Cases reported "Dermatitis, Contact"

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11/73. Long-standing dermatological manifestations in a patient with chronic heavy metal intoxication.

    A patient with chronic metal intoxication is described, presenting during four years after the cessation of her exposure to industrial substances, maculo-papular eruptions with several ulcerated lesions and excoriations on her abdomen and buttocks. She also had pallor of her face, greyish-dark discoloration of the hair, while the fingernails were brittle and sensitive. Scrupulous physical examination excluded further cutaneous involvement. The immunological workup revealed both phenotypic and functional defects in cellular immunity.
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12/73. Allergic contact dermatitis from chironomids.

    Although Type I allergy to chironomids is well-known, allergic contact dermatitis caused by these cosmopolitan insects has not previously been reported. In the case we describe in this report, patch tests disclosed a delayed-type hypersensitivity to 4 different species of chironomids (larvae of Chironomus thummi, Chironomus plumosus, and 2 different species of Glyptotendipes) as the probable cause of airborne facial contact dermatitis. An additional asymptomatic immediate-type allergy to chironomids was demonstrated by scratch tests and specific IgE. The possible sources of exposure to chironomids, their allergens and their distribution are discussed with regard to clinical implications.
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13/73. Contact allergy due to lichens in patients with a history of photosensitivity.

    Ten patients with a history of photosensitivity and of a rash showed abnormal reactions to long-wave UVR. The rash occurred particularly in areas exposed to light, though other areas were occasionally involved. The development of the rash could in all patients be related to contact with lichens and although exposure to sunlight usually led to an aggravation of symptoms, some patients, particularly forestry workers, showed exacerbations even during the winter. Positive responses were observed in both irradiated and non-irradiated patch tests with different species of lichen and in several patients irradiation precipitated a stronger response. These findings suggest that lichens can cause both contact and photocontact dermatitis. The suspected allergens contained in these lichens are atranorin, physodalic and pysodic acids.
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14/73. A farmer's occupational airborne contact dermatitis masqueraded by coexisting rosacea: delayed diagnosis and legal acknowledgement.

    A rare case of coexistence of occupational airborne dermatitis with rosacea is presented in a 41-year-old female farmer. Her first dermatitis symptoms appeared at the age of 10 when she started helping her parents on the farm. Uncovered skin areas of the face, neck, decollete, forearms and the hands gradually became involved. The dermatitis symptoms were provoked by agricultural dusts (especially of flax and dried herbs). For the subsequent 30 years, the work-related disease remained undiagnosed due to the lack of pre-employment and periodical health check in agriculture. She also suffered from protein contact dermatitis of the hands from cow epithelium. About 20 years after the onset of airborne dermatitis, rosacea developed, possibly secondary to the prolonged treatment. Diagnostic tests carried out at our department confirmed hypersensitivity to occupational allergens: type I allergy to storage mites, moulds, and cow epithelium. A cutaneous late-phase reaction on prick tests and serum precipitins to the bacterium pantoea agglomerans (erwinia herbicola) also were found. Among non-occupational hypersensitivities, type I allergy to house dust mites and contact allergy to methylchloroisothiazolinone/methylisothiazolinone (Kathon CG) was found. In connection with these results, the significance of agricultural dusts in farmers' airborne dermatitis is discussed. Also presented are the problems with obtaining acceptance from the State Sanitary Authority for qualification of this case as an occupational disease, which was due to the coexistence of the non-occupational rosacea. Discussed is also the problem of pre-employment exposure to occupational allergens among farmers' children, and the difficulties with delivering occupational health services to self-employed farmers.
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15/73. Four bakers showing positive patch-tests to a number of fragrance materials, which can also be used as flavors.

    Contact sensitization to fragrance materials may be caused by occupational exposure to flavor compositions in the food trade and needs not to be due to cosmetic exposure exclusively. To illustrate this, investigative results in four bakers are discussed.
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keywords = occupational exposure, exposure
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16/73. Allergic contact dermatitis caused by mushrooms. A case report and literature review.

    The first author is allergic to skin contact with mushrooms of Suillus americanus, S. granulatus, S. grevillei, S. luteus, or S. neoalbidipes. Symptoms develop between one and two days after contact and last for approximately a week, disappearing completely without treatment. Symptoms consist of reddening, swelling, and itching, at the sites of contact with pileus cuticle mucilage of all five species. Pore layer tissues (tested for S. americanus and S. luteus) also produced strong reactions, as did pileus trama (tested for S. luteus). spores from spore prints (tested for S. americanus and S. luteus) produced no reaction. The reaction can be avoided by wearing gloves when handling allergic species and by washing hands promptly after working with these species. Similar cases, reported from north america, europe, and russia, involve agaricus, Boletus, Lactarius, Paxillus, Ramaria, and Suillus species. Several cases involve allergy to multiple species or genera. Symptom severity varies, presumably with intensity of exposure. In one case, symptoms were renewed following ingestion. Most cases demonstrate delayed allergic contact sensitivity.
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17/73. Chromate sensitization and elicitation from cement with iron sulfate.

    For some years, iron sulfate has been added to cement manufactured in the Scandinavian countries to prevent sensitization to and elicitation from chromate in cement. Allergic contact dermatitis from chromate is reported here in 3 workers with hand dermatitis and exposure to cement containing iron sulfate. Although iron sulfate had been added to the cement, high chromate concentrations were found in many samples of cement to which these workers were exposed.
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18/73. Allergic contact dermatitis to two antioxidants in latex gloves: 4,4'-thiobis(6-tert-butyl-meta-cresol) (Lowinox 44S36) and butylhydroxyanisole. Allergen alternatives for glove-allergic patients.

    Allergic contact dermatitis developed on the hands and/or face of two patients after exposure to latex examination gloves. Both patients were patch test negative to the usual rubber allergens, but both had a positive patch test reaction to 4,4'-thiobis(6-tert-butyl-m-cresol) (Lowinox 44S36). Patient 2 was also patch test positive to butylhydroxyanisole. The patients were tested with other gloves, to find gloves that they could safely use. Glove manufacturers were queried to ascertain the occurrence of Lowinox 44S36 and butylhydroxyanisole in different brands of latex and vinyl examination gloves. A list of gloves and their associated allergens was generated and is provided to assist dermatologists in helping patients choose gloves free of specific allergens.
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19/73. Allergy and toxicodermia from shiitake mushrooms.

    Skin and respiratory symptoms developed within 2 months of exposure in a patient involved in the commercial production of shiitake mushrooms. A diagnosis of contact urticaria and allergic contact dermatitis from shiitake mushrooms was confirmed by prick and patch tests. The respiratory symptoms, their timing, the presence of precipitating IgG antibodies to shiitake spores and increased amounts of inflammatory cells and T lymphocytes in bronchoalveolar lavage indicated allergic alveolitis (mushroom worker's disease). A generalized exanthem developed in a second patient after eating raw shiitake mushrooms. Reactions to prick and patch tests with shiitake mushrooms were negative. The skin eruption in this patient corresponded to the previously reported shiitake-induced toxicodermia.
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20/73. The spectrum of IgE-mediated responses to latex.

    A spectrum of IgE-mediated allergic responses to latex is presented in this report of 14 patients, including health care workers, sensitized by exposure to latex gloves. Symptoms often occurred immediately after exposure to latex, and manifestations varied according to the route of latex antigen presentation. Skin exposure usually caused contact urticaria. Exposure to latex in the air elicited allergic rhinitis, conjunctivitis, and asthma. Systemic effects from latex occurred intraoperatively due to the surgeon's latex gloves. Anaphylactic shock included the above symptoms with the addition of tachycardia and hypotension. All patients had positive latex skin tests. serum IgE antibody to latex was found with a latex radioallergosorbent test in all but one tested patient. physicians should be aware that latex allergy can present as anaphylaxis during surgery, barium enema, or dental work. latex skin tests are a satisfactory method of diagnosis. Nonlatex gloves are available and are tolerated by affected people.
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