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1/42. The allergens of Dendropanax trifidus Makino and Fatsia japonica Decne. et Planch. and evaluation of cross-reactions with other plants of the araliaceae family.

    cis-9,17-Octadecadiene-12,14-diyne-1,16-diol (I), an analog of falcarinol has been identified in our previous report as an active component of Dendropanax trifidus and a strong sensitizer. In this report, 16-hydroxy-cis-9,17-octadecadiene-12,14-diynoic acid (II) and cis-9,trans-16-octadecadiene-12,14-diynoic acid (III) were elucidated as 2 other active components of the plant. Compound I, however, presented with the highest concentration and showed a stronger reaction on patch testing. The leaves of Fatsia japonica Decne. et Planch. were also found to contain compound I, but the amount was found to be 7x more in Dendropanax trifidus than in Fatsia japonica. 5 subjects with hypersensitivity to Dendropanax trifidus and compound I showed positive reactions when patch tested with the leaves of hedera helix L. and Schefflera arboricola. 1 of these also showed a positive reaction to the extract of panax ginseng root powder diluted 1% in ethanol. There was cross-reaction among these plants, which all belong to the araliaceae family.
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2/42. primula dermatitis.

    We report the cases of 2 patients diagnosed as having primula dermatitis. Both patients were housewives who had been exposed to primula plants. Although only one related her clinical manifestations with looking after plants, the symptoms of both remitted when contact with primula was avoided. The diagnosis was carried out with a patch test concentration of 0.01% primin pet. As primula dermatitis has variable clinical manifestations that can not easily be related to contact allergy, we emphasize the need to include synthetic primin in our standard patch test series.
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3/42. alstroemeria L. (Peruvian lily).

    Alstroemerias are one of the most common plants that cause allergic contact dermatitis in floral workers. This colorful plant has gained great popularity among florists and their patrons. This concise review will help dermatologists to gain familiarity with this plant and show how to diagnose problems that it may cause.
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4/42. Occupational contact dermatitis to phaseolus vulgaris in a farmer - a case report.

    A case of occupational contact dermatitis in a farmer is described, caused among others by phaseolus vulgaris. The patient's history of eczematous and vesicular and bullous skin reactions occurring after exposure to phaseolus was confirmed by skin tests with native leaves of the plant. To the best of our knowledge, this is the first description of occupational contact dermatitis caused by leaves of phaseolus plant.
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5/42. Airborne occupational allergic contact dermatitis from triglycidyl-p-aminophenol and tetraglycidyl-4,4'-methylene dianiline in preimpregnated epoxy products in the aircraft industry.

    BACKGROUND: Very little is known about allergic contact dermatitis (ACD) from preimpregnated epoxy products (prepregs). Objective: To describe a patient with occupational ACD from prepregs, and report new quantitative data on the content of prepregs. methods AND RESULTS: A laminator developed work-related vesicular hand dermatitis. He worked in an aircraft plant assembling aircraft parts, being exposed to preimpregnated carbon fiber and fiberglass sheets (prepregs), and epoxy adhesive tapes and foams. Triglycidyl-p-aminophenol (TGPAP; 1-0.25%, 2 ; 0.05%, 1 ) and tetraglycidyl-4,4'-methylene dianiline (TGMDA; 1%, 3 ; 0.5-0.05%, 2 ) provoked allergic patch test reactions, whereas o-diglycidyl phthalate was negative (1-0.05% pet) and standard epoxy provoked a weak (? ) reaction. Six prepreg products provoking allergic patch test reactions were analyzed for their TGPAP, TGMDA and diglycidyl ether of bisphenol A (DGEBA) content using gas and liquid chromatographic methods, showing up to 10% of TGPAP, 19% of TGMDA and 5% of DGEBA in the prepregs. An epoxy primer contained 61% of TGPAP. CONCLUSION: TGPAP and TGMDA caused occupational ACD. These chemicals need to be used when patch testing patients are exposed to prepregs, because patch testing with DGEBA may be negative.
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6/42. Intolerance of osteosynthesis material: evidence of dichromate contact allergy with concomitant oligoclonal T-cell infiltrate and TH1-type cytokine expression in the peri-implantar tissue.

    BACKGROUND: We report on a 37-year-old man without history of previous allergic disease who developed an aseptic intolerance reaction to a chromium-cobalt alloy, with local discomfort, loosening, and absence of fracture healing. Both in vivo and in vitro allergoimmunologic diagnostic tests were performed. methods: Patch testing was done with a European standard series. Specific serum IgE was measured by CAP-FEIA. In addition to immunohistology (APAAP method), peri-implantar tissue was further analyzed by PCR to determine T-cell-receptor-gamma rearrangement and thus the potential clonal (antigen-driven) T-cell repertoire. The actual tissue mRNA expression for IL-4, IL-6, and IFN-gamma was visualized by RT-PCR. RESULTS: Skin testing gave a delayed-type reaction to dichromate. Specific serum IgE to natural rubber latex and grass pollen was found--but without clinical symptoms. Immunohistology revealed a monocytic and dense T-cell infiltrate. The latter, instead of being random, showed an oligoclonal T-cell receptor rearrangement. In addition, there was TH1-type mediator expression (IL-6 and IFN-gamma, but not IL-4). CONCLUSIONS: Skin test, examination of peri-implantar tissue, and the prompt healing after replacement of the osteosynthesis material suggest an allergic reaction. PCR analysis of peri-implantar tissue can further help to identify and understand allergy-mediated implant intolerance reactions.
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7/42. Contact dermatitis to Asparagus officinalis.

    A 53-year-old farm worker presented with a 3-year history of an occupational allergic contact dermatitis to asparagus. The dermatitis cleared quickly with courses of systemic corticosteroids but relapsed within days of further exposure to asparagus. The genera Asparagus is made up of some 300 species. It belongs to the family liliaceae which includes tulips, onions and garlic. Asparagus contains asparagin, coniferin and the glucoside vanillin. The allergen may be a plant growth inhibitor, 1,2,3-Trithiane-5-carboxylic acid, which is present in young shoots.
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8/42. Patch test sensitization to Compositae mix, sesquiterpene-lactone mix, Compositae extracts, laurel leaf, Chlorophorin, Mansonone A, and dimethoxydalbergione.

    BACKGROUND: Compositae mix and sesquiterpene-lactone (SL) mix are important patch test substances to show allergic contact dermatitis from various Compositae plants. OBJECTIVES: The aims of this study are to calculate the sensitization rates to Compositae mix and SL mix in an occupational dermatology clinic and to describe cases of active sensitization caused by patch testing with Compositae mix and SL mix. methods: Conventional patch testing was performed. SL mix (0.1%) and Compositae mix (6% in petrolatum) were tested in a modified European standard series and a plant allergen series. Testing with other appropriate patch test series was also performed. RESULTS: SL mix provoked 8 allergic patch test reactions (0.7%) in 1,076 patients, whereas Compositae mix was positive in 15 of 346 patients (4.2%). Three patients were actively sensitized to Compositae mix and 1 patient to SL mix. One patient was also sensitized to other plant allergens in a series of allergenic plant chemicals, namely to Mansonone A, an ortho-quinone; (R)-3,4-dimethoxydalbergione, a quinone; and Chlorophorin, a hydroxy stilbene. Allergic patch test reactions to laurel leaf were caused by cross-sensitization to SLs. CONCLUSION: Compositae mix seems to be a more important patch test substance than SL mix to detect allergic contact dermatitis to Compositae plants, but patch testing may sensitize. The concentration of the individual components of the Compositae mix should be adjusted so that the mix detects allergic patients but does not sensitize.
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9/42. Fingertip dermatitis in a retail florist.

    prevalence of plant contact dermatitis in retail florists varies with exposure, and the number of reports of contact allergy to cut tulips is rather small. Alpha-methylene-gamma-butyrolactone is better known as the cause of both alstroemeria dermatitis in retail florists and tulip finger in wholesale floral workers who handle the bulbs. Our patient presented with prominent erythema, scaling, and peeling of the skin of the thumb, index, and middle fingers of his right hand. Results of a patch test to alpha-methylene-gamma-butyrolactone were strongly positive, and the patient determined that the exposure had occurred when he stripped leaves from the tulip stems to arrange cut flowers. Other natural sources of the antigen include alstroemeria; Bomarea; dioscorea hispida; Erythronium; Gagea; fritillaria; and at least one species of onion, allium triquetrum.
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10/42. Allergic contact dermatitis due to thiuram exposure from a fungicide.

    A 49-year-old man developed a widespread eczematous eruption following contact with plants sprayed with a fungicide. Patch testing revealed a strong reaction to thiuram mix and several of the individual thiuram mix constituents. The fungicide contained tetramethylthiuram disulphide, a thiuram chemical. Thiurams are widely recognized as a cause of rubber-glove allergy; however, they are also used extensively in fungicides.
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