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Lasse Kanerva - One of the best experts on this subject based on the ideXlab platform.
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Occupational allergic Contact Urticaria to yucca (Yucca aloifolia), weeping fig (Ficus benjamina), and spathe flower (Spathiphyllum wallisii).
Allergy, 2001Co-Authors: Lasse Kanerva, Tuula Estlander, Leena Petman, Soili Mäkinen-kiljunenAbstract:Background: Occupational Contact Urticaria (CU) from plants is often reported, but it is less often attributed to decorative houseplants. We present an atopic gardener and caretaker of plants who developed CU when occupationall_y exposed to weeping fig, spathe flower, and yucca. Methods: Sensitization was evaluated by skin prick tests (SPT) and analyses for IgE antibodies. Results: SPT were positive to all_ three plants, and IgE antibodies were found to weeping fig and spathe flower. SPT were also performed with several decorative houseplants in more than 600 patients. Positive SPT was found to weeping fig (12%), African milk tree (8.3%), yucca (5.8%), Chinese rose (4.7%), massangana (4.6%), bird's nest fern (3.2%), and spathe flower (3.2%). Conclusions: Our study indicates that SPT and tests for IgE antibody are useful in detecting occupational CU caused by houseplants.
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occupational allergic Contact Urticaria and rhinoconjunctivitis from a detergent protease
Contact Dermatitis, 2001Co-Authors: Lasse Kanerva, Markku VanhanenAbstract:Keywords: occupational; Contact Urticaria; protein Contact dermatitis; industrial enzymes; proteases; process man; prick testing; rhinitis; conjunctivitis; allergy
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occupational protein Contact dermatitis and paronychia from natural rubber latex
Journal of The European Academy of Dermatology and Venereology, 2000Co-Authors: Lasse KanervaAbstract:Protein Contact dermatitis (PCD) is a chronic recurrent dermatitis caused by Contact with a proteinaceous material. PCD may also present as paronychia. Here a case of PCD and paronychia from natural rubber latex (NRL) is presented. The correct diagnosis would not have been established if prick testing with NRL had not been performed. This case shows that Contact allergy presenting as dermatitis may occur despite negative patch test results. PCD from NRL may be relatively common, although very few cases have been published. This is probably due to the fact that the term Contact Urticaria is so closely connected to NRL that automatically all cases of type I allergy to NRL are considered Contact Urticaria, although the clinical picture is a dermatitis, i.e. PCD.
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occupational ige mediated allergy to tribolium confusum confused flour beetle
Allergy, 2000Co-Authors: Kristiina Alanko, M Pajaribackas, Timo Tuomi, K Havu, Kari Saarinen, Lasse Kanerva, Markku Vanhanen, Derk P BruynzeelAbstract:Background: We report on IgE-mediated allergy in a worker caused by Tribolium confusum (confused flour beetle). These beetles lived in the “old” flour to which he was exposed in his work. Case report: A 35-year-old, nonatopic mechanic in a rye crispbread factory developed rhinitis, conjunctivitis, and asthmatic symptoms, as well as Urticaria on his wrists, lower arms, hands, neck, and face, during the maintenance and repair of machines contaminated by flour. This flour had been in and on the machines for a long time, and it contained small beetles. The patient did not suffer any symptoms when handling fresh, clean flour. Results: Skin prick tests with standard environmental allergens, storage mites, enzymes, flours, and molds were negative. A prick test with flour from the machines gave a 10-mm reaction. An open application of the same flour caused Urticarial whealing on the exposed skin. Prick tests with fresh flour from the factory were negative. A prick test with minced T. confusum from the flour in the machines gave a 7-mm reaction. Histamine hydrochloride 10 mg/ml gave a 7-mm reaction. Specific serum IgE antibodies to T. confusum were elevated at 17.2 kU/l. Prick tests with the flour from the machines were negative in five control patients. Conclusions: The patient had occupational Contact Urticaria, rhinitis, conjunctivitis, and asthmatic symptoms from exposure to flour. His symptoms were caused by immediate allergy to the beetle T. confusum. Immediate allergy to this beetle has rarely been reported in connection with respiratory symptoms, but it may be more common. Contact Urticaria from this source has not been reported before.
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occupational ige mediated asthma rhinoconjunctivitis and Contact Urticaria caused by easter lily lilium longiflorum and tulip
Allergy, 1999Co-Authors: Paivi Piirila, Tuula Estlander, Kristiina Alanko, Lasse Kanerva, Helena Keskinen, And M Pajaribackas, M TuppurainenAbstract:Background: We report on IgE-mediated asthma, rhinoconjunctivitis, and Contact Urticaria to two Liliaceae plants, tulip and Easter lily (Lilium longiflorum), diagnosed in a floral shop worker. Methods: Occupational asthma was diagnosed according to patient history, PEF monitoring, and a work-simulating provocation test. Flower-specific IgE was studied, and RAST inhibition tests were performed. Results: Skin prick testing showed positive reactions to tulip, Easter lily, and chrysanthemum. Total IgE was 180 kU/l, and specific IgE to tulip was 2.6 and to Easter lily 6.5 kU/l. In the RAST-inhibition test, no cross-reactivity was found. Occupational asthma was diagnosed by peak flow monitoring at work and at home, as well as specific inhalation challenge with Easter lily, with an immediate 18% reduction in PEF. In addition, Contact Urticaria and conjunctivitis were diagnosed. After a 9-year follow-up without exposure to lilies, the skin prick tests to L. longiflorum and tulip were still positive, but the specific IgE had disappeared. Conclusions: A case of IgE-mediated occupational asthma, rhinoconjunctivitis, and Contact Urticaria caused by L. longiflorum and tulip is presented. RAST inhibition tests indicated concomitant sensitization to the two Liliaceae plants.
Howard I. Maibach - One of the best experts on this subject based on the ideXlab platform.
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Contact Urticaria Syndrome: Occupational Aspects
Kanerva’s Occupational Dermatology, 2020Co-Authors: Becky S. Li, Iris S. Ale, Howard I. MaibachAbstract:The term Contact Urticaria syndrome (CUS), also known as immediate Contact skin reactions (ICSR), was defined as a biological entity in 1975 (Maibach and Johnson 1975). It is characterized by a heterogeneous group of inflammatory reactions that appear within minutes after cutaneous or mucosal Contact with the eliciting agent and usually disappear within a few hours – although delayed-onset reactions are sometimes observed. The actual prevalence of these reactions is not well determined. Nonetheless, numerous cases of CUS continue to be reported, and the list of etiologic agents continues to increase, providing evidence for the high frequency of these entities (Ale and Maibach 2000a; Amin et al. 1997; Burdick and Mathias 1985; Harvell et al. 1992; Lahti and Maibach 1987, 1991). A multitude of substances ranging from simple chemicals to macromolecules has been reported, but its pathogenetic mechanism still remains a challenge.
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immediate Contact skin reactions an update of Contact Urticaria Contact Urticaria syndrome and protein Contact dermatitis a never ending story
European Journal of Dermatology, 2010Co-Authors: Ana Gimenezarnau, Marcus Maurer, Jesus De La Cuadra, Howard I. MaibachAbstract:Listening and paying attention to our patients is crucial for understanding a disease. A good example is Immediate Contact Skin Reactions (ICSR) which manifest as Contact Urticaria Syndrome (CUS), Contact Urticaria (CU) and Protein Contact Dermatitis (PCD). These entities are characterized by the immediate skin development of itchy flares, wheals, and/or dermatitis. All conditions usually appear within minutes of Contact with various substances, including chemicals, animal products, antibiotics, cosmetics, and many other materials. From the clinical and diagnostic viewpoint, the patient's clinical report is critical to its description, definition and classification. Its pathogenesis still remains a challenge and our knowledge of the agents potentially responsible is slowly increasing over time, based on the descriptions of a few isolated cases. This text reviews the classic concepts, introduces new compounds responsible for these immediate skin reactions, and suggests further investigation.
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cutaneous Contact Urticaria to pyrethrum real common or not documented an evidence based approach
Cutaneous and Ocular Toxicology, 2007Co-Authors: Jill A Franzosa, Thomas G Osimitz, Howard I. MaibachAbstract:Reports suggest that pyrethrum, the insecticidally active extract from Chrysanthemum cinerariifolium, can induce Type I hypersensitivity reactions in humans. Using knowledge of pyrethrum chemistry and an evidence-based analysis of literature, whether current refined pyrethrum induces and/or elicits skin manifestations of Contact Urticaria was assessed. Current extraction and refinement techniques suggest that refined pyrethrum lacks the presence of significant, if any, proteins speculated to induce Type I hypersensitivity. Our interpretation suggests that no reports of Type I reactions presented in the literature fulfill the criteria for immunologic Contact Urticaria. Future patient testing with current commercial material should clarify its Type I immunologic potential, if any.
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functional map and age related differences in the human face nonimmunologic Contact Urticaria induced by hexyl nicotinate
Contact Dermatitis, 2006Co-Authors: Slaheddine Marrakchi, Howard I. MaibachAbstract:: Variation in human skin reactivity to various irritants in association with age and body region has been reported. Hexyl nicotinate (HN), a lipophilic nicotinate ester, was used to induce nonimmunologic Contact Urticaria in human volunteers of 2 age groups: 10 young subjects [24-34 years, mean +/- standard deviation (SD) 29.8 +/- 3.9 years] and 10 older volunteers (66-83 years, mean +/- SD 73.6 +/- 17.4 years); and to define skin function and potential age-related differences in various facial areas. About 5 mM of HN in ethanol was applied to 8 locations on the face, neck, and volar forearm. A laser Doppler flowmeter was used to determine baseline blood flow and to monitor the skin blood flow changes after HN application. In the contralateral areas, stratum corneum turnover was determined using 5% dansyl chloride in petrolatum. In the young group, the perioral area exhibited the strongest reaction to HN. In the older group, the chin was the most sensitive site. In both the groups, the forearm was the least responsive. The older group demonstrated a stronger reaction than the younger group in 3 sites (forehead, cheek, and nasolabial area). Stratum corneum turnover was slower in the nasolabial area and in the forearm in both age groups, whereas the fastest was in the perioral area and the chin in the younger group and in the chin and the forehead in the older group. Compared to the older group, the younger group showed a slower stratum corneum turnover in the nose and the neck. This study demonstrates the regional and the age-related variability of the stratum corneum turnover and the skin reactions to HN. These observations may help explain some aspects of the cutaneous intolerance in skin care of the face.
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alcohol dermatitis allergic Contact dermatitis and Contact Urticaria syndrome a review
Contact Dermatitis, 1994Co-Authors: Suwirakorn Ophaswongse, Howard I. MaibachAbstract:In spite of not knowing the numbers of people exposed and obviously incomplete reporting, the known mechanisms of alcohol cutaneous intolerance and the literature classified according to mechanisms are listed. Testing techniques for delayed- and immediate-types are proposed.
Eva Helaskoski - One of the best experts on this subject based on the ideXlab platform.
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occupational Contact Urticaria and protein Contact dermatitis causes and concomitant airway diseases
Contact Dermatitis, 2017Co-Authors: Eva Helaskoski, Hille Suojalehto, Outi Kuuliala, Kristiina AaltokorteAbstract:SummaryBackground Contact Urticaria (CU) and protein Contact dermatitis (PCD) are mainly induced by an immediate, IgE-mediated immunological mechanism. Immediate sensitization is also linked to asthma and/or allergic rhinitis. Objectives To report causes of work-induced CU and PCD, and to evaluate the occurrence of concomitant airway diseases. Methods We retrospectively reviewed the patient files of cases diagnosed with CU or PCD at the Finnish Institute of Occupational Health during 1995–2011. We obtained data on occupation, exposures, clinical and immunological test results, and diagnosed occupational skin and respiratory diseases. Results Altogether, 291 cases of occupational CU or PCD were diagnosed during the study period. The most common causes were flour, cow dander, natural rubber latex and acid anhydrides. Concomitant occupational asthma caused by the same agent as the skin disease was detected in 60 patients (21%), and occupational rhinitis was detected in 111 patients (38%). Conclusions Almost half of the patients (46%) with occupational CU and PCD had concomitant occupational airway disease. Patients with CU/PCD should always be asked about respiratory symptoms, and preventive measures at the workplace should include protection of both the skin and the airways.
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Prick testing with chemicals in the diagnosis of occupational Contact Urticaria and respiratory diseases.
Contact Dermatitis, 2014Co-Authors: Eva Helaskoski, Hille Suojalehto, Outi Kuuliala, Kristiina Aalto-korteAbstract:SummaryBackground Little is known about the use of prick tests with chemicals in diagnosing occupational diseases. Objective To evaluate the use of prick tests in the diagnosis of occupational Contact Urticaria, asthma and rhinitis caused by chemicals (undertaken at the Finnish Institute of Occupational Health). Material and methods We retrospectively reviewed the patient and test files for the period 1 January 1991 to 31 May 2011. Prick tests were performed with chemical solutions and human serum albumin (HSA)–chemical conjugates. Results Positive prick test reactions to isocyanate–HSA conjugates were associated with isocyanate-specific IgE in all 20 patients, and 17 patients had a relevant occupational disease. Positive reactions to chloramine-T–HSA conjugates in 10 patients also indicated the presence of specific IgE, although occupational diseases were not always diagnosed. Eleven of 17 patients with positive reactions to persulfate solutions were diagnosed with an occupational disease. Methacrylates, colophonium-related substances, amine hardeners, ethanolamines, glutaraldehyde, glyoxal, pyrocatechol and ammonium thioglycolate did not elicit any relevant prick test reactions. No generalized reactions were detected. Conclusion Prick tests can be safely used for diagnosing Contact Urticaria, asthma and rhinitis caused by isocyanates, chloramine-T, persulfates, and chlorhexidine, but the results should be carefully interpreted and related to clinical symptoms and other diagnostic tests.
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occupational asthma rhinitis and Contact Urticaria caused by oxidative hair dyes in hairdressers
Annals of Allergy Asthma & Immunology, 2014Co-Authors: Eva Helaskoski, Hille Suojalehto, Outi Kuuliala, Hannele Virtanen, Liisa Airaksinen, Kristiina Aaltokorte, Maria PesonenAbstract:Background Oxidative hair dyes commonly contain paraphenylene diamine (PPD) and its derivatives, a well-known cause of delayed hypersensitivity among both consumers and hairdressers. They are also considered possible causes of occupational respiratory diseases. Despite the widespread use of hair dyes, there are only a few reports of asthma, rhinitis, and Contact Urticaria caused by PPD and related compounds. Objective To characterize patients with occupational asthma, rhinitis, or Contact Urticaria associated with oxidative hair dyes and to evaluate the diagnostic methods. Methods We reviewed the patient files of the Finnish Institute of Occupational Health for the period January 1, 2001, through May 31, 2011, to identify patients diagnosed as having asthma, rhinitis, or Contact Urticaria associated with oxidative hair dyes. The diagnoses of asthma and rhinitis were based on specific inhalation challenges with hair dye products. Skin prick tests were performed with hair dye ingredients as hapten conjugates of human serum albumin and with hair dye products and ingredients as is. Open skin tests confirmed the diagnosis of Contact Urticaria. Results We describe 11 hairdressers with occupational asthma (5 cases), rhinitis (5 cases), and Contact Urticaria (3 cases) due to hair dyes. Of the 52 specific inhalation challenges performed, 9 (17%) had positive results. One patient who experienced an anaphylactic reaction when having her own hair dyed had positive skin prick test results to PPD and toluene-2,5-diamine sulfate. Conclusion Hairdressers are at risk for occupational asthma, rhinitis, and Contact Urticaria due to oxidative hair dyes. Skin prick testing may be insensitive for detecting immediate hypersensitivity to PPD and related compounds.
An Goossens - One of the best experts on this subject based on the ideXlab platform.
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proposed icdrg classification of the clinical presentation of Contact allergy
Dermatitis, 2016Co-Authors: An Goossens, Korbkarn Pongpairoj, Peter Elsner, Iris Ale, Klaus Ejner Andersen, M Bruze, T L Diepgen, Cheeleok Goh, Hemangi JerajaniAbstract:The International Contact Dermatitis Research Group proposes a classification for the clinical presentation of Contact allergy. The classification is based primarily on the mode of clinical presentation. The categories are direct exposure/Contact dermatitis, mimicking or exacerbation of preexisting eczema, multifactorial dermatitis including allergic Contact dermatitis, by proxy, mimicking angioedema, airborne Contact dermatitis, photo-induced Contact dermatitis, systemic Contact dermatitis, noneczematous Contact dermatitis, Contact Urticaria, protein Contact dermatitis, respiratory/mucosal symptoms, oral Contact dermatitis, erythroderma/exfoliative dermatitis, minor forms of presentation, and extracutaneous manifestations.
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Contact-Allergic Reactions to Cosmetics
Journal of Allergy, 2011Co-Authors: An GoossensAbstract:Contact-allergic reactions to cosmetics may be delayed-type reactions such as allergic and photo-allergic Contact dermatitis, and more exceptionally also immediate-type reactions, that is, Contact Urticaria. Fragrances and preservative agents are the most important Contact allergens, but reactions also occur to category-specific products such as hair dyes and other hair-care products, nail cosmetics, sunscreens, as well as to antioxidants, vehicles, emulsifiers, and, in fact, any possible cosmetic ingredient. Patch and prick testing to detect the respective culprits remains the golden standard for diagnosis, although additional tests might be useful as well. Once the specific allergens are identified, the patients should be informed of which products can be safely used in the future.
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immunological occupational Contact Urticaria and Contact dermatitis from proteins a review
Contact Dermatitis, 2007Co-Authors: Cristina Amaro, An GoossensAbstract:Protein Contact with the skin can be associated with 2 major clinical conditions: Contact Urticaria and protein Contact dermatitis. This article reviews the pathogenesis, clinical pictures and the literature on the proteins having caused immunological occupation-related skin problems, i.e. fruits, vegetables, spices, plants, and woods; animal proteins; grains and enzymes, all affecting a wide variety of jobs. This is illustrated with some cases observed in the Contact-allergy unit in Leuven.
Tuula Estlander - One of the best experts on this subject based on the ideXlab platform.
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Occupational allergic Contact Urticaria to yucca (Yucca aloifolia), weeping fig (Ficus benjamina), and spathe flower (Spathiphyllum wallisii).
Allergy, 2001Co-Authors: Lasse Kanerva, Tuula Estlander, Leena Petman, Soili Mäkinen-kiljunenAbstract:Background: Occupational Contact Urticaria (CU) from plants is often reported, but it is less often attributed to decorative houseplants. We present an atopic gardener and caretaker of plants who developed CU when occupationall_y exposed to weeping fig, spathe flower, and yucca. Methods: Sensitization was evaluated by skin prick tests (SPT) and analyses for IgE antibodies. Results: SPT were positive to all_ three plants, and IgE antibodies were found to weeping fig and spathe flower. SPT were also performed with several decorative houseplants in more than 600 patients. Positive SPT was found to weeping fig (12%), African milk tree (8.3%), yucca (5.8%), Chinese rose (4.7%), massangana (4.6%), bird's nest fern (3.2%), and spathe flower (3.2%). Conclusions: Our study indicates that SPT and tests for IgE antibody are useful in detecting occupational CU caused by houseplants.
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occupational ige mediated asthma rhinoconjunctivitis and Contact Urticaria caused by easter lily lilium longiflorum and tulip
Allergy, 1999Co-Authors: Paivi Piirila, Tuula Estlander, Kristiina Alanko, Lasse Kanerva, Helena Keskinen, And M Pajaribackas, M TuppurainenAbstract:Background: We report on IgE-mediated asthma, rhinoconjunctivitis, and Contact Urticaria to two Liliaceae plants, tulip and Easter lily (Lilium longiflorum), diagnosed in a floral shop worker. Methods: Occupational asthma was diagnosed according to patient history, PEF monitoring, and a work-simulating provocation test. Flower-specific IgE was studied, and RAST inhibition tests were performed. Results: Skin prick testing showed positive reactions to tulip, Easter lily, and chrysanthemum. Total IgE was 180 kU/l, and specific IgE to tulip was 2.6 and to Easter lily 6.5 kU/l. In the RAST-inhibition test, no cross-reactivity was found. Occupational asthma was diagnosed by peak flow monitoring at work and at home, as well as specific inhalation challenge with Easter lily, with an immediate 18% reduction in PEF. In addition, Contact Urticaria and conjunctivitis were diagnosed. After a 9-year follow-up without exposure to lilies, the skin prick tests to L. longiflorum and tulip were still positive, but the specific IgE had disappeared. Conclusions: A case of IgE-mediated occupational asthma, rhinoconjunctivitis, and Contact Urticaria caused by L. longiflorum and tulip is presented. RAST inhibition tests indicated concomitant sensitization to the two Liliaceae plants.
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occupational allergic Contact dermatitis and Contact Urticaria caused by polyfunctional aziridine hardener
Contact Dermatitis, 1995Co-Authors: Lasse Kanerva, Tuula Estlander, Riita Jolanki, Kyllikki TarvainenAbstract:Polyfunctional aziridine (PFA) is increasingly used as a water-based cross-linker in 2-component paints, paint primers, lacquers, topcoats and other protective coatings. The cross-linker (PFA hardener) is made by reacting multifunctional acrylic monomer with a highly reactive aziridine compound. During 1992-1993, we came across 2 patients with allergic patch test reactions provoked by PFA hardener. One of the patients was a parquet layer, and the other a printer. Allergic Contact dermatitis (ACD) was diagnosed by positive allergic patch test reactions to PFA hardener in a dilution series in pet.:0.3%-1% gave ++ to allergic reactions in both patients, whereas 0.1% gave a weak (+) or questionable reaction (?+), respectively. The methacrylate patch test series was negative in both patients, although gas chromatography/mass spectrometry analysis showed that PFA hardener contained 0.3% of trimethylolpropane triacrylate (TMPTA), a multifunctional acrylic monomer. One of the patients also had symptoms of Contact Urticaria, and a prick test with PFA hardener (1% aq.) induced a histamine-sized prick test reaction. The positive reactions with the PFA hardener and the negative reactions with the starting chemicals and additives in PFA, namely acrylates, propyleneimine and dimethylethanolamine, indicate that PFA caused ACD. This is in accordance with our previous observations, but differs from the reports of others, whose patients had been sensitized to acrylates present as remnants in the PFA hardener. As test substance, 0.5% PFA hardener in pet. is recommended for patch testing. Testing should be performed in patients with Contact dermatitis if exposure to PFA has occurred. Skin prick tests may be of help to detect Contact Urticaria.