Irritation subclinical

Charbonnier, V., Morrison, B.M., Paye, M., and Maibach, H.I. Open application assay in investigation of subclinical irritant dermatitis induced by sodium lauryl sulfate (SLS) in man advantage of squamometry. Skin Res. Technol. 4, 244-250 (1998). 

Wilhelm, K.P., Pasche, F., Surber, C., and Maibach, H.I., Sodium hydroxide- duced subclinical irritation, Acfa Derm. Venereol., 70, 463, 1990. 

Before confirming a diagnosis of subjective irritation, patients must be patch tested and open tested to exclude allergic contact dermatitis and contact urticaria, respectively. Subclinical contact urticaria, in particular, mimics sensory irritation. 

Eye and throat irritation has been reported in humans. Independent of the exposure route, the lung appears to be a major target organ resulting in cough, dyspnea, and chest pains. Headache and nausea are common after exposure. Exposed workers have developed reversible subclinical elevations of liver function tests and reversible proteinuria. Skin irritation and blistering may occur from direct contact with liquid hexachlorocyclopentadiene, and skin contact with vapor has been reported to result in skin irritation. Reported human cases have generally been mild. 

Blood lead levels of 25-60 mcg/dL may be associated with headache, irritability, difficulty concentrating, slowed reaction time, and other neuropsychiatric effects. Anemia may occur, and subclinical slowing of motor nerve conduction may be detectable. 

Irritant-reaction ICD is a type of subclinical irritant dermatitis in individuals exposed to wet work, including hairdressers and metal workers, during their first months of training. This diagnosis is made if the clinical picture is monomorphic rather than polymorphic and is characterised by one or more of the following signs scaling, redness, vesicles, pustules and erosions (Frosch 1995). 

Nonerythematous ICD may be defined as a subclinical form of ICD with early stages of skin irritation characterised only by changes in the stratum-corneum barrier function without a clinical correlation (van der Valk et al. 1985 Berardesca and Maibach 1988 Lammintausta et al. 1988). 

Lee CH, Maibach HI (1994) Study of cumulative irritant contact dermatitis in man utilizing open application on subclinically irritated skin. Contact Dermatitis 30 271-275 Malten KE (1981) Thoughts on irritant contact dermatitis. Contact Dermatitis 7 238-247... 

Low humidity of the air is believed to cause dehydration of the horny layer and impairment of the epidermal barrier function (Agner and Serup 1989), i.e., increased irritability of the skin. Subclinical xerotic changes may occur within hours of exposure and are more pronounced in atopies (Eberlein-Konig et al. 1996). 

It may be argued that the patch tests are positive because the skin is in a state of hyper-reactivity termed excited-skin syndrome or angry back (Bruynzeel and Maibach 1995). This may lead to strong positive reactions to patch tests of minor irritants or subclinical or weak allergens. Authors who report compound allergies, such as Cox et al. (1989) or Kellett et al. (1986), have eliminated this as far as possible by repeating the patch tests 2 months later and obtaining another positive result. 

C. Tests for Faint Interactions Between Surfactants and the Stratum Corneum Subclinical Irritation... 

So far only acute adverse effects which could be readily associated with excessive lead exposure have been considered. However, studies on lead workers have elicited symptoms of lassitude, anorexia, abdominal discomfort, constipation, insomnia, irritability, pallor and anaemia - complaints which are common in the general population. The recent development of environmental and biological monitoring procedures, and of epidemiological methodology, now enables us to investigate non-specific and subclinical effects in relation to lead exposure with greater precision. 

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