Allergen Content of Patient Problem and Nonproblem Gloves: Relationship to Allergen-Specific Patch-Test Findings

Siegel, Paul D.; Fowler, Joseph F.; Storrs, Frances J.; Sasseville, Denis; Pratt, Melanie D.; Bledsoe, Toni A.; Law, Brandon F.; Beezhold, Donald H.; Zug, Kathryn A.; Fowler, Lynn M.

doi:10.2310/6620.2010.09088

Cited by 13 publications

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“…However, thiurams were not seen in any of the gloves. This is in accordance with observations published previously (2, 25). Nevertheless, thiuram mix seems to be a good marker for detecting contact allergy to the dithiocarbamate group of rubber chemicals.…”

Section: Discussionsupporting

confidence: 93%

Occupational allergic contact dermatitis caused by sterile non‐latex protective gloves: clinical investigation and chemical analyses

et al. 2012

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Section: Discussionsupporting

confidence: 93%

Occupational allergic contact dermatitis caused by sterile non‐latex protective gloves: clinical investigation and chemical analyses

et al. 2012

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“…For example, a patient may present with ACD from use of a rubber product and have a positive mercaptobenzothiazole patch test, but mercaptobenzothiazole may not be found in that product upon chemical analysis. 6 There are 2 main types of investigations related to allergen identification. The first is verifying the clinical relevance of an allergen identified by patch testing by confirming the presence or (relative) absence of that chemical allergen in the ACD etiological product (eg, analysis for diphenylguanidine in a glove from a patient found to have a positive patch test reaction to diphenylguanidine).…”

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confidence: 99%

Chemical Identification and Confirmation of Contact Allergens

2019

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Identification of the etiological chemical agent(s) associated with a case(s) of allergic contact dermatitis (ACD) is important for both patient management and public health surveillance. Traditional patch testing can identify chemical allergens to which the patient is allergic. Confirmation of allergen presence in the causative ACD-associated material is presently dependent on labeling information, which may not list the allergenic chemical on the product label or safety data sheet. Dermatologists have expressed concern over the lack of laboratory support for chemical allergen identification and possibly quantification from patients' ACD-associated products. The aim of the study was to provide the clinician a primer to better understand the analytical chemistry of contact allergen confirmation and unknown identification, including types of analyses, required instrumentation, identification levels of confidence decision tree, limitations, and costs. New chemicals are continuously introduced into the market. Several animal-based screening methods (ie, guinea pig maximization test and the marine local lymph node assay) have been used to identify chemicals with contact allergenic potential; however, patients are continually diagnosed with allergic contact dermatitis (ACD) to previously unrecognized chemical allergens. Between 2008 and 2015, 172 new contact allergens were identified through patient patch testing (119 of these were associated with ACD) and reported in Contact Dermatitis and Dermatitis. 1 The actual number of new contact allergens is likely much higher because of incomplete product labeling, new allergens identified by patch testing but not reported in the literature, and those associated with ACD for which the Address reprint requests to

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“…However, studies examining concomitant reactions to CM and TM in larger populations present mixed results (Table 1). [7][8][9][10][11][12][13][14][15][16] The largest study involved 29,522 patients patch tested by the European Surveillance System on Contact Allergies (ESSCA) and found that 31.8% of TM-allergic patients had positive reactions to CM and 21.1% of CM-allergic patients had reactions to TM. 9 Investigations of concomitant reactions to CM and TM in a large North American population have been lacking.…”

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Positive Patch Test Reactions to Carba Mix and Thiuram Mix: The North American Contact Dermatitis Group Experience (1994–2016)

et al. 2020

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Background/ObjectiveThis study characterizes concomitant reactions to carba mix (CM) and thiuram mix (TM) in a large North American population. Because thiurams and dithiocarbamates have structural similarity, concomitant reactions are expected.MethodsThe 1994–2016 North American Contact Dermatitis Group data were analyzed. Patients with a final reaction interpreted as “allergic” to either CM or TM were included.ResultsA total of 49,758 patients were tested to both CM and TM. A total of 3437 (6.9%) had positive reactions to CM and/or TM including the following groups: CM+ only (n = 1403, 40.8%), TM+ only (n = 1068, 31.0%), or both (n = 966, 28.1%). A total of 47.5% of TM+ patients were positive to CM and 40.8% of CM+ patients were positive to TM. Male sex, occupationally related dermatitis, and hand involvement were significantly more common in individuals positive to CM and/or TM as compared with those who were negative (P < 0.0001). More than 80% of CM+/TM+ reactions were currently relevant. Gloves were the most common source of CM and TM; clothing and footwear were also frequent.ConclusionsCarba mix and TM remain important, clinically relevant allergens. Although significant concomitant reaction frequency was demonstrated, more than half of the patients reacting to either CM or TM would have been missed if both had not been tested, underscoring the importance of testing to both.

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Allergen Content of Patient Problem and Nonproblem Gloves: Relationship to Allergen-Specific Patch-Test Findings

Cited by 13 publications

References 0 publications

Occupational allergic contact dermatitis caused by sterile non‐latex protective gloves: clinical investigation and chemical analyses

Occupational allergic contact dermatitis caused by sterile non‐latex protective gloves: clinical investigation and chemical analyses

Chemical Identification and Confirmation of Contact Allergens

Positive Patch Test Reactions to Carba Mix and Thiuram Mix: The North American Contact Dermatitis Group Experience (1994–2016)

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