carbamix and Hand-Dermatoses

The frequency of allergic contact dermatitis has significantly increased in healthcare workers since the transition from latex to synthetic rubber gloves, with 1,3-diphenylguanidine being identified as the most frequently implicated allergen.. To highlight the role of 1,3-diphenylguanidine as the culprit allergen in contact allergies to synthetic rubber gloves, to propose recommendations for patch testing, and to discuss alternatives for sensitized subjects.. Patch test data from healthcare workers who developed hand dermatitis after wearing rubber gloves and who reacted positively to glove samples and rubber additives were collected from September 2010 to December 2017 in a Belgian hospital.. A total of 44 caregivers were included in this study. Patch tests showed that: (a) 84% of the study population reacted positively to carba mix; (b) 86% reacted positively to 1,3-diphenylguanidine; and (c) 13 (30%) reacted positively to thiuram mix. Half of the subjects reacted positively to gloves containing 1,3-diphenylguanidine, whereas none reacted to accelerator-free gloves.. The most commonly identified allergen was 1,3-diphenylguanidine, far ahead of thiurams, which were previously described as the most sensitizing accelerators. The use of 1,3-diphenylguanidine-free gloves is recommended. No subject reacted to gloves without accelerators, thus confirming their efficiency among accelerator-sensitized patients. We recommend that 1,3-diphenylguanidine be added to the European baseline series.

Topics: Adult; Dermatitis, Allergic Contact; Dermatitis, Occupational; Ditiocarb; Elastomers; Female; Gloves, Surgical; Guanidines; Hand Dermatoses; Health Care Sector; Humans; Male; Middle Aged; Patch Tests; Thiram; Young Adult

Allergic contact dermatitis caused by rubber allergens is common, and causes significant patient morbidity. Contemporary data are important to allow appropriate preventive measures and identification of contact allergy trends.. To describe the pattern of patch test reactivity to rubber allergens, including those in the European baseline series.. Data collected by the European Surveillance System on Contact Allergies (ESSCA) network between 2009 and 2012 from 12 European countries were analysed.. Contact allergy to thiuram mix declined over the studied time period, with an overall prevalence of 1.87%. The prevalence of allergy to carba mix was 2.29%, and was significantly increasing. Prevalence rates of sensitization to other rubber allergens were largely unchanged. Statistical analysis with the MOAHLFA index confirmed the strong links between rubber allergy and occupational hand dermatitis.. Changing patterns of allergy to rubber additives have been identified. Inclusion of carba mix in the European baseline series may be appropriate.

Topics: Adult; Allergens; Dermatitis, Allergic Contact; Dermatitis, Occupational; Ditiocarb; Europe; Female; Guanidines; Hand Dermatoses; Humans; Latex Hypersensitivity; Male; Patch Tests; Population Surveillance; Prevalence; Rubber; Thiram

Because patients with atopic dermatitis are less prone to type IV allergies, there has been controversy regarding the role of patch testing in these patients.. The present study was conducted to evaluate the role of patch testing in atopic individuals.. One-hundred patients with hand eczema were patch tested using the standard patch test battery (HERMAL, Kurt Herrmann, Reinbek, West Germany) and the Finn chamber units. The total immunoglobulin class E (IgE) level was determined and correlated to the results of patch testing.. Eighty-seven patients had positive patch test reactions. Among the 87 patients, 39 (44.8%) had atopic dermatitis. The most common allergens yielding positive results were nickel sulfate, 2.5%, (58.6%); potassium dichromate, 0.25% (56.3%); carba mix, 3%, (44.82%); formaldehyde, 1% in H2O, (40.22%); neomycin sulfate, 20%, (33.3%); and balsam of Peru 25%, (17.24%) respectively. Patients with atopic dermatitis were more frequently sensitive to neomycin sulfate than nonatopics.. Patients with atopic dermatitis should be patch tested when indicated because they also develop contact allergic sensitization to a significant degree. Our observations indicate that patch testing with standard allergens often adds valuable information about contact sensitivity in these patients.

Topics: Adult; Allergens; Anti-Bacterial Agents; Balsams; Caustics; Dermatitis, Atopic; Ditiocarb; Evaluation Studies as Topic; Fixatives; Formaldehyde; Guanidines; Hand Dermatoses; Humans; Hypersensitivity, Delayed; Immunoglobulin E; Irritants; Middle Aged; Neomycin; Nickel; Patch Tests; Potassium Dichromate; Thiocarbamates