Acrylates in artificial nails-Results of product analyses and glove penetration studies.

BACKGROUND: Artificial nail materials are mixtures that are prone to contain several sensitizing (meth)acrylates. It is not known whether the listing of (meth)acrylates is correct in these products' packages. Protective gloves suited for nail work are needed. OBJECTIVES: To analyse (meth)acrylates in gel nail and acrylic nail products chemically and to compare the results with the information in the product labels, and to study penetration of artificial nail materials through selected disposable gloves. METHODS: We analysed 31 gel nail products and 6 acrylic nail products for their (meth)acrylate content by gas chromatography-mass spectrometry (GC-MS). We tested the penetration of two nail products through three disposable gloves: nitrile rubber, neoprene rubber and polyvinyl chloride (PVC). RESULTS: Altogether 32/37 products contained (meth)acrylates. In all of them, there was discrepancy between the listed (meth)acrylates and those discovered in the analysis. The commonest (meth)acrylates were hydroxyethyl methacrylate (HEMA, 20/37 samples) and hydroxypropyl methacrylate (HPMA, 9/37 samples), but many of the product packages failed to declare them. Isobornyl acrylate (IBA) was discovered in nine gel nail products. The neoprene glove could withstand nail gel for 20 min and thin nitrile glove and PVC glove for 5 min. Acrylic nail liquid penetrated through disposable gloves quickly. CONCLUSIONS: Labelling of artificial nail products was notably incorrect on most products. Requirements for product labelling must be updated so that the risk of sensitization associated with artificial nail products is clearly indicated. Disposable gloves can probably be used short-term in gel nail work, whereas disposable gloves do not protect the user from acrylic nail liquids.

Influence of polyester spacer fabric, cotton, chloroprene rubber, and silicone on microclimatic and morphologic physiologic skin parameters in vivo.

BACKGROUND: Skin diseases can develop upon disadvantageous microclimate in relation to skin contact with textiles of supporting devices. Increased temperature, moisture, mechanical fracture, pressure, and inflammatory processes often occur mutually and enhance each other in their adverse effects. Therefore, the early prevention of skin irritations by improvement of microclimatic properties of skin in contact with supporting devices is important. MATERIALS AND METHODS: In this study, the microclimate under occlusion with polyester, cotton, chloroprene rubber, and silicone textiles, used for supporting devices, was analyzed by determining several characteristic physiologic skin parameters in vivo, including temperature, moisture, and transepidermal water loss (TEWL). This is achieved by comparing a miniaturized in vivo detection device with several established optical and sensory methods in vivo. RESULTS: A highly significant TEWL decrease was found after polyester, chloroprene rubber, and silicone application. The application of all materials showed highly significant decrease in skin surface temperature, with chloroprene rubber showing the lowest. Similarly, all materials showed highly significant increase in relative moisture, where the highest increase was found for chloroprene rubber and silicone and the lowest increase for cotton. The cutaneous carotenoid concentration of chloroprene rubber, silicone, and polyester decreased. A manipulation of the surface structure of the stratum corneum was recognized for all materials except for cotton by laser scanning microscopy. CONCLUSION: The skin parameters temperature, relative moisture, antioxidant status, and TEWL can effectively characterize the microclimatic environment during occlusion with medical supporting materials. These parameters could potentially be used to develop standardized testing procedures for material evaluation.

Targeted testing with diethylthiourea often reveals clinically relevant allergic contact dermatitis caused by neoprene rubber.

BACKGROUND: Diethylthiourea is widely used in the rubber industry, particularly in neoprene rubber, and may cause allergic contact dermatitis. However, as thiourea allergens are not part of the European baseline series, the diagnosis of allergic contact dermatitis caused by thiourea compounds depends on clinical suspicion and aimed testing. OBJECTIVES: The aims of this study were to evaluate the occurrence of sensitization to diethylthiourea during a 19-year period by using data from the Allergen Bank database at the Department of Dermatology and Allergy Centre, Odense University Hospital, and to evaluate whether the yield of aimed patch tests with diethylthiourea differed between the dermatologists in practice and those working in the dermatology department. PATIENTS AND METHODS: A total of 239 patients were patch tested with diethylthiourea 1% in petrolatum obtained from the Allergen Bank. The records for patients with positive reactions were evaluated retrospectively. RESULTS: One hundred and fifty-one patients were tested by 27 different dermatologists in private practice, and positive reactions were found in 16% (24/151) of the patients; 88 patients were tested at the dermatology department, and positive reactions were found in 15% (13/88). Thus, 15% (37/239) had positive patch test reactions to diethylthiourea, all with current clinical relevance and all strong. CONCLUSION: Clinical suspicion of neoprene rubber allergy and subsequent aimed patch testing with diethylthiourea give a high yield of clinically relevant allergic patch test reactions for both dermatologists in practice and dermatologists in the hospital department.

[Allergic contact dermatitis to synthetic rubber, neoprene in compression stockings].

Compression stockings are used for patients under general anesthesia to prevent occurrence of deep venous thrombosis. We report a case of allergic contact dermatitis to synthetic rubber, neoprene in compression stockings. A 53-year-old house wife had a history of sensitivity like skin eruption and disstasis to rubber products such as rubber band. Left nephrectomy for rupture of renal angiomyolipoma was scheduled under general and epidural anesthesia. Further examination for gum allergy was not performed before the operation, although latex allergy was suspected. The operation was performed uneventfully under latex-safe environment in the operating room under guideline for latex allergy. Postoperatively, ringed edematous erythema and wheal occurred in her bilateral thighs compressed with the upper part of compression stockings. The skin symptoms continued for more than four days. After disappearance of the skin symptoms, she was discharged from the hospital on the ninth day after the operation. Synthetic rubber, neoprene, in the upper part of compression stockings to prevent slipping down might cause allergic contact dermatitis. We should take care of occurrence of allergic contact dermatitis to synthetic rubber, neoprene in compression stockings in patients with rubber allergy.

Neoprene.

Neoprene is a synthetic rubber with many common uses, including use in shoe insoles and adhesives, orthopedic braces, and gloves. Many cases of type IV hypersensitivity from neoprene contact have been reported. Thioureas, the most commonly used vulcanization accelerators in the manufacture of neoprene, are responsible for the majority of these cases. However, thioureas are not included in the TRUE Test whereas the North American Contact Dermatitis Group standard tray contains only mixed dialkyl thioureas. Since most data indicate that many cases will be missed when only mixed dialkyl thioureas are used for screening, a more complete thiourea panel should be used when neoprene hypersensitivity is suspected.

Neoprene splinting: dermatological issues.

Occupational therapists are expanding their use of custom and commercial soft splints fabricated from neoprene (polychloroprene), but little has been written regarding dermatological issues associated with this material. Skin contact with neoprene poses two dermatological risks: allergic contact dermatitis (ACD) and miliaria rubra (i.e., prickly heat). Allergic reaction to neoprene is generally ascribed to the accelerants used to manufacture the man-made rubber, specifically thiourea compounds and mercaptobenzothiazole (MBT). Symptoms of neoprene-related ACD include itching, skin eruptions, swelling, and hemorrhages into the skin. Miliaria rubra creates small, red, elevated, inflammatory papules and a tingling, burning sensation. Although neoprene hypersensitivity is rare, its incidence may grow as neoprene becomes a more commonly used material. It is recommended that therapists screen patients for a history of dermatological reactions to neoprene or other materials containing thiourea compounds or MBT and educate patients to discontinue splint use if dermatological symptoms develop. Therapists are also encouraged to notify splint manufacturers regarding all ACD reactions.

[Allergic contact eczema because of diethylthiourea in neoprene rubber]. / Allergisk kontakteksem på grund af diethylthiourea i neoprengummi.

Three cases are reported of acute allergic contact dermatitis caused by diethylthiourea in the neoprene rubber used in a diving suit and orthopedic braces. Patch testing should be done with the specific thiourea compounds, because testing with material from the suspected products may be negative. Cross-reactivity between thiourea compounds is uncommon.

Disproportionated rosin dehydroabietic acid in neoprene surgical gloves.

BACKGROUND: Allergic contact dermatitis (ACD) is a well-recognized immune-mediated disease often associated with the use of vulcanization accelerator-containing latex and nitrile gloves. Potential contact allergens in neoprene (polychloroisoprene, polychloroprene) gloves have not been reported. OBJECTIVE: The objective was to analyze extracts of neoprene surgical and examination gloves for potential contact allergens. METHODS: Four different brands of neoprene-type gloves were purchased, and dichloromethane extracts were derivatized and assayed by gas chromatographic mass spectrometry. A latex surgical glove was used as a negative control. RESULTS: Chemical species consistent with the composition of disproportionated rosin (dehydroabietic acid [DHA], didehydroabietic acid, and other pimaric or isopimaric species) were identified in dichloromethane extracts of neoprene gloves. Levels of DHA, a type IV prohapten that can be air oxidized to an active allergen, ranged from 7 to 31 mg/g of glove. A leaching study of DHA was conducted, and small amounts of DHA leached from the glove materials into artificial sweat. DHA oxidation products were not observed in any of the gloves assayed. CONCLUSION: DHA exposure may occur from neoprene-type glove use, although a potential association with glove ACD has not been established.

Contact allergy to p-tert-butylphenol formaldehyde resin and zinc diethyldithiocarbamate in a wet suit.

Rubber materials are common causes of contact dermatitis. Neoprene is a special synthetic rubber used in many products (eg, wet suits, elastic supports, gloves, shoes, and orthopedic devices). A 31-year-old man was admitted to our dermatoallergologic clinic with the development of a generalized itching erythematovesicular eruption. He reported that clinical manifestations occurred after he wore a neoprene wet suit that he was used to wearing for water sports. Although allergic contact dermatitis from a wet suit is not uncommon, it is usually due to thiourea derivatives whereas our patient presented with contact allergy to p-tert-butylphenol formaldehyde resin and zinc diethyldithiocarbamate.

Contact dermatitis from a prosthesis.

Patients wearing a prosthesis face a wide variety of medical problems. Skin complications have long been recognized, but their prevalence is still unknown. The most frequently reported disorders are allergic contact dermatitis (ACD), acroangiodermatitis, epidermoid cysts, epidermal hyperplasia, follicular hyperkeratosis, verrucous hyperplasia, bullous diseases, hyperhidrosis, infections, malignancies, and ulcerations. Contact dermatitis represents one-third of the dermatoses in amputees wearing prostheses. All patients who are suspected of having ACD should be patch tested with standard allergen series as well as materials from the patient's own prosthesis, topical medicaments, moisturizers, and cosmetics. We report a patient with an ACD to mixed dialkyl thiourea present in the rubber parts of his below-the-knee prosthesis. Thiourea derivates are used as accelerators in the manufacture of chloroprene rubber and as fixatives in photography and photocopy paper. Allergy to thiourea is relatively uncommon; different studies have shown a prevalence of 0.7% up to 2.4% in patch-tested patients. Thiourea derivates are often the allergic sources in ACD involving high-grade rubber products made of neoprene such as diving suits, protective goggles, knee braces, and continuous positive airway pressure masks. They are also present in the rubber material of prostheses, as in the case of our patient.

Positive patch-test reactions to mixed dialkyl thioureas: cross-sectional data from the North American Contact Dermatitis Group, 1994 to 2004.

BACKGROUND: Allergic contact dermatitis from thioureas is uncommon but may result from exposure to rubber, especially neoprene. OBJECTIVES: To (1) describe the population with positive patch-test reactions to mixed dialkyl thioureas (MDTU) (ie, diethylthiourea and dibutylthiourea); (2) determine clinical and occupational relevance associated with reactions to MDTU and identify the most commonly related sources and occupations; and (3) examine the frequency of co-reacting allergens in MDTU-positive patients. METHODS: A retrospective analysis of cross-sectional data of 22,025 patients patch-tested by the North American Contact Dermatitis Group between 1994 and 2004. RESULTS: Of 21,898 patients tested with MDTU, 225 (1.0%) had positive reactions; of these, 173 (76.9%) were currently relevant and 29 (17.1%) were occupationally relevant. Patients positive to MDTU were 2.6 times more likely to have foot involvement than patients with positive reactions to other allergens (p < .0001). Footwear was the most commonly identified source overall (20.0%) whereas gloves were the most common occupational source. Of the 173 patients with currently relevant MDTU reactions, 24.9% also reacted to another rubber allergen. CONCLUSIONS: Current clinical relevance of reactions to MDTU was high; occupational relevance was less frequent. Patch tests with common rubber allergens (carbamates, thiurams, and mercaptobenzothiazole) may fail to detect many cases of thiourea-induced rubber allergic contact dermatitis.

Allergic contact dermatitis to thiourea in a neoprene knee brace.

SUMMARY An elderly woman developed an itchy, weeping, erythematous, papular eruption, confined to the skin under her neoprene knee brace. Allergic contact dermatitis to diethylthiourea and to her neoprene knee brace were diagnosed by positive patch test reactions. Allergic contact dermatitis from thioureas may be underdiagnosed, as they are not tested as part of the standard patch test series. Clinicians are encouraged to consider this diagnosis in patients with reactions to synthetic rubber, especially neoprene.

Raccoon-like periorbital leukoderma from contact with swim goggles.

A 12-year-old girl developed a periorbital leukoderma from contact with swim goggles. She had worn the same goggles the preceding year and re-used them after the leukoderma had cleared without any ill effects. The hypopigmentation was believed to be caused by the leakage of breakdown products in the neoprene rubber or glue. These breakdown products may have caused a toxic rather than an allergic reaction on skin contact, inhibiting melanin production possibly by competitive inhibition of tyrosine oxidation. These chemical compounds probably leaked from the goggles and were eventually exhausted. This possibility may explain why the leukoderma did not recur after re-use of the goggles.

New resin allergens in shoe contact dermatitis.

Changes in the shoe industry have replaced some of the former allergens and introduced some new ones. In 45 cases of shoe contact dermatitis, the lack of response to known allergens inspired the authors to review present-day industrial shoe manufacture. Two new resin allergens for shoe dermatitis have been found: dodecyl mercapthane and polyurethanes. The first is used in the plastics industry to arrest the polymerization process. We suggest the possibility that a certain number of Neoprene sensitizations could be sensitizations to dodecyl mercapthane contained in it. The recommended solution for patch testing is: 0.1% in toluol.