Susceptibility to irritation

Held, E., Sveinsdottir, S., and Agner, T., Effect of long-term use of moisturizers on skin hydration, barrier function and susceptibility to irritants, Acta Derm. Venereol. (Stockh.), 79, 49, 1999. 

Wilhelm, K.P. and Maibach, H.I., Susceptibility to irritant dermatitis induced by sodium lauryl sulfate, J. Am. Acad. Dermatol., 23, 122-124, 1990. 

Persons who suffer from hepatic or renal insufficiency can become susceptible to ammonia toxicity. Toxicity from ammonia in these cases, however, results from endogenously produced ammonia. The limited systemic absorption of ammonia following inhalation exposure would be insignificant when compared with concentrations produced within the body (WHO 1986). Persons with hyperactive airway disease or other conditions that alter airway function (colds, cough, nasal congestion) are expected to be more susceptible to irritant effects of ammonia. 

Intranasal use of cromoglicate can cause sneezing and nasal congestion. There is nasal irritation in 35% of patients, swollen sore eyes in 17%, and a sore throat in 21%. The sensitive nasal mucosa can be susceptible to irritation by any nasal spray (6). 

Tretinoin is usually applied as a 0.05% polyethylene glycol (PEG)-400/ethanol liquid or a 0.05% hydrophilic cream. Daily application results in inflammation, erythema, and peeling of the skin. After 3 to 4 weeks. pu.stular eruptions may be seen, causing the expulsion of microcomedones. Treatment may then be changed to applications every 2 or 3 day.s. Because the homy layer is thinned, the skin is mote susceptible to irritation by chemical or physical abuse. Thus, it is recommended that other kerolytic agents (.salicylic, sulfur, resorcinol, benxoyl peroxide) be discontinued before beginning treatment with tretinoin. 

Oestrogen deficiency in postmenopausal women. This leads to thinning of the endometrial tissue with increased susceptibility to irritation and trauma and cystitis-like symptoms. It can be corrected by hormone replacement or topical oestrogen therapy. Vaginal lubricants can be used if symptoms are caused by intercourse. Honeymoon cystitis may occur in younger women as a consequence of increased sexual activity. 

Knowing that atopic patients are more susceptible to irritants, there should be an attempt to identify and remove the common irritants. Soaps, detergents, abrasive clothing, smoke, and exposure to extremes in temperature and humidity can be aggravating factors. Although UV light may be beneficial to some patients, sunscreens should be used to avoid sunburns. Care should be used in selection, as many chemical sunscreens can cause contact dermatitis. In... 

The iris is susceptible to irritation, resulting in leakage of serum proteins and leukocytes from the blood vessels. Chemicals that are sympathomimetic or parasympatholytic can dilate the pupil, while parasympathomimetic and sympatholytic chemicals can constrict the pupil. Certain mydriatics, such as atropine, can cause glaucoma by dilating the pupil, blocking drainage of the aqueous humor. 

The relationship between constitutional or irritant-mediated barrier impairment and contact sensitization is complex and reciprocal. Contact-sensitive subjects, especially nickel-sensitive ones, are reported to have an increased susceptibility to irritants. Van der Valk et al. showed a higher TEWL increase following SLS... 

Tupker RA, Pinnagoda J, Coenraads PJ, Nater JP (1990) Susceptibility to irritants role of barrier function, skin dryness and history of atopic dermatitis. Br J Dermatol 123 199-202... 

Schwarz T (1988) Die Bedeutung epidermaler Zytokine in der UV-induzierten Immunsuppression. Hautarzt 39 642-646 Tupker RA, Pinnagoda J, Coenraads PJ, Nater P (1990) Susceptibility to irritants role of barrier function, skin dryness and history of atopic dermatitis. Br J Dermatol 123 199-205 Widmer J, Eisner P, Burg G (1994) Skin irritant reactivity following experimental cumulative irritant contact dermatitis. Contact Dermatitis 30 35-39... 

People unable to seek protection indoors or especially susceptible to irritant gases or those who cannot easily undertake emergency action would be at serious risk from release of this size up to 1 kilometre from the release. In more stable weather, at slower wind speeds or with larger spills, there would be a serious hazard to people at greater distances. 

Held E, Agner T. Effect of moisturizers on skin susceptibility to irritants. Acta Derm Venereol. 2001 81 104-7. 

Heino et al. (1982) performed an electron microscopic study of the airways in those with farmer s lung disease and found cell destruction even at a level as high as the carina. The ciliated cells were affected most, showing a picture resembling that of bronchitis. Owing to the damage to the epithelium, superficial afferent nerves could be susceptible to irritation, inducing bronchial hyperreactivity. 

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