Allergic contact dermatitis reactivity

The interaction of a chemical (hapten) with epidermal proteins (carrier) can result in a hapten-carrier complex capable of activating skin-associated lymphoid tissue (sensitisation) and dissemination of antigen-specific T l)unphocytes (induction). Subsequent encoimter with the same or cross-reactive chemicals can result in the elicitation of a characteristic inflammatory skin reaction. The clinical condition is referred to as allergic contact dermatitis and is characterised by erythema, oedema, vesiculation and pruritus. Allergic contact sensitisation is, therefore, classed as a cell-mediated immunological response to chemicals that contact and penetrate the skin. 

Karlberg, A.T., Bergstrom, M.A., Borje, A., Luthman, K. and Nilsson, J.L. (2008) Allergic contact dermatitis — formation, structural requirements, and reactivity of skin sensitizers. Chem. Res. Toxicol., 21 (1), 53-69. 

Isaksson M, Bruze M. Allergic contact dermatitis in response to budesonide reactivated by inhalation of the allergen. J Am Acad Dermatol 2002 46(6) 880-5. 

The methods for assessing reactivity previously outlined are simple, convenient, inexpensive, and noninvasive or minimally invasive 6 However, cutaneous reactivity depends on many factors. None of the previous methods give a full picture of the characteristics of sensitive skin, only susceptibility of skin to irritants. Subtle manifestations of endogenous cutaneous conditions must still be clinically excluded. Exclusion of allergic contact dermatitis must still be performed by patch testing, exclusion of contact urticaria by open tests or PUT/ROAT, and exclusion of photoallergy by photopatch testing. 

Taniguchi S, Kono T. Allergic contact dermatitis due to lanoconazole with no cross-reactivity to other imidazoles. Dermatology 1998 196(3) 366. 

Allergic contact dermatitis due to carteolol eye drops occurred in a 61-year-old woman (257). Withdrawal of carteolol and the use of timolol instead led to improvement within 10 days, suggesting that in some cases there is no cross-reactivity between different beta-blockers. 

Sanchez-Perez J, Lopez MP, De Vega Haro JM, Garcia-Diez A. Allergic contact dermatitis from gentamicin in eye-drops, with cross-reactivity to kanamycin but not neomycin. Contact Dermatitis 2001 44(1) 54. 

There have been a few reports of allergic contact dermatitis caused by phenylephrine, and little is known about cross-reactivity between the phenylephrine, adrenaline, and ephedrine. 

Moulon C, Vollmer J, Weltzien HU. Characterization of processing requirements and metal cross-reactivities in T cell clones from patients with allergic contact dermatitis to nickel. Eur J Immunol. 1995 25 3308-3315. 

In a study of allergic contact dermatitis in consumers, 1813 consecutive patients were tested with an additional textile series of 12 reactive dyes, and 18 patients (0.99%) were found to be sensitized to reactive dyes. However, only five patients had a history of intolerance to garments, and two of the four patch tests performed with pieces of garment were positive. In practice, reactive dyes in clothing should not be sensitizers. If they can be extracted from fibers, they are in a hydrolyzed, nonsensitizing form. 

Key words Skin sensitization, Contact allergy, Allergic contact dermatitis, Local lymph node assay, In vitro alternatives, Direct peptide reactivity assay, KeratinoSens, Human cell line activation test... 

There is a large number of chemicals that is able to cause allergy in susceptible individuals. Many of these are associated with skin sensitization or allergic contact dermatitis. Contact allergens are chemicals that can gain access to the viable epidermis and that are protein-reactive (or are converted metabolically to protein-reactive species) such that they can form immunogenic complexes and stimulate a... 

CHRONIC HEALTH RISKS reactive airways dysfunction syndrome (RADS), referring to asthma persisting after exposure to irritants persistence of respiratory symptoms and airway hyper-reactivity for at least 3 months symptoms simulating asthma, with cough, wheezing, and dyspnea prolonged exposure has been associated with allergic contact dermatitis repeated exposure to wood dust and other irritants has contributed to risk of sinonasal neoplasms (nasal cancer). 

Reports of allergic contact dermatitis to topical creams containing guggul have been confirmed by patch testing. In one case, the patient was also sensitive to nickel and cobalt (Kolonte et al. 2006 Salavert et al. 2007). Cross-reactivity to... 

Armisen, M., V. Rodriguez, and C. Vidal. 2003. Photoaggravated allergic contact dermatitis due to Rosmarinus officinalis cross-reactive with Thymus vulgaris. Contact Dermat. 48(l) 52-53. Bakirel, T., U. Bakirel, O.U. Keles, S.G. Ulgen, and H. Yardibi. 2008. In vivo assessment of antidiabetic and antioxidant activities of rosemary Rosmarinus officinalis) in alloxan-diabetic rabbits. /. Ethnopharmacol. 116(l) 64-73. 

However, it is also known that, DGEBA epoxy resin, amine hardeners, dicarboxylic (phthalic) anhydride hardeners, and reactive epoxy diluents are all common causes of allergic contact dermatitis. And since all are health hazard causing organic pollutants, no remnants should be left in the composite, and must be decreased or avoided completely [73, 74]. 

As already mentioned, the thiol reactivity of fluazinam results in very low mammalian toxicity, with an acute oral LD50 for rats of >5000 mg kg [205]. However, its thiol reactivity does create some issues and is likely to be the cause of the skin sensitization effect of fluazinam. In cases of repeated exposure this can result in the development of allergic contact dermatitis in sensitive individuals [49-51]. 

Schauder S, Ippen H (1997) Contact and photocontact sensitivity to sunscreens. Contact Dermatitis 37 221-232 Scheinman PL (1996) Allergic contact dermatitis to fragrance a review. Am J Contact Dermat 7 65-76 Schleuter DP (1978) Airway reponse to hair spray in normal subjects and subjects with hyper-reactive airways. Chest... 

Palladium is used in the electronics and chemical industries, but there are no convincing case reports on work-related allergic contact dermatitis. Instead, the exposure has mainly been from jewelry and dental alloys (Aberer et al. 1993). The majority of patch-test positive patients show concomitant reactivity to nickel this has been interpreted as a sign of cross-reactivity. Patients who patch-test positive to palladium chloride rarely react when tested with palladium discs (Todd and Burrows 1992 de Fine Olivarius and Menne 1992). Palladium chloride is a potent sensitizer in the guinea pig, and animals induced with palladium chloride also react to nickel at patch testing (Wahlberg and Boman 1992). 

Conde-Salazar L, Gorospe M, Guimaraens D (1993) A new source of sensitivity to epoxy resin. Contact Dermatitis 28 292 Conde-Salazar L, Conzalez de Domingo MA, Guimaraens D (1994) Sensitization to epoxy resin system in special flooring workers. Contact Dermatitis 31 157-160 Dahlquist I, Fregert S (1979) Allergic contact dermatitis from volatile epoxy hardeners and reactive diluents. Contact Dermatitis 5 406-407... 

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