Cases reported "Dermatitis, Occupational"

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1/109. An epidemic of occupational contact dermatitis from an immersion oil for microscopy in laboratory personnel.

    Since November 1997, 14 successive cases of occupational contact dermatitis were observed in 13 laboratory technicians and 1 physician, working in a genetics laboratory in Leuven (belgium) in 3 laboratories of bacteriology in Strasbourg, Montbeliard and Angers, and in the laboratory of hematology in Bordeaux (france). The dermatitis, located on the hands, forearms and face, relapsed after each exposure to an immersion oil for microscopy. patch tests performed in 10 patients were positive to epoxy resin (ER) in the European standard series (10/10 patients) and to newly formulated Leica immersion oil (7/7), 1 patient testing negatively with the former oil. A breakdown performed in 2 patients with the oil's ingredients confirmed sensitization to liquid modified ER components, contained at >80% concentration in the oil. The presence of DGEBA was demonstrated by HPLC analysis at a /-30% rate. Although the safety data sheet indicated a revision of the formula, nobody was alerted to the risk of sensitization and the need for skin protection. ERs, as a source of occupational allergy, can provoke epidemics of contact dermatitis in industry. This report of epidemic contact dermatitis from ERs, used for their optical properties in an immersion oil for microscopy, emphasizes the need for perpetual vigilance in occupational medicine and the usefulness of multicentre contacts in dermato-allergology.
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2/109. Facial dermatitis, contact urticaria, rhinoconjunctivitis, and asthma induced by potato.

    BACKGROUND: Potato contains multiple heat-labile proteins which can induce immediate hypersensitivity reactions. Rhino-conjunctivitis, asthma, contact urticaria and protein contact dermatitis have been described in association with potato exposure. OBJECTIVE: A patient with possible airborne facial dermatitis to potato is described. RESULTS: A middle-aged atopic housewife with pre-existent atopic dermatitis suffered from rhino-conjunctivitis, asthma, and contact urticaria when pealing raw potatoes, but her main complaint was intense, treatment-resistant dermatitis of the face. The investigations showed a positive prick test, a positive patch test, and positive specific serum IgE to raw potato. Potato avoidance led not only to the resolution of the immediate symptoms, but also of the facial dermatitis, suggesting she had dermatitis due to this vegetable. CONCLUSIONS: Potato may induce contact dermatitis with positive immediate and delayed hypersensitivity tests.
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3/109. T cell involvement in persulfate triggered occupational contact dermatitis and asthma.

    BACKGROUND: Ammonium and potassium persulfates may induce a variety of cutaneous and respiratory diseases. The precise underlying mechanisms, however, are unclear. OBJECTIVE: To describe a hairdresser, who developed contact dermatitis, rhinoconjuntivitis, and bronchial asthma of delayed onset after occupational exposure to hair bleaches containing persulfate salts and to provide evidence for a common T-cell mediated mechanism responsible for the clinical manifestations. methods: We performed skin testing, routine histologic and immunohistochemical examination of the skin reaction after prick testing, lymphocyte proliferation analysis, nasal challenge test, and pulmonary function testing. RESULTS: The causative role of bleaching powder and ammonium persulfate was demonstrated by case history, skin tests, and a nasal challenge test. patch tests produced a delayed cutaneous reaction to ammonium persulfate confirming contact sensitization. Prick tests with bleaching powder and ammonium persulfate were negative at 15 minutes but revealed a late skin reaction with a papule at the prick sites after 24 hours. Histologic examination of this late reaction demonstrated a perivascular infiltration comprising predominantly T lymphocytes. Further, a significant proliferation of T cells to bleaching powder was reproducibly found by a lymphocyte proliferation analysis. Nasal challenge test with bleaching powder showed a significant reduction of air flow after 24 hours. CONCLUSION: Our findings suggest that immunologic mechanism with direct involvement of T cells may not only play an important role in the pathogenesis of the cutaneous but also in the respiratory and rhinoconjunctival reactions.
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ranking = 372.05351398201
keywords = occupational exposure, exposure
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4/109. Laboratory assistant's occupational allergic airborne contact dermatitis from nickel presenting as rosacea.

    A male laboratory assistant working in a metallurgical laboratory with airborne exposure to nickel dust developed highly pruritic, rosacea-like symptoms. The symptoms cleared within eight days without treatment when the patient was off work. Patch testing confirmed nickel allergy. Based on the patient's work and clinical history it was evident that occupational exposure to airborne nickel induced the highly abnormal rosacea-like symptoms, not previously reported from nickel.
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ranking = 373.05351398201
keywords = occupational exposure, exposure
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5/109. 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.
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6/109. Occupational induction of hypersensitivity after an accidental exposure to chloromethylisothiazolinone and methylisothiazolinone (CMI/MI) in an industrial worker.

    A process worker in a paper chemical plant developed an immediate local dermal irritation and delayed bullous dermatitis due to induction of hypersensitivity following an accidental exposure to chloromethylisothiazolinone and methylisothiazolinone (CMI/MI) biocide. Contact allergy to the isothiazolinone mixture was confirmed by skin patch testing. The dermatitis healed in four weeks, and the worker was advised to avoid all CMI/MI containing products. In a one-year follow-up he did not present with any further skin symptoms. Preventive measures are important for avoiding induction of hypersensitivity to concentrated CMI/MI solutions in industrial workers.
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7/109. Epoxy resin allergy from microscopy immersion oil.

    A bacteriology technical officer presented with episodes of burning pruritus and urticarial-like lesions on the face and forearms. Patch testing was strongly positive for epoxy resin. The exposure was occupational to the re-formulation of microscopy immersion oil.
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8/109. Occupational allergic airbone contact dermatitis and delayed bronchial asthma from epoxy resin revealed by bronchial provocation test.

    Diglycidyl ether of bisphenol A (DGEBA) epoxy resins belong to the most common causes of occupational allergic contact dermatitis. DGEBA has on rare occasions caused occupational asthma. Here we present a patient who first developed occupational allergic contact dermatitis (ACD) caused by a single accidental exposure to DGEBA. Then, on continued occupational exposure to DGEBA, the patient developed occupational asthma from DGEBA, in addition to ACD. A bronchial provocation test with DGEBA caused a 36% drop in the peak expiratory flow, reflecting a delayed type of occupational asthma. This bronchial provocation test caused a strong dermatitis of the exposed skin of the face, in accordance with airborne ACD from DGEBA.
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ranking = 373.05351398201
keywords = occupational exposure, exposure
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9/109. Occupational IgE-mediated allergy to tribolium confusum (confused flour beetle).

    BACKGROUND: We report on IgE-mediated allergy in a worker caused by tribolium confusum (confused flour beetle). These beetles lived in the "old" flour to which he was exposed in his work. CASE REPORT: A 35-year-old, nonatopic mechanic in a rye crispbread factory developed rhinitis, conjunctivitis, and asthmatic symptoms, as well as urticaria on his wrists, lower arms, hands, neck, and face, during the maintenance and repair of machines contaminated by flour. This flour had been in and on the machines for a long time, and it contained small beetles. The patient did not suffer any symptoms when handling fresh, clean flour. RESULTS: Skin prick tests with standard environmental allergens, storage mites, enzymes, flours, and molds were negative. A prick test with flour from the machines gave a 10-mm reaction. An open application of the same flour caused urticarial whealing on the exposed skin. Prick tests with fresh flour from the factory were negative. A prick test with minced T. confusum from the flour in the machines gave a 7-mm reaction. histamine hydrochloride 10 mg/ml gave a 7-mm reaction. Specific serum IgE antibodies to T. confusum were elevated at 17.2 kU/l. Prick tests with the flour from the machines were negative in five control patients. CONCLUSIONS: The patient had occupational contact urticaria, rhinitis, conjunctivitis, and asthmatic symptoms from exposure to flour. His symptoms were caused by immediate allergy to the beetle T. confusum. Immediate allergy to this beetle has rarely been reported in connection with respiratory symptoms, but it may be more common. Contact urticaria from this source has not been reported before.
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10/109. Papuloverrucous colloid milium: an occupational variant.

    We report a case of adult colloid milium in a 47-year-old mechanic with a long history of professional contact with lubricating oils and of sun exposure. In addition to the typical translucent papules seen on the forehead, there were warty papules on the backs of both hands with unusual histological and ultrastructural features: marked hyperplasia of the epidermis with orthokeratotic hyperkeratosis and papillary deposits of colloid material that were contiguous with the basal layer of the epidermis. The hand lesions caused by occupational exposure to mineral oils and solar radiation represent an occupational variant of adult colloid milium.
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ranking = 373.05351398201
keywords = occupational exposure, exposure
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