Allergic contact dermatitis caused by dimethylthiocarbamylbenzothiazole sulfide (DMTBS) in canvas shoes: in search of the culprit allergen

Abstract

SummaryBackground. During rubber vulcanization, new compounds can be formed. Objectives. To report a case of allergic shoe dermatitis in which the search for the allergen ultimately led to the identification of dimethylthiocarbamylbenzothiazole sulfide (DMTBS). Methods. A female presented with eczema on her feet after wearing Sperry Top Sider ® canvas sneakers. Patch testing was performed with the European baseline series, additional series, shoe materials, and extracts of shoe materials. Thin-layer chromatography (TLC) was performed for additional patch testing, and high-performance liquid chromatography and gas chromatography-mass spectometry were used for chemical analysis.Results. Positive reactions were found to thiuram mix (+), tetramethylthiuram monosulfide (TMTM) (+), shoe material (+), and shoe extracts in eth. (++) and acetone (+). The extracts did not contain TMTM or other components of thiuram mix. TLC strips yielded a positive reaction (+) to one spot, whereas chemical analysis gave a negative result. Thereafter, a similar sneaker from another patient with shoe dermatitis was analysed, and DMBTS was identified. New extracts of the shoe of our first patient were then also shown to contain DMTBS. DMTBS as culprit allergen was confirmed by positive patch testing with a dilution series with DMTBS. Conclusion. DMBTS was identified as the culprit allergen in shoe dermatitis, giving rise to compound allergy. The positive reaction to TMTM was considered to represent cross-reactivity.

Contact dermatitis caused by a new rubber compound detected in canvas shoes

“…There seems to be a high degree of cross-reactivity with thiuram mix, that is, tetramethylthiuram monosulfide, to which all 5 patients tested reacted in this study. The same principal finding was reported by Hansson et al (17) and by Schuttelaar et al (16). The patch testing in those actively sensitized to DMTBS supports the interpretation of cross-reactivity (A Pontén, pers.…”

“… and by Schuttelaar et al. . The patch testing in those actively sensitized to DMTBS supports the interpretation of cross‐reactivity (A Pontén, pers.…”

“…This young woman showed the same pattern of reactions as the patients described here, that is, positive reactions to thiuram mix and shoe material tested ‘as is’ as well as extracts. She also reacted positively to the spot corresponding to DMTBS, and further patch testing with a dilution series of DMTBS gave positive reactions to similarly low concentrations .…”

Acetophenone azine: a new shoe allergen causing severe foot dermatitis

“…For allergic foot dermatitis, compounds contained in footwear, socks or stockings may be the causal agents , and reported allergens include chromium, rubber accelerators, and dyes. Recently, octylisothiazolinone, which is used as an antifungal during the processing of leather , and dimethylthiocarbamyl benzothiazole, which is a strongly sensitizing rubber compound , have also gained attention as new shoe allergens.…”

Contact Allergy—Emerging Allergens and Public Health Impact

“…Chromium-tanned leather is a well-known source of ACD to chromium, see above under "Metals". A case of foot dermatitis related to the use of Sperry Top Sider™ canvas sneakers in an 18-year-old Dutch female as well as a large case series involving 18 young females (age 14-22 years) in Belgium suffering the same type of dermatitis after wearing these brand shoes were reported in which there was no leather contact [251,252]. Strikingly, all patients reacted to the screening allergen thiuram mix 1% pet.…”