RESUMO
d-Limonene, obtained as a by-product from the citrus juice industry, was introduced on the market as a more environmentally friendly defatting and cleaning agent than the traditionally used organic solvents. Autoxidation of d-limonene readily occurs to give a variety of oxygenated monocyclic terpenes that are strong contact allergens. The aim of the present study was to investigate the prevalence of contact allergy to air exposed d-limonene among dermatitis patients. A fraction consisting of d-limonene hydroperoxides was also tested. Screening with oxidized d-limonene will detect cases of allergic contact dermatitis. Additional cases were detected when testing with the fraction of limonene hydroperoxides. The proportion of positive patch test reactions to oxidized d-limonene was comparable to that seen for several of the allergens within the standard series. An increased use of d-limonene containing allergenic oxidation products in industry where high concentrations are used, as well as in domestic exposure, might result in contact sensitization and dermatitis. Patients reacting to d-limonene often reacted to fragrance mix, balsam of Peru and colophony in the standard series.
Assuntos
Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Produtos Domésticos/efeitos adversos , Terpenos/efeitos adversos , Intervalos de Confiança , Cicloexenos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/epidemiologia , Monitoramento Ambiental , Monitoramento Epidemiológico , Produtos Domésticos/análise , Humanos , Limoneno , Testes do Emplastro , Prevalência , Sensibilidade e Especificidade , Terpenos/análiseRESUMO
This article describes the results of an EECDRG multicentre study on contact allergy to corticosteroids. A total of 7238 patients were investigated: 6238 in 13 centres in the course of 1993, and 1000 patients in 1 centre in 1993 and 1994. The 5 corticosteroids tested were budesonide 0.1% pet., betamethasone-17-valerate 1% pet., clobetasol-17-propionate 1% pet., hydrocortisone-17-butyrate 1% eth., and tixocortol-21-pivalate 1% pet.; 189 (2.6%) gave a positive patchtest reaction (+, ++, + + +) to at least 1 of the corticosteroids. The data regarding the corticosteroid-sensitive patients, as well as the patchtest results, were recorded on a standardized form.
Assuntos
Anti-Inflamatórios/efeitos adversos , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Administração Tópica , Anti-Inflamatórios/farmacologia , Europa (Continente)/epidemiologia , Feminino , Glucocorticoides , Humanos , Incidência , MasculinoRESUMO
Mometasone furoate is a new corticosteroid, synthesized to have an improved ratio of anti-inflammatory potential to adverse effects. The guinea pig maximization test was used to determine the sensitizing capacity of mometasone furoate, and also to investigate cross-reaction patterns in animals sensitized to tixocortol pivalate and budesonide, respectively. Tixocortol pivalate was shown to be a sensitizer in the guinea pig, but cross-reactions to other tested corticosteroids were not observed. Furthermore, no sensitizing capacity could be demonstrated for budesonide or mometasone furoate.
Assuntos
Anti-Inflamatórios/farmacologia , Dermatite Alérgica de Contato/etiologia , Hidrocortisona/análogos & derivados , Pregnadienodiois/farmacologia , Pregnenodionas/farmacologia , Administração Cutânea , Administração Tópica , Animais , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/efeitos adversos , Budesonida , Reações Cruzadas , Feminino , Glucocorticoides/farmacologia , Cobaias , Hidrocortisona/administração & dosagem , Hidrocortisona/efeitos adversos , Hidrocortisona/farmacologia , Imunização , Injeções Intradérmicas , Furoato de Mometasona , Testes do Emplastro , Prednisolona/farmacologia , Pregnadienodiois/administração & dosagem , Pregnenodionas/administração & dosagem , Fatores de Tempo , Triancinolona Acetonida/farmacologiaAssuntos
Corticosteroides/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Corticosteroides/classificação , Corticosteroides/imunologia , Reações Cruzadas/imunologia , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/tratamento farmacológico , Hipersensibilidade a Drogas/imunologia , Humanos , Testes do EmplastroAssuntos
Cosméticos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatite Fotoalérgica/etiologia , Tensoativos/efeitos adversos , Cosméticos/administração & dosagem , Detergentes/administração & dosagem , Detergentes/efeitos adversos , Humanos , Perfumes/administração & dosagem , Perfumes/efeitos adversos , Sabões/administração & dosagem , Sabões/efeitos adversos , Tensoativos/administração & dosagemRESUMO
The objective of this study was to determine the frequency of reactivity to a series of commonly used fragrances in dermatological patients. A total of 48 fragrances (FF) were chosen, based on the publication of Fenn in 1989 in which the top 25 constituents of 3 types (1. perfumes, 2. household products, 3. soaps) of 400 commercial products on the US market had been determined. In a pilot study on a total of 1069 patients in 11 centres, the appropriate test concentration and vehicle were examined. For most fragrances, 1% and 5% were chosen, and petrolatum proved to be the best vehicle in comparison to isopropyl myristate and diethyl phthalate. In the main study, a set of 5 to 10 fragrances at 2 concentrations was patch tested in each centre on a minimum of 100 consecutive patients seen in the patch test clinic. These patients were also patch tested to a standard series with the 8% fragrance mix (FM) and its 8 constituents. In patients with a positive reaction to any of the 48 FF, a careful history with regard to past or present reactions to perfumed products was taken. A total of 1323 patients were tested in 11 centres. The 8% FM was positive in 89 patients (8.3% of 1072 patients). Allergic reactions to the constituents were most frequent to oak moss (24), isoeugenol (20), eugenol (13), cinnamic aldehyde (10) and geraniol (8). Reactions read as allergic on day 3/4 were observed only 10X to 7 materials of the new series (Iso E Super (2), Lyral (3), Cyclacet (1), DMBCA (1), Vertofix (1), citronellol (1) and amyl salicylate (1)). The remaining 41 fragrances were negative. 28 irritant or doubtful reactions on day 3/4 were observed to a total of 19 FF materials (more than 1 reaction: 5% citronellol (2), 1% amyl salicylate (2), 1% isononyl acetate (3), 0.1% musk xylol (2), 1% citral (2), and 1% ionone beta (2)). Clinical relevance of positive reactions to any of the FF series was not proved in a single case. This included the 4 reactions in patients who were negative to the 8% FM. In conclusion, the top 25 fragrances commonly found in various products caused few reactions in dermatological patients and these few appeared to be clinically irrelevant, with the possible exception of Lyral. However, this data should be interpreted in the light of the relatively small number of patients tested (only 100 in most centres).
Assuntos
Alérgenos/efeitos adversos , Irritantes/efeitos adversos , Monoterpenos , Testes do Emplastro , Perfumes/efeitos adversos , Acroleína/efeitos adversos , Acroleína/análogos & derivados , Monoterpenos Acíclicos , Aldeídos/efeitos adversos , Alérgenos/análise , Cicloexenos , Dermatite Alérgica de Contato/etiologia , Dermatite Irritante/etiologia , Eugenol/efeitos adversos , Eugenol/análogos & derivados , Europa (Continente) , Produtos Domésticos/efeitos adversos , Produtos Domésticos/análise , Humanos , Irritantes/análise , Miristatos , Perfumes/análise , Vaselina , Veículos Farmacêuticos , Ácidos Ftálicos , Projetos Piloto , Plantas , Sabões/efeitos adversos , Sabões/análise , Terpenos/efeitos adversos , Estados Unidos , Xilenos/efeitos adversosAssuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Toxidermias/etiologia , Eritema Multiforme/induzido quimicamente , Fenilbutazona/efeitos adversos , Idoso , Dermatite Alérgica de Contato/diagnóstico , Diagnóstico Diferencial , Toxidermias/diagnóstico , Eritema Multiforme/diagnóstico , Feminino , Humanos , Testes do EmplastroRESUMO
The frequency with which sensitisation to corticosteroids occurs is under-recognised, and depends on factors such as the type and amount of corticosteroid used, the awareness of the need to test for corticosteroid sensitivity and the methods used to do so. Topically applied corticosteroids, in particular, but also inhalation and systemic corticosteroids may cause allergic reactions. The clinical picture as well as the patch test reactions can be deceptive. Moreover, concomitant and cross-reactions are common.
Assuntos
Corticosteroides/efeitos adversos , Anti-Inflamatórios/efeitos adversos , Hipersensibilidade a Drogas/fisiopatologia , Corticosteroides/administração & dosagem , Corticosteroides/uso terapêutico , Animais , Anti-Inflamatórios/uso terapêutico , Reações Cruzadas , Toxidermias/fisiopatologia , Humanos , EsteroidesAssuntos
Acrilatos/efeitos adversos , Alérgenos , Dermatite Ocupacional/etiologia , Compostos de Epóxi/efeitos adversos , Dermatoses da Mão/induzido quimicamente , Metacrilatos/efeitos adversos , Papel , Têxteis , Adulto , Dermatite Ocupacional/fisiopatologia , Feminino , Dermatoses da Mão/fisiopatologia , Humanos , Testes do EmplastroRESUMO
The present article reviews the literature (up to 1994) on contact sensitivity to imidazoles and presents the results obtained from 15 patients observed at the Contact Allergy Unit in Leuven. The frequency as well as the cross-reaction patterns described are analyzed. Although allergic contact reactions may have been missed in the past (mainly because of problems with the correct choice of vehicle for patch testing), they seem to be relatively infrequent in view of their widespread use. The imidazole derivatives most frequently reported to be allergens are miconazole, econazole, tioconazole, and isoconazole. As far as cross-reactivity is concerned, statistically significant associations were found in the patient data between miconazole, econazole, and isoconazole; between sulconazole, miconazole, and econazole; and also between isoconazole and tioconazole. Patients sensitive to phenylethyl imidazoles (except ketoconazole) needing antimycotic therapy should be advised to use ketoconazole, clotrimazole, bifonazole, or, perhaps, the new flutrimazole. Clearly, non-imidazole antifungals can also be used.
Assuntos
Antifúngicos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Imidazóis/efeitos adversos , Animais , Antifúngicos/química , Antifúngicos/farmacologia , Reações Cruzadas , Humanos , Imidazóis/química , Imidazóis/farmacologia , Testes do EmplastroRESUMO
We present a 43-year-old man who worked in the plastics industry and who suffered from an occupational dermatitis on the hands and forearms. He was found to be allergic to an epoxy silane compound that was contaminated with allyl glycidyl ether, a reactive epoxy diluent. HPLC analysis and patch testing indicated that this impurity was probably the only sensitizer. Moreover, the gloves used provided absolutely no protection, as the inner side also generated strong positive reactions.
Assuntos
Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Compostos de Epóxi/efeitos adversos , Poliuretanos/química , Silicones/química , Adulto , Dermatite Alérgica de Contato/prevenção & controle , Dermatite Ocupacional/prevenção & controle , Luvas Protetoras , Humanos , MasculinoAssuntos
Carbodi-Imidas/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Administração Tópica , Adulto , Anti-Inflamatórios/uso terapêutico , Dermatite Alérgica de Contato/tratamento farmacológico , Dermatite Ocupacional/tratamento farmacológico , Feminino , Glucocorticoides , Humanos , MasculinoRESUMO
Contact allergy to corticosteroids now seems frequent among patients being patch tested. As corticosteroids are intrinsically anti-inflammatory, we investigated whether patch tests with a potent corticosteroid might suppress simultaneous adjacent patch test reactions to another allergen. Nickel-sensitive subjects were patch tested with an aqueous dilution series of nickel in duplicate, adjacent to patch tests with clobetasol propionate 1% in ethanol and with ethanol, respectively. Statistical evaluation of the results obtained in 2 different centers, using their own patch test techniques, did not reveal any suppression of the positive nickel patch test reactions.