Clinical history and dermatological examinations were performed in 51 patients with contact dermatitis due to metal working fluid who were working at the metal industry. Patch tests were also performed with standard series and oil cooling fluid series. Chronic lichenified eczema such as lichenified and fissured was the most common clinical type(45.1%). 19 patients had positive reaction to either one or more of the standard series and oil & cooling fluid series. We found ammoniated mercury chloride was the most common sensitizer in standard series, followed by potassium dichromate, 4-phenylendiamine dihydrochloride, cobalt chloride, nickel sulfate, quinoline mix and cabra mix. Microbiocide was the most common allergen(4 of 6 positive result in oil & cooling fluid series.
Cobalt ; Dermatitis, Contact* ; Eczema ; Humans ; Nickel ; Patch Tests ; Potassium Dichromate

BACKGROUND: Spectacle contact allergy is not infrequent. The fine scratches on the spectacle frames which may play a role in the sensitization to the potential allergenic components have not been studied. OBJECTIVE: We sought the relationship between the scratches on the spectacle frames and the allergic contact dermatitis (ACD) in the Republic of Korea. METHODS: A total of 42 Korean patients with ACD at the spectacle contact sites were enrolled. Their spectacle frames were examined with the dimethylglyoxime (DMG) test and analyzed by the scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Patch tests (thin-layer rapid use epicutaneous test [TRUE tests]) were performed to identify the skin allergens. RESULTS: The DMG-positive spectacle frames were identified in 78.5% of the frames. The SEM results showed that there were more scratches on the skin-contacting parts of the spectacle frames than the non-skin-contacting parts of the same frames. In the EDS findings, the mean nickel content (weight, %) of the spectacle frames was 15.7+/-5.5, and the mean chromium content was 20.3+/-3.4 at the skin-contacting parts. In the TRUE tests, nickel sulphate was the most common allergen (31 cases, 73.8%), and potassium dichromate was the second (9 cases, 21.4%). Three patients presented simultaneous positive reactions with nickel sulphate and potassium dichromate. CONCLUSION: Minor visible and non-visible fine scratches on the spectacle frames may present the provocation factors of the ACD. Nickel sulphate was the most common allergen suspected of provoking the spectacle frame-induced ACD, followed by potassium dichromate.
Chromium ; Dermatitis, Allergic Contact ; Humans ; Hypersensitivity ; Microscopy, Electron, Scanning ; Nickel ; Oximes ; Patch Tests ; Potassium ; Potassium Dichromate ; Skin ; Spectrum Analysis

BACKGROUND AND OBJECTIVE: : ?The etiology of atopic dermatitis is still not clear. Atopic dermatitis is known to develop through immunological and non-immunological pathomechanisms. The delayed hyper- sensitivity reaction in atopic dermatitis has been reported as decreasing due to disturbance of cellular immunity. However, in recent days, there is a dispute as to whether disturbed epidermal barrier of atopic dermatitis could elicit a delayed type hypersensitivity reaction by an acceleration in the penetration of allergen. The aim of this study was to determine whether transepidermal water loss (TEWL) increased in atopic dermatitis, and whether the TEWL differed with a presence of delayed type-skin reaction. In addition, the prevalence of positive patch test reaction and TEWL were measured in atopic dermatitis and normal controls. METHODS: We performed the patch test with 24 Korean standard allergens and 5 aeroallergens on 38 atopic dermatitis patients. TEWL was measured using DermaLab (Cortex technology, Denmark) on 38 patients with atopic dermatitis and 40 normal controls. RESULTS: 17 (44.7%) patients with atopic dermatitis had positive reactions on the patch test. The frequency of positive allergens was in the following order: nickel sulfate (18.4%), thimerosal (15.8%), D. pteronyssinus (15.8%), and potassium dichromate (13.1%). TEWL values of both clinically normal skin and eczematous skin in atopic dermatitis patients were higher than those of normal controls. There was no statistically significant difference in TEWL values of normal skin of atopic dermatitis between the positive patch test and negative patch test groups. In positive reaction sites of aeroallergen patch test, the TEWL increased in comparison with both the control site and the positive classical patch test reaction site but it was not statistically significant. CONCLUSION: These results revealed that epidermal barrier is disturbed in atopic patients and suggested that various allergens might easily penetrate the skin to induce the delayed-type hypersensitivity reaction.
Acceleration ; Allergens ; Dermatitis, Atopic* ; Dissent and Disputes ; Humans ; Hypersensitivity ; Immunity, Cellular ; Nickel ; Patch Tests* ; Potassium Dichromate ; Prevalence ; Skin* ; Thimerosal

BACKGROUND: With the growing use of cosmetics such as skin care products, toiletries, makeup products, fragrance on an expanding population, reports of unwanted side effects following application of these products is increasing. Allergic contact dermatitis commonly occurs with the use of cosmetics. However, treatment is extremely difficult without knowing the exact causative agent. Therefore, it is important to detect and clarify such agents in order to treat and ultimately prevent allergic contact dermatitis. OBJECTIVE: We attempted to find the popular causative factors of allergic contact dermatitis, especially within cosmetics, and compare the findings with previous Korean and international reports involving allergic contact dermatitis. METHODS: Patch test results of 332 patients suspected of having allergic contact dermatitis related to cosmetics were reviewed. The patients visited 3 hospitals in the Catholic medical center in Korea between 2000 and 2003. The patch tests adopted were of the standard series, cosmetic series, and test samples made from the patient's own cosmetics. RESULTS: The results of this study are summarized as follows; 1. Among allergens of the standard series, nickel sulfate induced the highest positive patch test results (30.5%) within the 321 patients who were tested followed by potassium dichromate, thimerosal and cobalt chloride. 2. Thimerosal showed the highest positive patch test rate (9.2%), followed by octyl gallate and t-butylhydroquinone in a cosmetic series patch test study with 109 patient. 3. A trial patch test with cosmetics from our own patients was made. Among the type of cosmetics to induce a positive patch test, skin care products constituted 47.8%, marking the highest proportion. However, toiletries were the most potent in inducing a positive test result. 4. Correlated to the patch test results from previous Korean and international studies, skin care products most commonly caused allergic contact dermatitis as in our study. However, personal cleanliness products were more common in causing allergic contact dermatitis in our study than in previous Korean and international studies. CONCLUSION: Although skin care products are most prevalent in causing allergic contact dermatitis, the prevalence of allergic contact dermatitis due to toiletries is increasing. This was a clear contrast to the result of previous Korean and international studies. The possibility of allergic contact dermatitis due to toiletries should not be overlooked.
Allergens ; Cobalt ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Humans ; Korea ; Nickel ; Patch Tests* ; Potassium Dichromate ; Prevalence ; Skin Care ; Thimerosal

BACKGROUND: Lichen simplex chronicus (LSC) may develop under various chronic pruritic conditions, such as allergic contact dermatitis (ACD). However, there have been only a few studies on the relationship between ACD and the development of LSC. OBJECTIVE: To investigate the clinical features and frequency of contact sensitization in patients with LSC. METHOD: In a retrospective study, 71 patients with LSC, who had shown resistance to conventional treatment and had been examined with patch tests in the Korean standard series, were evaluated for their clinical features and results of the patch testing. RESULTS: 1. The patients comprised of 32 males and 39 females. The mean age was 51.8 (19-80) years, and the highest incidence was shown in the 50-60 year age range. The predominant sites of the dermatitis were the trunk (25.4%), arms (16.7%), widespread on the body (14.7%), the scalp (9.8%) and the neck (9.8%). 2. Sixty five (91.5%) out of 71 patients showed a positive reaction to one or more allergens. The highest sensitization rates were found with: nickel sulfate (38%), balsam of Peru (25.6%), 4-phenylenediamine base (23.9%), fragrance mix (22.5%), mercury ammonium chloride (18.3%), cobalt chloride (18.3%) and potassium dichromate (15.5%). CONCLUSION: This study shows that contact sensitization may possibly play an etiologic role in the development of LSC, and there are some dominant allergens, including nickel, 4-phenylenediamine, balsam of Peru and fragrance mix. Therefore, when LSC is resistant to conventional treatment, it is important to carry out patch testing, and to bear in mind the possibility of ACD contributing to the development of LSC.
Allergens ; Ammonium Chloride ; Arm ; Cobalt ; Dermatitis ; Dermatitis, Allergic Contact ; Female ; Humans ; Incidence ; Lichens* ; Male ; Neck ; Neurodermatitis* ; Nickel ; Patch Tests* ; Peru ; Potassium Dichromate ; Retrospective Studies ; Scalp

BACKGROUND: Chromium is one of the most common metal allergens that cause allergic contact dermatitis. European regulation of chromium (VI) content in cement was first implemented in 2005, and regulation of chromium in leather in 2015. OBJECTIVE: This clinical study was performed to obtain basic data on subjects with allergic contact dermatitis due to chromium in Korea. We investigated the clinical characteristics of patients with chromium allergy among subjects with contact dermatitis who underwent patch tests. METHODS: Patch test data from June 1998 to January 2014 were retrospectively analyzed (n=975; men=290, women=685). Patients who showed positive reactions to potassium dichromate (chromium [+] group; n=58) and who showed positive reactions to other allergens except potassium dichromate (others [+] group; n=497) were identified and the characteristics of both groups were compared. Patients who only reacted to chromium (only chromium group; n=17) were identified, and their clinical characteristics were investigated. The prevalence of chromium allergy was analyzed in each 4-year period to study the changes over time. RESULTS: The sensitization rate of potassium dichromate was 5.9% (n=58) and women comprised 72.4% (n=42) of the chromium (+) group. Hands and feet were more frequently affected in the chromium (+) group (p=0.002 and 0.019, respectively). Occupational dermatitis was significantly less common in the chromium (+) group. Chromium allergy was the most prevalent in patients in their 50s (8.4%). The only chromium group had significantly more number of patients aged 40 years or older (p=0.004). The prevalence of chromium allergy was 13.5% during 1998~2002, but decreased to 5.4% during 2010~2014. CONCLUSION: The characteristics of patients with chromium allergy suggests that chromium exposure in daily activities, including leather exposure, is more relevant than occupational exposure for most patients. The prevalence of chromium allergy has been decreasing in Korea, which may be an effect of voluntary regulation of chromium content in cement by manufacturers.
Allergens ; Chromium* ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Dermatitis, Occupational ; Female ; Foot ; Hand ; Humans ; Hypersensitivity* ; Korea* ; Occupational Exposure ; Patch Tests ; Potassium Dichromate ; Prevalence ; Retrospective Studies

Studies on epidemiological aspects of contact dermatitis have been published in recent years since the introduction of standardized method of patch test.However, most previous epidemiologic reports studied patients with allergic contact dermatitis in hospitals with patcb testing. Such data are not directly applicable to the population at large. Very recentiy there are a few reports ahout rates of exposure and patch test reactivity to certain antigens in a general population. which is difficult to be applicable in a developing country at present. With regard to this, we have tried to analyze the contact dermatitis questionaire containing various items of common causative agents producting contact dermatitis (for example, metals, cosmetics, plants, medicaments and rubber etc.) for the detection of past contact dermatitis histories in a total new dermatologic outpatients. A11 2258 dermatologic outpatients entered this study including 303 contact dermatitis patients (allergic contact dermatitis, primary irritant dermatitis and housewife eczema). We also analyzed the patch test results of 107 patients with suggesting contact dermatitis who visited our hospital at the same period of collecting questionaires. The study results were as follows. 1. Positive rate of each item of the questionaire (No. of said Yes/ No. of responders) was metals, 10.4% cosmetics, 31.8%, plants, 18.2%; medicaments, 12.4%; rubber, 5.8%; and others, 11.7%. 2. The most common all regens of the patch test positive reactions were nickel sulfate (9.3%), fragrance mix(9.3%), formaldehyde(6.5%), potassium dichromate (5.6%), neomycin sulfate (5.6%), balsam of Peru (4.7%), cobalt chloride(3.7%), wood tar(3.7%) and paraphenylene diamine (2.8%) in order of frequency. And the patch test positive rate of commercial cosmetic products was 10.3%. In conclusion, cosmetics, medicaments, metals, plants and rarely rubber are found the most common etiologic agents of contact dermatitis in this study. The reasons and back-ground of the results were also discussed in various aspects.
Cobalt ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Dermatitis, Irritant ; Developing Countries ; Epidemiologic Studies* ; Humans ; Metals ; Neomycin ; Nickel ; Outpatients ; Patch Tests ; Peru ; Potassium Dichromate ; Rubber ; Wood

BACKGROUND: Hairdressers are individuals at high risk of occupational skin disease, especially occupational allergic contact dermatitis (OACD), because of continuous exposure to water, detergents, hair dyes and bleaches, permanent wave solutions and metal equipment. OBJECTIVE: We evaluated the frequency of OACD among hairdressers and the sources of sensitization through patch test and questionnaires. METHODS: We analyzed the occupational characteristics (age, gender, duration of work), site of dermatitis, suspicious sensitizers, and use of preventive measures in a group of 96 hairdressers who answered a questionnaire. Among them, 61 hairdressers who were suspected of having occupational allergic contact dermatitis were patch-tested with the Korean standard series and hairdressing series. RESULTS: Among 96 hairdressers, 74 hairdressers (78%) responded with their experiences of work-related skin problems. The results of patch test revealed an occupationally-relevant sensitization in 82% of the 61 hairdressers. Mean frequencies of sensitization ranked as follows: nickel sulfate (37.7%), cobalt chloride (34.4%), paraphenylenediamine base (21.3%), thimerosal (11.5%), potassium dichromate (9.8%), mercury ammonium chloride (8.2%), Balsam Peru (6.6%), glyceryl monothioglycolate (4.9%), and fragrance mix (4.9%). We also classified these allergens as hairdressing agents, and hair dye showed the highest frequency of positive reactions (30%). CONCLUSION: From this study, we were able to unravel the important sensitizers related to the hairdressing profession. To improve the safety of their job and to the prevent occupational allergic contact dermatitis, hairdressers should be aware of these common sensitizers, and try to improve protective measures and their applications.
Allergens ; Ammonium Chloride ; Cobalt ; Dermatitis ; Dermatitis, Allergic Contact ; Detergents ; Hair ; Hair Dyes ; Nickel ; Patch Tests* ; Peru ; Potassium Dichromate ; Skin Diseases* ; Skin* ; Thimerosal

BACKGROUND: A number of skin manifestations in patients with allergic contact dermatitis result from sensitization with specific allergens. The patch test is a primary diagnostic tool for identifying allergens causing allergic contact dermatitis. OBJECTIVE: We identified the results of patch test with Korean standard series in patients with clinically diagnosed with contact dermatitis, and evaluated the specific relationship with each allergen. METHODS: During a 5-year period, 743 patients were examined with patch test of standard Korean series. The results of patch test were then evaluated. Location of the skin lesion, age, sex, and occupation of the patients were completely reviewed. RESULTS: Overall, 68.5% of patients had at least one positive reaction and 43.6% of patients had two or more positive reactions. Allergens most frequently causing positive reactions were nickel sulfate (27.1%), cobalt chloride (22.1%), potassium dichromate (17.9%), mercuric ammonium chloride (13.8%), and 4-phenyledediamine base (10.2%). Those patients in their 10s and 40s showed the highest rate of positive reaction. Metal allergens displayed higher positive rates than any other standard allergens. Of 201 patients who showed positive reaction to nickel, 37.8% and 27.3% of them also showed positive reaction to cobalt and chromium, respectively, representing concomitant reactions between metal-related antigens. In addition, polysensitization to cosmetics-related antigens including balsam peru and fragnance mix was evident. CONCLUSION: There was no significant difference in overall positive rate in patch test results compared with recent studies. However, we confirmed that metal-related allergens remain most common, and that multiple contact allergy were relatively common.
Allergens ; Ammonia ; Ammonium Chloride ; Chromium ; Cobalt ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Humans ; Hypersensitivity ; Mercuric Chloride ; Nickel ; Occupations ; Patch Tests ; Peru ; Potassium Dichromate ; Skin ; Skin Manifestations

Chromium is a transition metal and has been shown to elicit contact dermatitis. Although leather products have been known to be the most significant source of chromium exposure these days, the majority of reports have been related to exposure from shoe products. We herein report a professional golfer who became allergic to golf gloves made of chromium-tanned leather. A 27-year-old woman golfer presented with recurrent, pruritic, erythematous plaques that had been occurring on both hands for several years. The lesions developed whenever she had worn golf gloves for an extended period of time, especially during tournament season. To identify the causative agent, patch tests were performed and the results demonstrated a strong positive reaction to potassium dichromate 0.5% and to her own glove. The amount of chromium in her golf glove was analyzed to be 308.91 ppm and based on this, a diagnosis of allergic contact dermatitis due to a chromium-tanned leather glove was made. She was treated with oral antihistamines combined with topical steroids and advised to wear chromium-free leather gloves. There has been no evidence of recurrence during a six month follow-up period.
Adult ; Chromium ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Female ; Follow-Up Studies ; Golf ; Hand ; Histamine Antagonists ; Humans ; Patch Tests ; Potassium Dichromate ; Recurrence ; Seasons ; Shoes ; Steroids ; Tanning