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: 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 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

The protective effect of sodium selenite (Na2SeO3) against the cytogenetic toxicity of heavy metals was investigated on human whole-blood cultures in relation to induction of sister chromatid exchange(SCE) in secondary metaphase chromosome. Methlmercury chloride (CH3HgCl), cadmium chloride (CdCl2), Potassium dichromate (K2Cr2O7), and sodium selenite caused to the typically dose-dependent increase in sister chromatid exchanges (SCEs) by the concentrations ranging from 0.3 micro M to 10 micro M. However, the inductions of sister chromatid exchanges by methymercury chloride or cadmium chloride were inhibited by the simultaneous addition of sodium selenite 1.2 micro M. The frequencies of SCE were decreased to the level of control in the molar ratios as 2 : 1, 1 : 1, 1 : 2, and 1 : 4 of selenium selenite vs. methylmercury chloride, and as 1 : 1 and 1 : 2 of selenium selenite vs. cadmium chloride, while the frequencies of SCE induced by potassium dichromate were not changed by the addition of sodium selenite in culture condition. Mitotic indices were decreased in the higher concentrations of chemicals and not significantly changed by the simultaneous addition of sodium selenite to the culture condition containing each chemicals.
Cadmium Chloride ; Chromatids ; Cytogenetics ; Humans* ; Lymphocytes* ; Metals, Heavy* ; Metaphase ; Mitotic Index ; Molar ; Potassium Dichromate ; Selenious Acid ; Selenium* ; Siblings ; Sister Chromatid Exchange ; Sodium Selenite

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

The author investigated the allergic contact dermatitis patients which visited our out-patient skin dispensary during 1969 and 1970. The patients were evaluated arcording to age, sex and cause of the disease. Furthermore, the patients were analysed as to the causative allergic contact factors by clinical inspection and history. The causes were confirmed by the patch test which was done on 88 of the allergic contact dermatitis patients. It is believed that patch test is clinically a most reliable procedure for the determination of responsible antigenic substance in allergic contact dermatitis and the positive reactions may be labelled as latent or potential hypersensitivity(Hjorth et al, 1968; Maibach, 1965). There is a group of chemicals used on the so-called routine screening patch test tray, which have proved to be frcquent causes of allergic contact dermatitis. Many diagnostic groups of chemicals and therapeutic trays, shoe trays, metal trays, etc., in addition to the standard routine screening patch test tray are used. Certain allergens seem to cause dermatitis in all countries hut many sensitizers vary from one country to anothcr (Calnan, 1955), The author has tried to establish a standard routine screening patch test tray fitted to our country according to the basic consideration used with standard routine patch test trays of the Skin and Cancer Unit, New York University Hospital. Paraphenylene diamine, ammoniated mercury, mercury bichloride, formalin, crude coal tar, potassium dichromate and mercaptobenzothiazole were the most potent sensitizers. These chemicals must be included in our standard screening routine patch test tray. However, the patch test results and the present clinical dermatitis (i.e. cosmetic dermatitis and rubber or leather dermatitis) did not coincide. Further investigation for the establishment of a proper stanard patch test tray for Korea should be carried out.
Allergens ; Coal Tar ; Dermatitis ; Dermatitis, Allergic Contact ; Formaldehyde ; Humans ; Korea* ; Mass Screening ; Mercuric Chloride ; Outpatients ; Patch Tests ; Potassium Dichromate ; Rubber ; Shoes ; Skin

The present work is the first joint epidermiological study of contact dermatitis carried out by the Korean Contact Dermatitis Research Group which was organized in 15i8p. For the past 2 years total 937 patients with contact dermatitie and suspected contact dermatitis have been routinely patch tested with Hollister-Stier standard battery (28 different antigens) by using Finn Chamber at 10 different General Hospitals which were located around Seoul area. The MOHL index was quite different from the western data, which was characterized with less male, rare leg ulcer and less occupational cases. However, housewife hand eczema cases were more common. The most common senaitiaers were ammoniated mercury, nickel sulfate, potassium dichromate, cinnamic alcohol, neomycin sulfate, paraphenylendiamine, balsam of Peru and thimerosal in order of frequency.
Dermatitis, Contact* ; Eczema ; Epidemiology ; Hand ; Hospitals, General ; Humans ; Joints ; Leg Ulcer ; Male ; Neomycin ; Nickel ; Patch Tests ; Peru ; Potassium Dichromate ; Seoul ; Thimerosal

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

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