Contact dermatitis from methylisothiazolinone in a paint factory.

Introduction of new potential contact-sensitizing chemicals have in the past led to epidemics of contact dermatitis. A new preservative containing only methylisothiazolinone (MI) and not methylchloroisothiazolinone (MCI) has recently been introduced in the European Union for use in products, such as paint, glue and cosmetics. The objective of this article is to describe a factory outbreak of contact allergy to MI and MCI preservatives. This factory outbreak describes allergic contact dermatitis towards MI in 4 patients of 14 persons working at a paint manufacturer. Patch test results from all patients showed positive reactions for MI and MCI/MI. The reactions were stronger for MI than MCI/MI indicating a primary sensitization to MI. The combination of MCI/MI remains widely used, and therefore various patterns of exposure and sensitization could be seen in the future. Our data show that MI holds a potential for eliciting and propably inducing contact allergy in humans. Whether this preservative is safe to use in cosmetics where billions of consumers are exposed needs a care full monitoring.

Problems in recruiting patients to controlled trials on children with secretory otitis media: a demographic comparison of excluded versus included patients.

One thousand one hundred and sixty-four patients formed the pool of patients from which we intended to recruit children to a controlled trial evaluating the efficacy of amoxicillin-clavulanate and penicillin-V in the treatment of secretory otitis media (SOM). Only 360 patients ended up to be evaluated, consisting only 30% of the primarily involved patients. The spontaneous improvement of the tympanometric condition was the major course of pre-trial dropouts. The demographic composition of included and excluded patients did not differ, as one might have expected. Very little has previously been published about this great number of excluded patients even though other authors must have had the same experience. It is concluded that a 3-month duration of SOM, evaluated by tympanometry by the investigators, is required as a minimum to qualify for entering a trial evaluating SOM.