sodium-dodecyl-sulfate and Dermatitis--Allergic-Contact

Various methodological aspects of skin sensitisation testing have been explored, particularly in the context of animal welfare considerations and reliability and sensitivity of test methods. Recommendations are made for the conduct of current and proposed OECD skin sensitisation tests with respect to appropriate test configurations for the purposes of hazard identification and labelling, and the requirement for positive controls. Specifically, the following aspects of guinea pig sensitisation test methods have been addressed: (1) the number of test and control animals required; (2) the option of using joint positive controls between independent laboratories; (3) the choice of positive control chemicals; (4) the optimal conduct and interpretation of rechallenge; and (5) the requirement for pretreatment with sodium lauryl sulfate. In addition, the use of the murine local lymph node assay (LLNA) has been considered. A number of conclusions have been drawn and recommendations made as follows: In many instances, particularly with the conduct of the guinea pig maximisation test, it is acceptable to halve the number of test and control animals used. An optional scheme for the conduct of joint positive control studies within a co-ordinated group of laboratories is appropriate. Only one positive control chemical (alpha-hexyl cinnamic aldehyde) is necessary for the routine assessment of assay sensitivity. The proper conduct and interpretation of rechallenge can provide valuable information and confirmation of results in guinea pig sensitisation tests. Sodium lauryl sulfate should no longer be used as a pretreatment in the guinea pig maximisation test. The LLNA is a viable and complete alternative to traditional guinea pig test methods for the purposes of skin sensitisation hazard identification. These recommendations provide the opportunity for both animal welfare benefits and improved hazard identification.

Topics: Allergens; Animal Welfare; Animals; Dermatitis, Allergic Contact; Disease Models, Animal; Guinea Pigs; Local Lymph Node Assay; Mice; Skin Tests; Sodium Dodecyl Sulfate; Surface-Active Agents

Glove occlusion might enhance skin sensitivity to a subsequent detergent challenge (occlusion effect). Thus, some skin protection creams (PC) claim to protect against this effect of occlusion, and are recommended to be used before wearing liquid-proof gloves.. To evaluate the effect of PC applied prior to glove occlusion on the 'occlusion effect'-refers to increased susceptibility of the skin to a model detergent.. One hundred and eleven volunteers were enrolled in a single-blind, randomized study. Seven PCs were applied before glove occlusion over 7 days (D1-D7). After sodium lauryl sulphate (SLS) challenge, we compared the irritation between the areas treated with PC and occlusion alone. Clinical scoring and bioengineering methods (capacitance, transepidermal water loss [TEWL], and colourimetry [erythema]) were used to quantify the irritant reactions.. After 1 week of occlusion and PC application, we did not observe significant changes in TEWL, nor in erythema, whereas skin hydration raised in three cream-treated areas. On day 10, after a challenge with SLS, some products significantly aggravated the skin irritation as compared to occlusion alone.. The 'occlusion effect'-shown as higher skin susceptibility to a model detergent-was not mitigated by PCs when applied prior to glove occlusion. On the contrary, some PCs might have negative effects on skin barrier function and augment such sensitivity.

Topics: Dermatitis, Allergic Contact; Dermatitis, Irritant; Detergents; Emollients; Erythema; Humans; Single-Blind Method; Skin; Sodium Dodecyl Sulfate; Water; Water Loss, Insensible

We performed a randomized, paired, double-blind trial involving 14 participants with self-declared normal skin and 15 participants with self-declared sensitive skin to test the cutaneous compatibility of materials of low irritation potential for skin irritation (sanitary pads) elicited by repetitive topical application.. Two test products patches and two control substance patches were applied to the lateral aspect of the upper arm once daily under fully occlusive conditions for 4 days. The positive control patch was moistened with sodium lauryl sulphate (0.1% w/v) and the negative control patch was moistened with 0.9% sodium chloride, as were the two test material patches. The patches were removed, skin irritation (erythema) graded, and new patches applied after each 24-hour period.. There was no significant difference in skin irritation from the test patches between the sensitive and normal skin groups. The two test patches and the negative control patch were significantly less irritating than the positive control in both test groups. Both test patches were comparable to the negative control patch in the normal and sensitive skin groups.. The test materials produced similar degrees of skin irritation among both groups. Overall, there was no statistically significant difference in skin compatibility when the two feminine hygiene product test patches were worn by self-declared normal and sensitive skin groups.

Topics: Adult; Aged; Analysis of Variance; Dermatitis, Allergic Contact; Dermatitis, Irritant; Double-Blind Method; Erythema; Female; Humans; Male; Menstrual Hygiene Products; Middle Aged; Severity of Illness Index; Skin; Skin Irritancy Tests; Sodium Chloride; Sodium Dodecyl Sulfate; Time Factors

Silicon image sensor (SIS) technology was recently introduced as an innovative tool (SkinChip, L'Oréal) providing sensitive imaging of the skin capacitance. This method can detect discrete focal variations in skin surface hydration, and thus early discrete manifestations of skin irritation induced by surfactants. In the present in vivo study, 2 neat and diluted shampoos, and 5% and 10% sodium laurylsulfate solutions were tested on human skin. Each surfactant solution was gently rubbed on the skin using wet hair wicks mimicking the casual use of a shampoo on the scalp. Clinical and SIS evaluations were carried out. In addition, the same products were tested using the ex vivo corneosurfametry bioassay performed on human stratum corneum (SC) harvested by cyanoacrylate skin surface strippings. The colourimetric index of mildness (CIM) was measured on these samples. The product reactivity with the SC was recognized by darker skin capacitance images, and by both lowered SkinChip-generated values and lowered CIM values. The extent in changes varied according to the nature of the test products and their concentrations. The SkinChip image changes likely corresponded to the acute surfactant-induced water swelling of the corneocytes. Skin capacitance imaging and corneosurfametry allow to disclose discrete surfactant-induced alterations of corneocytes.

Topics: Dermatitis, Allergic Contact; Double-Blind Method; Electric Capacitance; Hair Preparations; Humans; Skin; Skin Physiological Phenomena; Skin Tests; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible

An unequivocal distinction between allergic and irritant patch test reactions is often difficult with patch tests. This study was designed to evaluate the worth of video-macro camera documentation for differentiation between allergic and irritant test reactions and to investigate whether there are characteristic clinical differences in patch test responses between metal salts and fragrances. Patch testing was performed with nickel sulfate, fragrance mix and an irritant, sodium lauryl sulfate 1% aq., on the upper back of 82 patients, with evaluation and computer-aided video documentation after 48 and 72 hr. No reliable clinicomorphological criterion was found for assessing a weak patch test reaction as being definitely allergic. Even characteristic papules and vesicles were not regularly found in allergic reactions. However, unlike fragrance mix, patch test reactions to nickel sulfate were characteristic in that they showed a heterogeneous spread and an association with hair follicle openings, independent of reaction intensity. Evaluation based on additional computer-aided video-macro camera documentation did not add further advantage for the differentiation of allergic and irritant reactions. But well-defined clinicomorphological features and reaction patterns to single test substances or even whole substance categories could be helpful additional criteria for evaluating patch test responses in clinical practice.

Topics: Adult; Aged; Aged, 80 and over; Allergens; Dermatitis, Allergic Contact; Female; Humans; Irritants; Male; Middle Aged; Nickel; Patch Tests; Perfume; Prospective Studies; Sodium Dodecyl Sulfate; Video Recording

Combined exposure to different irritants in the workplace may lead to irritant contact dermatitis, which is the main type of occupational dermatitis among bakers and confectioners. Following previous work on "tandem irritation", a panel of healthy volunteers was exposed twice daily for 4 days to the organic fruit acids: citric, malic, and lactic acid, either alone or in tandem application with 0.5% sodium lauryl sulphate (SLS) in a repetitive irritation test. Irritant cutaneous reactions were quantified by visual scoring and non-invasive measurement of transepidermal water loss and skin colour reflectance. Twice daily application of either citric or malic acid alone did not induce a significant irritant reaction. Combined exposure to one of the fruit acids and SLS caused marked barrier disturbance, but the latter irritant effect was smaller than that obtained by combined exposure to SLS and water. Thus, combined exposure to the above-mentioned fruit acids and SLS did not enhance cumulative skin irritation.

Topics: Adult; Citric Acid; Citrus; Dermatitis, Allergic Contact; Dermatitis, Occupational; Drug Interactions; Female; Food Industry; Fruit; Humans; Irritants; Lactic Acid; Malates; Male; Predictive Value of Tests; Single-Blind Method; Skin Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible

Lipophilic extracts of Isatis tinctoria L. exhibit significant activity against several clinically relevant targets of inflammation. The alkaloid tryptanthrin was identified as one of the active principles in woad and characterised as a potent dual inhibitor of COX-2 and 5-LOX. Here, the anti-inflammatory efficacy of topical application of three different Isatis extracts and tryptanthrin was investigated in human volunteers. Two different models were used, namely the sodium lauryl sulphate (SLS)-induced irritant contact dermatitis (ICD) and UVB-induced erythema. Twenty healthy volunteers without any skin disease participated in the study. Cumulative irritant contact dermatitis was induced on test fields on the volunteers' backs by twice daily application of 0.5 % sodium lauryl sulphate over a period of four days. Half of the test fields were treated with the test substances during the eliciting phase, while the remaining test fields were treated over a period of 4 days after induction of dermatitis. In the second model, a UVB erythema on the volunteers' lower backs was induced using the double minimal erythema dose (MED). Twenty-four hours after irradiation the test fields were treated with the test substances over a period of 3 days. All reactions were assessed visually and by non-invasive bioengineering methods (evaporimetry and chromametry). Treatment with extracts during the ICD eliciting phase led to a significantly smaller increase of visual scores and transepidermal water loss compared to the untreated test field. For tryptanthrin this benefit was also observed, but the improvement was not statistically significant. When treatment was performed after completing the eliciting phase, accelerated resolution of the irritant reaction could not be observed. In the UVB erythema model anti-inflammatory effects of the test substances were not observed.

Topics: Adolescent; Adult; Anti-Inflammatory Agents; Dermatitis, Allergic Contact; Drugs, Chinese Herbal; Erythema; Female; Humans; Isatis; Male; Phytotherapy; Plant Extracts; Plant Leaves; Quinazolines; Single-Blind Method; Sodium Dodecyl Sulfate; Treatment Outcome; Ultraviolet Rays

Household and cleaning products often contain both allergens and irritants. The aim of this double-blinded, randomized, paired study was to determine whether patch testing with an allergen (hydroxycitronellal) combined with an irritant [sodium lauryl sulfate (SLS)] cause a stronger patch test elicitation reaction than patch testing with the allergen (hydroxycitronellal) alone, in patients previously patch tested positive to hydroxycitronellal. A stronger patch test elicitation reaction was defined as at least 1 day of patch test reading showing more positive patch tests (+, ++ or +++) on the forearm patch tested with 6 concentrations of SLS plus hydroxycitronellal than on the forearm tested with 6 concentrations of hydroxycitronellal alone and no day of patch test readings showing more positive tests on the hydroxycitronellal forearm. 15/20 (75%) had at least 1 day of patch test reading with more positive patch tests on the forearm patch tested with SLS plus hydroxycitronellal and no day of patch test readings with more positive patch tests on the forearm tested with hydroxycitronellal (P = 0.0253). Estimation of the blood flow with laser Doppler supported these findings.

Topics: Adult; Aged; Allergens; Dermatitis, Allergic Contact; Double-Blind Method; Female; Humans; Irritants; Laser-Doppler Flowmetry; Male; Middle Aged; Patch Tests; Severity of Illness Index; Skin; Sodium Dodecyl Sulfate; Surveys and Questionnaires; Terpenes

Ocean bathing has been considered "healthy" for skin, but its efficacy remains testimonial in nature. Our aim was to evaluate the effects of sea water and its main components on experimental irritant contact dermatitis induced by sodium lauryl sulphate (SLS) cumulative irritation.. After open application of 2% SLS for 10 min on volar forearm sites, solutions of sea water, 500 mM NaCl, 10 mM KCl, 55 mM MgCl2, 10 mM CaCl2, or deionized water were separately applied using filter paper discs for 20 min. The procedures were repeated daily for 2 weeks. The effects of the treatment were assessed daily using measurements of transepidermal water loss (TEWL), as an indicator of epidermal barrier function, and capacitance, as a parameter of stratum corneum water content.. Sea water, NaCl, and KCl significantly inhibited the increase of TEWL as compared with deionized water (P < 0.003, P < 0.05, P < 0.05, respectively). Sea water and NaCl inhibited the decrease of capacitance as well (P < 0.03, P < 0.01).. The effect of sea water may be attributed to skin barrier preservation by NaCl and KCl, and an emollient effect by NaCl.

Topics: Adult; Aged; Analysis of Variance; Dermatitis, Allergic Contact; Electric Conductivity; Female; Humans; Male; Middle Aged; Seawater; Sodium Dodecyl Sulfate; Water Loss, Insensible

In experimentally-induced irritant (ICD) and allergic (ACD) contact dermatitis, an oil-in-water (o/w) cream was applied to investigate its effects on a disturbed barrier function compared to untreated physiological barrier repair. Transepidermal water loss (TEWL) measurements were performed. Before the start of the experiments, the skin tolerance of the cream was examined, revealing the non-irritating characteristics of the ingredients and the absence of any contact allergic patch test reaction. In the ICD study, sodium lauryl sulfate (SLS) patches were applied to the forearms of young female volunteers. Consequently, it was observed that repeated cream application (14 days, 2x/day) significantly improved the TEWL of SLS-damaged skin, leading to a complete recovery on day 15. In the ACD study, disruption of skin barrier function was obtained by a nickel-mediated contact allergy patch (CAP) test. The cream was then applied 2x/day for 4 consecutive days. Assessment of TEWL clearly showed that recovery of the disrupted skin significantly improved after cream application in comparison to untreated barrier repair.

Topics: Adult; Dermatitis, Allergic Contact; Dermatitis, Irritant; Emollients; Female; Humans; Nickel; Skin; Skin Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible

There remains much room for improvement in the accuracy of the patch test procedure. There has been a lack of knowledge regarding the possible relationship between the intensity of test reactions and the quality of the tape used to apply patch tests. Using different brands of tape, patches coated with 2 mg/cm2 sodium dodecyl sulfate (SLS) were applied for 24 h to the backs of 10 volunteers. The tape specimens varied in terms of manufacture, elasticity, adhesive strength, and water permeability. The intensity of patch test reactions, evaluated visually and objectively with both the high resolution laser Doppler perfusion imaging technique (HR-LDPI) and transepidermal water loss measurements (TEWL), varied significantly with the different brands of tape. Observed variations in the intensity of reactions to the patch tests could not be explained by any of the 4 tape parameters investigated. In order to attain optimal test quality in the future, both the tape and patches used in the testing system should be standardized and clearly labelled.

Topics: Adhesives; Adult; Bandages; Dermatitis, Allergic Contact; Erythema; Female; Humans; Laser-Doppler Flowmetry; Male; Middle Aged; Patch Tests; Regional Blood Flow; Severity of Illness Index; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible

Evaluation of the irritant potential of new products or ingredients prior to human testing is generally performed in vivo on animals. However, according to the 6th amendment and following updates of the European Community directive on cosmetic products (93/35/EEC), animal testing will be banned when suitable substitutes will be available. To know whether in vitro tests for assessment of skin irritancy provide results approaching human conditions, comparisons have to be made between data deriving from in vitro tests and skin response in humans. The aim of our study was to assess the validity of the monolayer culture system of normal human keratinocytes as a model for the evaluation of the irritant effects of detergents, by comparing in vitro cell culture data to in vivo acute skin irritancy effects of cocamidopropyl betaine (CAPB), an amphoteric compound, Tween 20 (TW20) (polysorbate 20) and Tween 80 (TW80) (polysorbate 80), representing nonionic compounds, applied to the skin of 24 healthy volunteers at a concentration similar to that employed in commercial products. As parameters for cytotoxicity, cell proliferation, cell membrane integrity and cell metabolism were assessed by cell counts, thymidine incorporation, MTT conversion, and Neutral Red uptake. In order to increase the sensitivity of the in vivo evaluation, bioengineering methods for assessment of the effects of test products on the skin were employed. Whereas all 4 in vitro methods ranked the tensides according to their toxicity in the following order: CAPB>SLS>TW20>TW80, both in vivo methods agreed in identifying SLS as the most irritating substance. Moreover, as compared with the irritation potential on human skin, all 4 in vitro tests overestimated the toxicity of CAPB. This suggests that the keratinocyte monolayer cell culture technique cannot directly replace in vivo methods, and that data obtained by this method should be interpreted cautiously.

Topics: Adolescent; Adult; Betaine; Cell Survival; Cells, Cultured; Dermatitis, Allergic Contact; Dose-Response Relationship, Drug; Erythema; Excipients; Female; Humans; Keratinocytes; Middle Aged; Patch Tests; Polysorbates; Severity of Illness Index; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible

2 acute irritants and 1 allergen were selected: sodium lauryl sulfate (SLS) representative of irritant household and occupational contact dermatitis, the combination of ammonium hydroxide (NH4OH) and urea to simulate diaper dermatitis, and Rhus to evaluate the effect of model protective materials. The putative protective materials and vehicle were applied to both ventral forearms of 10 subjects in each group, according to a randomized code. Test materials were spread over a marked 2.0 cm2 area, massaged in, allowed to dry for 30 min, and reapplied with another 30 min drying period. The model irritants and allergen were then applied (0.025 ml) to an Al-test occlusive patch, which in turn was placed for 24 h over each of the 8 designated sites. Inflammation was scored according to a clinical scale 72 h post-application. Paraffin wax plus Acetulan in cetyl alcohol, and beeswax plus Acetulan in cetyl alcohol, markedly (p < 0.001) suppressed SLS irritation. Paraffin wax plus beeswax in cetyl alcohol, and Acetulan in cetyl alcohol reduced NH4OH and urea irritation (p < 0.05), paraffin wax in cetyl alcohol significantly (p < 0.01) decreasing Rhus allergic contact dermatitis. This model, provides an easy approach to screening protectants. Its clinical significance requires comparison with an open rather than an occluded challenge.

Topics: Administration, Topical; Adult; Ammonium Hydroxide; Anti-Inflammatory Agents; Dermatitis, Allergic Contact; Fatty Alcohols; Humans; Hydroxides; Irritants; Lanolin; Male; Middle Aged; Paraffin; Patch Tests; Pharmaceutic Aids; Plants, Toxic; Random Allocation; Reference Values; Sodium Dodecyl Sulfate; Time Factors; Toxicodendron; Urea; Waxes

Topics: Adult; Dermatitis, Allergic Contact; False Negative Reactions; Female; Humans; Nickel; Patch Tests; Premedication; Sodium Dodecyl Sulfate

The purpose of the study was to assess the effect of topical corticosteroid on the patch test response in patients with known positive allergens and also to study any effect on the irritant response. In Study 1, 10 patients with known positive allergens had their backs pre-treated 2 x daily for 3 days with either betamethasone dipropionate 0.05% or the equivalent ointment base. On day 4, previous known allergens and dilutions of sodium lauryl sulfate (5% and 10%) as an irritant were applied to each side of the back. In Study 2 (4 patients), a 1:4 dilution of betamethasone dipropionate was substituted for the full-strength preparation. Betamethasone dipropionate 0.05% caused total or partial suppression of the allergic reaction in 8 of 10 cases. The 1:4 dilution caused partial suppression in 3 cases. The irritant reaction was totally suppressed by betamethasone dipropionate in 1 of 10 cases and partially suppressed in 7 of 10. The 1:4 dilution decreased the intensity of the irritant reaction in 3 of 4 cases. The relevance of these results to clinical practice is discussed.

Topics: Administration, Topical; Allergens; Anti-Inflammatory Agents; Betamethasone; Dermatitis, Allergic Contact; Dermatitis, Irritant; Double-Blind Method; Drug Eruptions; Follow-Up Studies; Glucocorticoids; Humans; Irritants; Ointments; Patch Tests; Sodium Dodecyl Sulfate; Surface-Active Agents

Semipermeable membranes might be suitable for glove liners or comfort gloves in individuals with irritant contact dermatitis (ICD).. To evaluate the effects of different glove materials on inflammation and epidermal barrier impairment after experimental skin irritation.. Nine test areas on the volar forearms of 24 healthy volunteers were irritated with sodium lauryl sulfate (1%) and afterward covered for 6 days (6 or 8 h/day) with semipermeable Sympatex (SYM), vinyl (OCC), combinations of vinyl with Sympatex (SYM/OCC) or cotton (COT/OCC), or left uncovered (CON). Up to day 10, measurements of transepidermal water loss (TEWL), erythema (a*), skin humidity (SH) and visual scoring (VS) were applied.. No significant differences in skin parameters were found between COT/OCC and SYM/OCC as well as between each of the combinations and CON. SYM, COT/OCC and SYM/OCC led to better results for most skin parameters than OCC alone.. Occlusive material has a negative impact on skin barrier recovery and inflammation after skin irritation whereas SYM is not inferior to uncovered areas indicating good tolerability. Altogether, the data suggest that SYM is a useful alternative to COT as material for glove liners and comfort gloves in ICD patients.

Topics: Dermatitis, Allergic Contact; Dermatitis, Irritant; Epidermis; Humans; Inflammation; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible

Surfactants are long-chain compounds comprising a hydrophobic tail and a hydrophilic head, lending them the ability to act as a “bridge” between oil and water. Their detergent, foaming and other properties prove useful in a number of settings, including home and workplace sanitation, cosmetics (rinse and no-rinse cleansers) and medicine. When used on skin, surfactants reduce the superficial surface tension of proteins and lipids on the stratum corneum. This helps to eliminate skin debris such as sebum, oils and dirt, but also presents a risk of damage to the skin barrier. The irritation potential of surfactants has long been common knowledge, but with the development and deployment of novel compounds, notably to replace first-generation, mostly sodium-lauryl-sulphate-based products, their potential to cause allergic contact dermatitis has come to light. Knowledge about this allergic potential and the associated dermatitises must also become commonplace so that contact allergies are considered in the presence of surfactant exposure.

Topics: Dermatitis, Allergic Contact; Epidermis; Humans; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents

Knowledge about the required duration of exposure for elicitation of allergic nickel dermatitis in nickel-allergic individuals is limited. However, it often has been proposed that short skin contact is safe.. To examine whether repeated skin contact with nickel over short time periods (3 × 10 min) can elicit allergic nickel dermatitis.. Sixteen nickel-allergic adults and 10 controls were exposed to, respectively, nickel- and aluminium-containing discs on each volar forearm and on each earlobe for 3 × 10 min. One arm was pretreated for 24 h with sodium lauryl sulfate (SLS) 0·5% under occlusion before exposure. One aluminium and one nickel exposure site were clinically evaluated, and blood flow was measured with laser Doppler flowmetry at day 2 and day 4.. Ten of 16 (63%) nickel-allergic participants developed allergic nickel dermatitis on SLS-pretreated arm skin and three of 16 (19%) developed it on normal skin on the earlobe. On the SLS-pretreated arms of nickel-allergic participants, blood flow increased significantly more on the nickel-exposed skin than on the aluminium-exposed skin on days 2 and 4. No change in clinical reactivity or blood flow was found on normal forearm skin in nickel-allergic participants or on any skin in controls.. This experimental study showed that relatively short repeated skin contact (3 × 10 min) with metallic nickel elicits allergic nickel dermatitis in irritated skin and at sites with previous dermatitis. The results support the restrictions in current nickel regulation.

Topics: Adult; Allergens; Aluminum; Dermatitis, Allergic Contact; Female; Human Experimentation; Humans; Irritants; Male; Middle Aged; Nickel; Skin Tests; Sodium Dodecyl Sulfate; Time Factors

Recent studies have demonstrated allergen-specific differences in the gene expression of inflammatory mediators in patch tested skin.. To determine levels of various inflammatory mediators in the stratum corneum (SC) after patch testing with common contact allergens and the skin irritant sodium lauryl sulfate (SLS).. In total, 27 individuals who had previously patch tested positive to nickel, chromium, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) or para-phenylenediamine were retested and then patch tested with SLS and petrolatum, with petrolatum serving as the patch test control. At 72 h, the test sites were clinically graded and the SC samples collected on adhesive tape.. The levels of 18 of the 32 quantified mediators differed significantly from that of the control patches for at least one of the tested substances. SLS and MCI/MI induced the largest number of immunomediators. Interleukin (IL)-16 levels were significantly higher in patch test reactions in all allergens than they were in the controls, while no significant difference was detected for SLS. Furthermore, a strong negative correlation was found between strength of patch test reaction and IL-1α levels.. Cytokine profiles in the SC of patch tested skin did not show a distinct allergen-specific pattern. However, MCI/MI induced a larger and wider immune response than the other allergens, perhaps due to its potency as an irritant. The levels of IL-16 were significantly increased in patch test reactions to allergens but not to SLS; thus, they may help clinicians to differentiate between allergic contact dermatitis and irritant contact dermatitis.

Topics: Allergens; Cytokines; Dermatitis, Allergic Contact; Dermatitis, Irritant; Epidermis; Female; Humans; Irritants; Male; Middle Aged; Patch Tests; Sodium Dodecyl Sulfate

The irritant sodium lauryl sulfate (SLS) is known to cause a decrease in the stratum corneum level of natural moisturizing factor (NMF), which in itself is associated with changes in corneocyte surface topography.. To explore this phenomenon in allergic contact dermatitis.. Patch testing was performed on patients with previously positive patch test reactions to potassium dichromate (Cr), nickel sulfate (Ni), methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI), or p-phenylenediamine. Moreover, a control (pet.) patch and an irritant (SLS) patch were applied. After 3 days, the stratum corneum from tested sites was collected, and NMF levels and corneocyte morphology, expressed as the amount of circular nanosize objects, quantified according to the Dermal Texture Index (DTI), were determined.. Among allergens, only MCI/MI reduced NMF levels significantly, as did SLS. Furthermore, only MCI/MI caused remarkable changes at the microscopic level; the corneocytes were hexagonal-shaped with pronounced cell borders and a smoother surface. The DTI was increased after SLS exposure but not after allergen exposure.. MCI/MI significantly decreased NMF levels, similarly to SLS. The altered corneocyte morphology suggests that skin barrier damage plays a role in the pathogenesis of MCI/MI contact allergy. The DTI seems to differentiate reactions to SLS from those to the allergens tested, as SLS was the only agent that caused a DTI increase.

Topics: Allergens; Dermatitis, Allergic Contact; Epidermis; Humans; Irritants; Patch Tests; Skin Physiological Phenomena; Sodium Dodecyl Sulfate

There are no studies on contact allergy in patients with prurigo. With itch being important in the pathophysiology of prurigo diseases and being a symptom of allergic contact dermatitis, we aimed to investigate contact allergy in patients suffering from prurigo.. Exploratory analysis of patch test results in prurigo patients.. A retrospective analysis of data of the Information Network of Departments of Dermatology, 2005-2014, was performed.. Of 116 744 patch tested patients, 639 (0.55%) were diagnosed with prurigo. The median age was 61 years, 286 (45%) were pensioners, and 252 (39.5%) had generalized prurigo. The indication for patch testing was exclusion of contact allergy in 412 patients (64.5%), and 223 patients (35%) had at least one positive patch test reaction. There was no distinctive pattern of sensitization. Prurigo patients had significantly more (and stronger) reactions to the irritant control patch test with sodium lauryl sulfate than a control group (27.6% versus 21.0%).. Although prurigo is not a typical clinical manifestation of contact sensitization, our results indicate that patch testing in these patients may be helpful.

Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Austria; Dermatitis, Allergic Contact; Dermatitis, Irritant; Germany; Humans; Middle Aged; Patch Tests; Prurigo; Retrospective Studies; Sodium Dodecyl Sulfate; Surface-Active Agents; Switzerland; Young Adult

Fruit-derived organic compounds and detergents are relevant exposure factors for occupational contact dermatitis in the food industry. Although individuals with atopic dermatitis (AD) are at risk for development of occupational contact dermatitis, there have been no controlled studies on the effects of repeated exposure to multiple irritants, relevant for the food industry, in atopic skin.. The aim of the study was to investigate the outcomes of repeated exposure to a fruit-derived organic acid and a detergent in AD compared to healthy volunteers.. The volunteers were exposed to 2.0% acetic acid (AcA) and/or 0.5% sodium lauryl sulfate (SLS) in controlled tandem repeated irritation test. The outcomes were assessed by measurements of erythema, transepidermal water loss (TEWL) and natural moisturizing factor (NMF) levels.. In the AD volunteers, repeated AcA exposure led to barrier disruption and significant TEWL increase; no significant differences after the same exposure in the healthy controls were found. Repeated exposure to SLS and the irritant tandems enhanced the reactions and resulted in a significantly higher increase in TEWL in the AD compared to the control group. Cumulative irritant exposure reduced the NMF levels in both groups.. Differences in the severity of irritant-induced barrier impairment in atopic individuals contribute to the risk for occupational contact dermatitis in result of multiple exposures to food-derived irritants and detergents.

Topics: Acetic Acid; Adult; Aged; Dermatitis, Allergic Contact; Dermatitis, Occupational; Detergents; Female; Food Industry; Fruit; Hand Dermatoses; Humans; Male; Middle Aged; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible; Young Adult

It is often difficult to differentiate between allergic and irritant patch test reactions by visual inspection. The purpose of this study was to test an image analysis-based method that differentiates between the two reactions by quantifying the degree of erythema at the patch test site.. A total of 172 Japanese patients were patch-tested with sodium lauryl sulfate (SLS) and nickel sulfate, followed by digital photography and visual evaluation of the patch test areas by dermatologists at 48 and 72 h. The digital images were converted to erythema index (EI) images by image processing, and changes in ΔEI (the difference in the EI between the patch test site and the adjacent normal skin) values were analyzed.. The ΔEI was significantly increased at 72 h relative to that at 48 h for positive nickel sulfate reactions (P < 0.0001), while no significant difference in the ΔEI was found for SLS reactions.. Using image analysis, allergic patch test reactions may be distinguished from irritant reactions by evaluating the change in the degree of erythema at 48 and 72 h.

Topics: Allergens; Dermatitis, Allergic Contact; Dermoscopy; Female; Humans; Image Interpretation, Computer-Assisted; Irritants; Male; Middle Aged; Nickel; Observer Variation; Patch Tests; Reproducibility of Results; Sensitivity and Specificity; Sodium Dodecyl Sulfate

Many attempts have been made to develop in vitro sensitization tests that employ dendritic cells (DCs), DC-like cell lines or keratinocytes. The aim of the present investigation was to establish a co-culture of THP-1 cells and keratinocytes for evaluation of skin sensitization potential of chemicals. Co-cultures were constructed by THP-1 cells cultured in lower compartments and keratinocytes cultured in upper compartments of cell culture inserts. After 24 h exposure to sensitizers (2, 4-dinitrochlorobenzene, p-phenylenediamine, formaldehyde, nickel sulfate, isoeugenol and eugenol) and non-sensitizers (sodium lauryl sulfate, benzalkonium chloride and lactic acid), the expression of CD86 and CD54 on THP-1 cells were evaluated by flow cytometry, and cell viabilities were determined. The sensitizers induced the augmentation of CD86 and CD54 expression, but the non-sensitizers had no significant effect. Compared with mono-cultures of THP-1 cells, the augmentation of CD86 and CD54 could be detected even at a non-toxic concentration of sensitizers in THP-1 cell/keratinocyte co-cultures. Moreover, isoeugenol was distinguished as a sensitizer in co-cultures, but failed to be identified in mono-cultures. These results revealed that the co-cultures of THP-1 cells and keratinocytes were successfully established and suitable for identifying sensitizers using CD86 and CD54 expression as identification markers.

Topics: Animal Testing Alternatives; B7-2 Antigen; Benzalkonium Compounds; Cell Line, Tumor; Cell Survival; Coculture Techniques; Dermatitis, Allergic Contact; Dinitrochlorobenzene; Eugenol; Formaldehyde; Haptens; Humans; Intercellular Adhesion Molecule-1; Keratinocytes; Lactic Acid; Monocytes; Nickel; Phenylenediamines; Sensitivity and Specificity; Skin Tests; Sodium Dodecyl Sulfate

A total of 56 departments of dermatology from Germany, Austria, and Switzerland collaborate to study the clinical epidemiology of contact allergies (CA). Data generated in the course of the diagnostic work-up of CA (e.g., patch test data) have been stored since 1989 in the data center in Göttingen, Germany, including data for more than 200,000 patients (March 2011). These data can be used as a register and as a surveillance system. Analysis of the register may identify and quantify risk factors of sensitization to an allergen, which is exemplified with the case of the allergen para-phenylenediamine. It turned out that-in addition to the risk factor hair dyeing-other important risk factors must be considered. In contrast, data collected every 6 months (from approximately 6,000 patients) allow for time-trend analyses of allergens, thus, identifying allergens of concern, which is of utmost importance for early preventive intervention. Here, the epidemiology of allergies to epoxy resins serves as an example. Continuous monitoring of contact allergens will also be mandatory in the future, as the CA premarketing screening systems will have imperfect predictive values with regard to human CA risk. Unfortunately, the (current) national regulatory framework severely hampers clinical surveillance/epidemiology of contact sensitization and, thus, prevention of contact allergy.

Topics: Adult; Austria; Coloring Agents; Comorbidity; Cross Reactions; Cross-Sectional Studies; Dermatitis, Allergic Contact; Dermatitis, Occupational; Epoxy Resins; Female; Fungicides, Industrial; Germany; Health Surveys; Humans; Male; Phenylenediamines; Population Surveillance; Public Health; Registries; Risk Factors; Sodium Dodecyl Sulfate; Surface-Active Agents; Switzerland; Thiram

Contact allergy to fragrance chemicals is an increasing problem. Polysensitization is likely to be a phenotype of increased susceptibility to contact allergy. The factors that play a role in polysensitization are largely unknown. Identifying these risk factors is important with regard to future studies on the aetiology of contact allergy.. To investigate whether enhanced skin irritability is a risk factor for the development of polysensitization to fragrance chemicals.. One hundred participants characterized by fragrance contact allergy were included in our study. The participants were patch tested on the back with 25 individual fragrance chemicals and fragrance mixes I and II, and on the upper arm with sodium lauryl sulfate (SLS) (consisting of SLS concentrations of 0.45%, 0.67%, 1%, and 1.5%). Reading of both tests was performed during the following visits at days 2, 3, and 7. The response to SLS was monitored by measuring transepidermal water loss (TEWL). Polysensitization was defined as three or more allergic reactions to non-cross-reacting fragrance chemical allergens.. Individuals with polysensitization showed significantly higher irritation responses to SLS 1% and 1.5% as assessed by TEWL.. We found an enhanced skin irritation response to be a risk factor for the development of polysensitization to fragrance chemicals.

Topics: Adolescent; Adult; Aged; Allergens; Dermatitis, Allergic Contact; Female; Humans; Irritants; Male; Middle Aged; Patch Tests; Perfume; Risk Factors; Severity of Illness Index; Skin Irritancy Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible; Young Adult

Langerhans cells (LC) migrate rapidly from epidermis to lymph node following epicutaneous application of antigen. In this study, we have explored the role of IL-18, a cytokine with structural similarities to IL-1 beta, in murine LC migration and contact hypersensitivity (CHS), which to oxazolone (OX) and 2-4,dinitrofluorobenzene (DNFB) was suppressed significantly in IL-18 knockout (IL-18-/-) mice and could be rescued by local intradermal administration of IL-18 prior to sensitization, suggesting that the defect in these mice was in the afferent phase of CHS. To determine the effect of IL-18 on LC migration, mice were treated topically with OX or DNFB, and remaining LC numbers were assessed. A significant decline in remaining epidermal LC occurred in wild-type (WT) mice but did not occur in IL-18-/- mice. Sodium lauryl sulfate, a nonantigenic LC migratory stimulus, induced equivalent LC migration in IL-18-/- and WT mice. In IL-18-/- mice, IL-1 beta and TNF-alpha were equally able to mobilize LC from epidermis, indicating that migration in response to these cytokines is not dependent on IL-18 and suggesting that IL-18 acts upstream of these cytokines in the initiation of antigen-induced LC migration. Moreover, IL-1 beta but not IL-18 was able to rescue the defective CHS response observed in caspase-1-/- mice, which have no functional IL-1 beta or IL-18. These data indicate that IL-18 is a key proximal mediator of LC migration and CHS, acting upstream of IL-1 beta and TNF-alpha, and may play a central role in regulation of cutaneous immune responses.

Topics: Animals; Caspase 1; Cell Count; Cell Movement; Dermatitis, Allergic Contact; Dinitrofluorobenzene; Epidermis; Interleukin-18; Interleukin-1beta; Langerhans Cells; Mice; Mice, Knockout; Oxazolone; Recombinant Proteins; Sodium Dodecyl Sulfate; Tumor Necrosis Factor-alpha

According to the European Society of Contact Dermatitis (ESCD) guidelines on the sodium lauryl sulfate (SLS) exposure test 'the flexor side of forearm skin with cubital fossa and wrist excluded is the preferred study site'. In this study we analysed the exact anatomic region within the suggested test area in respect to the outcome of the SLS exposure test. 3 test areas at the volar forearm were chosen: 'distal' with a 5-cm distance to the wrist, exact 'midvolar' and 'proximal' with a 5-cm distance to the cubital fossa. 25 healthy volunteers were irritated for 24 hr with 1% SLS. Transepidermal water loss (TEWL) measurements were taken before and 1 and 24 hr after removal of Finn Chambers((R)). Median baseline TEWL showed no significant differences in the 3 test sites. However, postexposure TEWL proximal was significantly (P < 0.01) higher than midvolar and distal. The distal volar forearm showed the lowest TEWL 24 h after the irritation. The differences were in comparison to midvolar (P < 0.01) and proximal (P < 0.001) significant. The results show that it is essential to point out the exact position of the test area at the volar forearm in study reports and to randomize the irritation areas at the volar forearm if different treatments are to be compared.

Topics: Adult; Allergens; Dermatitis, Allergic Contact; Female; Forearm; Humans; Male; Middle Aged; Predictive Value of Tests; Skin; Skin Irritancy Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible

It has been suggested that the recent increase in inflammatory diseases is related to an increase in environmental chemicals and psychiatric stress. To investigate the effect of chronic topical exposure to chemicals and isolation stress, low-dose formalin (a mild contact sensitizer and an irritant), 2,4,6-trinitrochlorobenzene (TNCB; a potent contact sensitizer) and sodium lauryl sulphate (SLS; an irritant) were applied to mouse ears at 7-d intervals under no-stress or stress conditions. Skin reactions (ear swelling) elicited by formalin and TNCB increased time dependently. At the chronic stage, a significant skin reaction peaking at 1 h after application was elicited on the formalin-treated sites, while a shift from a delayed-type hypersensitivity to an immediate-type response was observed on the TNCB-treated sites. At the formalin-treated sites, genes related to neurogenic inflammation, i.e., bradykinin (BK) B2 receptor, IL-6, and membrane metallo endopeptidase (NEP) mRNA were upregulated. In the TNCB-treated sites, marked upregulation of IFN-gamma, IL-1beta, IL-4, and IL-6 mRNA was observed in addition to B2 receptor mRNA. Pretreatment with HOE140, the B2 receptor antagonist suppressed these skin reactions. Increased skin sensitivity to an unrelated chemical, ethanol, and thermal stimuli were elicited in formalin and TNCB-treated mice. Cortisol levels in formalin-treated mice and IgE levels in TNCB-treated mice were elevated respectively. Stress markedly amplified the skin reactions and gene expression related to neurogenic inflammation. SLS did not induce any changes. It was concluded that chronic topical exposure to low-dose noxious chemicals and stress could easily induce skin sensitivity relating to the BK-B2 pathway and nociceptive sensitization reflecting neural sensitization.

Topics: Administration, Topical; Animals; Chronic Disease; Dermatitis, Allergic Contact; Disease Models, Animal; Environmental Exposure; Gene Expression; Inflammation; Male; Mice; Picryl Chloride; Risk Factors; Skin Diseases; Sodium Dodecyl Sulfate; Stress, Psychological; Time Factors

The first step in regulatory evaluation of substances involves the identification of their intrinsic hazards, including the potential for skin sensitization. This is, quite properly, entirely different from assessment of the risks to human health, which might arise from incorporation of substances in products. EU guidance on regulations concerning the classification of skin sensitizers suggests a range of sources of information be deployed in the hazard identification process. These include chemical structure, predictive animal tests, and various types of human data. Where the information is clear-cut, then uncertainties rarely arise. However, for some materials, discordant information arises, perhaps because the substance is on the borderline of test sensitivity and classification (sensitizing materials of insufficient potency do not classified according to the EU scheme), due to conflicting results in predictive tests or for other reasons. In this study, we review data on a number of substances where a classification decision is complicated by such discordances and seek to use these examples to demonstrate how best to make a weight of evidence decision on whether a substance should, or should not, be classified as a skin sensitizer.

Topics: Allergens; Animals; Benzalkonium Compounds; Betaine; Cyclohexenes; Dermatitis, Allergic Contact; False Negative Reactions; False Positive Reactions; Humans; Limonene; Nitriles; Parabens; Preservatives, Pharmaceutical; Sodium Dodecyl Sulfate; Solvents; Sulfanilic Acids; Surface-Active Agents; Terpenes

The impact of many human variables on the response to skin irritating substances has been studied to varying degrees, including the impact of age, sex, and atopic status. However, the importance of ethnic origin has been more difficult to investigate, leading to a relative paucity of compelling data, either for or against the existence of differences. A primary reason for this lack is that studies on different ethnic groups often have to be undertaken in different locations thus introducing variables, e.g. time, environmental conditions that confound interpretations. In the present work, an attempt has been made to eliminate all variables except ethnicity by conducting a study on 2 distinct populations (Punjabis and Tamils) at the same location on the same day with a single assessor of the skin reactions, using sodium lauryl sulfate as the skin irritant. The skin reactions were assessed visually, and it was demonstrated that the modality of the reactions in these 2 populations had clear differences, but that the dose-response profiles were very similar. Thus, although the irritant response was expressed differently (e.g. erythema was much less evident in the darker Tamil population), the overall outcome was that the populations reacted in an equivalent manner.

Topics: Adult; Dermatitis, Allergic Contact; Female; Genetic Variation; Humans; India; Irritants; Male; Patch Tests; Sodium Dodecyl Sulfate; Surface-Active Agents; White People

There is evidence that a higher skin susceptibility may induce nonspecific erythematous or weak positive reactions to contact allergens in patch testing.. To evaluate whether simultaneous application of sodium lauryl sulphate (SLS) along with diagnostic patch tests with contact allergens can provide information regarding skin irritability which may help to discriminate allergic from nonspecific irritant reactions to contact allergens.. Between July 2001 and June 2003, this prospective study collected patch test data of 5971 patients from 19 centres in Germany and Austria in the Information Network of Departments of Dermatology (IVDK). In addition to contact allergens (standard series and eight known 'problematic' allergens with a low reaction index and a high positivity ratio: 1,3-diphenylguanidine, amerchol L-101, benzalkonium chloride, benzoyl peroxide, cocamidopropyl betaine, octyl gallate, phenyl mercuric acetate and propylene glycol), patches with SLS 0.5% and 0.25% aq. were applied. Reactions to the allergens and to SLS were analysed at the IVDK data centre. The association between an erythematous or positive reaction to a certain allergen and an irritant reaction to SLS was assessed with logistic regression analysis, at the same time controlling for the influence of age and sex.. Of the 29 allergens of the standard series, 23 and 21 gave a higher percentage of nonspecific erythematous reactions in patients with an irritant reaction to 0.25% and 0.5% SLS, respectively, in comparison with SLS-negative patients. All eight 'problematic' allergens gave an increased percentage of nonspecific erythematous reactions. Similarly, 22 and 21 allergens of the standard series gave a higher percentage of positive allergic reactions in patients with an irritant reaction to 0.25% and 0.5% SLS, respectively, and seven of the eight 'problematic' allergens gave a higher percentage of positive allergic reactions (exception: octyl gallate). For most allergens, the markers of skin reaction (reaction index and positivity ratio) were worse in SLS-positive patients. Differences were more pronounced when testing with SLS 0.25% than with SLS 0.5%.. Because there is a convincing association between skin irritability (evaluated by SLS test) and the degree of skin reaction to contact allergens, the SLS test may help in deciding whether a doubtful erythematous or weakly 'positive' skin reaction should be interpreted as allergic or irritant.

Topics: Adult; Allergens; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Contact; Dermatitis, Occupational; Diagnosis, Differential; Diagnostic Errors; Erythema; Female; Humans; Male; Patch Tests; Predictive Value of Tests; Prospective Studies; Sodium Dodecyl Sulfate

Topics: Dermatitis, Allergic Contact; Dermatitis, Irritant; Diagnosis, Differential; Humans; Patch Tests; Sodium Dodecyl Sulfate; Surface-Active Agents

In patients suspected of allergic contact dermatitis because of topical ophthalmic medicaments, patch tests performed with patients' own products are often negative. The irritant anionic surfactant sodium lauryl sulfate (SLS) may alter the stratum corneum and increase antigen penetration. Pre-treatment of the skin with SLS 0.5% for 24 h was performed in the sites of patch tests with patients' own products in 15 selected patients. In patients previously negative to their own products tested with conventional patch tests, SLS pre-treatment showed 6 new relevant positive reactions and induced a stronger positive reaction in 1 patient. SLS pre-treatment could be proposed as an alternative promising method, which may increase sensitivity of patch tests with patients' own products.

Topics: Adult; Aged; Aged, 80 and over; Allergens; Dermatitis, Allergic Contact; Eyelids; Female; Humans; Male; Middle Aged; Ophthalmic Solutions; Patch Tests; Premedication; Prospective Studies; Risk Assessment; Sampling Studies; Sensitivity and Specificity; Sodium Dodecyl Sulfate

Little is known of the predictive value of methods to test an individual's susceptibility to acquiring occupational contact dermatitis. Recently, the recovery rate after induced irritation was suggested for this purpose. Although it is likely that repeated exposure to sodium lauryl sulphate (SLS) is preferable to a single application, there is little evidence to support this idea. Similarly, little is known about whether the outcome of a repeated SLS test can be predicted by a brief test.. We studied the relationship between the skin reaction after a repeated SLS test and two brief tests, devoting special attention to the recovery rate.. In 29 healthy volunteers, we measured transepidermal water loss (TEWL) and erythema after applying 0.03, 0.1 and 0.3% SLS for 6 h, 3 days per week, over a course of 3 weeks. The data were compared with the effects after applying 0.1, 0.3 and 1.0% SLS for 24 h and with 10 and 15 repetitions of tape stripping.. A poor correlation was found between the repeated test and the brief SLS test, or tape stripping, when using an increase in TEWL (r = 0.04 and 0.26, respectively) or its recovery rate (r = - 0.01 and 0.42, respectively).. We presume that in a repeated test of sufficient duration, additional mechanisms come into play that are absent in a brief test, e.g. an alteration in the thickness of the epidermis, with a resulting change in the permeability of SLS. When such an effect differs between subjects it could explain the lack of agreement between the acute and the repeated tests. At present, a brief irritation test will, in all likelihood, be unable to assess an individual's susceptibility to occupational contact dermatitis.

Topics: Adult; Dermatitis, Allergic Contact; Dermatitis, Occupational; Erythema; Female; Humans; Hypersensitivity, Immediate; Male; Patch Tests; Permeability; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible

The present study was undertaken to evaluate the combined effect of the preservative methyldibromo glutaronitrile (MDBGN) and sodium lauryl sulfate (SLS) on the elicitation response of allergic contact dermatitis. 20 volunteers with contact allergy to MDBGN were patch tested with 5 concentrations (10, 50, 100, 500 and 1000 p.p.m.) of MDBGN alone and in combination with 0.25% SLS on the upper arms for 24 h. Skin reactions were evaluated by clinical scoring, and data were evaluated by logistic dose-response models. Additionally, evaluation of skin reactions was performed by measurement of transepidermal water loss (TEWL) and skin colour. Measurements were obtained at baseline and at D3 and D7. As evaluated by clinical assessment, allergic reactions to MDBGN were elicited at lower concentrations when applied in combination with SLS than when applied alone. The response was augmented by a factor of 6.4. An increased response to combined exposure to SLS and MDBGN as compared with MDBGN alone was confirmed by TEWL and colour measurements. Effects of exposure time and concentration of the detergent are discussed. In conclusion, an augmented response was found after concurrent application of MDBGN and SLS. The response was augmented by a factor of 6.4, with confidence limits of 2.8-14.6 (P < 0.0001). This result is important in relation to the determination of threshold values and the risk assessment of contact allergens in consumer and industrial products, where allergens are often present in combination with surfactants.

Topics: Allergens; Colorimetry; Dermatitis, Allergic Contact; Detergents; Dose-Response Relationship, Drug; Female; Humans; Logistic Models; Male; Nitriles; Patch Tests; Preservatives, Pharmaceutical; Sodium Dodecyl Sulfate; Time Factors

Topics: Case-Control Studies; Catechols; Dermatitis, Allergic Contact; Dermatitis, Contact; Dermatitis, Irritant; Dermatitis, Toxicodendron; Humans; Immunosuppressive Agents; Ointments; Pilot Projects; Single-Blind Method; Sodium Dodecyl Sulfate; Surface-Active Agents; Tacrolimus; Toxicodendron

The cutaneous reaction to detergents follows distinct kinetic rules: the duration of application and the irritant concentration are of major importance. The aim of this study was to evaluate the differences in kinetics of skin reaction between the standard irritant sodium lauryl sulfate (SLS), and 2 modern detergents: sodium laureth sulfate (SLES) and alkyl polyglucoside (APG). We performed patch testing with SLS and SLES (or APG) at different concentrations (0.125, 0.25, 0.5, 1.0 and 2.0%) and with different exposure times (6, 12 and 24 h). Evaluation was conducted by measurement of transepidermal water loss (TEWL) and laser Doppler flowmetry (LD) 24 h, 7 and 10 days after patch removal. We found a pronounced reaction to SLS, and a far milder one to SLES. Even at the highest concentration the skin reaction to APG was hard to detect. During the regeneration period (day 3-10) SLS showed even at day 10 an increased TEWL at all concentrations tested. The irritation due to SLES was convincingly detectable only up to day 7, whereas the APG-tested skin areas showed no significant reaction even at day 3. These results demonstrate the improvement in reduction of skin irritation achieved by development of novel detergents.

Topics: Adolescent; Adult; Dermatitis, Allergic Contact; Detergents; Dose-Response Relationship, Drug; Female; Glucosides; Humans; Irritants; Laser-Doppler Flowmetry; Male; Middle Aged; Patch Tests; Reference Values; Sodium Dodecyl Sulfate; Water Loss, Insensible

Several contact allergens are tested at concentrations which might cause irritant reactions. In this study we investigated whether the reactivity to a standard irritant is useful in identifying subjects with hyperreactive skin yielding a higher rate of doubtful or irritant reactions. Sodium lauryl sulfate (SLS) 0.5% (aqua) was tested in addition to the standard series routinely for 5 years in the Department of Dermatology, Dortmund. For data analysis, we compared reactions at D3 to the standard series, the vehicle/emulsifier and preservative series and benzoyl peroxide to the reactions obtained with SLS. Proportions were standardized for age and sex. The association between reactivity to a certain allergen and SLS reactivity as a dichotomous outcome, controlled for age and sex as potential confounders, was assessed with logistic regression analysis. Results showed that of the 1600 tested patients, 668 (41.8%) had an irritant reaction to SLS which exceeded 2 + in only 41 patients. Seasonal variation was statistically significant, showing reduced SLS reactivity in summer vs. winter. Patients with irritant reactions to SLS showed significantly more erythematous reactions to the following 10 allergens of the standard series: fragrance mix, cobalt chloride, balsam of Peru (Myroxylon pereirae), lanolin alcohol, 4-phenylenediamine base (PPD), propolis, formaldehyde, N-isopropyl-N'-phenyl-p-phenylenediamine (IPPD), benzocaine, and 4-tert-butylphenol-formaldehyde resin. No significant differences regarding strong positive allergic reactions were observed. Concerning other allergens, significantly more erythematous reactions were observed in SLS-reactive patients to benzoyl peroxide, octyl gallate, cocamidopropyl betaine, Amerchol L-101, tert-butylhydroquinone, and triethanolamine. In the SLS-reactive group of patients, the reaction index was negative for 10 allergens of the standard series compared to only 5 in the SLS non-responder group. For the first time, this study, based on a large data pool, revealed a significant association between reactivity to the irritant SLS and erythematous reactions to certain allergens. With SLS as a marker for hyperreactive skin at hand, some of these reactions can now be classified as irritant more confidently, particularly if there is no history of exposure to the allergen.

Topics: Allergens; Cohort Studies; Confidence Intervals; Dermatitis, Allergic Contact; Female; Germany; Humans; Incidence; Irritants; Logistic Models; Male; Mass Screening; Patch Tests; Probability; Retrospective Studies; Risk Assessment; Sensitivity and Specificity; Sodium Dodecyl Sulfate

To support the decision as to whether erythematous patch test reactions to allergens are irritant or allergic, sodium lauryl sulfate (SLS, 0.5% in water) has been added to the standard patch tests since July 1996 in the Dortmund Department of Dermatology. Data on 1600 patients patch tested up until June 2001, as well as standardized data on ambient temperature and humidity obtained by the German Meteorological Service, were included in a logistic regression analysis taking age, sex and atopy as potential confounders into account. The pattern of association was heterogeneous: while doubtful reactions to nickel sulfate were significantly associated with dry/cold weather conditions, but not with SLS reactivity, the opposite was observed for lanolin alcohol, benzocaine and Myroxylon pereirae resin (balsam of Peru). Doubtful reactions to other allergens, namely formaldehyde, fragrance mix or p-phenylenediamine, were associated with both factors. For several other allergens of the standard series, no distinct, significant pattern could be discerned. In conclusion, meteorological conditions and SLS reactivity independently contribute information on individual irritability at the time of patch testing, and both should be considered.

Topics: Allergens; Dermatitis, Allergic Contact; Dermatitis, Irritant; Diagnosis, Differential; Female; Germany; Humans; Humidity; Irritants; Logistic Models; Male; Patch Tests; Sodium Dodecyl Sulfate; Temperature

The aim of study was to determine usefulness of the method of continuous TEWL measurement in the evaluation of skin barrier function in physiological conditions and in allergic contact dermatitis (ACD) and atopic dermatitis (AD).. Study was conducted on a group of 86 persons: 48 patients with allergic contact dermatitis, 18 with atopic dermatitis and 20 healthy individuals. Measurements of transepidermal water loss were made using custom-constructed device for continuous TEWL measurement. In each person the measurements of TEWL were made 4 times: measurement 0 (baseline)--before occlusion with 1% lauryl sulphate for 24 h, measurement 1-15 minutes after SLS patch removal, measurement 2-30 minutes after measurement 1 and measurement 3-30 minutes after measurement 2. Obtained data were statistically analyzed.. TEWL ratio values obtained in measurement 0 were as follows in individual groups of patients: 13.20 +/- 8.25 in the AD patients, 10.09 +/- 8.29 in ACD patients and 9.02 +/- 5.99 in control group. Analogous TEWL values in the subsequent measurements were: in measurement 1--16.08 +/- 11.17; 11.63 +/- 6.43; 17.39 +/- 12.41, in measurement 2--23.72 +/- 14.58; 14.71 +/- 6.46; 17.55 +/- 8.25, measurement 3--24.09 +/- 14.93; 16.34 +/- 6.32; 18.44 +/- 8.26. TEWL ratio values were higher in both groups of patients as compared to control group but not statistically significant (p = 0.1778). After 24 h exposition to SLS, TEWL ratio values increased in all examined groups as compared to baseline (0) measurement. All measurements, except for measurement No 1 in AD group of patients, showed statistically significant differences. The highest increase of TEWL values were observed in group of AD patients.. Delay in skin reaction to SLS in patients with atopic dermatitis provides evidence for different properties of water barrier of the skin in this group as compared to healthy individuals. Increasing tendency in TEWL values 1 hour after SLS removal might reflect persistent damage to water barrier of the skin by detergent. Method of continuous assessment of water barrier of epidermis, through the possibility of multiple measurement by TEWL in examined periods of time, decreased the risk of mistake and increased accuracy of measurement. Measurement of TEWL values allows for assessment of otherwise unnoticed damage to water barrier of the skin.

Topics: Adolescent; Adult; Dermatitis, Allergic Contact; Dermatitis, Atopic; Female; Humans; Male; Middle Aged; Patch Tests; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible

In the screening of topical drugs, cosmetics and other chemicals for human use, it is very important, both from a safety and an economic point of view, to have biological markers to discriminate irritant and allergic contact dermatitis that have different impacts on human health. Owing to their anatomical location, keratinocytes are among the first cells to be exposed to various antigens and the use of these cells as a simplified in vitro model to evaluate the potential toxicity of chemicals destined for cutaneous application is amply justified. The purpose of this work was to identify new genes selectively modulated by skin toxicants. Commercially available reconstituted human epidermis (Epiderm) was treated for 18 h with sodium dodecyl sulfate (SDS) 0.4 mg/ml, as reference irritant, or with dinitrochlorobenzene (DNCB) 0.2 mg/ml, as reference allergen, or with vehicle control. Differential display PCR (DD-PCR) was performed. Results identified adipose differentiation-related protein (ADRP) as up-regulated by both irritant and allergen, and KIAA0368 as selectively up-regulated by contact allergen. These data indicate the enormous potential of functional genomic techniques, which allow the identification of genes not immediately connected with the immune response, or even novel genes with unknown functions, which nevertheless may be potential markers of skin irritation and allergy.

Topics: Allergens; Biomarkers; Cell Culture Techniques; Dermatitis, Allergic Contact; Dinitrochlorobenzene; DNA, Complementary; Enzyme-Linked Immunosorbent Assay; Epidermal Cells; Epidermis; Gene Expression Regulation; Humans; Irritants; Membrane Proteins; Nerve Tissue Proteins; Perilipin-2; Reverse Transcriptase Polymerase Chain Reaction; Sodium Dodecyl Sulfate; Surface-Active Agents; Up-Regulation

Knowledge of the combined effects of irritants and allergens is of interest with respect to accurate risk assessment. The threshold for elicitation of allergic contact dermatitis in previously sensitized individuals may theoretically be markedly influenced by the simultaneous presence of irritants and allergens. Combined exposures have, however, only been studied infrequently. In the present study, the combined effect of an irritant and an allergen was evaluated in a dose-response designed experimental study. 20 nickel-sensitized subjects were exposed to patch testing with varying concentrations of NiCl2 (nickel chloride) and sodium lauryl sulfate (SLS) alone and in combination. Evaluation of skin reactions was performed by colorimetry, measurement of transepidermal water loss and clinical evaluation, and the data were analyzed by logistic dose-response models. A synergistic effect was found of combined exposure to NiCl2 and SLS, as compared to each of the substances applied separately, as evaluated by colorimetry and clinical scoring. This means that the effect produced by the combined exposure was substantially greater than the effect produced by either of the substances alone. A synergistic effect of combined exposure on skin barrier impairment was not found, since the barrier function is significantly influenced by SLS-exposure only and not by NiCl2. Concentration limits are used by industry and government agencies to protect consumers. The present results clearly illustrate that elicitation thresholds and concentration limits may be influenced considerably by combined exposure to allergens and irritants.

Topics: Adult; Allergens; Dermatitis, Allergic Contact; Dose-Response Relationship, Drug; Drug Synergism; Female; Humans; Irritants; Male; Middle Aged; Models, Biological; Nickel; Patch Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible

Hand eczema is a common skin disease. Because of its variable etiologies and clinical manifestations, it is difficult to determine the etiology from the clinical manifestation. Among the contact allergens, nickel is the most common. Patients with hand eczema and a nickel allergy have a poorer prognosis than patients without a nickel allergy. The reason is still uncertain; suggestions include persistent exposure to nickel or a weak skin barrier. The purpose of our study was to identify the characteristic clinical manifestations by etiology and to compare the skin barrier state between patients with nickel allergies and those without them. Ninety-three patients were classified into 4 types; irritation contact type, allergic contact type, atopic type and mixed type. After the sodium lauryl sulfate (SLS) test to compare the skin barrier state, visual score and transepidermal water loss (TEWL) were measured and analyzed statistically. From this study, it was not possible to ascertain a statistical difference, however a few characteristic clinical manifestations according to etiology can be stated. There was no difference in the visual scoring system or the TEWL after the SLS irritation test between the nickel-allergy group and the non-allergy group. Therefore, we believe that the poor prognosis of hand eczema with nickel allergy may be due to the nickel allergy itself rather than skin barrier state.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Irritant; Eczema; Female; Hand Dermatoses; Humans; Infant; Irritants; Male; Middle Aged; Nickel; Patch Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible

Rice starch added to bath water was studied for its possible beneficial effects on impaired barrier function as evaluated by transepidermal water loss measurements. The forearm skin of healthy volunteers was irritated by sodium lauryl sulphate. Exposure to rice-starch-containing bath water--twice daily for 15 min--led to a 20% improvement on the healing capacity of damaged skin. The beneficial effect was also observed for a rice-starch-containing lipid-free bath formulation, and an oil-in-water bath lotion enriched with evening primrose oil. Skin barrier function in patients with atopic dermatitis also improved after the addition of starch powder to bath water. Rice starch in powder or formulated in a bath product can therefore be recommended as a skin repair bathing additive for barrier damaged skin, particularly in the case of atopic dermatitis patients.

Topics: Adult; Baths; Dermatitis, Allergic Contact; Dermatitis, Atopic; Female; Humans; Hydrotherapy; Middle Aged; Oryza; Phytotherapy; Plant Preparations; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Wound Healing

The variability in human skin irritation responses has been well documented and can confound our ability to accurately assess differences in skin reactivity between human subpopulations. In the current analysis, results were compiled from nine acute irritation patch test studies, conducted at three test facilities over a 5-year period. Four irritant test chemicals, 20% sodium dodecyl sulphate, 100% decanol, 100% octanoic acid and 10% acetic acid, were tested in sufficient numbers of test subjects to enable the stratification of results for different human subpopulations. An increased reactivity was noted for Asian versus Caucasian subjects for each of three test chemicals, in contrast to the previously described individual study results from which these data were drawn. Male subjects were directionally or significantly more reactive to each of the test chemicals than female subjects. The oldest age cluster of subjects (56-74 years of age) was directionally or significantly less reactive than younger age clusters. There was virtually identical reactivity between self-assessed 'sensitive' and normal skin groups. Lastly, there was little correlation between the results from individual subjects tested in two or more studies with the same chemicals. These results add to our general understanding of population differences in skin reactivity and the potential implications for ingredient and product skin safety testing and risk assessment.

Topics: Acetic Acid; Adult; Age Factors; Aged; Asian; Caprylates; Dermatitis, Allergic Contact; Fatty Alcohols; Female; Humans; Irritants; Linear Models; Male; Middle Aged; Patch Tests; Risk Factors; Sex Factors; Sodium Dodecyl Sulfate; White People

We investigated the involvement of mitogen-activated protein kinases (MAPKs) in the maturation of CD83(-) dendritic cells (DC) derived from human blood monocytes. Maturating agents such as LPS and TNF-alpha induced the phosphorylation of members of the three families of MAPK (extracellular signal-regulated kinase l/2, p46/54 c-Jun N-terminal kinase, and p38 MAPK). SB203580, an inhibitor of the p38 MAPK, but not the extracellular signal-regulated kinase l/2 pathway blocker PD98059, inhibited the up-regulation of CD1a, CD40, CD80, CD86, HLA-DR, and the DC maturation marker CD83 induced by LPS and TNF-alpha. In addition, SB203580 inhibited the enhancement of the allostimulatory capacity and partially prevented the down-regulation of FITC-dextran uptake induced by LPS and TNF-alpha. Likewise, SB203580 partially prevented the up-regulation of IL-1alpha, IL-1beta, IL-lRa, and TNF-alpha mRNA upon stimulation with LPS and TNF-alpha, as well as the release of bioactive TNF-alpha induced by LPS. DC maturation induced by the contact sensitizers 2,4-dinitrofluorobenzene and NiSO(4), as seen by the up-regulation of CD80, CD86, and CD83, was also coupled to the phosphorylation of p38 MAPK, and was inhibited by SB203580. The irritants SDS and benzalkonium chloride that do not induce DC maturation did not trigger p38 MAPK phosphorylation. Together, these data indicate that phosphorylation of p38 MAPK is critical for the maturation of immature DC. These results also suggest that p38 MAPK phosphorylation in DC may become useful for the identification of potential skin contact sensitizers.

Topics: Allergens; Antigens, CD; Benzalkonium Compounds; Cell Differentiation; Cells, Cultured; Cytokines; Dendritic Cells; Dermatitis, Allergic Contact; Dinitrofluorobenzene; Down-Regulation; Endocytosis; Enzyme Inhibitors; Flavonoids; Humans; Imidazoles; Irritants; JNK Mitogen-Activated Protein Kinases; Lipopolysaccharides; Lymphocyte Activation; Mitogen-Activated Protein Kinase 10; Mitogen-Activated Protein Kinases; Nickel; p38 Mitogen-Activated Protein Kinases; Phosphorylation; Protein-Tyrosine Kinases; Pyridines; RNA, Messenger; Sodium Dodecyl Sulfate; T-Lymphocytes; Tumor Necrosis Factor-alpha; Up-Regulation

Test chambers for irritant patch testing are usually larger than those used in allergic patch testing. In general, larger areas show stronger skin reactions than smaller areas.. This study investigated whether this difference is of practical relevance, when a model irritant is applied in small and large Finn chambers and evaluated by measurement of transepidermal water loss (TEWL).. Patch testing was performed with 2 concentrations of sodium lauryl sulfate (SLS) (0.25% and 0.5%) on forearms of healthy volunteers. Large (inner diameter, 12 mm) and small (inner diameter, 8 mm) chambers were used.. A variance analysis (3 factors, 2-tailed) showed that the test outcome, as assessed by TEWL, was strongly dependent on SLS test concentration and test chamber size. The larger chambers gave approximately 30% to 50% higher values than the smaller.. This may be explained by the fact that with the small chambers, the adjacent small area of nontreated skin was also assessed by the evaporimeter, biasing the results. A formula estimating TEWL value of the large chamber from values of the small chambers has been proposed.

Topics: Adolescent; Adult; Dermatitis, Allergic Contact; Female; Forearm; Humans; Irritants; Male; Middle Aged; Patch Tests; Predictive Value of Tests; Reference Values; Skin Irritancy Tests; Sodium Dodecyl Sulfate

Many different patch systems are available for predicting contact dermatitis. It is important to determine the ideal patch to meet the objective of the testing method.. The 21-day cumulative irritation test is well accepted for predicting irritation after repeated exposures. The patch type must allow separation of materials to predict irritation potential in the marketplace. Three patch systems were compared to determine which best provides this separation and prediction.. Four test materials were evaluated using 3 patch systems in a 21-day cumulative irritation test. Tested were water, 0.06% sodium lauryl sulfate (SLS), and 2 underarm products (UAP), one having lower and one having higher irritation potential. The patch types were; Webril pad and 8-mm and 12-mm Finn Chambers.. Both the 12-mm Finn Chamber and Webril pad showed the ability to differentiate the higher irritating UAP and the 0.06% SLS from the lower irritation UAP product and water. The 8-mm Finn chamber was less discriminating, showing the 0.06% SLS to be the same as water and the lower-irritating UAP.. The Webril pad and the 12-mm Finn Chamber are better at discriminating irritation potential than is the 8-mm Finn Chamber. The 12-mm Finn Chamber might also allow discrimination with a lower degree of irritation.

Topics: Adolescent; Adult; Cosmetics; Dermatitis, Allergic Contact; Female; Humans; Irritants; Male; Patch Tests; Predictive Value of Tests; Sodium Dodecyl Sulfate

It is well-known that humans show a wide range of variation in skin reactivity to irritant chemicals. This has been established through population studies, through the examination of inter-subject variability, and (to a limited extent) through studies of skin site variation in response within subjects. However, simple response variability within individual test subjects has not been examined as carefully, and this has implications for our ability to predict irritant reactivity. Some key questions are: (i) how consistently do human beings respond, even within a given study, to different equally irritating chemicals, or to the same chemical when comparing different concentrations or durations of exposure, and, (ii) Do individual test subjects' responses to one chemical (or exposure scenario) correlate with their responses to another? To examine these questions in some detail, we reexamined individual study subjects' responses from earlier published studies involving both acute and cumulative irritation patch test protocols. Acute irritation responses were compared across chemicals with similar irritation profiles. Cumulative irritation responses were compared across different concentrations of the anionic surfactant, sodium dodecyl sulfate (SDS). Acute (high concentration) and cumulative (low concentration) patch test responses to SDS were also compared. The analysis showed that, as might be expected, response correlations were greatest within test types, either when comparing chemicals of similar overall irritancy, or when comparing similar concentrations of a single chemical. However, individually divergent responses were also frequent, reinforcing the conclusion that a given individual's response to one chemical or exposure condition does not always predict their response to another. This has important ramifications for other questions related to population differences in skin reactivity.

Topics: Acetic Acid; Acute Disease; Asian People; Caprylates; Chronic Disease; Dermatitis, Allergic Contact; Fatty Alcohols; Humans; Irritants; Patch Tests; Predictive Value of Tests; Severity of Illness Index; Sodium Dodecyl Sulfate; White People

The factors which determine individual susceptibility to the development of allergic contact dermatitis (ACD) are not well defined. Since it is known that the presence of skin irritation is well-documented as a promoter of sensitization, the sensitivity to irritation of subjects with ACD has been compared with a normal control group. Whilst 78% of those with a positive patch test reaction to the contact allergen colophony (colophonium) responded to a concentration of no higher than 2.5% sodium lauryl sulfate (SLS), only 44% of the matched control group reacted at this level of SLS. Thus, the results are consistent with the hypothesis that individuals with enhanced susceptibility to skin irritation are also more liable to develop allergic skin reactivity.

Topics: Adolescent; Adult; Allergens; Case-Control Studies; Dermatitis, Allergic Contact; Disease Susceptibility; Dose-Response Relationship, Drug; Female; Humans; Immunization; Irritants; Male; Middle Aged; Patch Tests; Resins, Plant; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Tars

Topics: Adult; Cheilitis; Dermatitis, Allergic Contact; Female; Humans; Middle Aged; Sodium Dodecyl Sulfate; Surface-Active Agents; Toothpastes

Chronic irritant contact dermatitis (ICD) is a common skin disease, especially in the workplace, but determining the recovery time of chronic ICD is not easy. To measure the recovery time of chronic ICD, we examined the skin reactivity to a model surfactant, sodium lauryl sulfate (SLS), on previous chronic ICD and normal sites by visual grade and non-invasive instruments. Chronic ICD was induced on the forearms of 10 volunteers (aged 23 to 43 years) by occluded application of 1% SLS for 30 min on 5 consecutive days each week for 3 weeks. Previous ICD and normal sites were provoked by the occluded application of 7.5% SLS for 30 min daily on 4 consecutive days, 2, 5 and 10 weeks after induction. Skin reactivity was assessed daily by awarding visual erythema scores, visual scale scores and measuring transepidermal water loss, skin color reflectance, and electrical capacitance. Skin reactivity of previous chronic ICD sites to SLS showed hyperreactivity compared to normal sites even after the 10th week post-induction.

Topics: Adult; Arm; Chronic Disease; Colorimetry; Dermatitis, Allergic Contact; Electric Conductivity; Erythema; Female; Humans; Irritants; Male; Severity of Illness Index; Skin Pigmentation; Sodium Dodecyl Sulfate; Time Factors; Water Loss, Insensible

The human CD80 costimulatory molecule is an important signal between professional antigen-presenting cells and T helper cells. The immunobiology of CD80 expression by keratinocytes, especially during allergic and irritant contact dermatitis, however, is less well understood. CD80 cell surface expression and gene transcription by keratinocytes was increased when keratinocytes were exposed to certain allergens (chemicals that induce inflammation via hapten-specific T cells) and irritants (chemicals that are toxic to epidermal cells). Therefore, the human CD80 promoter was cloned and luciferase reporter constructs containing various promoter fragments were engineered. Promoter mapping of these CD80 constructs in transiently transfected keratinocytes showed that a construct containing the proximal 231 bp immediately upstream of the transcription start site of the CD80 promoter was most active in keratinocytes and was inducible to a level ranging from 2- to 10-fold higher in keratinocytes treated with certain allergens and irritants, compared with untreated keratinocytes. This pattern of promoter fragment activity in keratinocytes is identical to that found in professional antigen-presenting cells. This is the first demonstration that the CD80 promoter is active in keratinocytes and that this activity is further increased in keratinocytes treated with certain allergens and irritants. These data suggest that allergens and irritants may, in part, break peripheral tolerance by their direct effects on keratinocyte costimulatory molecule expression, thereby facilitating interactions with epidermotropic T helper cells via the CD80-CD28 or CTLA-4 pathways.

Topics: Allergens; Antigen-Presenting Cells; B7-1 Antigen; Chromosome Mapping; Dermatitis, Allergic Contact; Humans; Infant, Newborn; Interferon-gamma; Irritants; Keratinocytes; Male; Nickel; Promoter Regions, Genetic; Sodium Dodecyl Sulfate; Tetradecanoylphorbol Acetate; Transcription, Genetic; Up-Regulation

It has been reported previously that in vitro treatment of human blood derived dendritic cells (DC) with contact allergens provokes the elevated expression of mRNA for interleukin (IL) 1beta, under conditions where similar treatment of cells with the non-sensitizing skin irritant sodium lauryl sulfate (SLS) did not alter IL-1beta mRNA levels (Reutter et al., 1997). The purpose of the present investigation was to evaluate further this phenomenon and to explore the potential utility of this approach for the purpose of skin sensitization testing. Human peripheral blood progenitor cells prepared from healthy adult volunteers were cultured in the presence of IL-4 and granulocyte/macrophage colony stimulating factor. After 5 days of culture, the majority of cells had a Langerhans cell-like phenotype, with characteristic dendritic morphology and cell surface expression of CD83, major histocompatibility complex class II and CD1a determinants. These blood-derived DC were cultured in the presence of the contact allergen 2,4-dinitrofluorobenzene (DNFB), SLS or vehicle alone and mRNA expression for IL-1beta, IL-6 and IL-18 was analysed by semiquantitative reverse transcriptase polymerase chain reaction. Constitutive expression of all three cytokines was observed for DC isolated from all donors examined. Exposure to DNFB resulted in upregulation of IL-1beta mRNA (two- to threefold) in cells derived from three out of eight donors whereas IL-6 and IL-18 were largely unaffected by allergen exposure. In contrast, SLS treatment did not induce IL-1beta mRNA expression in any of the donors investigated. Analysis of cytokine mRNA expression using the protocol described by Reutter et al. (1997), did not increase the sensitivity of measurement of induced cytokine expression. Although selected upregulation of IL-1beta by blood derived DC has been confirmed, a wider range of contact allergens and irritants need to be assessed before this approach could be considered for hazard identification.

Topics: Adult; Animal Testing Alternatives; Cells, Cultured; Dermatitis, Allergic Contact; Dinitrofluorobenzene; DNA Primers; Female; Flow Cytometry; Humans; Immunophenotyping; Interleukin-1; Interleukin-18; Interleukin-6; Langerhans Cells; Middle Aged; Predictive Value of Tests; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Sodium Dodecyl Sulfate; Up-Regulation

The purpose of this study was to investigate whether the specific and non-specific inflammatory responses to allergens and irritants give rise to immuno-histochemical detectable differences in the cytokine profile in the skin. Skin biopsies taken at 0, 6, 24 and 72 h from contact allergic reactions to nickel and from irritant reactions to sodium lauryl sulphate were analysed. The main finding was that the dermal cells expressed similar patterns of cytokines (IL-1alpha, IL-1beta, IL-2, IL-4, IL-6 and IL-10) in both types of contact reaction at 72 h. However, two differences were observed. Staining for the IL-1 receptor antagonist was more prominent in the dermis at the late stages of the allergic reaction compared with the late stage of the irritant reaction. The other difference was an increased interferon-gamma staining of infiltrating mononuclear inflammatory cells in the dermis in the sodium lauryl sulphate group compared with the nickel group. A more rapid general onset of cytokine production was found in the sodium lauryl sulphate group than in the nickel group. The main conclusion of this study was that after 6 h the cytokine patterns did not differ between the specific and the non-specific inflammatory responses in the skin.

Topics: Adult; Cytokines; Dermatitis, Allergic Contact; Dermatitis, Irritant; Female; Humans; Immunohistochemistry; Interferon-gamma; Interleukins; Male; Middle Aged; Nickel; Skin; Sodium Dodecyl Sulfate; Time Factors; Tumor Necrosis Factor-alpha

Contact sensitivity is a T-cell-mediated immune disease that can occur when low-molecular-weight chemicals penetrate the skin. In vivo topical application of chemical sensitizers results in morphological modification of Langerhans cells (LC). Moreover, within 18 h, LC increase their major histocompatibility complex (MHC) class II antigens expression and migrate to lymph nodes where they present the sensitizer to T lymphocytes. We wanted to determine if such an effect could also be observed in vitro. However, because of the high genetic diversity encountered in humans, assays were performed with dendritic cells (DC) obtained from a Balb/c mouse strain. The capacity of a strong sensitizer, DNBS (2,4-dinitrobenzene sulfonic acid), to modulate the phenotype of bone marrow-derived DC in vitro, was investigated. A specific and marked increase of MHC class II molecules expression was observed within 18 h. To eliminate the use of animals in sensitization studies, the XS52 DC line was tested at an immature stage. A 30-min contact with the strong sensitizers DNBS and oxazolone, or the moderate mercaptobenzothiazole, resulted in upregulation of MHC class II molecules expression, analyzed after 18-h incubation. This effect was not observed with irritants (dimethyl sulfoxide and sodium lauryl sulfate) nor with a neutral molecule (sodium chloride). These data suggested the possibility of developing an in vitro model for the identification of the sensitizing potential of chemicals, using a constant and non animal-consuming material.

Topics: Animal Testing Alternatives; Animals; Antigens, CD; Antigens, Surface; Benzothiazoles; Bone Marrow Cells; Cell Adhesion; Cell Line; Cells, Cultured; Dendritic Cells; Dermatitis, Allergic Contact; Dimethyl Sulfoxide; Dinitrofluorobenzene; Female; Gene Expression Regulation; Genes, MHC Class II; Haptens; Histocompatibility Antigens Class II; Immunophenotyping; Irritants; Mice; Mice, Inbred BALB C; Oxazolone; Sodium Chloride; Sodium Dodecyl Sulfate; Thiazoles

Novel approaches to testing of skin sensitizing chemicals have made use of immature dendritic cells (DCs) cultured from different hematopoietic progenitors. These cells resemble Langerhans cells (LCs), which are the most potent antigen presenting cells in the skin. Former research has focused on the phenotypic and functional changes of LCs after application of skin sensitizers. But it has proven difficult to isolate sufficient numbers of LCs from skin. This disadvantage is overcome by cultures of immature DCs providing high numbers of reactive cells. The aim of the present investigation was to test the response of DC cultures established from different blood donors to known sensitizers, an irritant and a vehicle. The sensitizers NiSO(4), dinitrochlorobenzene (DNCB), 2,4,6 trinitrobenzene sulfonic acid (TNBS), alpha-hexylcinnamaldehyde (Cinn) and eugenol (Eu) induced the up-regulation of the co-stimulatory molecule CD86, of intercellular adhesion molecule CD54 and of the HLA-DR antigen. The irritant sodium dodecyl sulfate (SDS) and the vehicle dimethyl sulfoxide (DMSO) had no effect. A high rate of responders within blood donors was found for NiSO(4), TNBS, Cinn and Eu, while DNCB was less effective. The augmentation of surface marker expression in dendritic cells obtained from peripheral human blood seems to be a promising readout in prescreening for strong and moderate sensitizers. This test could thus help to reduce animal numbers for in vivo testing.

Topics: Acrolein; Allergens; Antigens, CD; Antigens, Surface; B7-2 Antigen; Cells, Cultured; Dendritic Cells; Dermatitis, Allergic Contact; Dimethyl Sulfoxide; Dinitrochlorobenzene; Enzyme-Linked Immunosorbent Assay; Eugenol; Flow Cytometry; HLA-DR Antigens; Humans; Intercellular Adhesion Molecule-1; Interleukin-1; Interleukin-6; Membrane Glycoproteins; Nickel; RNA, Messenger; Sodium Dodecyl Sulfate; Trinitrobenzenesulfonic Acid; Up-Regulation

When performing skin irritation tests with sodium lauryl sulfate (SLS), the quality of the test solution is of major importance for the reproducibility and comparability of the results. The influence of 4 different storage parameters (concentration, duration, temperature, material of the storage vials) on the stability of aqueous SLS solutions was investigated under non-sterile conditions. SLS solutions at 5 different concentrations (0.001%, 0.01%, 0.1%, 0.5%, 1%) were analysed by mobile phase ion chromatography. Analyses were performed after a storage time of 3 h, 1 week, and 4 weeks. Storage was carried out at different temperatures: -18 degrees C, 6 degrees C, and 23 degrees C. The storage containers were of 2 different materials (glass and polypropylene). After a storage of 1 week, no decrease in SLS concentration was observed, regardless of the chosen conditions. After 4 weeks at 6 degrees C and 23 degrees C, the SLS concentration was found to be significantly decreased for the 2 lowest concentrations (0.001% and 0.01%). At higher concentrations and lower temperatures, no decrease in SLS concentration had occurred. In parallel to the loss of SLS, contamination with bacteria was found in the solutions, especially at the 2 lowest concentrations. Bacterial growth was not observed at higher concentrations. The possibility of biodegradation of SLS has to be taken into account, especially when dealing with low concentrations of SLS.

Topics: Allergens; Bacteria; Biodegradation, Environmental; Dermatitis, Allergic Contact; Drug Packaging; Drug Stability; Drug Storage; Humans; Patch Tests; Sodium Dodecyl Sulfate; Temperature; Time Factors

Squamometry for evaluating skin barrier substances is described. Forearms of 8 volunteers were dosed with 0, 0.25, 0.5, and 1% sodium lauryl sulfate (SLS) in distilled water (semi-open method) for 24 h, to skin pretreated with distilled water and 5% tannic acid, a model barrier protectant. Squamometric evaluation indicated the skin damage increased with SLS concentration in a dose-dependent manner, and that tannic acid reduced the damage (p<0.01). The results suggest that squamometry may be a useful method for determining efficacy of skin barrier substances.

Topics: Aged; Astringents; Colorimetry; Dermatitis, Allergic Contact; Female; Humans; Hydrolyzable Tannins; Male; Middle Aged; Patch Tests; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents

Cytokines have been shown to play a pivotal role in the development and elicitation of contact hypersensitivity reactions. The sources of these cytokines in the skin include T cells, keratinocytes, and Langerhans cells.. In an effort to characterize the cytokines involved in the elicitation phase of a contact allergic response, we examined mRNA expression in human epidermis following patch testing with a known allergen and vehicle.. Allergic subjects were patch tested with poison ivy allergen (rhus), irritant (sodium lauryl sulfate [SLS]) and vehicle controls for 24 hours. Epidermal samples were obtained from the patch sites by a suction blister technique. Total RNA was isolated from the epidermis and the level of cytokine gene expression was determined using reverse transcriptase polymerase chain reaction (RT-PCR). PCR products for the various cytokines were confirmed and semiquantitated by liquid hybridization with (32)P-labeled product-specific probes.. Results of liquid hybridization confirmed the presence of message for interleukin (IL)-2, IL-4 and IL-10 in rhus, SLS, and vehicle treated sites. Generally, in rhus treated sites, the steady state level of message for IL-2 was highest, followed by IL-4 and IL-10, in decreasing levels. In contrast, only minimal expression of mRNA for these cytokines was observed in irritant and vehicle treated sites. Interestingly, interferon (IFN)-gamma mRNA was not detected at 24 hours in rhus, SLS, or vehicle treated sites.. These preliminary results indicate differences in the steady state levels of cytokine mRNA in allergen versus vehicle and irritant treated sites at 24 hours after treatment.

Topics: Cytokines; Dermatitis, Allergic Contact; DNA Primers; Epidermis; Female; Humans; Interleukin-10; Interleukin-2; Interleukin-4; Irritants; Male; Patch Tests; Plants, Toxic; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Sodium Dodecyl Sulfate; Toxicodendron

Protective gloves are used in the workplace to protect the hands from occupational hazards, but side effects from glove use are frequently reported. Among these side effects, irritant skin reactions are common.. The present study was undertaken to investigate whether applying a moisturizer to compromised skin before wearing an occlusive glove could reduce skin irritation.. Healthy volunteers had both hands immersed in a sodium lauryl sulfate solution twice daily for 2 days. After each immersion, one hand had a moisturizer applied and both hands were put in occlusive gloves for 2 hours. Skin barrier function was evaluated by transepidermal water loss, skin hydration was measured by electrical capacitance and inflammation was evaluated by colorimetry.. The moisturizer had a statistically significant positive effect on both the water barrier function and the hydration level of the skin. Although not statistically significant, less inflammation was observed on the moisturizer-treated hand.. The findings suggest that use of a moisturizer under an occlusive glove may diminish irritation from exposure to a detergent followed by glove wearing.

Topics: Adult; Dermatitis, Allergic Contact; Emollients; Epidermis; Female; Gloves, Protective; Hand Dermatoses; Humans; Male; Occupational Exposure; Reference Values; Sodium Dodecyl Sulfate; Surface-Active Agents

The effectiveness of skin protective formulations was evaluated in a previously-described in vivo human model. All formulations failed to inhibit ammonium hydroxide and urea irritation. Only paraffin wax in cetyl alcohol statistically (p<0.01) reduced Rhus allergic contact dermatitis. 3 commercial formulations markedly (p<0.001) suppressed sodium lauryl sulfate irritation. Paraffin wax in cetyl alcohol was quantitatively the most effective formulation. These results suggest that some formulations may provide protective effects against certain, but not all, irritants or allergens.

Topics: Adult; Ammonium Hydroxide; Dermatitis, Allergic Contact; Dermatitis, Irritant; Dermatitis, Toxicodendron; Fatty Alcohols; Humans; Hydroxides; Irritants; Male; Middle Aged; Paraffin; Patch Tests; Pharmaceutic Aids; Plants, Toxic; Skin; Sodium Dodecyl Sulfate; Toxicodendron

For the investigation of the skin irritancy potential of chemicals in an in vitro model, it is necessary to have sensitive end-points that predict the effects on native human skin. Our aim was to investigate whether the induction of the proteinase inhibitor SKALP in reconstructed epidermis can be used as a marker. The influence of culture conditions and the effect of topical application of sodium lauryl sulfate and oleic acid on SKALP expression were evaluated using immunohistochemistry and Northern blotting. SKALP expression was induced by serum, epidermal growth factor and fibroblasts. In the presence of retinoic acid and 1,25-dihydroxyvitamin D3 SKALP expression was inhibited, whereas supplementation with ascorbic acid and a-tocopherol had no effect. Tape-stripping of excised skin and topical treatment with sodium lauryl sulfate induced SKALP protein expression. Application of sodium lauryl sulfate and oleic acid on reconstructed epidermis also induced SKALP at the protein level but no significant effects could be demonstrated at mRNA levels. In conclusion, SKALP expression, which was increased upon application of sodium lauryl sulfate and oleic acid, can be used as an in vitro end-point for skin irritancy, irrespective of the modifying effects of culture conditions.

Topics: Biomarkers; Blotting, Northern; Dermatitis, Allergic Contact; Female; Gene Expression Regulation, Enzymologic; Humans; In Vitro Techniques; Irritants; Oleic Acid; Protein Biosynthesis; Proteinase Inhibitory Proteins, Secretory; Proteins; Serine Proteinase Inhibitors; Skin; Sodium Dodecyl Sulfate; Vitamins

It is desirable to further evaluate the clinical relevance of a positive patch test. The repeated open application test (ROAT) has been suggested as such a supplementary method. To compare the results of patch testing with the outcome of ROATs, 13 colophony-sensitive subjects and 9 controls were patch-tested with colophony in a serial dilution test. Five microliters, of three concentrations of a colophony solution and the vehicle were then applied to small test areas on the lower arm, once daily for 2 weeks. Prior to each application, all test sites were examined visually and with bioengineering techniques. In the ROATs, 10/13 colophony-sensitive subjects--but no controls--reacted to a 20% colophony solution, 4 also 1%. A correlation was found between the threshold concentration at patch testing and the outcome of ROATs. There was great variation in the reactivity in the ROATs. Objective measures for evaluating the ROAT reactions gave no further information than visual assessment.

Topics: Adolescent; Adult; Aged; Dermatitis, Allergic Contact; Female; Humans; Inflammation; Irritants; Laser-Doppler Flowmetry; Male; Middle Aged; Patch Tests; Resins, Plant; Skin Test End-Point Titration; Sodium Dodecyl Sulfate

It has long been recognized that human skin can be subdivided into simple categories based on their sensitivity to sunlight--from Type I, never tans, always burns, to Type VI, marked constitutive pigmentation. There is also evidence that the more readily sunburnt type of skin is also more susceptible to the effect of irritants. In the present work, the irritancy threshold for sodium lauryl sulfate (SLS) has been assessed using a recently described 4-h acute skin irritation patch test. A total of 110 subjects covering all 6 skin types were examined and their threshold for acute irritancy defined as the lowest concentration of SLS, applied under 4-h occlusion, which would induce a clinically detectable irritant response. The SLS dose response generated using a range of concentrations (0.1%-20%) demonstrated that there was no significant difference between the groups under these test conditions. Even for Type VI skin (n = 25), the dose-response curve fell within the general pattern. These results reinforce the general applicability of predictions of acute irritant potential made in groups of human volunteers.

Topics: Acute Disease; Adolescent; Adult; Aged; Dermatitis, Allergic Contact; Dose-Response Relationship, Drug; Female; Humans; Irritants; Male; Maximum Allowable Concentration; Middle Aged; Patch Tests; Reference Values; Skin Pigmentation; Sodium Dodecyl Sulfate

A human 4-h patch test has recently been developed for testing the irritation hazard potential of chemicals. The original method was developed for comparative irritation assessments relative to benchmark irritants using simple statistical tests. In this context, the method has been shown to be robust in intralaboratory testing over time. Recent interlaboratory testing has also established the consistency of the method in assessment of the relative irritation potential of selected chemicals. These data help to position the method as a suitable replacement for animal test methods in assessment of skin irritation hazard. In addition, the method has great utility for investigating different parameters of clinical skin irritation. Using kinetic response patterns and curve fitting analysis, we have compared the relative irritation potential of chemicals in greater detail, using as a basis the time required for test subjects to respond as well as the incidence of positive responses. Also, using the response to 20% sodium dodecyl sulfate (SDS) as a benchmark, we've been able to examine the intersubject variation in clinical skin irritation responses. In general, subjects most reactive to 20% SDS, in terms of the exposure time required to produce a positive response, were relatively more sensitive to a 2nd irritant chemical as well. However, this was not an absolute correlation in that some test subjects showed divergent patterns of response. The method was also used to compare directly the relative skin reactivity of different populations, based on race (Caucasian versus Asian) or on neurosensory skin sensitivity. Our results using this acute exposure test method indicate little difference in visually assessed skin irritation among these diverse human subpopulations.

Topics: Acetic Acid; Asian People; Dermatitis, Allergic Contact; Fatty Alcohols; Humans; Irritants; Patch Tests; Sodium Dodecyl Sulfate; Sodium Hydroxide; Time Factors; White People

In 2 earlier studies, we found increased nickel re-test reactivity at earlier experimentally induced nickel eczema sites. The aim of this study was to investigate if earlier contact dermatitis caused by another allergen or earlier irritant contact dermatitis also influenced the reactivity when nickel was applied topically on earlier but healed dermatitis sites. Twenty-three females with contact allergy to both nickel and cobalt were involved in the study. Experimental contact dermatitis from nickel, cobalt and SLS was induced on the lower back. One month later, challenge patch testing with a serial dilution of nickel on the previous but healed dermatitis sites, and on a control area, was done. The tests were read blindly. Significantly higher test reactivity was found at the site with previous allergic contact dermatitis from nickel, and significantly lower test reactivity was observed at the previous SLS dermatitis site.

Topics: Adult; Cobalt; Data Interpretation, Statistical; Dermatitis, Allergic Contact; Eczema; Female; Humans; Hypersensitivity, Delayed; Middle Aged; Nickel; Patch Tests; Severity of Illness Index; Skin; Sodium Dodecyl Sulfate

Allergic contact dermatitis and irritant contact dermatitis have different pathogenic mechanisms. It is therefore plausible that the epidermal expression of HLA-DR and the invariant chain associated with antigen processing and presentation might differ between allergic contact dermatitis and irritant contact dermatitis. We have quantified the volume of epidermal HLA-DR and invariant chain reactivity and the total epidermal volume in allergic contact dermatitis and irritant contact dermatitis using confocal laser scanning microscopy and indirect immunofluorescence on acetone-fixed 25 microns thick vertical skin sections. Eight nickel allergic patients were patch-tested with 5% nickel sulfate and 8 healthy volunteers were patch-tested with 4% sodium lauryl sulfate. Skin biopsy specimens were taken at 0, 6, 24, and 72 h after application of the patch tests. Sodium lauryl sulfate induced a statistically significant increased epidermal volume at 24 h and 72 h compared to 0 h and 6 h (p < 0.003 and p < 0.001, respectively), whereas an increase in epidermal volume in the allergic contact dermatitis group was not noted until 72 h after patch testing with nickel sulfate compared to 0, 6 h (p < 0.001) and 24 h (p < 0.004). No significant changes in the epidermal volume of HLA-DR reactivity were found at any time point within or between the two groups, nor was there any significant change in the epidermal volume of invariant chain reactivity in the allergic contact dermatitis group. In the irritant contact dermatitis group, however, the epidermal volume of invariant chain reactivity was significantly reduced from 17 +/- 8 x 10(3) microns 3 at 24 h to 9 +/- 3 x 10(3) microns 3 at 72 h (p < 0.04), which was also significantly lower than the 14 +/- 4 x 10(3) microns 3 observed in allergic contact dermatitis at 72 h (p < 0.01). Furthermore, the invariant chain expression was significantly lower than the HLA-DR reactivity in the irritant contact dermatitis group at 72 h (p < 0.001). The decrease of invariant chain reactivity at 72 h in irritant contact dermatitis might reflect an epitope-induced alteration by sodium lauryl sulfate or a down-regulated biosynthesis of the invariant chain due to variance in local cytokine production between allergic contact dermatitis and irritant contact dermatitis.

Topics: Adult; Analysis of Variance; Antigen Presentation; Antigens, CD; Antigens, Differentiation, B-Lymphocyte; Cytokines; Dermatitis, Allergic Contact; Dermatitis, Irritant; Down-Regulation; Epitopes; Female; Fluorescent Antibody Technique, Indirect; Follow-Up Studies; Gene Expression Regulation; Histocompatibility Antigens Class II; HLA-DR Antigens; Humans; Irritants; Male; Microscopy, Confocal; Middle Aged; Nickel; Patch Tests; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents

In this study of 152 women, comparison of patch test responses between 2 irritants over 96 h at 2 symmetrical anatomical sites is studied. 2 irritants, each at 4 different concentrations (nonanoic acid (NAA) 80%, 40%, 20%, 10%; sodium lauryl sulfate (SLS) 3%, 2%, 1% and 0.5%) and using propan-1ol and 'water for injection' as the respective controls, were placed as 15 microl aliquots, soaked onto filter paper discs in Finn Chambers, on the volunteer's left and right lower back. The patches were removed at 47, and read at 48 and 96 h. Irritant reactions were evaluated for erythema and surface changes by degree and area affected. Statistical analysis of the results showed that erythema decreased with time for all concentrations of NAA, and at higher concentrations for SLS. Surface changes increased with time for SLS and at higher concentrations of NAA. There was no statistically significant difference comparing left and right sides. Traditionally in patch testing, reactions which fade after 48 h have been regarded as irritant rather than allergic. This study refutes that assumption. Data from our left to right comparisons, made in the same individuals at the same time, show that irritant reactions may be more reproducible than previously appreciated.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Dermatitis, Allergic Contact; Fatty Acids; Female; Humans; Irritants; Middle Aged; Patch Tests; Reproducibility of Results; Sodium Dodecyl Sulfate; Time Factors

Topics: Allergens; Dermatitis, Allergic Contact; Dermatitis, Irritant; Diagnosis, Differential; Humans; Irritants; Patch Tests; Sodium Dodecyl Sulfate; Tretinoin

Sequential biopsies from skin lesions induced by nickel sulphate and sodium lauryl sulphate, respectively, were investigated with respect to expression of extracellular matrix proteins and adhesion molecules on lymphocytes, endothelial cells, and keratinocytes. The majority of the infiltrating lymphocytes expressed VLA-4, LFA-1, CD44 and ICAM-1, a variable fraction expressed Leu-8 and VLA-5, and few or no cells were positive for VLA-1, VLA-2 and VLA-6. Noteworthy, was that the infiltrating cells showed a substantial amount of fibronectin but relatively small or negligible presence of laminin, collagen type IV, IgG, IgA, IgM, and albumin. The fibronectin was associated with cell bodies as well as the area surrounding infiltrating cells. The number of infiltrating cells was larger in biopsies from nickel-sulphate induced lesions and the infiltrates contained more fibronectin than biopsies from lesions induced by sodium lauryl sulphate. However, at the single-cell level, the expression of VLA antigens, LFA-1, CD44 and ICAM-1 was similar in both groups. The endothelial cells of skin biopsies from nickel-sulphate-induced lesions showed a stronger expression of VCAM-1, ELAM-1 and ICAM-1 compared to biopsies from sodium lauryl sulphate-induced lesions. In the biopsies from nickel sulphate-induced lesions, the keratinocytes showed a tendency to less VLA-6 expression. These results suggest that fibronectin plays a role in lymphocyte extravasation or extravascular lymphocyte migration.

Topics: Adult; Allergens; Cell Adhesion Molecules; Cell Movement; Dermatitis, Allergic Contact; Endothelium, Vascular; Epidermis; Female; Fibronectins; Humans; Irritants; Keratinocytes; Ligands; Lymphocytes; Middle Aged; Nickel; Sodium Dodecyl Sulfate

A fair % of patients with a clinical history of nickel allergy show negative patch test results. To improve the response rate to NiSO4 5% pet. patch tests, a testing procedure utilizing pre-treatment of the test area by a 24-h application of sodium lauryl sulfate (SLS) was introduced. 46 women with a clinical history of nickel sensitivity, who exhibited negative reactions to nickel sulfate 5% pet. patch tests, were studied. Patients underwent 6 patch tests on adjacent sites on the volar surface of the forearms. 4 patch tests were performed with a 72-h application of 40 mg nickel sulfate 5% pet. While 1 of these patch tests served as control, 3 test areas underwent 24-h pre-treatment with 40 microliters SLS, 1 with 0.1% and 2 with 0.5% solution. To evaluate differences in the reactivity to SLS plus nickel sulfate related to the site on the forearm, 0.5% SLS pre-treatment was performed both on a proximal and on a distal test site. At the 72-h evaluation, 19 subjects out of 46 showed positive reactions to nickel sulfate 5% pet. at skin sites pre-treated with 0.1% SLS, whereas 23 patients reacted positively at 0.5% SLS pre-treated areas. Echographic values of skin thickness and of hypo-echogenic dermal areas at positive pre-treated nickel test areas were higher than at control test areas, confirming the clinical evidence of an increased response to NiSO4 after SLS pre-treatment. The inflammatory reaction, as evaluated clinically and echographically, was much higher at distal skin areas (0.1% SLS and distal 0.5% SLS) than at proximal 0.5% SLS ones.

Topics: Adult; Analysis of Variance; Dermatitis, Allergic Contact; False Negative Reactions; Female; Humans; Middle Aged; Nickel; Patch Tests; Sensitivity and Specificity; Sodium Dodecyl Sulfate; Surface-Active Agents

Topics: Acyclic Monoterpenes; Allergens; Antigen Presentation; Cells, Cultured; Coumarins; Dermatitis, Allergic Contact; Diazonium Compounds; Epidermal Cells; Epidermis; Fluorescein-5-isothiocyanate; Haptens; Humans; Irritants; Langerhans Cells; Lymphocyte Activation; Monoterpenes; Perfume; Phenylenediamines; Pyridines; Sodium Dodecyl Sulfate; T-Lymphocytes; Terpenes; Trinitrobenzenesulfonic Acid

Recent data suggest a key rôle for IL-1 beta in the induction phase of allergic contact dermatitis. In the present study, the protein levels of IL-1 beta were measured in skin lymph derived from normal untreated skin as well as from irritant and allergic (induction and elicitation phase) contact dermatitis. IL-1 beta increased in the course of both types of contact dermatitis, displaying the highest levels in irritant CD. Using a reverse transcriptase-polymerase chain reaction, low signal strength of IL-1 beta mRNA was demonstrated in lymph cells derived from normal skin and allergic CD. In lymph cells collected 2 x daily during the induction phase of allergic contact dermatitis, no upregulation of the IL-1 beta mRNA signal was found. Isolated CD1a+ lymph cells derived from normal skin as well as from the induction and elicitation phase of allergic contact dermatitis did not express IL-1 beta mRNA. Our results demonstrate that in human skin lymph, the IL-1 beta profiles do not discriminate between irritant and allergic contact dermatitis and that besides resident epidermal and dermal cells, circulating lymph cells may also contribute to IL-1 beta protein production.

Topics: Adult; Allergens; Cyclopropanes; Dermatitis, Allergic Contact; Dermatitis, Irritant; Dinitrochlorobenzene; Epidermis; Female; Humans; Interleukin-1; Irritants; Langerhans Cells; Lymph; Lymphocytes; Male; Polymerase Chain Reaction; RNA-Directed DNA Polymerase; RNA, Messenger; Skin; Sodium Dodecyl Sulfate; Transcription, Genetic; Up-Regulation

Topics: Azepines; Dermatitis, Allergic Contact; Ethylene Glycols; Female; Humans; Irritants; Nickel; Patch Tests; Pharmaceutical Vehicles; Skin Absorption; Sodium Dodecyl Sulfate; Surface-Active Agents

Damage to the skin following the repeated use of 2 different wash solutions was investigated. Stratum corneum capacitative resistance, stratum corneum lipids, transepidermal water loss, skin surface pH, laser Doppler flow and skin reddening were determined. All skin function parameters already showed a marked change after a single wash (e.g., the median of TEWL values increased by more than 0.5 g/m2 h). Repetitive washing for 1 week led to a further deterioration of TEWL and corneometry values (e.g., TEWL increased for about 2.9 g/m2 h after repetitive washing with sodium lauryl sulfate). The rate of skin function regeneration after repetitive washing was unaltered compared to regeneration after a single wash. The surfactants used showed quantitatively differing effects on corneometry, TEWL and laser Doppler flow (e.g., after repetitive washing with Geliderm, the median of TEWL values increased only up to 1.55 g/m2 h). However, damage arising from repetitive washing could not be completely prevented by the selection of a mild surfactant. Skin function regeneration showed no difference with the 2 surfactants used.

Topics: Adult; Dermatitis, Allergic Contact; Female; Humans; Hydrogen-Ion Concentration; Lipid Metabolism; Male; Middle Aged; Regional Blood Flow; Skin; Skin Physiological Phenomena; Skin Tests; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible

A critical role of tumor necrosis factor (TNF)-alpha in irritant contact dermatitis and in the challenge phase of allergic contact dermatitis has recently been demonstrated in vivo. As in situ hybridization studies have indicated that keratinocytes were the cellular source of TNF-alpha in these reactions, we studied the mechanisms of TNF-alpha mRNA induction in keratinocytes by agents that induce contact dermatitis. Murine la-/CD3- epidermal cells were stimulated with phorbol myristate acetate (PMA), dimethylsulfoxide (DMSO), sodium dodecyl sulfate (SDS) and NiSO4, all of which up-regulated epidermal cell TNF-alpha mRNA production. In contrast, trinitrobenzenesulfonic acid and trinitrochlorobenzene did not significantly up-regulate TNF-alpha mRNA. These results were confirmed with murine keratinocyte cell lines. In keratinocytes transfected with a chloramphenicol acetyltransferase construct containing the -1059 to +138 base pair TNF-alpha promoter, increased promoter activity was observed upon stimulation with PMA and DMSO. In addition, PMA stimulation did not affect the stability of TNF-alpha mRNA. The PMA- but also the DMSO- and SDS- induced up-regulation of TNF-alpha mRNA was abolished by an inhibitor of protein kinase C (PKC). In contrast, NiSO4 up-regulated TNF-alpha mRNA by a PKC-independent mechanism, did not increase TNF-alpha promoter activity, but markedly increased the stability of the TNF-alpha mRNA. Co-stimulation with PMA and NiSO4 induced a marked increase in TNF-alpha mRNA over that obtained with each agent alone. Thus, whereas PKC-dependent irritants act by up-regulating TNF-alpha promoter activity, nickel acts via post-transcriptional regulation. Our results also establish that some irritants and irritant sensitizers directly induce TNF-alpha in keratinocytes without intermediate Langerhans cell-derived signals.

Topics: 1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine; Animals; Cell Line; Dermatitis, Allergic Contact; Dimethyl Sulfoxide; Drug Synergism; Gene Expression Regulation; Irritants; Isoquinolines; Keratinocytes; Mice; Mice, Inbred BALB C; Nickel; Piperazines; Protein Kinase C; RNA, Messenger; Sodium Dodecyl Sulfate; Tetradecanoylphorbol Acetate; Transcription, Genetic; Tumor Necrosis Factor-alpha

Topics: Acetylcholine; Adaptation, Physiological; Administration, Cutaneous; Antigens; Autacoids; Benzalkonium Compounds; Chronic Disease; Dermatitis, Allergic Contact; Dermatitis, Irritant; Dinitrochlorobenzene; Dinoprostone; Epidermis; Forearm; Humans; Hypersensitivity, Delayed; Immunologic Memory; Injections, Intradermal; Maleates; Patch Tests; Sodium Dodecyl Sulfate

Topics: Back; CD36 Antigens; Cosmetics; Dermatitis, Allergic Contact; Dermatitis, Irritant; Epidermis; Frozen Sections; HLA-DR Antigens; Humans; Intercellular Adhesion Molecule-1; Keratinocytes; Patch Tests; Sodium Dodecyl Sulfate

Topics: Cytokines; Dermatitis, Allergic Contact; Dermatitis, Contact; Dermatitis, Irritant; Humans; Interleukin-6; Laser-Doppler Flowmetry; Microdialysis; Nickel; Perfusion; Pilot Projects; Receptors, Interleukin-2; Sodium Dodecyl Sulfate

Topics: Animals; Data Display; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Irritant; Edema; Fatty Acids; Humans; Hydrochloric Acid; Image Processing, Computer-Assisted; Mice; Mice, Hairless; Nickel; Patch Tests; Skin; Sodium Dodecyl Sulfate; Sodium Hydroxide; Ultrasonography

Epidermal cytokines are known to participate in the initiation of immune and inflammatory processes in the skin. In the present study, we examined epidermal cytokine mRNA levels to elucidate the initial molecular events in the sensitization and elicitation phases of allergic contact dermatitis (ACD) as well as in irritant contact dermatitis (ICD). BALB/c mice were sensitized on the dorsal skin with 0.5% dinitrofluorobenzene (DNFB) and challenged with 0.2% DNFB on the ears 6 days later to elicit allergic contact hypersensitivity (ACDe), the elicitation phase. To examine cytokine profiles during the sensitization phase from the same anatomic area, other animals were sensitized on ear instead of dorsal skin. The sensitization phase of ACD (ACDs) was induced by painting the ears of naive mice with 0.5% DNFB. Sodium lauryl sulfate (SLS), utilized as an irritant control, was also applied to the ears of another group of mice to induce ICD. Total RNA was extracted from the epidermis of the treated ears at various time points after each treatment, reverse transcribed to cDNA, and amplified by PCR using radiolabeled cytokine-specific primers. Amplified products were sized by electrophoresis and autoradiography and semiquantitated by densitometry. Autoradiographs were normalized relative to beta-actin signals. ACDs and ACDe showed similar patterns of cytokine mRNA levels; that is, at 6 h after hapten application, interleukin (IL)-1 beta, IL-6, IL-10, and granulocyte-macrophage colony-stimulating factor (GM-CSF) mRNA levels were upregulated, and this upregulation was observed until 24 h after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Base Sequence; Cytokines; Dermatitis, Allergic Contact; Dermatitis, Irritant; Dinitrofluorobenzene; DNA Primers; Female; Gene Expression; Mice; Mice, Inbred BALB C; Molecular Sequence Data; Polymerase Chain Reaction; RNA, Messenger; Skin; Sodium Dodecyl Sulfate; Time Factors

Using microsurgery a superficial peripheral lymph vessel draining the skin of the upper and medial part of the foot was cannulated on the lower leg of two healthy human volunteers. An irritant contact dermatitis was induced 2 days later by the application of 10% sodium lauryl sulphate to the drained skin area. After a further 3 days the spontaneously regressing skin reaction was treated with clobetasol propionate. Lymph was continuously collected in two aliquots per day for 7 days. The levels of total protein, of albumin and globulins, and of complement components of the classical, the alternative and the lytic pathway as well as the C4A and C4B gene products and the regulatory proteins FB, C1INH, C4BP, FH and FI were determined by ELISA and radial immunodiffusion techniques. Postoperatively, the levels of complement proteins and globulins in the lymph were 5-10 times lower than those in normal human serum, but increased during the course of the skin reaction, while the irritant contact dermatitis did not induce a change in their plasma concentration. In comparison to the baseline, the mean values for C1q, C1r, C2, C5, C6, C7, C8, C9, FB, C1INH, C4BP, FH and FI exhibited a 3-5-fold increase, C3, total C4, albumin and the alpha 1-globulin fraction a 6-9-fold increase, and C1s, C4A, C4B, FB and alpha 2-, beta- and gamma-globulins a 10-20-fold increase.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Albumins; Complement C1q; Complement C1r; Complement C2; Complement C4a; Complement C4b; Complement System Proteins; Dermatitis, Allergic Contact; Globulins; Humans; Lymph; Male; Skin; Sodium Dodecyl Sulfate

The aim of this study was to establish an objectively assessable procedure simulating simultaneous exposure to irritants and allergens in domestic and occupational environments, in order to evaluate differences in the reactivity to the combination of these substances in atopic and non-atopic nickel-sensitized subjects. Thirty-four nickel-sensitive patients, 20 of whom were affected by atopic dermatitis, underwent four patch tests with NiSO4 0.05% aq. on two adjacent sites of both volar forearms, with a 24-h application time. Two of the test sites were treated with sodium lauryl sulfate (SLS) 5% for 30 min, before application of the nickel sulfate preparation. Echographic recordings were performed by a 20-MHz B-scanner and processed by an image analysis program, providing a numerical representation of the picture data, based on the attribution of fictional values to the amplitudes of the echoes. The dermal inflammatory reaction was quantified by an amplitude band, marking the hypo-reflecting part of the dermis, whereas epidermal damage was assessed by a band highlighting the entrance echo. Pre-treatment with SLS of the skin area where nickel sulfate was subsequently applied greatly enhanced the allergic response at 24 and 72 h, both in subjects with atopic dermatitis and in subjects with allergic contact dermatitis. However, in atopics, the increase in the allergic reactivity after irritation of the skin was more pronounced both by clinical and by echographic evaluation. These observations stress the importance of the concurrent action of irritants and allergens in maintaining the dermatitis in atopics.

Topics: Adolescent; Adult; Dermatitis, Allergic Contact; Dermatitis, Atopic; Humans; Irritants; Middle Aged; Nickel; Skin; Sodium Dodecyl Sulfate; Ultrasonography

Topics: Animals; Dermatitis, Allergic Contact; Dermatitis, Irritant; Evaluation Studies as Topic; Female; Irritants; Mice; Mice, Inbred BALB C; Skin; Sodium Dodecyl Sulfate; Ultrasonography

Nickel is a very common contact allergen, with some reports showing that more than 10% of women are affected. It is therefore important to be able to assess the risk of elicitation of nickel dermatitis in such individuals, particularly in relation to repeated exposure to low levels of this metal. It has been shown previously that under the conditions of a 48-h occluded patch test, some subjects will react to as little as 0.5 ppm nickel on compromised skin. In the present study, the effect of repeated open nickel application combined with repeated treatment with the anionic surfactant sodium dodecyl sulphate has been evaluated on the hand skin of 4 nickel-allergic subjects. Despite 2 of these being known to be particularly sensitive, there was no evidence of a nickel-allergic reaction following 2x daily immersion of hand skin sites in up to 1 ppm nickel over a period of 23 days.

Topics: Adult; Dermatitis, Allergic Contact; Erythema; Female; Hand; Humans; Immersion; Male; Nickel; Skin; Skin Diseases; Sodium Dodecyl Sulfate; Thumb

In order to optimize patch test strategies and counselling in occupational dermatology, it is important to identify risk markers of contact sensitization. Since nickel is the most frequent contact allergen in European countries, we studied the potential of the irritant response to sodium lauryl sulfate (SLS) to predict nickel sensitization. In 100 patients subsequently tested in our patch test clinic with the standard patch test series of the German Contact Dermatitis Group (DKG), the atopy score as described by Diepgen et al. was determined and an SLS patch test was performed. Relative transepidermal water loss (TEWL), expressed as the ratio between the TEWL of the SLS-irritated and the control site, atopy score, age and sex were tested by logistic regression analysis for their association with patch test-proven nickel sensitization. Age, sex and relative TEWL were found to be significant predictors of nickel sensitization, whereas the atopy score was not. Patients with nickel sensitization were significantly younger (mean age 35.0 +/- 4.1 versus 46.2 +/- 2.1 years), more frequently of female gender (28.6% versus 3.9%) and had a significantly higher relative TEWL following SLS exposure (471.0 +/- 40.8% versus 344.0 +/- 16.2%). The mean atopy score of nickel-sensitized patients was slightly higher than that of patients not sensitized (6.0 +/- 1.3 versus 5.3 +/- 0.5), but the difference was not significant. In previous studies on larger patient samples, atopy was found to be a predictor of nickel allergy. This discrepancy may be explained by the smaller statistical power of our study.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Irritant; Female; Humans; Male; Middle Aged; Nickel; Patch Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible

Dimethyl sulfoxide (DMSO) and sodium lauryl sulfate (SLS) are known to cause irritation of the skin, and to enhance the penetration of chemicals into the epidermis. In the present study, the lymph node cell (LNC) proliferative response following exposure to irritants, such as SLS and DMSO, was examined in the murine local lymph node assay (LLNA). Exposure to DMSO or SLS aqueous solution induced a small increase in lymph node cell proliferation compared with aqueous solution alone. Exposure to SLS in DMSO caused a significant increase in LNC proliferation. Further, the effect of addition of the irritants in a vehicle on the detection of contact sensitivity to metal allergens was examined. Application of potassium dichromate and nickel sulfate in DMSO or SLS aqueous solution caused increases in LNC proliferation. Exposure to metal allergen with SLS in DMSO also induced a significant LNC proliferative response, but did not induce a significant increase in stimulation index (increase in 3H-thymidine incorporation relative to vehicle-treated control group). This was because of increased 3H-thymidine incorporation following exposure to SLS-DMSO in the control group. These results suggest that irritants enhance the LNC proliferative responses to metal allergens. The use of SLS in aqueous solution is effective for the detection of sensitivity to water-soluble allergens, such as metal allergens, in the LLNA, as well as the use of DMSO as an application vehicle.

Topics: Animals; Dermatitis, Allergic Contact; Dimethyl Sulfoxide; Dose-Response Relationship, Drug; Female; Irritants; Lymphocyte Activation; Metals; Mice; Mice, Inbred BALB C; Nickel; Potassium Dichromate; Skin Absorption; Sodium Dodecyl Sulfate; T-Lymphocytes

Most cases of primary nickel sensitization are caused by occluded exposure to nickel released from earrings, buttons, etc. Nickel-sensitive females are both domestically and occupationally exposed to trace amounts of nickel. The present study was designed to define the minimum eliciting threshold concentration of nickel exposure in previously nickel-sensitized individuals, after open application on normal forearm skin with and without surfactant. A dilution series of NiCl2, ranging from 0.1 to 4000 ppm nickel with and without 4% sodium lauryl sulfate, was applied to healthy volar forearm skin. None reacted with definite allergic reactions to 100 ppm and below. Follicular reactions were seen in the concentration range from 0.1-100 ppm in a few patients and 1 healthy control. The results are discussed in relation to consumer products containing 1-10 ppm nickel.

Topics: Dermatitis, Allergic Contact; Dose-Response Relationship, Immunologic; Environmental Exposure; Female; Humans; Nickel; Patch Tests; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents

The transition metal nickel is a very common cause of allergic contact dermatitis (ACD). In the general population, adults with hand eczema have a high incidence of allergy to nickel, and nickel allergy is high in occupational dermatoses and is often linked to wet work. Nickel may be found as a trace contaminant in some consumer products, e.g., household cleaning agents. It has therefore been debated whether these levels, whilst not a primary cause, might be sufficient to maintain ACD. The minimal concentration of nickel in patch tests on normal skin that will elicit an allergic reaction in highly sensitised subjects is 1-10 ppm. This trial assessed whether reactivity to nickel was altered on compromised dorsal forearm skin and compared this to normal skin on the contralateral dorsal forearm and on the back. Skin damage consequent upon arm immersion in sodium dodecyl sulphate (SDS) greatly enhanced reactivity to nickel on the forearm, with the dorsal aspect reacting most both in number of reactions at each concentration and in the minimal eliciting concentration, which was 0.5 ppm in 2/20 under the conditions of a 48 h occluded patch.

Topics: Adolescent; Adult; Dermatitis, Allergic Contact; Dermatitis, Irritant; Dose-Response Relationship, Immunologic; Female; Forearm; Humans; Immersion; Irritants; Male; Middle Aged; Models, Biological; Nickel; Patch Tests; Skin; Sodium Dodecyl Sulfate

1. In the increasingly chemical environment of modern life, there are individuals whose marginal state of contact sensitization may not be revealed by standard methods of patch test- ing. The substances are often comparatively weak allergens with extremely limited capacity to penetrate normal skin. 2. Provocative patch tests magnify the manifestations of allergic contact dermatitis. Threshold states of contact sensitization are brought to light. Provocative testing is indispensable in screening new substances for allergenic potentiality. 3. Physical and chemical insults which mildly damage the skin may act as provocative agents. Physical injuries such as sandpapering and ultraviolet radiation are inferior to chemical insults. 4. The promoting effect of provocative tests is mediated by assuring penetration into the immunologic target tissue by damaging the horny layer barrier and by initiating a mild inflammatory response which conditions the tissue to react in an exaggerated but specific way to allergens. 5. Sodium lauryl sulfate (SLS) was the most effective provocative agent. The SLS provocative test is performed by pre-treating the skin for one hour with a 10% aqueous solution of SLS.

Topics: Dermatitis, Allergic Contact; Humans; Patch Tests; Sodium Dodecyl Sulfate