Subject(s)
Allergens/adverse effects , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Occupational/diagnosis , Dicyclohexylcarbodiimide/adverse effects , Adult , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/pathology , Dermatitis, Occupational/etiology , Dermatitis, Occupational/pathology , Diagnosis, Differential , Facial Dermatoses/chemically induced , Facial Dermatoses/diagnosis , Facial Dermatoses/pathology , Female , Hand Dermatoses/chemically induced , Hand Dermatoses/diagnosis , Hand Dermatoses/pathology , Humans , Male , Neck/pathology , Occupations , Patch Tests , Wrist/pathologyABSTRACT
While the frequency of patch test reactivity to many cosmetic allergens has decreased over the last 20 years, we have previously shown that in our clinic, the patch test reactivity to p-phenylenediamine (PPD) has remained stubbornly high between 2.5% and 4.2% in the years when patch testing was performed with 1% PPD. Further retrospective analysis of the PPD patch test frequency over the last 6 years shows an increasing rate of PPD patch test frequency, showing an upward linear trend. This increasing trend cannot be fully explained by any increase in patch testing of Southern Asian patients or of sensitization caused by PPD exposure from 'temporary henna tattoos'. An alternative explanation may be the increasing use of permanent hair dyes.
Subject(s)
Dermatitis, Contact/etiology , Hair Dyes/adverse effects , Patch Tests , Phenylenediamines/adverse effects , Dermatitis, Contact/diagnosis , Female , Follow-Up Studies , Humans , MaleABSTRACT
Although chlorhexidine is a widely used substance, allergic contact dermatitis from chlorhexidine has rarely been reported. Our objective was to study all cases of allergic contact dermatitis from chlorhexidine that were seen at St John's Institute of Dermatology from January 1983 to June 2002. The case records of all patients with positive patch-test reactions to chlorhexidine during the study period were retrieved. The clinical presentation, strength, and relevance of the positive patch-test results as well as possible sources of exposure were studied. There were five cases of allergic contact dermatitis from chlorhexidine during the study period; three of these patients had positive patch-test reactions to chlorhexidine that were of current relevance. The possible sources of exposure included Hibisol, Hibiscrub, a chlorhexidine spray, and peri- and postoperative antiseptic solutions. We concluded that allergic contact dermatitis from chlorhexidine is rare. However, when it occurs, it may cause a severe dermatitis reaction.
Subject(s)
Allergens/adverse effects , Anti-Infective Agents, Local/adverse effects , Chlorhexidine/adverse effects , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Occupational/diagnosis , Adult , Arm , Child, Preschool , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/pathology , Dermatitis, Occupational/etiology , Dermatitis, Occupational/pathology , Diagnosis, Differential , Facial Dermatoses/chemically induced , Facial Dermatoses/diagnosis , Facial Dermatoses/pathology , Female , Hand Dermatoses/chemically induced , Hand Dermatoses/diagnosis , Hand Dermatoses/pathology , Humans , Leg , Male , Middle Aged , Patch TestsABSTRACT
Cross-sensitization between para-phenylenediamine (PPD) and Disperse Orange 3 (DO3), among other textile dyes, has frequently been reported. We evaluated the frequency of simultaneous patch test reactions to PPD and a range of textile dyes. Retrospectively, we studied 128 patients who were patch test positive to PPD and who had also been tested to textile dyes. The dyes that most commonly also reacted were DO3 (46.1%) followed by Disperse Yellow 3 (21.9%). 80% of 55 patients who had a + + or stronger reaction to PPD also reacted to DO3. Dyes that were least likely also to react were Bismarck Brown (0%), Naphthol AS (1.06%), Disperse Yellow 9 (1.06%), Disperse Blue 3 (1.56%) and Disperse Red 11 (2.13%). We interpreted the simultaneous patch test reactions to PPD and DO3 as due either to cross-sensitivity proper, or to metabolic conversion of textile dyes in the skin to PPD.
