[Allergic contact reactions]. / Allergische Kontaktreaktionen.

This paper gives an introduction into the pathomechanism of allergic contact dermatitis and test procedures.

Tiaprofenic acid induced photosensitivity.

45 patients (34 patients with PLE, 11 with phototoxic or photoallergic dermatitis) were photopatch tested to tiaprofenic acid. In 23 patients (51%), phototoxic reactions were found. Positive reactions appeared within 0.5 to 48 h of irradiation. Although each patient was irradiated with 2 different UVA light sources, with significantly different energy outputs (10 J/cm2 against 72 J/cm2), the intensity and duration of positive reactions was virtually the same. We found a considerably higher rate of positive reactions than other investigators, independent of the light energy delivered. None of the patients gave a history of previous tiaprofenic acid exposure.

[Problems with dental prosthesis and dental filling materials: results of epicutaneous tests, consequences and follow-up]. / Probleme mit Zahnprothesen und Zahnfüllungsmaterialien: Epicutantestergebnisse, Konsequenzen und Nachbeobachtung.

Positive ECT results were found in 29 out of 70 patients (41%) tested for suspected denture sore mouth syndrome. 11 of them reacted to nickel (16%), 4 to benzoyl peroxide, 4 to mercury chloride, but only 3 out of 38 patients reacted to their own prosthetic material. A follow-up study covered a group of 31 patients with dentures. 20 of them had mechanical or material changes made, but only 4 because of ECT results (1 nickel, 1 benzoyl peroxide, 1 own prosthetic material). After elimination of the suspected allergen, these 4 patients showed improvement, but the symptoms did not completely clear. A similar beneficial effect was seen in 13 of the 20 patients, whose dentures were only mechanically adapted; but 6 out of 11 patients without any dental correction showed improvement, as well. Our results suggest that clinically relevant contact allergies are rare in patients with burning mouth syndrome. Mechanical, microbial, and psychic factors have to be taken into consideration, as well.

[Treatment success using topical drugs containing urea in papillomatosis cutis verrucosa (lymphostatic edema papillomatosis)]. / Therapieerfolge mit harnstoffhaltigen Externa bei Papillomatosis cutis verrucosa (Lymphostatischer Stauungspapillomatose).

Due to keratolytic and epidermis-thinning effects 10% urea/w/o is effective in the treatment of papillomatosis cutis verrucosa (lymphostatic papillomatosis). If possible, compression bandages should be used. Indirect lymphography reveals abnormalities of dermal lymphdrainage in papillomatosis cutis verrucosa.

[Dandruff--an atopic sign?]. / Kopfschuppen--ein atopisches Stigma?

Dandruff is a sign of low specificity but high sensitivity for atopic constitution. Of 32 (40%) patients consulting the clinic for other reasons than dandruff, atopic dermatitis, or seborrheic dermatitis, 13 had raised IgE PRIST values of greater than 120 IU/ml. In only 6 (19%) of these patients was screening for atopy completely negative (family and personal history, total and specific IgG, prick test).

Tolerability of a new vitamin K1 preparation for parenteral administration to adults: one case of anaphylactoid reaction.

The efficacy and tolerability of a conventional vitamin K1 preparation containing polyoxyethylated castor oil as solubilizer were compared with those of a new compound containing mixed micelles as solubilizer in 30 patients. A statistically significant increase in the thrombotest was detected after treatment in both groups. No hematological or chemical toxicity was observed during the observation period. One patient had an anaphylactoid reaction after intravenous injection of the mixed micelles preparation. Intradermal testing yielded positive results. The authors conclude that intravenous administration of vitamin K preparations should be reserved for acute emergencies.

Demodicidosis mimicking granulomatous rosacea and transient acantholytic dermatosis (Grover's disease).

A patient with rosacea-like lesions and transient acantholytic dermatosis (TAD; Grover's disease), who showed follicle mites and perifollicular granulomas in involved skin, is presented. A possible relationship between the infestation with the follicle mite and TAD in this case is discussed.

[Intolerance reaction following glucagon administration in a double-contrast study]. / Intoleranzreaktion nach Glukagonapplikation in der Doppelkontrastuntersuchung.

Whereas intolerance reactions against contrast media are a well-known hazard during radiologic procedures, intolerance reactions to other preparations used in radiology are rare. Glucagon, frequently used to induce gastrointestinal hypotonia, is said to have almost no side-effects. A case of anaphylactic reaction during double-contrast upper gastrointestinal examination is reported. Pseudoallergic reaction to propylparaben, a preservative agent in glucagon, is suspected. IgE-antibodies to glucagon could not be detected by RAST.

Contact sensitivity to aluminium.

Contact sensitivity to aluminium is extremely rare. Sensitization occurs during continuous application of aluminium containing antiperspirants or by aluminium adjuvants in vaccines and pollen extracts. Two types of reaction pattern are known: persistent granuloma at the injection site and recurrent eczema. We report a patient with a positive patch test reaction to Al (OH)3, who had been sensitized by aluminium adsorbed triple vaccine, Previous reports are reviewed.

[Occupational eczema in billposters]. / Berufsekzeme bei Plakatierern.

Occupational contact dermatitis of the irritant type with sudden onset was observed in a group of 30 billposters after the introduction of two new pastes. The lesions were most likely caused by acetone-formaldehyde resins, impurities of pentachlorophenol, solvents such as acetone and the alkalinity of one paste.

[Marghescu-Braun-Falco syndrome]. / Marghescu-Braun-Falco-Syndrom.

A 32-year-old male patient with congenital poikilodermia syndrome is presented. The case history details of blister formation in the past and the association of the characteristic symptoms prompted us to make the diagnosis of Marghescu-Braun-Falco Syndrome in a male patient.

Isotretinoin intoxication in attempted suicide.

Only mild symptoms of retinoid intoxication--headache, hallucinations and vertebral pain--were observed after ingestion of 800 mg isotretinoin among other drugs. Transaminases and serum lipids were found within normal range five days later. Mucocutaneous effects due to overdosage were absent.

[Eczema of the lower leg and contact allergy]. / Unterschenkelekzem und Kontaktallergie.

Seventy-three patients suffering from stasis dermatitis with or without leg ulcers (group A) and 565 patients with other eczemas (group B) were patch tested with a series of 37 vehicle constituents and topical preparations. In group A the most common reactions were obtained with wool alcohols (24.7%), eucerin (21.9%), lanette N (17.2%), lanette O (11.0%) lanette E (8.2%), parabens (9.6%), a number of preparations containing these ingredients, and prophylene glycol (9.6%). In group B there were only positive reactions to lanette E (6.0%, test concentration 20%/vaseline) and sodium lauryl sulfate (5.8% positive, 5%/water), but irritant reactions were suspected in most cases. Additionally, group A patients were patch tested with standard allergens, which most frequently revealed contact allergies to balsam of Peru (19.1%) and mercuric bichloride (6.8%). Among the local antibacterial agents, the most common allergens were neomycin (32.9%) and bacitracin (12.3%). The number of patients with stasis dermatitis who reacted to one or more test substances had increased to 71.3%, as compared to the 57% evaluated in a similar study in 1977.

[Hairdresser eczema and nickel allergy]. / Friseurekzem und Nickelallergie.

Contact allergy to nickel could be found in 44.7% of 247 Austrian hairdressers with hand eczema. Two-thirds had become sensitive to nickel during their apprenticeship. The hairdressers' occupational exposure to nickel, chromium and cobalt was screened and different materials were analysed by a flame atomic absorption spectrophotometer. Hairdressers' nails (means = 54.22 ppm) contained ten times more nickel than those of controls (means = 6.5 ppm), but the differences were not statistically significant. Pooled customers' hair gave values of 3 ppm nickel; metals could not be released by shampoos, permanent wave liquids or oxidizing agents. The nickel, chromium and cobalt contents of 8 shampoos were beyond the detection limit of 1 microgram/100 ml. In 2 of 6 hair colours, in 2 bleaching agents and 8 of the 9 permanent liquids analysed (means 0.063 mg/100 ml), nickel could be found in detectable amounts. No metal traces could be detected in Viennese tap water samples which had been collected from a commonly used boiler. First samples of cold tap water collected in Leoben contained only 2 micrograms/100 ml, first hot water samples (60 degrees C) up to 4 micrograms nickel/100 ml; after 5 min of flushing, hot water samples contained 3 micrograms nickel/100 ml. From a nickel rod 13 micrograms/nickel/cm2/h was leached into 15 degrees C cold water and 0.28 microgram/nickel/cm2/h was leached into 70 degrees C hot water. It is recommended that hairdressers be supplied with only nickel-free instruments and that the contents of nickel and chelating agents be analysed in hair cosmetics.

[Reactions to vaccinations against tetanus and tick-borne encephalitis caused by merthiolate (thiomersal)]. / Impfreaktionen nach Tetanus- und Frühsommermeningoenzephalitis-Schutzimpfungen durch Merthiolat (Thiomersal).

Thirty patients with suspected adverse reactions to tetanus- or tick-borne encephalitis-vaccines were subjected to allergy tests. In 8 of 30 patients epicutaneous and/or intracutaneous tests with merthiolate were positive. Testing anorganic mercury, formaldehyde, aluminium hydroxide, gentamycin and egg white (i.c. and RAST), no positive reactions were found. After vaccination - prior to testing - merthiolate - positive patients had suffered from local inflammatory reactions at the injection site, fever and lymphadenopathy (four patients), urticarial (three patients) or lichenoid exanthemas (one patient). Reviewing the literature it is suggested that alternatively merthiolate-free vaccines be provided for sensitized individuals.

[Enzymatic debridement in venous ulcus cruris. Report of a multicenter clinical comparative study with various enzyme preparations]. / Enzymatische Wundreinigung beim venösen Ulcus cruris. Bericht über eine multizentrische klinische Vergleichsstudie mit verschiedenen Enzympräparaten.

In a multicenter trial (comprising 258 patients in eight centers) three topical preparations for enzymatic debridement, which are widely used in our country, have been compared in the treatment of leg ulcers. Preparation A is a combination of bovine fibrinolysin and desoxyribonuclease (but without antibiotic); preparation B is a combination of clostridiopeptidase and chloramphenicol and preparation C of trypsin and framycetin sulphate. The results showed no significant difference in the effects of treatment between the preparation. Preparation A however was much better tolerated; preparation B and C induced a lot of side effects. This means that antibiotics in preparations for enzymatic debridement are not of real advantage.

[Eczema in hairdressers]. / Das Friseurekzem.

Among cases of occupational dermatoses, eczema in hairdressers was reported most frequently in Austria during 1981 and 1982. Analysing 247 reports, extensive data could be obtained with regard to predisposition, clinical pattern, course, contact sensitization, skin tests, prognosis, influence on occupational development, rehabilitation, and disability pension. Epicutaneous tests with standard allergens and a hairdressers' screening tray proved to be positive in 71%. Nickel (44,7%) and para-haircolors (40,2%) top the allergen list. With exception of cobalt (19,1%) and balsam of Peru (4%) all other substances tested were found to be positive in less than 4%. 65% of nickel sensitive probands reacted to their occupationally used shampoos, as compared to only 34% of nickel-negative probands. Of hairdressers allergic to para-colors, 48.1% showed positive ECT tests to their haircolors, 4/13 patients allergic to ammonium thioglycollate reacted to permanent wave liquids used at their work. Two thirds of nickel sensitive hairdressers were sensitized during apprenticeship. Alkali resistance (AR) was decreased in 35% of patients tested. AR results from the irritant dermatitis patients were worse than those from persons with contact allergy. Of the hairdressers affected, 61.8% had to discontinue their professions for medical reasons. Of those who continued a hairdresser's career only 32% of patients with allergic contact eczema and 58% of patients with irritant eczema had no skin problems (mean period of observation: 15 months). The proportion of atopics was found to be normal within the patient material, but prognosis is unfavorable once atopic hairdressers have developed hand eczema. After discontinuation of occupation, clinical resolution was slowest in patients allergic to nickel. Of those previously occupied as hairdressers 15% ended up in a wet working environment unsuitable to their skin condition.(ABSTRACT TRUNCATED AT 250 WORDS)

[Repetitive skin testing in patients with lower leg eczema and leg ulcer]. / Repetitive Epicutantestung bei Patienten mit Unterschenkelekzemen und Ulcera Crurum.

16 patients with lower leg dermatitis and venous ulcers had been subject to patch-testing during 1974 to 1977. When retested in 1982, the number of positive reactions per patient increased from 3.82 to 5.87 on an average. 54% of the positive epicutaneous test reactions could be reproduced in the repeated patch test. Meanwhile, 9 of 16 of patients were free of lower leg dermatitis and 8 of them were free of venous ulcers. This paper deals with the problematic nature as well as the likely causes of the apparent inconsistency of epicutaneous test reactions in patients with lower leg dermatitis and venous ulcers.