Nickel release from nickel-plated metals and stainless steels.

Nickel release from nickel-plated metals often induces allergic contact dermatitis, but, for nickel-containing stainless steels, the effect is not well-known. In this paper, AISI 304, 316L, 303 and 430 type stainless steels, nickel and nickel-plated materials were investigated. 4 tests were performed: patch tests, leaching experiments, dimethylglyoxime (DMG) spot tests and electrochemical tests. Patch tests showed that 96% of the patients were intolerant to Ni-plated samples, and 14% to a high-sulfur stainless steel (303), while nickel-containing stainless steels with a low sulfur content elicited no reactions. Leaching experiments confirmed the patch tests: in acidic artificial sweat, Ni-plated samples released about 100 micrograms/cm2/week of nickel, while low-sulfur stainless steels released less than 0.03 microgram/cm2/week of nickel, and AISI 303 about 1.5 micrograms/cm2/week. Attention is drawn to the irrelevance of the DMG spot test, which reveals Ni present in the metal bulk but not its dissolution rate. Electrochemical experiments showed that 304 and 316 grades remain passive in the environments tested, while Ni-plated steels and AISI 303 can suffer significant cation dissolution. Thus, Ni-containing 304 and 316 steels should not induce contact dermatitis, while 303 should be avoided. A reliable nitric acid spot test is proposed to distinguish this grade from other stainless steels.

Systemic contact dermatitis from pseudoephedrine.

A patient with rhinitis developed systemic contact dermatitis when starting oral treatment with Rhinalair, containing pseudoephedrine hydrochloride. A few months later, another oral treatment Rinutan, containing norephedrine hydrochloride, provoked a more severe generalized eczema. Patch test reactions were strongly positive to ephedrine and pseudoephedrine, slightly positive to phenylephrine and negative to epinephrine. Norephedrine was not tested.

An epidemiological study of contact allergy to 5-chloro-3-methyl isothiazolone/3-methyl isothiazolone in Strasbourg.

In Strasbourg, the incidence of allergy to the mixture of 5-chloro-3-methyl isothiazolone and 3-methyl isothiazolone (MCI) in 540 patients (313 women and 227 men), routinely tested with this preservative as part of the standard series of allergens, was 1.11%. The frequency was 1.6% in women and 0.44% in men. A total of 6 cases of allergy, 5 in women and 1 in a man, to MCI were detected. In 5 cases out of 6, the patient was shown to have used cosmetic products containing this preservative. Finally, in 5 cases out of 6, the subjects allergic to MCI also tested positively for nickel, while only 15% of the total of 540 subjects tested with MCI had a nickel allergy confirmed by patch tests.

Allergic contact dermatitis from safety clothes and individual protective devices.

Safety clothing and individual protective devices may induce contact dermatitis. Typical clinical patterns cannot always be found. Patch testing must be performed with articles actually used and with specific allergens. In some cases, it is necessary to analyze chemically the article itself.

Contact allergy to Manilla resin. Nomenclature and physico-chemistry of Manilla, kauri, damar and copal resins.

16 cases of allergic eczema from a resin used in a surgical adhesive (Alphacopal) are described. Because of the extreme confusion regarding the nomenclature and origin of the resins called copals and damars, this report attempts to give a terminological, botanical, physico-chemical and allergological restatement of this problem. Copals and damars are produced by trees belonging to the Araucariaceae, Caesalpiniaceae, Dipterocarpaceae and Burseraceae families. We suggest that the word "copal" be reserved for the resins of the Caesalpiniaceae and that of "damar" for the resins of the Dipterocarpaceae. The resins of the Araucariaceae are special products that may be called Manilla resin and kauri resin, which are relatively different from each other. As far as the soft resins of the Burseraceae are concerned, it would be appropriate to use the word "elemi". The component resin of the surgical adhesive implicated (Alphacopal) is a Manilla resin, produced by a variety of Agathis dammara (Lamb.) Rich., native to the Philippines. We suggest 3 allergen screening series. Finally 2 pseudo-cross-sensitivities are mentioned.

Allergic contact dermatitis from topical corticosteroids.

22 cases of allergic contact dermatitis from topical corticosteroids were observed in Strasbourg and previously published. 7 further cases are reported here and the vehicle and concentration of corticosteroids for patch tests are discussed. A 0.1% concentration in petrolatum seemed adequate for testing the 4 molecules (triamcinolone acetonide, dexamethasone, desonide and amcinonide) responsible for the 7 new cases. In 1 case, several cross-reactions were seen. A corticosteroid screening series permits patch testing of the suspected molecule(s) in a selective way. Without this series, long delays are required to make the correct diagnosis by patch testing. We have reviewed more than 60 papers on corticosteroid allergy published up to now.

Allergy to nickel or cobalt: tolerance to nickel and cobalt samples in man and in the guinea pig allergic or sensitized to these metals.

The aim of this study was to evaluate, in animals and humans sensitive to nickel or cobalt, the tolerance to manufactured metal samples of nickel and cobalt of a defined metallographic structure, plated or not with a layer of chrome or copper/chrome of a determined thickness. Under the defined experimental conditions, a guinea pig sensitized to one metal (nickel or cobalt) was intolerant to both metals (nickel and cobalt). A plating of chrome or copper/chrome did not act as a protection. In the human, it was not the same: the tolerance to metal samples was determined by the specific sensitivity. A plating of chrome or copper/chrome did not act as protection.

Nickel allergy: tolerance to metallic surface-plated samples in nickel-sensitive humans and guinea pigs.

The purpose of this work is to evaluate in nickel-sensitive patients and guinea pigs the tolerance to nickel samples, surface-plated with one or several metals of varying structures and thicknesses. All the metal samples elicited allergic reactions in the guinea pig. In humans, absolute tolerance was not observed for any sample. In humans, the interposing of a layer of bright copper between nickel and surface chrome greatly increased the tolerance.

Mini-epidemic of contact dermatitis from ginkgo tree fruit (Ginkgo biloba L.).

3 cases of contact dermatitis from ginkgo fruit are reported. Swelling of the prepuce can be the only clinical sign of intolerance, as was observed in 1 case. Diagnosis of contact dermatitis to ginkgo fruit should be made in cities where female ginkgo trees grow, in Chinese, Japanese and South-East Asian subjects, who are aware of the ginkgo nut's culinary qualities within the fruit, as well as in children who play with the fallen fruits as "marbles".

Contact dermatitis after ultrasonography and electrocardiography.

We report 4 patients who developed allergic contact dermatitis after ultrasound investigations. Patch testing was positive with conducting gels, and in 2 cases with propylene glycol. Contact dermatitis to gels is also seen in electrographic practice and after transcutaneous electrical analgesia.