ABSTRACT
BACKGROUND: alpha-Amylase, an enzyme commonly used in flour additives, has been reported to be an important cause of rhinitis and asthma in bakers. OBJECTIVE: Our purpose was to determine whether this enzyme could also cause dermatitis. We tested it routinely in bakers with hand eczema. METHODS: Patch tests were administered with the International Contact Dermatitis Research Group standard series and a bakery series and scratch-chamber or prick tests were performed with the bakers' own material and with alpha-amylase powder. RESULTS: Of 32 bakers tested, seven had an immediate wheal-and-flare reaction and two also had a delayed eczematous reaction. High dilutions of the alpha-amylase powder still gave strong reactions. CONCLUSION: alpha-Amylase is an important cause of skin reactions in bakers and should be tested routinely if a contact allergy is suspected.
Subject(s)
Cooking , Dermatitis, Contact/immunology , Dermatitis, Occupational/immunology , Flour , Hand Dermatoses/chemically induced , alpha-Amylases/adverse effects , Adult , Biopsy , Dermatitis, Contact/diagnosis , Dermatitis, Occupational/diagnosis , Hand Dermatoses/diagnosis , Humans , Immunoglobulin E/blood , Male , Predictive Value of Tests , Sensitivity and Specificity , Skin/pathology , Skin Tests , Time FactorsABSTRACT
Two cases of pulmonary cystic adenomatoid malformation are presented. The first case presented with bilateral pulmonary cystic involvement associated with oligoamnios and feto-placental anasarca. A peculiar feature of this case was the elevated level of alphafetoprotein in the amniotic fluid. In the second case, the pulmonary involvement was limited to one lobe. There was coexistent aplasia of the diaphragm. Premature rupture of the amniotic membranes necessitated a therapeutic abortion at 21 weeks of pregnancy. In connection with these two cases, a discussion based on the data in the literature.
