The problems of rubber hypersensitivity (Types I and IV) in chronic leg ulcer and stasis eczema patients

Abstract

The prevalence of Type I and Type IV hypersensitivity to rubber allergens in patients with stasis eczema and/or venous leg ulcers over an 18‐month period was studied by prick and patch testing. Results from 109 patients were analysed. Positive patch tests were found in 71 patients (65%). Delayed‐type hypersensitivity to rubber chemicals was found in 17 patients (15.6%). However, only 1 patient who had additional risk factors showed Type I hypersensitivity to natural rubber latex. We therefore conclude that, although Type IV hypersensitivity to rubber chemicals is relatively common in our patients, Type I hypersensitivity to natural rubber latex remains rare.

Contact sensitization in patients with chronic venous leg ulcers in Singapore

“…In our study, povidone iodine tested as is may be an irritant. In contrast to several other studies (3,6,20,21), our sensitization rates to topical corticosteroids (4.5%) and rubber accelerators (2.3%) remain low.…”

“…Together with the antimicrobials, our study clearly shows the importance of TTCM as contact allergens in our group of patients with chronic venous leg ulcers. The overall sensitization rate of 61.4% was in agreement with studies from previous centres (2–7).…”

“…Conversely, in a recent meta-analysis on the common sensitizers in patients with leg ulcer, fragrance mix (cumulative sensitization rate of 18.8%), lanolin (17.5%), Balsam of Peru (25.4%), and aminoglycosides (13.9%) were cited (1). A rising trend of rubber accelerator allergy was noticed as well (5.5%-12.0%) (1,3,6). In contrast, our sensitization rates to these allergens, i.e.…”

Allergic contact dermatitis to rubber‐containing bandages in patients with leg ulcers

“…Allergens were applied in Finn Chambers ® , Epitest Ltd, and readings were performed at D2 and D3 or D4 according to the International Contact Dermatitis Research Group (ICDRG) guidelines. All patients reacted to rubber components – carba mix (5), thiuram mix (6), and/or mercapto mix (1) and to its constituents and 6 of them to other allergens as well (Table 1).…”

“…Allergic contact dermatitis occurs in 40–82.5% of patients with venous insufficiency of the lower limbs, mainly because of lanolin (wool alcohols), fragrances, and antimicrobial agents (1–4). However, other allergens may be involved, as in the cases reported below.…”