Degradation of triglycidyl isocyanurate as a cause of false-negative patch test reaction.

Triglycidyl isocyanurate (TGIC) is mainly used in polyester-based powder paints, but also in laminates, insulating varnishes, coatings and adhesives. Several cases of contact allergy to TGIC have been reported during the last 10 years. Contact allergy to TGIC has developed in a factory producing the chemical, in a factory producing powder paints containing TGIC, and in industries using powder coating. In this paper, we report a man who developed a work-related dermatitis when working on the painting of metal frames. He was exposed to polyester powder pigments containing TGIC. When patch tested, he was negative to TGIC (prepared in 1988) 3x and positive to polyester powder pigment. Only when a new test preparation of fresh TGIC powder was tested, was a positive reaction obtained. Chemical analyses showed that there was no TGIC in the test preparation from 1988, and that in the TGIC powder from 1988, there was only 30% of the expected amount of TGIC. The investigations, clinical and chemical, strongly indicate degradation of TGIC in the test preparation and powder. Both substances and the test preparations made from them may change over time. Therefore, if a false-negative reaction due to a test preparation is strongly suspected, we recommend a re-test of the patient with a new test preparation of fresh material. As a general rule, patch testing should be performed with fresh substances and test preparations made from them, unless their stability and durability are known.

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.