Textiles patch test

A 57-year-old man developed a pigmented contact dermatitis after using topical minoxidil 5% for 2 years (12). Patch tests were negative with the European standard series and with a textile and finishes series, but positive with minoxidil 5% on days 3 and 7. However, withdrawal of the minoxidil did not lead to improvement after 10 months. 

The monoazoic compound Disperse Blue 124 (Figure 7) is the most frequently positive dye on patch testing with the textile series, particularly in women. It is probably the main cause of textile contact dermatitis today. It is closely related to another azo dye, Disperse Blue 106 (Figure 8), marketed since 1985, and both are frequently used together. This latter dye seems to have the stronger sensitizing potential and can provoke infiltrated lesions. Concomitant positive reactions to both Disperse Blue 106 and 124 are expected because of their structural similarity, and are very consistent. 

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. 

In patients sensitive to p-phenylenediamine, the intake of certain azo dyes caused a flare of their dermatitis (Baer and Leider 1949 Sidi and Arouete 1959). The cross-reactivity between various allergenic dyes has been tested by Weirich (1961). Contact dermatitis to azo dyes employed in the textile and leather industries was described by Sultrmond et al. (1967). Roeleveld and van Ketel (1976) reported a patient with a dermatitis caused by a yellow shirt. The patch test was positive to the azo dye, tartrazine. Interestingly the eruptions worsened after drinking orange juice which could have contained tartrazine. Calnan (1976) found positive patch tests to quinazoline yellow which is used in foods, drugs, and cosmetics. Grater (1976) reported 133 positive reactions to a set of such dyes. 

A 43-year-old man with recurrent vesicular eczema on the hands, wrists, feet, ankles, and lower legs underwent patch testing, which was positive to potassium dichromate, cobalt chloride, nickel sulfate, chromium sulfate, ammoniated mercury, and phenylmercuric acetate [44 ]. Despite avoidance of contact with metals, leather, dark-coloured textiles, and dyes, and a low chromate and nickel diet for the next month, the lesions failed to improve. However, when he stopped taking multivitamin/multimineral tablets that... 

Skin In 14464 patients (68% women and 32% men) with suspected allergic dermatitis who underwent patch tests about 10% reacted positively to cobalt chloride [43 ]. Cobalt sensitization was associated with textile and leather work in women and with cleaning work in men. 

When compiling the dyes for Tables 1 and 2, we included every dye that was identified in the literature as being a textile allergen, keeping track of how many independent reports and how many patients were patch-test positive in each report. Note that there are... 

Fowler et al. retrospectively tested the identified patients with the Chemotechnique Diagnostic patch-test series or the Hermal textile series, the North American Contact Dermatitis Group standard screening tray, and other selected allergens. They used Finn Chambers, removed the patches at two days, and read them at 4 days or 7 days. Of the 678 patients, 16 were patch-test positive to textile formaldehyde resins. Formaldehyde-releasing preservatives as well as to textile formaldehyde resins caused allergic reactions in 12 patients. 

The data indicate that, in many cases, the causal agent was probably formaldehyde released from the resin. In both studies, most patients were patch-test positive to both formaldehyde and to a textile formaldehyde resin. More patch tests were positive when resins releasing high amounts of formaldehyde were applied than when resins releasing medium- or low amounts of formaldehyde were applied. 

The data also indicate that, in some cases, the causal agent is probably the resin itself (not the formaldehyde that it may release). A significant number of patients -3 of 11 in the Sherertz study (1992) and 4 of 16 in the Fowler et al. study (1992) - were patch-test positive to textile formaldehyde resin without being patch-test positive to formaldehyde. 

Lisboa C, Barros MA, Azenha A (1994) Contact dermatitis fi-om textile dyes. Contact Dermatitis 31 9-10 Maibach, H (1975) Panty hose dermatitis resembling and complicating tinea pedis. Contact Dermatitis 1 329-330 Manzini BM, Seidenari S, Danese P, Motolese A (1991) Contact sensitization to newly patch tested non-disperse textile dyes. Contact Dermatitis 25 331-332... 

Manzini BM, Motolese A, Conti A, Ferdani G, Seidenari S (1996a) Sensitization to reactive textile dyes in patients with contact dermatitis. Contact Dermatitis 34 172-175 Manzini BM, Donini M, Motolese A, Seidenari S (1996b) A study of 5 newly patch-tested reactive textile dyes. Contact Dermatitis 35 313... 

Patrizi A, Lanzarini M, Tosti A (1990) Persistent patch test reactions to textile dyes. Contact Dermatitis 23 60-61... 

Sertoli A, Francalanci S, Giorgini S (1994) Sensitization to textile disperse dyes validity of reduced-concentration patch tests and a new mix. Contact Dermatitis 31 47-48 Shehade SA, Beck MH (1990) Contact dermatitis from disperse dyes in synthetic wigs. Contact Dermatitis 23 124-125 Sherertz EF (1994) Clothing dermatitis practical aspects for the clinician. Am J Contact Dermat 3 55-64 Sim-Davies D (1972) Studies in contact dermatitis. 24. Dyes in trousers. Trans St Johns Hosp Dermatol Soc 58 251-260 Society of Dyers and Colorists and American Association of Textile Chemists and Colorists (1997) Colour index, 3rd edn. H. Charlesworth, Huddersfield... 

There are frequent reports about non-occupational cases of epoxy-resin sensitivity too. Contact dermatitis due to the epoxy resin in textile label patches has been attributed to the epoxy containing adhesive (Fregert and Orsmark 1984). We recommend limiting patch tests with epoxy chemicals to the standardised test series because of the danger of active sensitisation. Once proven, epoxy resins should not be re-tested, in our opinion. When testing epoxy-exposed individuals, never forget to include chemical additives such as the broad range of hardeners. 

This hard shiny metal is often alloyed to other elements. It is used in various industrial fields, such as those making or using batteries, printing machines, bearing, textiles, and ceramics. It caused positive patch test reactions in two workers in a ceramics industry. 

Disperse orange 3 is an azo dye which can induce contact dermatitis in workers in the textile industry. Patch tests are frequently positive (about 30%) in hairdressers with a hand dermatitis. It is probably an indicator of contact sensitization to PPD, but disperse orange 3 can also be found in some semipermanent hair dyes. 

Disperse blue 124 is a textile dye responsible for occupational contact dermatitis in the textile industry. A positive patch-test reaction was observed in a painter sensitized to phtalocyanine dyes, with no occupational relevance. 

Trimethylolpropane triacrylate (TMPTA) is a multifunctional acrylic monomer. It reacts with propylenei-mine to form polyfunctional aziridine. Sensitization was observed in a textile fabric printer. Patch tests were positive with the polyfunctional aziridine hardener, but were negative to TMPTA. TMPTA caused contact dermatitis in an optic-fiber manufacturing worker and was reported as a sensitizer in a floor top coat or in photopolymerizable inks. 

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