1/49. Fingertip dermatitis in an ophthalmologist caused by proparacaine.PURPOSE: To report the late diagnosis of allergic response to proparacaine hydrochloride in an ophthalmologist. METHOD: Case report. In a 49-year-old practicing ophthalmologist, the history, clinical findings of fingertip dermatitis, skin pathology, and skin patch testing are described. RESULTS: Proparacaine, as the initiating agent, took almost 3 years to identify because of the unusual pattern of allergy. We explored numerous treatment options before identifying and removing the offending agent. CONCLUSIONS: Ophthalmologists may be exposed to proparacaine on a daily basis. This unique report heightens the awareness of this rare work-related complication.- - - - - - - - - - ranking = 1keywords = dermatitis (Clic here for more details about this article) |
2/49. Occupational protein contact dermatitis to cornstarch in a paper adhesive.BACKGROUND: Protein contact dermatitis is better known in food-service and health-care workers than in industrial workers. Cornstarch has seldom been a problem, although it can cause contact urticaria to glove powder. OBJECTIVE: To present the case of a paper-bag maker who developed severe occupational (protein) contact dermatitis within two-three hours after returning to work. She lacked any evidence of urticaria and demonstrated largely negative patch-test results. methods: Following a history of occupational exposure to a cornstarch-based adhesive, the patient was patch-tested to materials with which she had worked, which she contacted, and with which she had attempted treatment. Following patch testing, she was prick-tested to cornstarch, the principal ingredient in the adhesive. RESULTS: Patch testing was negative except for a very mild reaction to the adhesive. Prick testing to cornstarch was more severe than the histamine control. The test site became eczematous and remained so for more than ten weeks. Avoidance of cornstarch and the adhesive was followed by clearing. CONCLUSION: Workup for prominent occupational contact dermatitis without urticaria may sometimes require testing for type 1 allergy.- - - - - - - - - - ranking = 1.4keywords = dermatitis (Clic here for more details about this article) |
3/49. Occupational asthma and contact dermatitis in a spray painter after introduction of an aziridine cross-linker.A 23-year-old spray painter developed contact dermatitis and respiratory difficulty characterized by small airways obstruction shortly after the polyfunctional aziridine cross-linker CX-100 began to be used in his workplace as a paint activator. The symptoms resolved after he was removed from the workplace and was treated with inhaled and topical steroids. Painters may have an increased risk of asthma due to exposure to a variety of agents, such as isocyanates, alkyd resins, and chromates. This case illustrates the importance of using appropriate work practices and personal protective equipment to minimize exposure. Occupational asthma is diagnosed by a history of work-related symptoms and exposure to known causative agents. The diagnosis is confirmed by serial pulmonary function testing or inhalational challenge testing. The risk of asthma attributable to occupational exposures is probably underappreciated due to underreporting and to inappropriate use of narrow definitions of exposure in epidemiologic studies of attributable risk.- - - - - - - - - - ranking = 1keywords = dermatitis (Clic here for more details about this article) |
4/49. Occupational allergic rhinitis and contact urticaria caused by bishop's weed (ammi majus).Bishop's weed (ammi majus) has been known to induce toxic phytophotodermatitis. We now describe IgE-mediated rhinitis and contact urticaria caused by exposure to bishop's weed in a 31-year-old atopic female florist. A skin prick-prick test with bishop's weed flowers gave an 8-mm wheal, and the bishop's weed-specific IgE level in the patient's serum was 9.7 PRU/ml (RAST class 3). In an immunoblotting experiment with the patient's serum, nine IgE-binding protein bands with the molecular weights 19, 34, 39-41 (doublet), 52-61 (doublet), and >67 (triplet) kDa were detected in bishop's weed extract. The patient became symptomless after she had ceased to work as a florist.- - - - - - - - - - ranking = 0.2keywords = dermatitis (Clic here for more details about this article) |
5/49. Sensitization to triglycidylisocyanurate (TGIC) with cutaneous and respiratory manifestations.The case is presented of a man with allergic contact dermatitis and occupational asthma due to triglycidylisocyanurate (TGIC), which is used as a hardener in thermosetting powder paint. The contact dermatitis was confirmed by patch testing (TGIC 0.5% and 5% in petrolatum), and the occupational asthma was confirmed by bronchial provocation testing: two challenges to an aerosol of lactose containing TGIC (0.05% and 0.1%, w/w, each for 0.5 1 2 4 min) led to a maximal decrease in FEV1 of 22% and 31% after 6 and 4 h, respectively. skin prick tests with unconjugated TGIC were possibly positive. This case confirms that exposure to TGIC in powder paints may cause not only contact dermatitis, but also occupational asthma.- - - - - - - - - - ranking = 0.6keywords = dermatitis (Clic here for more details about this article) |
6/49. 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.- - - - - - - - - - ranking = 0.2keywords = dermatitis (Clic here for more details about this article) |
7/49. Too hot to handle: an unusual exposure of HDI in specialty painters.BACKGROUND: Hexamethylene Diisocyanate (HDI) is a color stable aliphatic isocyanate that is used in specialty paints as a hardener. Due to the lower vapor pressure of its commercial biuret form, it is considered a relatively "safe" isocyanate from an exposure standpoint. This case series reports on an unusual toxic exposure to HDI. Between November 1993 and May 1994, seven specialty painters and one boiler maker who were working at three different power plants were examined at the Institute of Occupational and environmental health at west virginia University. At their respective work sites, HDI was applied to the hot surfaces of boilers that were not shut down, and allowed sufficient time to cool. Consequently, these workers were exposed to volatile HDI and its thermal decomposition products. methods: All of these workers underwent a complete physical examination, spirometry, and methacholine challenge testing. RESULTS: All 8 workers complained of dyspnea, while 4 of the 8 also complained of rash. On examination 3 workers were methacholine challenge positive and 2 had persistent rash. At follow-up 4 years later, 5 workers still had to use inhalation medication and one had progressive asthma and dermatitis. All 8 workers, by the time of the follow-up, had gone through economic and occupational changes. CONCLUSIONS: This case series reports on an unusual exposure to HDI. It is unusual in that: 1) There were two simultaneous sentinel cases with two different material safety data sheets (MSDS) for the same product, 2) Exposure was to volatile HDI and its decomposition products and 3) Hazardous conditions of exposure occurred at three different sites.- - - - - - - - - - ranking = 0.2keywords = dermatitis (Clic here for more details about this article) |
8/49. Allergic onycholysis and paronychia caused by cyanoacrylate nail glue, but not by photobonded methacrylate nails.Artificial acrylic nails may induce side effects such as fingertip dermatitis, periungual dermatitis, onycholysis, paresthesiae, Raynaud's phenomenon, ectopic facial involvement, and allergic contact dermatitis. We present a patient who developed allergic onycholysis from a cyanoacrylate used in a nail adhesive. She was able to use photobonded sculptured nails because they contain methacrylates that do not cross-react with cyanoacrylates.- - - - - - - - - - ranking = 0.6keywords = dermatitis (Clic here for more details about this article) |
9/49. Aluminium allergy in a patient with occupational contact dermatitis.Case of a 57-year-old hospital attendant with hand eczema. patch tests were read at 2 and 3 days using the 1 to 3 scoring system recommended by the Contact dermatitis research Group.- - - - - - - - - - ranking = 0.8keywords = dermatitis (Clic here for more details about this article) |
10/49. 1,6-hexanediol diacrylate: a rapid and potent sensitizer in the printing industry.Printers are exposed to a wide variety of irritants and sensitizers. Allergy developing from a single exposure to any compound is rare. We report two cases of workers in the printing industry who developed allergic contact dermatitis to 1,6-hexanediol diacrylate (HDDA) within a short period of exposure. The first developed within weeks of exposure to a plastic sheet primed with HDDA. The second developed after a single accidental exposure.- - - - - - - - - - ranking = 0.2keywords = dermatitis (Clic here for more details about this article) |
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