Contact urticaria from nickel and plastic additives (Butylhydroxytoluene, oleylamide)

Abstract

In two patients urticaria was elicited by contact with nickel-containing objects. Chamber-prick test with nickel sulfate 2.5% in pet. evoked a strong urticarial reaction in both patients. In one of the patients contact with plastic articles also provoked urticaria. A 20-min patch test with several articles of plastic (polyethylene and PVC) and with butylhydroxytoluene (BHT) 1% in ethanol elicited urticarial reactions. BHT is used as an antioxidant in plastic. Furthermore, open patch test with oleylamide (amide of oleic acid) 0.1% in ethanol elicited a strong urticarial reaction in 20 min. This chemical is used as a slipping agent in plastic.

Occupational contact urticaria caused by polyvinylchloride gloves

“…Sugiura et al reported a case of contact urticaria syndrome caused by di(2‐ethylhexyl) phthalate in the dotted PVC grip of cotton gloves (1) and in work clothes (2). BHT and oleylamide, used respectively as antioxidant and slipping agent in plastics, have caused contact urticaria (3). Mitchell described a case of contact urticaria caused by a plastic shower curtain, but could not identify the causative agent (4).…”

Type 1 and type IV hypersensitivity to nickel

“…Very few cases of type 1 hypersensitivity to nickel have been reported 2–4 . The mechanism behind this is not fully understood, although it has been postulated that nickel may act as a mast cell discharger on a non‐immunological basis 5 …”

Immediate and delayed allergy to nickel with contact urticaria, rhinitis, asthma and contact dermatitis

“…Davies 1986 [6] reported three cases of probable nickel asthma, but no specific tests were made. In the previous cases the patch test substance, nickel sulphate in petrolatum, has been used to demonstrate the immediate skin reaction [7][8][9]21,23] but it is probable that in most cases hapten-HSA conjugates [ 18, or hapten-water solutions are better for skin-prick testing. Nickel sulphate-HSA has been used in one study with success [2] but we had difficulties in developing a good nickel-HSA conjugate although conjugates with many other small molecular weight chemicals such as phthalic anhydrides, diisocyanates and epoxy resins have been prepared and tested with success [18,26].…”