Following skin patch testing, it was discovered that she was allergic to three different types of gloves. This article provides an extensive listing of different glove types to help people with specific allergies choose an appropriate glove. (Consumer Summary produced by Reliance Medical Information, Inc.)

Occupationally-related disorders frequently involve the skin. Up to 80 percent of occupational skin disorders are caused by exposure to primary irritants resulting in contact dermatitis, while the remainder are immediate or delayed allergic reactions. Most of the contact dermatitis involves the hands, and hand eruptions related to the use of disposable gloves by health professionals are a significant problem. Disposable gloves may be made from rubber or plastic derivatives. The components that are used in glove manufacturing that may be irritants are discussed. A wide range of skin and body reactions to disposable gloves are possible, from itching, hives, swelling to asthma, conjunctivitis, and anaphylactic shock (an extreme allergic reaction with swelling of the airway). Subjects with a past history of allergic reactions are more at risk for reactions to allergens in disposable gloves. Vinyl gloves are less allergenic and are often recommended. Patients have been reported to have allergic reactions to disposable gloves worn by physicians. Diagnosis of dermatitis associated with disposable gloves depends on determining the location of the reaction, the times at which it occurs and resolves, and other factors. Patch or prick testing of the subject with rubber samples may aid diagnosis. Avoiding contact with rubber gloves following diagnosis of glove-related dermatitis is difficult. Several types of surgical gloves are available which are known to produce few allergic reactions. Sterile vinyl gloves may be worn under latex gloves, or a cotton glove can be worn if sterile conditions are not necessary. A new triple-layered glove is also available. Replacement of some factors, such as ethylene oxide sterilization by radiation, or using unpowdered gloves, is a good alternative. Application of steroids before donning gloves may diminish the dermatitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Contact dermatitis is an inflammation of the skin caused by contact with an irritating or allergy-producing substance. The outcome and prognosis of this condition are reviewed, particularly with reference to cases of occupational exposure to irritants. Skin disorders are responsible for 30 percent of occupational illnesses in the United States, yet only a few studies suggest that job changes lead to resolution of the dermatitis. Most studies find that there is a poor prognosis for contact dermatitis, meaning the condition tends to become chronic. The outcome of contact dermatitis from contact with allergy-provoking substances is similar to that from irritants. Certain practices intended to help the dermatitis may actually exacerbate the problem; these include the use of skin cleansers which may be irritating, skin creams which may contain sensitizers, and rubber gloves, which may cause hives. Workers have the best outcome if they continue their skilled occupation while avoiding known irritants or allergens. Job modifications are preferred to job changes. Persistent or recurrent dermatitis is likely in many cases, and workers need to be educated to anticipate this and to cope with the situation. Nickel and chromate allergies are two significant causes of severe contact dermatitis. Other conditions, especially eczema, may be difficult to distinguish from contact dermatitis. Further research into the causes and prognosis of contact dermatitis is greatly needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

(TABULAR DATA OMITTED) A United Kingdom consumer's association study of 11,062 individuals and the USA Westat study of 35,490 subjects suggest that approximately 10 percent of the adult population may [...]

The possibility that people suffering from contact dermatitis (skin rash as a result of exposure to an irritating substance) were reacting to nickel was tested in 1,074 patients at a contact dermatitis clinic in Toronto, Canada. Subjects underwent patch tests, the application of the suspected irritant on a test strip or in a chamber worn continuously for 48 hours. The substances applied were either 2.5 percent or 5 percent nickel sulfate in petrolatum, as well as other suspected irritants. After removal of the patch, the skin response was scored according to a three-point scale. Results showed that, of 629 subjects tested with 5 percent nickel sulfate, 10.5 percent had positive reactions, with a greater percentage of females than males demonstrating reactivity. Approximately 12 percent of the 447 subjects who received the lower concentration of nickel sulfate reacted, with the same tendency for women to react more. There were no differences in occupational category between people who responded to nickel and people who did not. Potassium chromate, cobalt chloride, and formaldehyde were more likely to elicit a response in people sensitive to nickel than in people who were not sensitive to nickel, which could indicate that the threshold for irritation has been reduced in such subjects. A review of research on the subject of patch test results for nickel is presented, as well as an epidemiological discussion of nickel exposure. The findings imply that domestic exposure to nickel is more likely to induce nickel allergy than occupational exposure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Contact Dermatitis: Solutions to Rash Mysteries When it comes to solving mysteries, a super sleuth like Sherlock Holmes has nothing on a good dermatologist. Consider the case of the woman [...]

Perfumes can cause a 'contact dermatitis' reaction on skin, and it sometimes happens after the particular fragrance has been worn for awhile. Often there is just one component of the perfume that irritates the skin, but finding that component may be difficult and may require a patch test., YOU APPLY YOUR FAVORITE PERFUME behind your ears as always. By mid-morning, you're aware of a tickling sensation. By noon, it's a downright itch. It can't be the perfume you've [...]

Members of the order Lepidoptera, which includes butterflies, moths, and skippers, may cause contact dermatitis, or inflammation of the skin due to contact with an irritating substance. The larvae of the brown moth were shown to cause urticaria, a blood vessel reaction of the skin characterized by the formation of itching hives. The gypsy moth, the most important defoliating insect affecting hardwood forests in the northeastern United States, was reported to cause outbreaks of pruritic urticaria, or itching hives, in Connecticut, Massachusetts, Rhode Island, and Pennsylvania. The skin disease developed after direct physical contact with the caterpillar of the gypsy moth. Clinical characteristics of gypsy moth-induced urticaria included patchy redness; red, solid, round skin lesions; urticarial skin lesions; and the formation of linear streaks on the skin, most often in the extremities. The skin lesions may result from one of three mechanisms: the injection of toxins into the skin by the gypsy moth; irritation due to insect hairs or appendages, which are the limb-like structures of the insect; or a hypersensitivity reaction to insect antigens, or elements that can provoke an immune response. Cases are described of two patients with gypsy moth caterpillar dermatitis who developed the disease in the spring of 1990. The mechanism underlying the development of gypsy moth caterpillar dermatitis probably involves the release of histamine by the caterpillar and delayed hypersensitivity reaction in the patient. Histamine causes the triple response, characterized by the formation of a small red spot, which develops into a wheal surrounded by a flare, followed by swelling at the site of the red spot. The patients were treated with corticosteroids applied to the surface of the skin, and the skin lesions healed within a week. (Consumer Summary produced by Reliance Medical Information, Inc.)

The shiitake mushroom is the second most common edible mushroom in the world. Although allergies to mushrooms are not frequently reported, it is estimated that they may be as prevalent as allergies to pollen and mold. Allergic reactions resulting from the commercial preparation of mushrooms have been reported. The clinical symptoms reported include: bronchial asthma; allergic alveolitis (inflammation of the lung membranes), or mushroom worker's disease (MWD); and skin disorders. Recent reports of MWD have appeared in the United States. In Japan, ingestion of raw shiitake mushrooms has been associated with itching skin (toxicodermia). Allergic reactions to other types of mushrooms, such as Agaricus campestris, yellow boletus and finger mushroom, have been reported. This article describes two cases of allergic reactions to shiitake mushrooms. The first case involved a woman who had been growing shiitake mushrooms for two months. Six hours after handling the mushrooms she developed fever, chills, hives and a cough. The symptoms disappeared when she was not working. The woman began to grow oyster mushrooms instead of shiitake mushrooms and her symptoms disappeared. A skin prick test revealed that she was allergic to shiitake mushrooms. The second case involved a man who developed an itchy rash on his scalp, face and upper body after eating raw shiitake mushrooms. He was treated with corticosteroid cream, and the rash cleared up in eight weeks. The best treatment for a person with an allergy to shiitake mushrooms is to avoid contact with that type of mushroom. (Consumer Summary produced by Reliance Medical Information, Inc.)

A 33-year-old woman presented to the patch test clinic with eczema around the nail folds of both hands, which appeared 12 hours after having shellac nail polish applied at a [...]

To better characterize the vulnerability of normal, healthy skin to irritation, sodium lauryl sulfate (SLS), a known irritant, was applied to the skin of 10 female volunteers. The substance was applied to the forearm and the upper back on a patch, and allowed to remain in place for 24 hours. Control patches, used for comparison, contained water only. Twenty-four hours after patch removal, several aspects of the skin's response were evaluated. Additional measurements were made after removal of superficial skin layers by five tape strips. Results showed that the skin became more acid after removal of its superficial layer. Transepidermal water loss (TEWL, a measure of the amount of water that evaporated from the skin's surface) increased at SLS-treated regions. Skin surface pH (a measure of acidity) before and after use of the five tape strips correlated with the severity of the irritant dermatitis induced by SLS. Skin pH also correlated with the TEWL caused by exposure to the irritant. The possible mechanisms behind these relationships are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Purpuric contact dermatitis is the inflammation and bleeding of the skin due to contact with an irritating substance. A case is described of a 22-year-old woman who developed reddened, pimple-like skin lesions associated with areas of bleeding on the cheeks and chin after using five percent benzoyl peroxide gel. The lesions cleared within five weeks after discontinuing the benzoyl peroxide. This is the first report of purpuric contact dermatitis resulting from benzoyl peroxide. Typical allergic contact dermatitis is associated with accumulation of fluid in the skin, abnormalities of the epidermis, or outer skin layer, dilation of blood vessels in the skin, and accumulation of white blood cells around the skin blood vessels. In contrast, this patient had a normal epidermis, but developed an accumulation of eosinophils, a type of white blood cell, around the skin blood vessels, and blockage of skin blood vessels. Similar findings were observed in a patients with contact dermatitis due to cobalt. Microscopic examination of the blood vessels underlying the skin lesions revealed that the capillary endothelial cells inside the blood vessels were selectively damaged. This deterioration of endothelial cells may have resulted directly from selective toxic effects of the irritant, or from cytotoxic effects of natural substances called lymphokines released by cells, such as lymphocytes, in the presence of foreign substances, such as the irritant. (Consumer Summary produced by Reliance Medical Information, Inc.)

Table of Contents Abstract Case Report References Abstract An 11-year-girl presented to the Allergy department with a severe bullous, erythema and edema reaction accompanied by pruritus on the day following [...]

HERSHEY, PA. -- Although rinse-off products generally are not associated with allergic contact dermatitis, a surfactant used increasingly in shampoos, bath gels, and similar products can trigger such a reaction, [...]

When evaluating the possibility of systemic allergic contact dermatitis from nickel, consider the intensity and time since the previous reactions as well as the allergen dose. That is the advice [...]

SAN FRANCISCO -- Normally, a henna "tattoo" would be a delight for any physician concerned about the safety and permanence of tattooing. The reddish-brown drawings fade from skin in a [...]

INDIAN WELLS, CALIF. -- Contact irritants cause most cases of chronic paronychia or onycholysis, with yeast infection playing an exacerbating rather than a causative role, two small retrospective studies suggested. [...]

CLEVELAND -- Common cosmetic practices--such as use of hair dyes--may be the culprits in cases of facial contact dermatitis, said Dr. James Taylor of the Cleveland Clinic. "When considering facial [...]

Background: A 6-year-old girl who was diagnosed with diabetes mellitus 20 months previously developed erythematous, raised lesions at the site of her insulin injections. The reactions occurred when isophane and lispro insulin were administered individually or combined but not when insulin was obtained from the bottle after the septum had been removed. Objectives: To describe latex hypersensitivity in a child with diabetes and to review the literature. Design: Case report. Results: Findings from intradermal testing confirmed latex hypersensitivity. A change to insulin administration by insulin pen decreased the frequency of the reactions. Conclusion: Latex hypersensitivity should be considered in children with type 1 diabetes who develop local reactions to insulin injections. Arch Pediatr Adolesc Med. 2000;154:281-282, A pediatrician reports the case of a 6-year-old girl with type 1 diabetes who had a reaction to her insulin injections. The reaction occurred at the site of the injection. Her doctor suspected a latex sensitivity, which was confirmed by skin tests. The plungers in insulin syringes and the stoppers in insulin vials are made of latex. She began using an insulin pen, which prevented most of the reactions.

Hair dye is underappreciated as an allergen in contact dermatitis, said Dr. James Taylor of the Cleveland Clinic. Paraphenylendiamine (PPDA) in permanent hair-coloring products is the major culprit, causing contact [...]

A variety of agents, including some hand protection products, can contribute to contact dermatitis among workers. Here are some steps you can take to prevent this common problem in your […]

Health care purchasing decision-makers are showing a stronger preference for powder-free and non-latex gloves, according to a survey of infection control practitioners conducted by Healthcare Purchasing News. However, they are [...]