fumarates and Dermatitis--Contact

Topics: Clinical Trials as Topic; Dermatitis, Contact; Drug Eruptions; Exanthema; Female; Fumarates; Histamine H1 Antagonists; Humans; Male; Mycosis Fungoides; Neurodermatitis; Pruritus; Pyrrolidines; Scabies; Skin Diseases; Skin Neoplasms; Urticaria

Di-n-butyl phthalate (DBP), a phthalate ester, has been shown to have an adjuvant effect on fluorescein isothiocyanate (FITC)-induced contact hypersensitivity (CHS) mouse models. Di-n-butyl maleate (DBM), widely used as a plasticizer for industrial application, has been reported to cause dermatitis in humans. DBM is a butyl alcohol ester of di-carboxylic acid that represents a part of the DBP structure, while di-n-butyl fumarate (DBF) is a trans isomer of DBM. We examined whether DBM or DBF exhibits an adjuvant effect like DBP does. When BALB/c mice were epicutaneously sensitized with FITC in the presence of DBM or DBF, the FITC-specific CHS response was enhanced, as we have observed for DBP. As to underlying mechanisms, DBM and DBF facilitated the trafficking of FITC-presenting CD11c(+) dendritic cells (DCs) from skin to draining lymph nodes and increased the cytokine production by draining lymph nodes. In conclusion, DBM and DBF may have an effect that aggravates contact dermatitis through a skin sensitization process.

Topics: Animals; Cytokines; Dermatitis, Contact; Drug Hypersensitivity; Fluorescein-5-isothiocyanate; Fumarates; Gene Expression Regulation; Lymph Nodes; Maleates; Mice; Mice, Inbred BALB C; Molecular Structure

Dimethyl fumarate (DMF) has been recognized as an extremely potent irritant and sensitizer found in sachets inside furniture. The first skin manifestations were correlated to contact with sofas, chairs, and other furniture. In these last years, some papers have reported a development of allergic contact dermatitis on the foot caused by DMF present in high concentration in shoes made in China.. We report the case of a 37-year-old woman who presented with severe eczema on the foot shortly after having bought a new pair of shoes. The diagnosis was performed by patch tests with DMF in several dilutions, with pieces of internal and external parts of the shoes, and by chemical analysis of the shoes.. In the last three years, goods containing DMF increased diffusely despite the augmentation on global preventive measures by Europe.. Therefore, new cases of contact dermatitis could be dependent on DMF, and it is of note that this allergen is not included in most series for patch testing.

Topics: Adrenal Cortex Hormones; Adult; Anti-Infective Agents; Dermatitis, Contact; Dermatologic Agents; Dimethyl Fumarate; Female; Foot Diseases; Fumarates; Humans; Patch Tests; Shoes

Dimethyl fumarate (DMF) has been identified as being responsible for an outbreak of shoe contact dermatitis in Europe. All reported cases to date have involved the dorsa of the toes and the dorsa of the feet, sometimes in association with other areas.. To establish a correlation between the site of the lesions and the concentration of DMF in different parts of the footwear from patients suffering from shoe contact dermatitis.. We performed a retrospective study of 8 patients with shoe contact dermatitis caused by DMF. Clinical data and patch test results obtained with DMF were recorded. The contents of DMF in different parts of eight samples of shoes involved were analysed with gas chromatography-mass spectrometry.. The chemical analysis of all samples studied showed the presence of DMF, both in the uppers and the soles of the shoes. A clinical-analytical correlation was found in all cases. The presence of DMF in a child's boot was detected 1 year after withdrawal of the sachet with DMF from the shoe box.. A correlation exists between the concentrations of DMF in the different parts of the shoe and the localization of the lesions. Although DMF is a volatile substance, it can remain impregnated in shoes for a long period of time.

Topics: Adolescent; Adult; Antifungal Agents; Child, Preschool; Dermatitis, Contact; Dimethyl Fumarate; Female; Foot Dermatoses; Fumarates; Humans; Male; Middle Aged; Patch Tests; Shoes; Urticaria; Young Adult

Topics: Antifungal Agents; Dermatitis, Contact; Dimethyl Fumarate; Foot Dermatoses; Fumarates; Humans; Patch Tests; Shoes; Spain; Urticaria

For the first time in Argentina, we describe an outbreak of contact dermatitis. New pairs of shoes caused intense pruritus, pain, and eruption, followed by edema, blisters, and a severe negative impact on the epidermal barrier of the feet. We identify dimethylfumarate as the causal agent and suggest an analytical method for its fast identification.

Topics: Adult; Animals; Anti-Bacterial Agents; Argentina; Blister; Dermatitis, Contact; Dimethyl Fumarate; Epidemics; Erythema; Female; Foot; Fumarates; Fungicides, Industrial; Gentamicins; Humans; Hypersensitivity; Miconazole; Patch Tests; Pruritus; Rabbits; Shoes

Following similar events in other European countries, some cases of dermatitis related to contact with China-imported furniture possibly treated with dimethyl(E)-butenedioate (dimethylfumarate [DMF]) were reported to the French institute for public health surveillance at the beginning of September 2008. An active multisource case collection was conducted in order to provide an epidemiological description of this outbreak. Results of this investigation show that, in France, mainly during the 4th quarter of 2008, a large number of people presented dermatological symptoms at least plausibly due to a contact with DMF-treated consumer products. The products involved were mostly shoes and sofa (94% of cases). This work offers an example of a multipartner investigation in the field of environmental health. It also shows how the results obtained contributed to decision-making and resulted in the limitation of DMF-treated products in France and in Europe.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Dermatitis, Contact; Dimethyl Fumarate; Disease Outbreaks; Female; France; Fumarates; Humans; Infant; Interior Design and Furnishings; Male; Middle Aged; Young Adult

Furniture components can cause contact allergies. In the last years several cases of eczema after sofa contact have been reported. Typically the skin lesions develop on the back, the buttocks, the dorsal aspects of the thighs and arms and are often very resistant to topical corticoid therapy. Dimethylfumarate (DMF) is postulated to be the causative agent for this Type IV hypersensitivity reaction. DMF is an antimicrobial substance, which is used in asian upholstered furniture industry amongst others. We report the case of a 65-year old patient with generalised severely itching maculopapular, partly eczematous skin lesions on the buttocks, back, abdomen and arms. The resistance to therapy, several relapses after discharge from hospital as well as the detailed history lead us to the tentative diagnosis. The sofa dermatitis was proven by positive patch testing with furniture material and dimethylfumarate.

Topics: Aged; Dermatitis, Contact; Dimethyl Fumarate; Fumarates; Humans; Interior Design and Furnishings; Male

The present paper describes a case of shoe contact dermatitis from DMF identified by the Poison Control Centre of Milan (PCCM), Italy, in 2009. A 35 year old woman was affected by irritant reactions while wearing shoes contaminated with DMF. Exposure to these shoes was limited to a 8 hour period and was not repeated. In the following days the patient suffered feet blistering and swelling limited to the area in contact with shoe vamp. Topical application of cortisone did not prevent development of bullous eczema. After 20 days from exposure, the lesions were healed but the skin remained red, dry and very sensitive. Chemical analyses of shoes quantified an average concentration of DMF of 383 mg/kg. The patient refused to be patch tested. The observation here reported confirm that DMF should be considered a possible causal agent in shoe contact dermatitis. Documentation of cases exposed to this chemical provide a relevant support to characterize clinical manifestations and to identifying contaminated articles.

Topics: Adult; Dermatitis, Contact; Dermatologic Agents; Dimethyl Fumarate; Female; Foot Diseases; Fumarates; Humans; Italy; Shoes; Skin Tests

Topics: Allergens; Dermatitis, Contact; Dimethyl Fumarate; Female; Fumarates; Humans; Interior Design and Furnishings; Irritants; Male; Middle Aged

The methyl ester form of fumaric acid named dimethyl fumarate (DMF) is an effective mould-growth inhibitor. Its irritating and sensitizing properties were demonstrated in animal models. Recently, DMF has been identified as responsible for furniture contact dermatitis in Europe.. To describe the clinical manifestations, patch test results, shoe chemical analysis, and source of exposure to DMF-induced shoe contact dermatitis.. Patients with suspected shoe contact dermatitis were studied in compliance with the Declaration of Helsinki. Patch test results obtained with their own shoe and the European baseline series, acrylates and fumaric acid esters (FAE), were recorded according to international guidelines. The content of DMF in shoes was analysed with gas chromatography and mass spectrometry.. Acute, immediate irritant contact dermatitis and non-immunological contact urticaria were observed in eight adults and two children, respectively. All the adult patients studied developed a delayed sensitization demonstrated by a positive patch testing to DMF < or = 0.1% in pet. Cross-reactivity with other FAEs and acrylates was observed. At least 12 different shoe brands were investigated. The chemical analysis from the available shoes showed the presence of DMF.. DMF in shoes was responsible for severe contact dermatitis. Global preventive measures for avoiding contact with DMF are necessary.

Topics: Adult; Aged; Antifungal Agents; Dermatitis, Contact; Dimethyl Fumarate; Female; Foot Dermatoses; Fumarates; Gas Chromatography-Mass Spectrometry; Humans; Infant; Male; Middle Aged; Molecular Structure; Patch Tests; Shoes; Urticaria

A small epidemic of severe contact dermatitis cases related to newly acquired sofas and chairs has surpassed the news threshold in Finland and the U.K.. To study affected patients and to identify the cause.. Five patients with contact dermatitis related to a newly purchased chair or sofa were studied. Furniture samples were analysed by gas chromatography-mass spectrometry. Compounds were identified using a mass spectrum library and measured semiquantitatively. Patch tests were performed with commercial standard allergens, furniture upholstery and chemicals found in the analysis.. Patch tests with commercial allergens did not solve the problem. Up to 470 microg kg(-1) of dimethylfumarate was found in chairs. The patients showed strong positive patch test reactions to upholstery fabric samples and to dimethylfumarate, down to a level of 1 p.p.m. in the most severe case.. The cause of the Chinese sofa/chair dermatitis epidemic is likely to be contact allergy to dimethylfumarate, a novel potent contact sensitizer.

Topics: Adult; Anti-Infective Agents; Arm; Back; Buttocks; Dermatitis, Contact; Dimethyl Fumarate; Female; Fumarates; Humans; Interior Design and Furnishings; Leg Dermatoses; Male; Middle Aged; Patch Tests

YM-393059 is a novel phosphodiesterase (PDE) 7A and PDE4 dual inhibitor that inhibits both Th1 [interleukin (IL)-2 and interferon-gamma] and Th2 (IL-4) cytokines in vitro [Yamamoto, S., Sugahara, S., Naito, R., Ichikawa, A., Ikeda, K., Yamada, T., Shimizu, Y., 2006. The effects of a novel phosphodiesterase 7A and -4 dual inhibitor, YM-393059, on T-cell-related cytokine production in vitro and in vivo. Eur. J. Pharmacol. 541, 106-114]. To characterize the pharmacological profile of YM-393059, its effects on several acute and chronic inflammation models were examined. In acute inflammation models, YM-393059 significantly suppressed the delayed-type hypersensitivity reaction to sheep red blood cells in mice with an ED(50) value of 17.1 mg/kg. YM-393059 failed to suppress paw edema in the carrageenin-induced edema model in rats. These pharmacological effects were similar to those of cyclosporine, a typical T-cell immunosuppressant. However, YM-393059, but not cyclosporine, significantly inhibited zymosan-induced neutrophil accumulation in mice with an ED(50) value of 25.7 mg/kg. In mouse toluene-2,4-diisocyanate-induced contact dermatitis, a chronic inflammation model, YM-393059 and cyclosporine significantly suppressed ear edema at doses of 30 and 20 mg/kg, respectively. In this model, YM-393059 also tended to reduce the serum immunoglobulin E antibody level, whereas cyclosporine dramatically potentiated it. These results suggest that YM-393059 inhibits both Th1- and Th2-cell-dependent reactions and also the function of neutrophils.

Topics: 3',5'-Cyclic-AMP Phosphodiesterases; Acute Disease; Animals; Anti-Inflammatory Agents; Carrageenan; Chronic Disease; Cyclic Nucleotide Phosphodiesterases, Type 4; Cyclic Nucleotide Phosphodiesterases, Type 7; Cyclosporine; Dermatitis, Contact; Edema; Erythrocytes; Fumarates; Hypersensitivity, Delayed; Immunosuppressive Agents; Indoles; Inflammation; Male; Mice; Mice, Inbred BALB C; Peritonitis; Phosphodiesterase Inhibitors; Rats; Rats, Sprague-Dawley; Sheep; Sulfonamides; Toluene 2,4-Diisocyanate; Zymosan

Systemic and sometimes topical therapy with fumaric acid (FA) and its derivatives is used in the treatment of psoriasis. Scattered data show that the topical application of these derivatives elicits side effects. Application of FA and some derivatives on the skin was accompanied by perilesional skin irritation, macular papular rashes and urticarial reactions. In order to determine the irritating and sensitizing properties of FA derivatives we used a cytotoxicity, flank irritation, ear swelling and guinea pig maximization test. The results of the cytotoxicity test demonstrated that dimethylfumarate (DMF) was the most toxic derivative. DMF induced also contact-urticarial reactions in contrast to mono-ethylfumarate (MEF). Challenge experiments with FA, MEF and DMF in MEF- and DMF-sensitized guinea pigs demonstrated that both MEF and DMF are moderate contact sensitizers. In DMF-sensitized animals cross-reactions with MEF were found. As DMF and MEF have cytotoxic, contact-urticarial and/or sensitizing properties, topical application should be avoided.

Topics: Administration, Topical; Animals; Dermatitis, Contact; Fumarates; Guinea Pigs; Immunization; Urticaria

The contact urticariagenic properties of diethyl fumarate were studied using the guinea pig ear swelling assay and by open application on the human upper back skin. Diethyl fumarate caused non-immunologic contact urticaria in both human and guinea pig skin, and the reactions exhibited similar dose dependency and timing of maximal response.

Topics: Adult; Animals; Dermatitis, Contact; Female; Fumarates; Guinea Pigs; Humans; Male; Middle Aged; Urticaria

Topics: Adult; Dermatitis, Contact; Female; Fumarates; Humans; Urticaria

Atranorin, one of the most common lichen substances, gave positive patch test reactions in eight subjects (1%) in a routine series. These subjects also reacted to fumarprotocetraric acid and some of them to evernic acid. Stictic acid and usnic acid gave negative reactions. The lichen oak moss Evernia prunastri and an oak moss perfume gave positive reactions. Thin-layer chromatography and a spot test indicated that atranorin is present in oak moss perfumes which are made from oak moss and tree moss. Contact with oak moss perfumes and lichens in nature may cause atranorin allergy. None of the eight subjects had a history of light sensitivity or atopy and none had chronic facial eczema.

Topics: Adult; Dermatitis, Atopic; Dermatitis, Contact; Female; Fumarates; Humans; Hydroxybenzoates; Lichens; Male; Middle Aged; Patch Tests; Perfume