sodium-dodecyl-sulfate and Eczema

The aim of the study was to assess the susceptibility of clinically normal skin to a standard irritant trauma under varying physiological and patophysiological conditions. Evaluation of skin responses to patch tests with sodium lauryl sulphate (SLS) was used for assessment of skin susceptibility. The following noninvasive measuring methods were used for evaluation of the skin before and after exposure to irritants: measurement of transepidermal water loss by an evaporimeter, measurement of electrical conductance by a hydrometer, measurement of skin blood flow by laser Doppler flowmetry, measurement of skin colour by a colorimeter and measurement of skin thickness by ultrasound A-scan. The studies were carried out on healthy volunteers and patients with eczema. In the first studies the standard irritant patch test for assessment of skin susceptibility was characterized and validated. SLS was chosen among other irritants because of its ability to penetrate and impair the skin barrier. The implications of use of different qualities of SLS was investigated. The applied noninvasive measuring methods were evaluated, and for quantification of SLS-induced skin damage measurement of TEWL was found to be the most sensitive method. Application of the standard test on clinically normal skin under varying physiological and patophysiological conditions lead to the following main results: Seasonal variation in skin susceptibility to SLS was found, with increased susceptibility in winter, when the hydration state of the stratum corneum was also found to be decreased. A variation in skin reactivity to SLS during the menstrual cycle was demonstrated, with an increased skin response at day 1 as compared to days 9-11 in the menstrual cycle. The presence of active eczema distant from the test site increased skin susceptibility to SLS, indicating a generalized hyperreactivity of the skin. Taking these sources of variation into account healthy volunteers and patients with hand eczema and atopic dermatits were studied and compared. In healthy volunteers increased baseline TEWL and increased light reflection from the skin, interpreted as "fair" skin, was found to be associated with increased susceptibility to SLS. Hand eczema patients were found to have fairer and thinner skin than matched controls. Increased susceptibility to SLS was found only in patients with acute eczema. Patients with atopic dermatitis had increased baseline TEWL as well as increased skin susceptibility as c

Topics: Colorimetry; Dermatitis, Atopic; Eczema; Galvanic Skin Response; Hand Dermatoses; Humans; Irritants; Patch Tests; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible

The skin of patients with atopic dermatitis is characterized by abnormal stratum corneum lipid levels. Consequently, the lamellar matrices are disrupted and skin barrier function is diminished, increasing skin sensitivity to irritants and allergens.. To determine whether a cream containing ceramides, triglycerides and cholesterol in a multivesicular emulsion can reinforce the skin barrier and protect against skin irritation.. A randomized observer-blind intrapatient-controlled study in 34 adults with dry, eczema-prone skin was conducted. Each participant underwent 4 weeks of treatment with the test cream on one forearm and lower leg and a reference emollient cream on the other. Skin properties were determined before and after treatment. Lipid structure was assessed by Fourier-transform infrared spectroscopy using a novel interface.. Skin barrier integrity was greater at sites treated with the test cream [effect size for area under the transepidermal water loss curve -162, 95% confidence interval (CI) -206 to -118]. Skin sensitivity to sodium lauryl sulfate was reduced (-0·5 points visual redness, 97·57% CI -1·00 to -0·25), as was transepidermal water loss (-15·3 g m. The test cream facilitates skin barrier restoration and protects the skin from dryness and irritation. Compared with a commonly prescribed emollient in the UK, the test cream is highly suited to the management of dry, sensitive skin.

Topics: Adult; Eczema; Emollients; Humans; Skin; Skin Abnormalities; Sodium Dodecyl Sulfate; Water; Water Loss, Insensible

Eczematous skin disease is a serious work-related illness. Since 1995, reimbursement by insurance companies for treatment of skin diseases has become the largest cost source in some countries. This study was a randomized controlled trial (N = 20) of the efficacy of Pro-Q, a skin protectant product, in the prevention of contact dermatitis from sodium lauryl sulfate and urushiol, the resinous sap of poison ivy and poison oak. Pro-Q was significantly effective in reducing the irritation from sodium lauryl sulfate but did not prevent the allergic reaction to urushiol.

Topics: Administration, Cutaneous; Aerosols; Catechols; Dermatitis, Irritant; Dermatitis, Occupational; Dermatitis, Toxicodendron; Dermatologic Agents; Detergents; Dimethylpolysiloxanes; Double-Blind Method; Eczema; Glycerol; Humans; Irritants; Plants, Toxic; Protective Agents; Simethicone; Sodium Dodecyl Sulfate; Toxicodendron

It was the aim of our studies to estimate predictively the individual eczema risk for persons due to repetitive contact with washing-active substances, by a barrier function test on clinically healthy skin over 2 weeks. Within the scope of the study 3 groups with different atopy scores were compared. As washing solutions, 0.1 m SLS and a slightly acid soap-free washing emulsion were used in comparison to tap water. Prior to the 1st washing procedure, on days 3, 5, 8, 10, and 12, the transepidermal water loss, the horny layer moisture, and the skin blood flow were measured as parameters of barrier function, as well as the inflammatory reaction. The results prove that the atopy score has only limited validity as a predictive method for the acceptance of washing-active substances. The repetitive washing test, however, seems to be more adequate for evaluating the individual barrier function as well as the eczema risk. Irritation by a washing procedure may be greatly influenced by choice of the washing solution.

Topics: Adult; Dermatitis, Atopic; Dose-Response Relationship, Drug; Eczema; Emulsions; Evaluation Studies as Topic; Female; Hand Disinfection; Humans; Middle Aged; Predictive Value of Tests; Risk Factors; Severity of Illness Index; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Time Factors; Water; Water Loss, Insensible

Topical corticosteroids are frequently used in the treatment of irritant contact dermatitis (ICD). The efficacy of this treatment has, however, not been thoroughly established, and experimental studies on the topic have provided conflicting results. The aim of the present study was to evaluate the effect of potent topical corticosteroids on experimentally-induced irritant skin reactions in a double-blind, vehicle-controlled study. 16 healthy volunteers had sodium lauryl sulfate patch tests symmetrically applied to the upper arms. After removal of patch tests, a potent topical corticosteroid (betamethasone-17-valerate) was applied to the irritant skin reaction on one arm, while the corresponding vehicle was applied to the irritant skin reaction on the opposite arm 2x daily for 7 days. Reactions were evaluated by measurement of transepidermal water loss (TEWL) and erythema. After 7 days, statistically significant lower values of TEWL and erythema were found in corticosteroid-treated, compared to the vehicle-treated, skin reactions. The results indicate that topical corticosteroids improve healing of ICD.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Dermatitis, Contact; Dermatitis, Irritant; Double-Blind Method; Eczema; Erythema; Female; Glucocorticoids; Humans; Male; Middle Aged; Patch Tests; Skin Absorption; Sodium Dodecyl Sulfate; Treatment Outcome; Water Loss, Insensible

A total of 330 patients with eczematous lesions were tested with 27 topical substances. Among the 88 patients with leg ulcers, 85 (2%) were allergic to one or more substances present in one out of two cases of allergy to wool alcohol. Among the 242 patients suffering from eczematous dermatitis, the percentage of allergic reactions reached 54.6%. A great number of allergic reactions of cetyl alcohol (11.2%), chloramphenicol (10%) and sodium lauryl sulfate (6.4%) was observed. These allergens are not included in the European standard series adopted by the ICDRG. The findings are discussed and compared with data taken from the literature.

Topics: Adult; Alcohols; Chloramphenicol; Clinical Trials as Topic; Cosmetics; Dermatitis, Atopic; Drug Compounding; Drug Eruptions; Eczema; Evaluation Studies as Topic; Humans; Leg Ulcer; Methanol; Middle Aged; Ointments; Patch Tests; Sodium Dodecyl Sulfate

Alcohol-based hand rub (ABHR) is widely used for hand disinfection in the health care sector. ABHR is, however, known to cause discomfort when applied on damaged skin emphasizing the unmet need for alternative and better tolerated types of disinfectants. Active chlorine hand disinfectants (ACHDs) are potential new candidates; however, the effect on the skin barrier function compared to ABHR remains to be assessed.. In Study A, the forearm skin of healthy adults was repeatedly exposed to ACHD and ABHR. Skin barrier function was assessed by measurement of transepidermal water loss, electrical conductance, pH, and erythema at baseline and at follow-up after 2 days, and subjective discomfort was likewise assessed. Study B was performed in the same way; however, in order to induce an experimental irritant contact dermatitis, sodium lauryl sulfate patch tests were applied to forearms before exposure to ACHD and ABHR.. In both studies, the skin barrier function was unaffected after repetitive exposure to ACHD and ABHR, and with no significant differences between the products. Subjective discomfort was reported as sporadic or very mild in relation to both products.. Our results illustrate that use of ACHD does not affect the skin barrier function negatively, neither in intact skin nor in skin with experimentally induced contact dermatitis. Future studies should include real-life evaluation of skin barrier function and subjective discomfort following ACHD use in individuals with and without hand eczema.

Topics: Adult; Chlorine; Disinfectants; Eczema; Hand Sanitizers; Humans; Sodium Dodecyl Sulfate; Water Loss, Insensible

Hand eczema (HE) is a multifactorial disease, comprising different aetiological conditions and different morphologies. There are two aetiologically distinct groups of HE recognised: exogenous, such as contact dermatitis (allergic and/or irritant HE) and endogenous, such as the classic hyperkeratotic HE. Differences in the skin barrier properties of these two conditions could theoretically be expected.. To examine whether differences exist in the lipid profile and the susceptibility of the stratum corneum (SC) in patients with allergic/irritant HE and those with hyperkeratotic HE.. Using cyanoacrylate, SC samples were taken from 23 patients with allergic/irritant HE and 15 with hyperkeratotic HE for lipid analysis by high-performance thin-layer chromatography (HPTLC). Samples were also taken from adjacent, unaffected skin. Severity of HE was assessed by the Hand Eczema Severity Index (HECSI), and skin barrier susceptibility was assessed by measuring transepidermal water loss (TEWL) after a 24-hour patch test with sodium lauryl sulfate (SLS).. No statistically significant difference was found between groups for the lipid analysis or for skin susceptibility to SLS. We found a significantly higher HECSI score for hyperkeratotic HE compared with irritant or allergic HE (P = 0.02).. There appears to be no difference in skin barrier between allergic/irritant HE (exogenous eczema) and hyperkeratotic HE (endogenous eczema) with regard to SC lipids or susceptibility to SLS.

Topics: Adult; Aged; Ceramides; Chromatography, High Pressure Liquid; Eczema; Epidermis; Female; Hand Dermatoses; Humans; Irritants; Keratosis; Male; Middle Aged; Patch Tests; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible; Young Adult

Exposure to humid environments/water and prolonged glove occlusion are both believed to cause irritant contact dermatitis.. To study the effects of different forms of wet work, especially the differences between water exposure and occlusion, by using an experimental model simulating occupational wet work.. The responses to water exposure and occlusion over multiple daily exposure periods for 7 days were compared in 73 volunteers. After the 1 week exposure, the sites were irritated with sodium lauryl sulfate (SLS). Comparison was performed via visual inspection and bioengineering methods.. Whereas occlusion did not induce measurable alterations in skin physiology, water exposure for more than 3 hr daily caused a significant increase in transepidermal water loss (TEWL) as compared with the control areas. SLS irritation of the previously occluded and the water-exposed sites induced higher TEWL and clinical scores in a time-dependent fashion as compared with the control areas, with more pronounced reactions in the water-exposed sites than in the occluded sites.. Both previous occlusion and water exposure were capable of inducing higher susceptibility to SLS irritation. Skin hydration by occlusion had a different biological effect than water exposure. Short occlusions seem to harm the skin less than water exposure for the same duration.

Topics: Adult; Dermatitis, Irritant; Dermatitis, Occupational; Eczema; Female; Gloves, Protective; Humans; Male; Skin; Sodium Dodecyl Sulfate; Time Factors; Water; Water Loss, Insensible

Alitretinoin is a new drug for systemic treatment of chronic hand eczema. Previous functional tests of skin topically treated with retinoids have indicated impaired skin barrier function, but no data are available on barrier parameters after systemic alitretinoin treatment. To investigate the effect of systemic alitretinoin on skin barrier function and response to irritants, a secondary objective was to determine if changes occur in the lipid profile of stratum corneum after treatment with systemic alitretinoin. We conducted an open clinical intervention study on eight people ascribed to systemic alitretinoin treatment. The criteria for being ascribed to alitretinoin were chronic hand eczema and insufficient therapeutic response to potent topical corticosteroids. Before initiation and after 2 months of systemic treatment with 30 mg alitretinoin, a challenge with sodium lauryl sulphate (SLS) was performed on the volar forearm and evaluated by trans-epidermal water loss (TEWL), erythema, and a cyanoacrylate skin sample was obtained for lipid analysis. We found no significant changes in response to SLS irritation as evaluated by TEWL and erythema, after treatment with alitretinoin for 2 months. No significant changes in stratum corneum lipids were found after 2 months of treatment. In conclusion, systemic alitretinoin does not influence skin susceptibility to irritants or the ceramide profile of stratum corneum.

Topics: Alitretinoin; Ceramides; Chronic Disease; Disease Progression; Eczema; Epidermis; Erythema; Humans; Irritants; Retinoids; Sodium Dodecyl Sulfate; Tretinoin; Water Loss, Insensible

Identification of subjects at risk for contact dermatitis by screening tests is desirable in order to adjust the preventive measures to individual skin susceptibility. The present study aimed to examine the effects of basic physiological features, such as baseline electrical impedance (IMP) and transepidermal water loss (TEWL), on reactivity to sodium lauryl sulphate (SLS).. On the basis of two previous studies, we re-evaluated the experimental irritant skin reactions (50 microL of 2% SLS in large Finn Chambers for 24 h) on the volar forearms of 29 patients with eczema and 19 healthy controls.. We found definite differences in the baseline values of IMP, between the patients and the controls. Moreover, patients with eczema showed higher TEWL and lower MIX values on day 3 after exposure to SLS, which may indicate differences in SLS reactivity. After the study, the biophysical parameters of the eczema patients did not return to baseline, which suggests that their skin heals more slowly than that of normal subjects.. Our findings indicate that the IMP technique may help to 'detect' chemically vulnerable skin. However, more studies are needed to determine the value of the basal electrical impedance parameters in assessing the risk of developing irritant contact dermatitis.

Topics: Adult; Aged; Eczema; Electric Impedance; Female; Humans; Irritants; Male; Middle Aged; Predictive Value of Tests; Reference Values; Skin; 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

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

It has been reported that occlusive treatment of irritated skin results in a reduction of barrier repair activities in hairless mice. In contrast, the clinically observed benefit of occlusion in the treatment of hand eczema and other chronic skin diseases with a perturbed barrier function is well-known. While the beneficial effect of occlusion has been proven for the treatment of psoriasis there are no controlled clinical studies of the effect of occlusion on irritated human skin. We have therefore evaluated the effect of various occlusive treatments on repair of the human skin permeability barrier under controlled experimental conditions. Barrier perturbation was induced either by application of sodium lauryl sulfate (SLS) or by repeated tape stripping. This was followed by treatment with different occlusive and semipermeable dressings, partly after pre-treatment with petrolatum. Repair of water barrier function was evaluated by daily measurements of transepidermal water loss (TEWL) for 1 week. SLS irritation and tape stripping led to a 6-fold increase in TEWL as a sign of severe water barrier perturbation, followed by a stepwise decrease over the following days. Occlusion did not significantly delay barrier repair as measured by TEWL. Only in tape-stripped skin did TEWL stay at high levels during treatment with self-adhesive dressings. This may be explained by damage of newly formed stratum corneum caused by changing of these membranes. Our results indicate that, in contrast to earlier observations in hairless mouse skin, permeability barrier repair activities are not significantly delayed by occlusive treatment in human skin.

Topics: Adult; Animals; Bandages; Chronic Disease; Dermatitis, Irritant; Eczema; Emollients; Female; Hand Dermatoses; Humans; Irritants; Male; Mice; Mice, Hairless; Middle Aged; Occlusive Dressings; Permeability; Petrolatum; Polyethylenes; Polytetrafluoroethylene; Polyurethanes; Psoriasis; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible; Wound Healing

The epidermal response to 2 different irritants, nonanoic acid (NAA) and sodium lauryl sulfate (SLS), was investigated with 2 different methods. NAA 80% and SLS 4% were applied under occlusion for up to 24 h. Elemental changes were determined in cryosections by x-ray microanalysis. Compared to unexposed skin a significantly higher sodium/potassium ratio was found after 6 h in NAA-exposed skin and a lower ratio in SLS-exposed. At 24 h both substances had induced similar changes, compatible with a cell injury. The findings demonstrate a time-dependent NAA and SLS response. With reverse transcription polymerase chain reaction, the mRNA expression of interleukin-1 alpha (IL-1 alpha), -1 beta (IL-1 beta), -6 (IL-6), and -8 (IL-8), tumor necrosis factor alpha (TNF alpha) and granulocyte macrophage colony stimulating factor (GM-CSF) in shave biopsies from irritated and unexposed skin was studied at 0. 4. 8 and 24 h. NAA, but not SLS, induced an increase in mRNA expression for IL-6 mRNA-expression for GM-CSF was increased after SLS exposure, but not after NAA. These findings indicate a time and substance dependent difference in the up-regulation of mRNA for different cytokines in epidermis during the first 24 h of the irritant reaction. This might be the effect of differences in the irritants action on the cell membranes, which is also reflected by the differences found in the elemental content at 6 h.

Topics: Adult; Biopsy; Cations; Cytokines; Dermatitis, Irritant; DNA Primers; Eczema; Electron Probe Microanalysis; Fatty Acids; Female; Humans; Irritants; Male; Polymerase Chain Reaction; RNA, Messenger; Skin; Sodium Dodecyl Sulfate

Ninety-seven patients suffering from a pruritic dermatosis were screened for the detection of bullous pemphigoid (BP) antibodies (ab) using the Western immunoblot (WB) analysis technique.. Twenty-four patients (25%) reacted at least twice with the BP antigen on WB analysis at a 1/10 dilution: seven had typical BP, four had papular BP, 10 had pruritus and prurigo of unknown origin, two had eczema, and one had lichen planus. This corresponds to 13% of BP-type ab in patients who did not fulfill criteria for BP. Therefore, we did the following: (1) tested a control group of 24 subjects; (2) assessed the reproducibility of the WB method by retesting the same serum samples on different epidermal extracts; and (3) estimated the BP ab titer. None of the 24 control subjects had detectable BP ab, and reproducible results were obtained in all groups when serum samples were retested at the 1/10 dilution. Although 86% (6/7) of patients with BP had BP ab titers of 1/100 or greater, only 60% (6/10) of the group with pruritus and prurigo and 33% (1/3) of the group with eczema reached such titers.. These results indicate that due to its sensitivity, the WB method can detect low titers of BP ab in patients with pruritic dermatoses who did not fulfill criteria for BP, and therefore we question the specificity of this method.

Topics: Adult; Aged; Aged, 80 and over; Antibodies; Blotting, Western; Eczema; Electrophoresis, Polyacrylamide Gel; Epitopes; Female; Fluorescent Antibody Technique; Follow-Up Studies; Humans; Keratinocytes; Lichen Planus; Male; Middle Aged; Pemphigoid, Bullous; Prurigo; Pruritus; Reproducibility of Results; Skin; Sodium Dodecyl Sulfate

Basic physiological characteristics were examined in the uninvolved skin of 39 patients with hand eczema and in 39 healthy controls. Susceptibility to sodium lauryl sulphate (SLS)-induced irritant dermatitis was evaluated by the application of a single 24-h SLS patch test to the upper arm. Transepidermal water loss (TEWL) was measured by an evaporimeter, skin thickness by ultrasound A-scan, blood flow by laser-Doppler flowmetry and skin colour by a chroma meter using the L*a*b* system of the Commission Internationale de l'Eclairage (CIE). No difference in basal TEWL values was found between patients and controls. A decreased skin thickness was found in those with hand eczema as compared to the controls. The hand eczema patients had significantly increased L* and decreased b*-values compared to controls, indicating a more 'fair' skin. Susceptibility to SLS was increased only in patients with acute eczema, indicating that the presence of an active eczema increases the reactivity to irritants of distant uninvolved skin.

Topics: Acute Disease; Adult; Body Water; Color; Dermatitis, Contact; Eczema; Female; Hand Dermatoses; Humans; Male; Middle Aged; Patch Tests; Regional Blood Flow; Skin; Sodium Dodecyl Sulfate

Topics: Age Factors; Aged; Cold Temperature; Dermatitis, Contact; Eczema; Fatty Acids; Humans; Middle Aged; Seasons; Skin Physiological Phenomena; Sodium Dodecyl Sulfate

Minimum eliciting levels of nickel have been estimated in 25 nickel-sensitive subjects, and of chromium in 14 chromium-sensitive subjects by patch tests with aqueous solutions of the respective metals. The minimum level of each metal required to provoke a patch test reaction was considerably greater than that found in fabric washing powder solutions and was in the majority of patients tested of the order of 112 ppm nickel (0.05% nickel sulphate) or 885 ppm hexavalent chromium (0.25% potassium dichromate). One nickel-sensitive subject and one chromium-sensitive subject reacted to 1 ppm of the respective metal. Fabric washing powder did not significantly alter the patch test reaction to nickel sulphate or provoke reactions in nickel- or chromium-sensitive subjects. EDTA significantly reduced the number and severity of patch test reactions to nickel sulphate but not those to potassium dichromate or trivalent chromium.

Topics: Chlorides; Chromates; Chromium; Chromium Compounds; Dermatitis, Contact; Detergents; Eczema; Edetic Acid; Female; Hand Dermatoses; Humans; Male; Nickel; Patch Tests; Potassium Dichromate; Sodium Dodecyl Sulfate; Surface-Active Agents; Water

Allergens eliciting weak positive reactions were retested to ascertain their reproducibility. Weak positive patch test reactions, concomitant to other weak or strong positive reactions, were retested after 3 weeks in 61 patients. 79 reactions were retested; 35 (44.3%) were negative. Allergens which are marginal irritants, e.g., formaldehyde, often gave weak positive reactions which were lost at retesting. In patients without dermatitis but with several strong positive reactions, lost reactions were frequently encountered, suggesting that strong reactions induced a state of hyperirritability. False positive reactions were often found in the proximity of strong reactions. We attempted to develop a nonspecific irritant (sodium lauryl sulfate) as a hyperirritability marker. A correlation between the score of this test and false positive reactions was not found. It is concluded that weak positive reactions should not be accepted as a proof of sensitization. The allergens eliciting these reactions should be retested at a later date.

Topics: Adolescent; Adult; Aged; Dermatitis, Atopic; Dermatitis, Contact; Diagnosis, Differential; Eczema; Female; Humans; Male; Middle Aged; Patch Tests; Skin Tests; Sodium Dodecyl Sulfate

Topics: Adolescent; Adult; Aged; Benzalkonium Compounds; Cantharidin; Eczema; Female; Hand Dermatoses; Humans; Hydrochloric Acid; Irritants; Male; Mercury; Middle Aged; Patch Tests; Phenols; Skin Tests; Sodium Dodecyl Sulfate; Trichloroacetic Acid

Topics: Acetone; Dermatitis, Contact; Dermatitis, Occupational; Dermatitis, Toxicodendron; Drug Eruptions; Eczema; Humans; Hydrochloric Acid; Hydrogen-Ion Concentration; Hydroxides; Irritants; Lipids; Nitrates; Permeability; Potassium; Skin; Skin Absorption; Skin Diseases; Skin Tests; Sodium Dodecyl Sulfate; Sodium Hydroxide; Solubility; Sweating; Turpentine

Topics: Adult; Benzalkonium Compounds; Cantharidin; Croton Oil; Drug Hypersensitivity; Eczema; Female; Hand Dermatoses; Humans; Hydrochloric Acid; Irritants; Male; Mercury; Middle Aged; Occupations; Phenols; Potassium; Saponins; Sex Factors; Skin; Skin Tests; Sodium Dodecyl Sulfate; Thigh; Trichloroacetic Acid