对斑贴试验致敏性结果的回顾性评估

The risk of actively sensitizing a patient in connection with diagnostic patch tests exists. This risk, however, is extremely low, especially from standard allergens, and if the test is carried out according to internationally accepted guidelines. This retrospective study investigates the clinical consequences in cases of possible patch test sensitization. Among 7619 consecutively tested eczema patients in a 14- year period 26 (0.3% ) were identified in the database as having had a late patch test reaction, which may be an indication of patch test sensitization. 9 of these cases were not suitable or available for the follow-up investigation and 3 patients were not traceable. Among the 14 remaining patients 1 had a reaction to gold sodiumthiosulphate, which was assessed to be a persistent reaction and not a late reaction, and in 2 patients a clear relevance for the late reacting allergen was found. For the remaining 11 patients we could not rule out that they were patch test sensitized, and they were investigated further. 1 was diseased and 10 were interviewed regarding the possible consequences of the alleged patch test sensitization. 9 had not experienced any dermatitis problems, and 1 could not exclude the possibility that the alleged patch test sensitization had aggravated her dermatitis problems, although we find it unlikely based on the full clinical history. Even though the patient material is small and the limitations inherent in such a retrospective study, the results and the literature indicate that development of clinical contact dermatitis following patch test sensitization is very rare.

松香和菊科混合物作为芳香物过敏的标记物:在芳香萜、松香及菊科植物提取物间的交叉反应

The aim of this study was to assess the strength of any association between sensitization to ‘ new’ fragrance compounds and sensitization to Compositae, fragrance mix, Myroxylon pereirae resin and colophonium, respectively. Consecutive eczema patients were tested with a series of essential oils and selected fragrance compounds and another series of oxidized terpenes in connectionwith European multicentre fragrance projects. Contact allergy to either series was frequently detected, in 5% of 318 and 4.6% of 262 persons tested, and both had a statistically significant association with Compositae, colophonium and fragrance mix sensitization. The individual results indicated that simultaneously occurring positive reactions to essential oils, colophonium and Compositae were based on cross- reactivity rather than concomitant sensitization. Thus, all patients with positive reaction to the rare fragrance sensitizer β - caryophyllene had positive colophonium reactions, and cross- reactivity between essential oils and Compositae was related to the Compositae plant extracts of the Compositae mix and not the pure sesquiterpene lactones of the standard series. The implication is that Compositae mix and colophonium may be markers of fragrance allergy, which is important to know when assessing the relevance of positive reactions to Compositae plant extracts and colophonium.

儿童重度染发剂过敏反应8例

Serious adverse skin reactions to permanent hair dyes and temporary black tattoos have been reported. As temporary tattoos have become fashionable among adolescents, the risk profile for p-phenylenediamine (PPD) sensitization of the population has changed simultaneously with an increasing use of hair dyes in this age group. This investigation reports PPD sensitization in children with regard to cause of sensitization, clinical presentation and consequences. Clinical history and patch test results for consecutive children below 16 years of age with suspected hair dye allergic reactions and positive patch tests to PPD were collected over 2 years in 2 Danish dermatology clinics. 8 children aged 12-15 years were collected, and they all reacted to several hair dye ingredients. 5 of the patients were hospitalized, 1 in the intensive care unit. 6 of the patients gave a history of prior reaction to temporary black tattoos. These children showed simultaneous positive patch reactions to N-isopropyl-N-phe-nylp-phenylenediamine and local anaesthetics, while such reaction patterns were not seen in children with hair dye reactions only. The clinical consequences of these reactions are unknown. A re-evaluation of the risk assessment/risk management for hair dyes is required.

金黄色葡萄球菌定植动力学和儿童特应性皮炎致病因子

A prospective cohort study was undertaken to determine the clonal dynamics of Staphylococcus aureus colonization and infection during 1 y in children with atopic dermatitis, and to correlate specific clones, accessory gene regulator (agr) groups, and production of virulence factors with eczema activity. Eleven children were examined every 6 wk with swaps taken from active eczema, anterior nose, axillae and perineum, and scoring of eczema activity by severity scoring of atopic dermatitis (SCORAD). Individual S. aureus clonal types were identified and examined for production of superantigens, toxins, and were assigned to agr groups. S. aureus colonization patterns ranged from rare colonization over transient colonization to persistent colonization by a single clone or a dynamic exchange of up to five clones. Production of no single virulence factor including superantigens and toxins was significantly associated with exacerbation of eczema. In four children there was a shift between visits in agr group of colonizing clones. These shifts were associated with an increased SCORAD value of 19 (SE = 7, p = 0.009). Change of clones belonging to the same agr group was not associated with a higher SCORAD value. In 11 of 12 cases with two different clones co-colonizing a child the clones belonged to the same agr group. In conclusion, this limited group of children with atopic dermatitis showed highly variable colonization patterns of S. aureus, and communication between strains by use of agr encoded octa peptides appeared to be active in vivo. Increased severity of eczema was related to a change in agr group and may have been because of inflammation triggered by the takeover of an antigenically different clone, as agr groups represent ancient phylogenetic lineages.

对二甲基溴戊二腈接触性过敏:每天1次与每天多次接触的结果

Some types of cosmetic products such ashand soaps and creams are commonly used several times a day, especially in occupational use situations. Little has experimentally been shown of how the daily frequency of the application of an allergen in a product influences the allergic response. This study investigates the allergic responses elicited in presensitized individuals when exposed to a specific amount of allergen applied either in 1 application per day or distributed over 4 applications per day. As model allergen, the cosmetic preservative methyldibromo glutaronitrile (MDBGN) is used. 19 contact allergic individuals and 12 controls participated in a double- blind, randomized use test. To areas on the forearms were applied 2 drops either once daily of a solution containing 0.04% MDBGN or 4 times a day of a solution containing 0.01% MDBGN. 14 of 19 patients developed dermatitis following the application of approximately equal amounts of MDBGN on both arms. Controls were negative. In this experiment, applications of 0.04% MDBGN once daily or 0.01% MDBGN 4 times daily had, in a use test, approximately equal capabilities of provoking allergic contact dermatitis. This adds new knowledge to the risk assessment and regulation of cosmetic allergens. However, these results may be highly allergen dependent, and further studies are needed before more general conclusions can be made.

12年间两次以上TURE TestTM试剂盒1和2斑贴试验的连续湿疹患者的接触变应性病程

Non-reproducibility of positive patch test reactions is common. In this retrospective study, we investigated the reproducibility of previously positive patch test reactions and the appearance of new positive reactions in a consecutive series of 264 eczema patients tested at least twice over a 12-year period using the TRUE TestTM standardized patch test system. Out of 297 positive reactions, 66%remained positive in a 2nd test, 10%were scored as doubtful and 24%as negative. Among the previously recorded doubtful reactions, 13%were positive in the 2nd test, 13%were again doubtful and 74%negative. In relation to the degree of patch test reactivity, 48%of the +reactions were reproducible, compared to 87%of ++and +++reactions. No difference in reproducibility was observed between patients tested with a short or a long-time interval between tests. With the use of the TRUE TestTM panels 1 and 2, methodological factors are minimized. The variation in patch test positivity may then be attributed to biological variation, which depends on several individual factors such as patch test reading, patient-related factors such as changed immunological sensitivity, regional variation of the skin on the back and the presence of more or less active dermatitis.

巯基苯并噻唑或巯基混合物:何为标准品系?

Mercaptobenzothiazole (MBT) compounds are well known contact allergens. To detect rubber allergic patients we use both MBT (2% in petrolatum) and a mercapto-mix with 4 constituents of 0.5% each in our standard series. In this article the EECDRG presents data of in total 32 475 consecutive tested patients attending the respective contact dermatitis clinics from 11 centres in Europe to determine if the mix and MBT detected the same allergic patients. We found 327 patients positive to the mix or MBT, or to both. 261 were positive to the mix and 254 to MBT. MBT was negative in 73 patients who were positive to the mix. If the mix had not been in the standard series, on average 22% of patients allergic to a mercapto-compound would have been missed, for MBT this would have been on average 20% . All clinics would have missed a significant number of positive reactions if both compounds had not been tested. We conclude, that both the mercapto mix and MBT are required in the standard series.

腋臭剂:异丁子香酚的实验性激发研究

Axillary dermatitis is common and overrepresented in people with contact allergy to fragrances. Many people suspect their deodorants to be the incriminating products. In order to investigate the significance of isoeugenol in deodorants for the development of axillary dermatitis when used by people with and without contact allergy to isoeugenol, patch tests with deodorants and ethanol solutions with isoeugenol, as well as repeated open application tests (ROAT) with roll-on deodorants with and without isoeugenol at various concentrations, were performed in 35 dermatitis patients, 10 without and 25 with contact allergy to isoeugenol. A positive ROAT was observed only in patients hypersensitive to isoeugenol (P < 0.001) and only in the axilla to which the deodorants containing isoeugenol had been applied (P < 0.001). Deodorants containing isoeugenol in the concentration range of 0.0063-0.2%used 2 times daily on healthy skin can thus elicit axillary dermatitis within a few weeks in people with contact allergy to isoeugenol.