RESUMEN
Contact dermatitis is a common cutaneous inflammatory condition, triggered by exposure to irritant substances or allergens. Nickel is the most prevalent allergen, a metal widely used in accessories, furniture, office materials, food and in industry, with multiple exposure pathways, making it difficult to assess which exposure is causing allergic dermatitis. Here, we report a case of an administrative worker with chronic hand eczema, limited to the radial metacarpophalangeal region of the left hand, caused by occupational exposure to nickel, confirmed by nickel deposition test on the hand and a positive test with a metallic stapler used at her workplace.
Asunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Profesional , Níquel , Humanos , Níquel/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Profesional/etiología , Dermatitis Profesional/diagnóstico , Femenino , Dermatosis de la Mano/inducido químicamente , Dermatosis de la Mano/etiología , Adulto , Exposición Profesional/efectos adversos , Persona de Mediana EdadAsunto(s)
Dermatitis Alérgica por Contacto , Dermatosis de la Mano , Humanos , Dermatosis de la Mano/inducido químicamente , Dermatosis de la Mano/etiología , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/diagnóstico , Niño , Eccema/inducido químicamente , Uñas/patología , Pruebas del Parche , Masculino , FemeninoAsunto(s)
Peróxido de Benzoílo , Dermatitis Alérgica por Contacto , Dermatitis Profesional , Dermatosis de la Mano , Humanos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Profesional/etiología , Dermatitis Profesional/diagnóstico , Dermatosis de la Mano/inducido químicamente , Dermatosis de la Mano/etiología , Peróxido de Benzoílo/efectos adversos , Dermatosis Facial/inducido químicamente , Dermatosis Facial/etiología , Eccema/inducido químicamente , Pruebas del Parche , Femenino , Adulto , Masculino , Blanqueadores/efectos adversos , Púrpura/inducido químicamente , Púrpura/etiologíaAsunto(s)
Alcohol Bencilo , Dermatitis Alérgica por Contacto , Dermatitis Profesional , Dermatosis de la Mano , Pintura , Humanos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Profesional/etiología , Dermatitis Profesional/diagnóstico , Pintura/efectos adversos , Dermatosis de la Mano/inducido químicamente , Dermatosis de la Mano/etiología , Alcohol Bencilo/efectos adversos , Pruebas del Parche , Femenino , Masculino , Adulto , Persona de Mediana EdadAsunto(s)
Dermatitis Alérgica por Contacto , Dermatosis de la Mano , Pruebas del Parche , Fútbol , Humanos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/diagnóstico , Masculino , Dermatosis de la Mano/etiología , Dermatosis de la Mano/inducido químicamente , Adolescente , Dermatitis Profesional/etiología , Dermatitis Profesional/diagnósticoRESUMEN
BACKGROUND: Allergic contact dermatitis (ACD) from rubber glove usage is usually caused by rubber additives such as the accelerators. However, in analyses of the suspected gloves, ordinary rubber allergens are not always found. Accelerator-free rubber gloves are available, but some patients with accelerator allergy do not tolerate them and might also be patch test positive to them. OBJECTIVES: To identify and chemically characterize a new allergen, 2-cyanoethyl dimethyldithiocarbamate (CEDMC), in rubber gloves. We describe two patient cases: patient 1 that led us to the identification of CEDMC and patient 2 with occupational ACD caused by CEDMC. METHODS: The patients were examined with patch testing including baseline and rubber series, and their own rubber gloves. High-performance liquid chromatography (HPLC) was used for chemical analysis of rubber gloves. The allergen was synthesized and identified by nuclear magnetic resonance, mass spectrometry and infrared spectrometry, and tested on patient 2. RESULTS: CEDMC was identified by HPLC in a nitrile glove associated with hand eczema in patient 1. Patient 2 whose nitrile gloves contained CEDMC was patch test positive to CEDMC. CONCLUSIONS: CEDMC is a new contact allergen in nitrile gloves and probably forms during vulcanization from residual monomer acrylonitrile and rubber additives.
Asunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Profesional , Guantes Protectores , Nitrilos , Pruebas del Parche , Humanos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/diagnóstico , Guantes Protectores/efectos adversos , Dermatitis Profesional/etiología , Dermatitis Profesional/diagnóstico , Nitrilos/efectos adversos , Dimetilditiocarbamato/efectos adversos , Masculino , Dermatosis de la Mano/inducido químicamente , Femenino , Persona de Mediana Edad , Alérgenos/efectos adversos , Alérgenos/análisis , Adulto , Cromatografía Líquida de Alta Presión , Ditiocarba/efectos adversos , Ditiocarba/químicaAsunto(s)
Antioxidantes , Dermatitis Alérgica por Contacto , Dermatitis Profesional , Pruebas del Parche , Goma , Humanos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/prevención & control , Dermatitis Profesional/etiología , Dermatitis Profesional/prevención & control , Antioxidantes/efectos adversos , Goma/efectos adversos , Adulto , Masculino , Femenino , Dermatosis de la Mano/inducido químicamente , Dermatosis de la Mano/etiología , Dermatosis de la Mano/prevención & control , Persona de Mediana EdadAsunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Profesional , Eccema , Dermatosis de la Mano , Humanos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Dermatitis Profesional/diagnóstico , Dermatitis Profesional/etiología , Plantas , Dermatosis de la Mano/inducido químicamente , Dermatosis de la Mano/diagnóstico , Pruebas del ParcheAsunto(s)
Dermatitis Alérgica por Contacto , Eccema Dishidrótico , Eccema , Dermatosis de la Mano , Dispositivos Intrauterinos , Humanos , Femenino , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Cobre/efectos adversos , Dermatosis de la Mano/inducido químicamente , Dermatosis de la Mano/diagnóstico , Pruebas del ParcheRESUMEN
BACKGROUND: Allergic contact dermatitis to gloves is mostly induced by rubber accelerators. The European baseline series (EBS) appears insufficient to detect glove allergy. Since 2017, it is recommended to use the European rubber series (ERS) and to test the patients' own gloves. OBJECTIVES: To investigate the clinical profile of glove-wearing patients with hand eczema (HE) and to evaluate their sensitisation profile to glove allergens and the value of testing the patients' own gloves. METHODS: We conducted a French multicentre study of patients evaluated for HE between 2018 and 2020 and tested with the EBS, the ERS and their own gloves in patch tests and semi-open (SO) tests. RESULTS: A total of 279 patients were included; 32.6% of patients had positive tests to their own gloves or to glove allergens. Almost 45% of the sensitisations to glove allergens were detected only by the ERS. Among the patients tested both in patch tests and SO tests with their own gloves with positive results, 28% had positive SO tests only. Polyvinylchloride (PVC) gloves were positive in four patients. CONCLUSION: Our series confirms the need to test the ERS. All the patients' gloves must also be tested including PVC gloves. SO tests with gloves are useful as a complement to patch tests.
Asunto(s)
Dermatitis Alérgica por Contacto , Eccema , Dermatosis de la Mano , Humanos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Goma/efectos adversos , Eccema/etiología , Alérgenos/efectos adversos , Pruebas del Parche , Cloruro de Polivinilo/efectos adversos , Dermatosis de la Mano/inducido químicamente , Guantes Protectores/efectos adversosRESUMEN
BACKGROUND: The burden of occupational hand eczema in hairdressers is high, and (partly strong) allergens abound in the hair cosmetic products they use. OBJECTIVES: To systematically review published evidence concerning contact allergy to an indicative list of active ingredients of hair cosmetics, namely, p-phenylenediamine (PPD), toluene-2,5-diamine (PTD), persulfates, mostly ammonium persulfate (APS), glyceryl thioglycolate (GMTG), and ammonium thioglycolate (ATG), concerning the prevalence of sensitization, particularly in terms of a comparison (relative risk; RR) between hairdressers and non-hairdressers. METHODS: Following a PROSPERO-registered and published protocol, eligible literature published from 2000 to February 2021 was identified, yielding 322 publications, and extracted in standardized publication record forms, also considering risk of bias. RESULTS: Based on 141 publications, the contact allergy prevalence to PPD was 4.3% (95% CI: 3.8-4.9%) in consecutively patch tested patients. Other ingredients were mostly tested in an aimed fashion, yielding variable, and partly high contact allergy prevalences. Where possible, the RR was calculated, yielding an average increased sensitization risk in hairdressers of between 5.4 (PPD) and 3.4 (ATG). Additional evidence related to immediate-type hypersensitivity, experimental results, exposures, and information from case reports was qualitatively synthesized. CONCLUSIONS: An excess risk of contact allergy is clearly evident from the pooled published evidence from the last 20 years. This should prompt an improvement in working conditions and product safety.
Asunto(s)
Industria de la Belleza , Dermatitis Alérgica por Contacto , Dermatitis Profesional , Preparaciones para el Cabello , Dermatosis de la Mano , Exposición Profesional , Humanos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Dermatitis Profesional/diagnóstico , Dermatitis Profesional/epidemiología , Dermatitis Profesional/etiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/complicaciones , Tinturas para el Cabello/efectos adversos , Tinturas para el Cabello/química , Preparaciones para el Cabello/efectos adversos , Preparaciones para el Cabello/química , Hipersensibilidad Inmediata/inducido químicamente , Hipersensibilidad Inmediata/diagnóstico , Hipersensibilidad Inmediata/epidemiología , Exposición Profesional/efectos adversos , Exposición Profesional/análisis , Pruebas del Parche , Dermatosis de la Mano/inducido químicamente , Dermatosis de la Mano/diagnóstico , Dermatosis de la Mano/epidemiología , Industria de la Belleza/estadística & datos numéricosRESUMEN
A case report of a dentist presenting with allergic contact dermatitis to methacrylates present in dental bonding agent applied on the dorsum of a gloved hand. The patient presented with a localized dermatitis to the dorsum of the non-dominant hand which can be described as a 'manual tray sign'.
Asunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Profesional , Eccema , Dermatosis de la Mano , Humanos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Metacrilatos/efectos adversos , Dermatitis Profesional/etiología , Dermatitis Profesional/complicaciones , Eccema/complicaciones , Torso , Dermatosis de la Mano/inducido químicamente , Dermatosis de la Mano/diagnóstico , Dermatosis de la Mano/complicaciones , Pruebas del Parche/efectos adversosAsunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Profesional , Eccema , Dermatosis de la Mano , Humanos , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Autoinforme , Eccema/etiología , Dermatitis Profesional/epidemiología , Dermatitis Profesional/etiología , Dinamarca/epidemiología , Dermatosis de la Mano/inducido químicamenteAsunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Profesional , Dermatosis de la Mano , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Dermatitis Profesional/diagnóstico , Dermatitis Profesional/etiología , Guantes Protectores/efectos adversos , Dermatosis de la Mano/inducido químicamente , Humanos , Nitrilos/efectos adversos , TiazolesRESUMEN
BACKGROUND: Occupational hand eczema (OHE) is common in hairdressers, and many leave the trade because of the disease. However, the exact impact of OHE on career length is unknown. OBJECTIVE: To assess the effect of OHE on career length and risk factors associated with leaving the trade because of OHE in hairdressers followed-up for up to 35 years. METHODS: A prospective cohort study of Danish hairdressers graduating between 1985 and 2007 (n=5219) was performed. A questionnaire was sent in 2009 and 2020. The Danish Labor Marked Supplementary Pension Scheme provided information on affiliation to the hairdressing profession. Career length was assessed by Kaplan-Meier analyses. RESULTS: The median survival time was 12.0 (95% CI 11.0 to 13.0) years in graduates with OHE and 14.0 (95% CI 12.6 to 15.4) years in graduates without OHE (p<0.001). Graduates with a frequency of hand eczema (HE) of 'once', 'several times' and 'almost all the time' had a median survival time of 20.0 (95% CI 14.6 to 25.4), 12.0 (95% CI 10.7 to 13.3) and 7.0 (95% CI 5.6 to 8.4) years, respectively. Graduates with OHE that left the trade (partly) because of HE constituted 11.7% of the study population. Factors associated with leaving the trade because of HE included a history of atopic dermatitis (adjusted OR (aOR) 2.2 (95% CI 1.2 to 4.0), a history of a positive patch test (aOR 5.1 (95% CI 2.3 to 11.0) and allergy to hair dyes (aOR 9.4 (95% CI 3.4 to 25.6). CONCLUSION: Career length is reduced in hairdressers with OHE, especially if frequently relapsing or caused by contact allergy, for example, to hair dyes.
Asunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Profesional , Eccema , Tinturas para el Cabello , Dermatosis de la Mano , Dinamarca/epidemiología , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Dermatitis Profesional/epidemiología , Dermatitis Profesional/etiología , Eccema/epidemiología , Tinturas para el Cabello/efectos adversos , Dermatosis de la Mano/inducido químicamente , Dermatosis de la Mano/complicaciones , Dermatosis de la Mano/epidemiología , Humanos , Estudios ProspectivosRESUMEN
INTRODUCTION: Chronic hand eczema (CHE) is a highly prevalent, burdensome condition associated with functional impairment. Currently, topical therapeutics are the mainstay of CHE management. However, many cases are refractory to existing topical therapeutics, and the few existing systemic options are often limited in efficacy and by their side effect profiles. AREAS COVERED: Following a brief overview of CHE pathogenesis and existing treatments, this review will outline the mechanisms and available data on emerging and investigational drugs currently being studied in clinical trials for the treatment of CHE. EXPERT OPINION: Immunomodulatory drugs such as topical and systemic JAK inhibitors and Th2-targeting antibodies such as dupilumab are currently under investigation for CHE treatment, with early promise. Management of CHE will likely move toward more targeted treatments through clinical trials and away from broad immunosuppressants such as cyclosporine and methotrexate, which have previously been investigated for CHE and have more side effects. In coming years, CHE patients may benefit from a wider range of both topical and systemic therapeutics that target immune pathways relevant to the various CHE subtypes.