Contact allergy to metals in adolescents: nickel release from metal accessories 7 years after the implementation of the EU Nickel Directive in Poland.

BACKGROUND: Contact allergy among adolescents is an important issue. OBJECTIVES: To assess the prevalence of contact allergy to metals in adolescents aged 15 years and nickel release from metal accessories that are in direct contact with the skin. METHODS: Three hundred and nine females and 219 males, all 15 years old, from randomly selected secondary schools were examined and patch tested with nickel sulfate, cobalt chloride, palladium chloride, and potassium dichromate. Three hundred and ninety-nine metal accessories were tested with the dimethylglyoxime (DMG) test. RESULTS: 'Metal dermatitis' was reported by 19.4% of females and 0.5% of males. Positive patch test reactions were found in 8.5% of the adolescents (12.9% in females; 2.3% in males), namely to: nickel (12.3% of females; 1.4% of males); palladium (5.2% of females; 0.5% of males); cobalt (3.2% of females; 1.4% of males); and chromium (1.3% of females; 0.9% of males). Allergic contact dermatitis caused by metals was diagnosed in 9.7% of females and in 0.5% of males. Of the metal items, 26.1% gave positive DMG test results: 10.0% of earrings, 11.4% of snaps, and 56.2% of belt buckles. CONCLUSIONS: Despite the implementation of the Nickel Directive in Poland, nickel still remains an important causal factor for allergic contact dermatitis. Numerous metal accessories do not comply with the Directive.

Current patch test results with the European baseline series and extensions to it from the 'European Surveillance System on Contact Allergy' network, 2007-2008.

BACKGROUND: The pattern of contact sensitization to the supposedly most important allergens assembled in the baseline series differs between countries, presumably at least partly because of exposure differences. Objectives. To describe the prevalence of contact sensitization to allergens tested in consecutive patients in the years 2007 and 2008, and to discuss possible differences. METHODS: Data from the 39 departments in 11 European countries comprising the European Surveillance System on Contact Allergy network (www.essca-dc.org) in this period have been pooled and analysed according to common standards. RESULTS: Patch test results with the European baseline series, and country-specific or department-specific additions to it, obtained in 25 181 patients, showed marked international variation. Metals and fragrances are still the most frequent allergens across Europe. Some allergens tested nationally may be useful future additions to the European baseline series, for example methylisothiazolinone, whereas a few long-term components of the European baseline series, namely primin and clioquinol, no longer warrant routine testing. CONCLUSIONS: The present analysis points to 'excess' prevalences of specific contact sensitization in some countries, although interpretation must be cautious if only few, and possibly specialized, centres are representing one country. A comparison as presented may help to target in-depth research into possible causes of 'excess' exposure, and/or consideration of methodological issues, including modifications to the baseline series.

Dermatological screening and results of patch testing among Polish apprentice hairdressers.

BACKGROUND: High prevalence of occupational dermatoses among hairdressers has been confirmed in many studies, while work-related skin disorders in apprentice hairdressers are less known. OBJECTIVES: The aim of the study was to investigate the frequency of work-related skin disorders among apprentice hairdressers, and to identify the factors contributing to the development of dermatoses during vocational training. PATIENTS AND METHODS: One hundred thirty-nine apprentice hairdressers, aged 17-19 years, were included in the study. A questionnaire survey, personal interview, dermatological examination and patch tests were conducted. RESULTS: Present or past work-related skin conditions affecting the hands were reported by 43.9% of individuals, and diagnosed in 25.9% on dermatological examination. Positive patch test results were found in 38.1%. The most frequent allergens were nickel (29.3% of all tested) and ammonium persulfate (8.3%). Allergic contact dermatitis was recorded in 27.3%, and was of occupational origin in 87.9% of all tested individuals. Irritant contact dermatitis was diagnosed in 51.1% of participants (this prevalence was higher than that based only on an interview). Survey responses revealed inadequate knowledge of the risk of occupational skin diseases and protective measures. CONCLUSIONS: It is necessary to implement an educational programme for apprentice hairdressers, in order to increase their knowledge of the risk of skin damage and to promote appropriate use of protective measures, starting from the earliest stages of their training.

Systemic contact dermatitis to nickel present in cocoa in 14-year-old boy.

Systemic contact dermatitis can be elicited in nickel sensitive individuals by oral nickel exposure from food with high content of this metal, such as cocoa. We present a case report of a nonatopic teenager who developed allergic contact dermatitis due to nickel, cobalt, copper, and palladium, but exacerbations of skin lesions were mainly related to cocoa consumption.

[Irritant contact dermatitis. Part III. Non-invasive methods to assess biophysical properties of the skin]. / Kontaktowe zapalenie skóry z podraznienia. Czesc III. Nieinwazyjne metody oceny wlasciwosci biofizycznych skóry.

Disturbances in biophysical properties of the skin during irritant reactions induced by exposure to chemicals may be assessed by several non-invasive methods. The most popular one involves determinations of transepidermal water loss, stratum corneum hydration, skin pH and evaluation of erythema, pigmentation and skin blood flow. Non-invasive techniques are also applied to assess individual skin susceptibility to irritants. In dermatology and cosmetology they provide information about efficacy and safety of medicines, cosmetics and hygiene products. Determinations of skin parameters may also be useful in diagnosing and monitoring of various dermatoses and in the observation of changes in skin properties caused by the disease.

[Wet work]. / Wet work--praca w srodowisku mokrym.

Wet work is one of the most important risk factors of occupational skin diseases. Exposure of hands to the wet environment for more than 2 hours daily, wearing moisture-proof protective gloves for a corresponding period of time or necessity to wash hands frequently lead to the disruption of epidermal stratum corneum, damage to skin barrier function and induction of irritant contact dermatitis. It may also promote penetration of allergens into the skin and increase the risk of sensitization to occupational allergens. Exposure to wet work plays a significant role in occupations, such as hairdressers and barbers, nurses and other health care workers, cleaning staff, food handlers and metalworkers. It is more common among women because many occupations involving wet work are female-dominated. The incidence of wet-work-induced occupational skin diseases can be reduced by taking appropriate preventive measures. These include identification of high-risk groups, education of workers, organization of work enabling to minimize the exposure to wet work, use of personal protective equipment and skin care after work.

[Irritant contact dermatitis. Part II. Evaluation evaluation of skin irritation potential of chemicals]. / Kontaktowe zapalenie skóry z podraznienia. Czesc II. Metody badania dzialania drazniacego substancji chemicznych.

The evaluation of skin irritation potential of chemicals is essential to secure the safety of individuals exposed to several substances designed for industrial, pharmaceutical or cosmetic use. Until recently, preclinical safety assessment of chemicals was largely based on animal experiments. Ethical concerns and the limited value of animal models in evaluating human skin irritation potential resulted in the development of alternative in vitro methods, such as EpiDerm, EPISKIN or SkinEthic, to assess irritation, i.e. cell cultures and human epidermis models. International organizations like the European Centre for the Validation of Alternative Methods (ECVAM) promotes and monitors the development of nonanimal tests. Human patch tests and use tests also provide an opportunity to identify substances with significant skin irritation potential without recourse to the use of animals. These tests are useful to assess skin irritation potential of cosmetics and detergents.

[Occupational contact dermatitis in hairdressers]. / Zawodowe kontaktowe zapalenie skóry u fryzjerów.

Numerous data from the medical literature show that working as a hairdresser is associated with the highest risk of occupational contact dermatitis. In Europe, hairdressers rank first of all occupation groups with the highest prevalence of occupational dermatitis. It is estimated that 10-20% and even 50% of hairdressers are affected with skin disorders. Skin problems occur soon after commencing hairdressing, in the first 2 years of work, sometimes during vocational training. The most common factors contributing to skin damage include water, shampoos, detergents, conditioners, hair dyes, bleaches, permanent wave solutions and components of gloves. Water and wet work are prime skin irritants - causal factors of irritant contact dermatitis while p-phenylenediamine, glyceryl monothioglycolate, ammonium persulfate and also fragrances, preservatives, disinfectants and metals are the most important allergens, which induce allergic contact dermatitis.

[The role of regulatory T cells in allergic contact dermatitis]. / Rola limfocytów T regulatorowych w alergicznym kontaktowym zapaleniu skóry.

Regulatory T cells (Treg) play a crucial role in the regulatory mechanisms of immune system. They are responsible for the induction and maintenance of immune tolerance. They are also involved in the pathogenesis of autoimmune and allergic diseases and implicated in transplant rejection and immunopathology of cancers. Treg cells constitute the population of lymphocytes heterogeneous in their phenotype. CD4+CD25+Foxp3+ cells are most important among Treg subsets. Modification of Treg actvity may be useful in the therapy of different diseases, including allergic disorders.

[Results of patch test in hairdressers examined in the institute of occupational medicine in Lódz]. / Wyniki testów naskórkowych u fryzjerów badanych w instytucie medycyny pracy w Lodzi.

BACKGROUND: Occupational contact dermatitis is a significant health problem in hairdressers. The number of occupational skin diseases in this group constantly increases. The most frequent factors contributing to the skin damage include water, shampoos, detergents, conditioners, hair dyes, bleaches, permanent wave solutions, and components of gloves. MATERIAL AND METHODS: A group of 121 hairdressers (106 women and 6 men) was selected from 4523 patients (2996 women and 1527 men) referred to the Nofer Institute of Occupational Medicine, Lódz, in 1995-2008, with suspected occupational skin disease. All hairdressers underwent dermatological examination and allergy tests (patch tests with allergens of the European Standard Series and Hairdressing Series, Chemotechnique Diagnostics, Sweden; skin prick tests, Allergopharma, Germany). RESULTS AND CONCLUSIONS: Females were more prevalent than males and constituted 94.6% of the study group. Of all the study participants, 30% were trainee hairdressers. At least one positive patch test reaction was found in 69.7% of patients whereas in 30.3% patch tests were negative. The most frequent contact allergens were: nickel sulfate (40% of females), p-phenylenediamine (one fourth of the study group), ammonium persulfate (23.2%), cobalt chloride (21.4%), 2,5-diaminotoluene sulfate (9.8%), formaldehyde (9.8%), ammonium thioglycolate (7.1%), and glyceryl monothioglycolate (7.1%). Moreover, we found positive patch test reactions to thimerosal (14.3%), palladium chloride (11.6%), potassium dichromate (5.3%) and fragrance mix (4.5%). Altogether, occupational origin of skin disease was confirmed in 46.4% of hairdressers with allergic contact dermatitis, in 48.2% of those diagnosed with irritant contact dermatitis and in 0.9% of hairdressers suffering from urticaria. 71% of trainee hairdressers were finally diagnosed with allergic contact dermatitis, caused first of all by ammonium persulfate, p-phenylenediamine, nickel and thimerosal. In conclusion, it seems to be indispensable to implement health education program during vocational training of hairdressers and to promote specific preventive measures in this occupational group.

[The role of Langerhans cells in the skin immune system]. / Znaczenie komórek Langerhansa w ukladzie immunologicznym skóry.

Langerhans cells (LC) are members of the dendritic cells family, residing in the basal and suprabasal layers of the epidermis and in the epithelia of the respiratory, digestive and urogenital tracts. They specialize in antigen presentation and belong to the skin immune system (SIS). LC acquire antigens in peripheral tissues, transport them to regional lymph nodes, present to naive T cells and initiate adaptive immune response. LC have strong immunogenic properties but they may also act as mediators of tolerance, for example to comensal bacteria. They are involved in antimicrobial immunity, skin immunosurveillance, induction phase of the contact hypersensitivity and in the pathogenesis of chronic inflammatory diseases of the skin or mucosa. We present the current knowledge of Langerhans cells' role in the skin immune system.

[Irritant contact dermatitis. Part I. Epidemiology, etiopathogenesis and clinical manifestation]. / Kontaktowe zapalenie skóry z podraznienia. Czesc I. Epidemiologia, etiopatogeneza i obraz kliniczny.

Irritant contact dermatitis is a frequent problem in dermatology. It compromises the majority of all occupational skin diseases in most countries. It develops as a result of the environmental or work-related exposure to irritants. Cutaneous reaction depends on the intrinsic properties of the irritant, individual skin susceptibility and environmental conditions. A great morphological variety of irritant contact dermatitis and difficulties in diagnosis may lead to misdiagnosis and inadequate treatment. The prognosis is variable. Preventive measures, including education, individual skin protection and proper skin care may contribute to the reduced incidence of occupational irritant contact dermatitis.