Cases reported "Dermatitis, Occupational"

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21/109. Occupational contact urticaria from diglycidyl ether of bisphenol A epoxy resin.

    BACKGROUND: Epoxy resin (ER) is a common cause of occupational allergic contact dermatitis (ACD), but contact urticaria from ER is very rare. methods AND RESULTS: A plastic-product worker first developed ACD from diglycidyl ether of bisphenol A (DGEBA) epoxy resin, and subsequent exposure resulted half a year later in contact urticaria: first with edema of the lips and eyelids, and later an urticarial reaction on the upper chest, with strong swelling of the eyelids and tightness of the throat. The diagnosis was based on a positive skin prick test to his "own" ER compound, a positive prick test reaction to DGEBA, and a positive skin provocation test with the ER compound and DGEBA. The contact urticaria test reaction was strongly aggravated when the allergen was wiped off with an alcohol solution, apparently because the solution enhanced the penetration of the allergen. CONCLUSIONS: Our case is of interest, first, because contact urticaria from ER is very rare, and second, because this is the second report in which a strongly intensified contact urticaria reaction was provoked by an alcohol solution. We suggest that if the contact urticaria provocation test with low-molecular-weight chemicals is negative, a contact urticaria provocation test with alcohol (CUPTA) should be performed.
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ranking = 1
keywords = exposure
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22/109. Allergic contact dermatitis in dental professionals: effective diagnosis and treatment.

    BACKGROUND: Like other health care workers, dental professionals are at risk of developing allergic contact dermatitis, or ACD, after exposure to allergenic chemicals. Common allergens include antimicrobials, preservatives, rubber additives and methacrylates. CASE DESCRIPTION: The authors describe an orthodontic assistant with severe skin disease, whose symptoms included redness, cracking and bleeding that persisted for 10 years. The patient had previously received an incomplete diagnosis. After performing patch testing, assessing symptoms and evaluating the patient's medical history, the authors diagnosed ACD resulting from exposure to several dental allergens. The patient received appropriate treatment and counseling to better manage her allergies; this resulted in resolution of all symptoms and averted permanent occupational disability. CLINICAL IMPLICATIONS: Not all skin reactions are related to gloves or natural rubber latex. Dental professionals should be aware of common chemical allergens, symptoms of ACD and the appropriate treatment of occupational skin disease.
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ranking = 2
keywords = exposure
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23/109. Two cases of occupational allergic contact dermatitis from a cycloaliphatic epoxy resin in a neat oil: case report.

    BACKGROUND: Metal-working fluids contain complex mixtures of chemicals and metal workers constitute a potential risk group for the development of allergic contact dermatitis. CASE PRESENTATION: Two metal workers developed allergic contact dermatitis on the hands and lower arms from exposure to a neat oil used in metal processing. Patch testing revealed that the relevant contact allergen was a cycloaliphatic epoxy resin, 1,2-cyclohexanedicarboxylic acid, bis(oxiranylmethyl) ester, added to the oil as a stabilizer. None of the patients had positive reactions to the bisphenol A-based epoxy resin in the standard series. CONCLUSIONS: These cases emphasize that well-known contact allergens may show up from unexpected sources of exposure. Further, it can be a long-lasting, laborious process to detect an occupational contact allergen and cooperation from the patient and the manufacturer of the sensitizing product is essential.
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ranking = 2
keywords = exposure
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24/109. Allergic contact dermatitis from occupational exposure to ranitidine hydrochloride.

    Contact sensitivity to ranitidine hydrochloride has been demonstrated in 6 of 8 symptomatic exposed pharmaceutical manufacturing employees; a 7th has been found to be sensitized to ranitidine base. Although closed manufacturing processes diminish the risk of such sensitization, operatives with potential exposure should be made aware of the importance of avoiding skin contact.
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ranking = 1489.214055928
keywords = occupational exposure, exposure
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25/109. Airborne allergic contact dermatitis from 3-iodo-2-propynyl-butylcarbamate at a paint factory.

    3-Iodo-2-propynyl-butylcarbamate (IPBC) is a fungicide used in both industrial products and cosmetics. We report the first case of allergic contact dermatitis from airborne exposure to this preservative. A 34-year-old female production worker at a paint factory developed dermatitis on air-exposed skin areas. Patch testing showed a reaction to the preservative IPBC 0.01% in petrolatum. The compound was used as a preservative in wood treatment products manufactured at her work place. Based on animal studies, IPBC is considered safe as a cosmetic preservative. However, widespread use of the chemical might lead to increasing levels of contact allergy, and therefore, close monitoring of IPBC is recommended.
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ranking = 1
keywords = exposure
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26/109. dermatitis caused by dimethyl cyanocarbonimidodithioate.

    Dimethyl cyanocarbonimidodithioate (CAS No. 10191-60-3) a raw material for cimetidine synthesis, is labelled as an irritant on its storage tank. There is no information available regarding the toxic effects of human exposure. We report a case of severe dermatitis clinically resembling erythema multiforme following an accidental exposure to dimethyl cyanocarbonimidodithioate in an occupational setting. A clerk sifted a handful of dimethyl cyanocarbonimidodithioate from an unlabelled bucket through his bare hands during an inspection prior to customs clearance. Five hours later, while he was washing his hands, pruritus, erythema and vesicles developed over the exposed area. The skin condition worsened within two weeks, extending to his whole body with generalized erythema and vesicles of various sizes. Some vesicles became confluent with ruptured bullae, resembling a second degree burn over 40% of the body. Elevation of the serum IgE (705 mu/mL, normal less than 300 mu/mL) and lymphocyte activation with an increased 3H-thymidine uptake by the patient's mononuclear cells suggested that this episode resulted from a cell-mediated allergic skin reaction. The skin lesions improved progressively after systemic steroid therapy for about two weeks. Dimethyl cyanocarbonimidodithioate is used as a raw material for cimetidine synthesis by some pharmaceutical manufacturers. Our experience suggests that a severe reaction similar to that caused by another H2-blocker, ranitidine and its intermediate may be caused by dimethyl cyanocarbonimidodithioate in occupational exposures. Systemic steroid administration is beneficial in treatment.
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ranking = 3
keywords = exposure
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27/109. Allergic contact dermatitis from cardamom.

    A case is presented of a confectioner with a chronic hand dermatitis and positive patch test reactions to cardamom and certain terpenoid compounds present in the dried ripe seeds of cardamom. Cardamom is a popular traditional flavouring agent for baked goods and confectionery. dermatitis from skin exposure to cardamom has to the best of our knowledge not been reported. We report one case of allergic contact dermatitis to cardamom elicited by terpenes present in the seeds.
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ranking = 1
keywords = exposure
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28/109. 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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ranking = 1
keywords = exposure
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29/109. Cutaneous larva migrans, an occupational disease.

    Creeping skin eruption is known to follow exposure to canine and feline hookworm larvae found in contaminated soil encountered in humid, tropical and subtropical regions. A little known hazard of similar infections exists among veterinarians and laboratory workers exposed to strongyloides larvae from horses located in temperate climates. The evolving clinical picture is described in detail. Continued exposure may lead to a state of hypersensitivity to the parasitic protein resulting in severe hyperimmune reactions. The invasiveness of strongyloides larvae through intact skin and the pathologic changes associated with infection were demonstrated in a rabbit.
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ranking = 2
keywords = exposure
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30/109. Atypical systemic sclerosis following exposure to vinyl chloride monomer. A case report and review of the cutaneous aspects of vinyl chloride disease.

    An unusual case of systemic sclerosis occurring in a patient exposed to the vinyl chloride monomer (VCM) is presented. The dermatological aspects of vinyl chloride disease (VCD) are outlined and the mechanisms of pathogenesis discussed.
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ranking = 4
keywords = exposure
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