Dever Tara T. Walters Michelle Jacob Sharon

Military personnel encounter the same allergens and irritants as their civilian counterparts and are just as likely to develop contact dermatitis from common exposures encountered in everyday life. In addition, they face some unique exposures that can be difficult to avoid owing to their occupational duties. Contact dermatitis can be detrimental to a military member's career if he or she is unable to perform core duties or avoid the inciting substances. An uncontrolled contact dermatitis can result in the member's being placed on limited-duty (ie, nondeployable) status, needing a job or rate change, or separation from military service. We present some common causes of contact dermatitis in military personnel worldwide and some novel sources of contact dermatitis in this population that may not be intuitive.

Balato Nicola Nino Massimiliano Patruno Cataldo Matarese Giuseppe Ayala Fabio

Background:Leptin belongs to the helical cytokine family and has structural similarity to interleukin (IL)-6, IL-12, IL-15, prolactin, and growth hormone. It is mainly secreted by adipocytes but (at lower levels) also by stomach, skeletal muscle, and placenta. Initially, leptin was considered an antiobesity hormone, but experimental evidence has also shown pleiotropic effects on hematopoiesis, angiogenesis, lymphoid organ homeostasis, and T-lymphocyte functions. Recent evidence indicates that leptin modifies T-cell immunity by promoting T helper 1 proinflammatory immune response and production of cytokines.Objective:The aim of the present study was to evaluate leptin serum levels in patients with allergic contact dermatitis (ACD) and atopic dermatitis and to evaluate the correlation of these levels with different patterns of lymphocyte subpopulations.Methods:Serum leptin was assayed by enzyme-linked immunosorbent assay. Immunophenotypic analysis of peripheral blood was performed by flow cytometry.Results:We found that serum leptin levels were higher in ACD patients than in healthy controls (p  =  .02). In these patients, an inverse correlation between serum leptin and the percentage of CD4+CD25+ T lymphocytes was observed (p  =  .002).Conclusion:These data seem to suggest that leptin might play a role in the pathogenesis of ACD and thus have implications for the therapy for ACD.

Dou Xia Zhao Yi Ni Chunya Zhu Xuejun Liu Lingling

Background:The prevalence of contact allergy varies in different regions and populations.Objective:To describe the frequency of sensitization in patients with dermatitis or eczema referred to Peking University First Hospital and analyze the trends in the prevalence of common allergens from January 1, 1990, to December 31, 2009.Methods:A total of 1,858 patients were patch tested with the Chinese baseline series of contact allergens. Data were collected from retrospective charts and analyzed.Results:Positive reactions to one or more allergens were shown in 1,374 patients (74.0%). The most common sensitizers were nickel sulfate (25.7%), fragrance mix I (25.6%), thiuram mix (25.5%), ammoniated mercury (20.5%), and p-phenylenediamine (19.1%). A statistically significant increase of sensitization over the 20-year period was seen for nickel sulfate, fragrance mix, ammoniated mercury, colophony, ethylenediamine, and potassium dichromate. Mercapto mix showed a trend of a statistically significant decrease in sensitizations from 1990 to 2009.Conclusions:The patterns of contact allergy in patients from Peking University Hospital are different from those of patients in other regions of China, in European countries, and in the United States. Nickel and fragrance mix were the most common allergens, and the sensitization rates of these two allergens had been increasing remarkably during the 20 years from 1990 to 2009.

LaBerge Lauren Pratt Melanie Fong Bensun Gavigan Genevieve

Background:p-Phenylenediamine (PPD) is an important allergen; 5.0% of patients tested positive to PPD when patch-tested, according to the North American Contact Dermatitis Group. Hair dyes are the main source of exposure.Objective:To assess the significance of PPD allergy at the Ottawa Patch Test Clinic.Methods:We assessed the epidemiology of PPD allergies and determined the cross-reactivity with other para-amino compounds. Charts of patients visiting the Ottawa Patch Test Clinic between May 1997 and July 2009 were reviewed.Results:One hundred thirty-four patients were found to have a contact allergy to PPD; 75.4% were female, 24.6% were male, 13.4% were hairdressers, 18.7% had a history of atopy, 90.3% were sensitized by hair dye, 2.2% were sensitized by henna tattoos, and 7.5% were sensitized by other sources. Positive patch-test reactions to textile dyes were seen in 24.6%, 7.5% reacted to benzocaine, 6.0% reacted to sulfa drugs, 1.5% reacted to isopropyl-para-phenylenediamine, and 1.5% reacted to para-aminobenzoic acid.Conclusions:PPD is an important source of allergic contact allergy. Our results show a significant relationship of PPD with other related para-amino compounds.

Malinauskiene Laura Zimerson Erik Bruze Magnus Ryberg Kristina Isaksson Marlene

Background:It is known that some patch-test preparations containing disperse dyes contain impurities with unknown relevance for the development or elicitation of contact allergy.Objective:To evaluate the significance of the impurities found in the commercial dyes Disperse Orange 1 (DO1) and Disperse Yellow 3 (DY3) regarding contact allergy in patients with known sensitivity to them.Methods:Ten patients allergic to DY3 and/or DO1 were tested with a dilution series of commercial and purified DY3 and DO1 (with water-soluble parts prepared from the commercial dyes) and with naphthalene sulfonate. Nine patients were additionally tested with thin-layer chromatograms (TLCs) made from the commercial DO1 and DY3 and with paper chromatograms made from the water-soluble part of these dyes.Results:Eight of nine and three of six patients tested positively to the TLCs of DO1 and DY3, respectively. Among them, 4 of 8 and 2 of 3 patients, respectively, were positive also to another spot on the TLCs. One patient was positive to the paper chromatogram from the water-soluble part of DO1. None of the tested patients reacted to naphthalene sulfonate.Conclusion:The results of our study suggest that there are more relevant allergens in the fat-soluble and water-soluble fractions of the commercial disperse dyes.

Wu Peggy A. James William D.

Lavender is a commonly used product in personal and household care items as well as for aromatherapy. It is increasing in popularity as a fragrance. Additionally, multiple recent publications attest to its antimicrobial activity. Whereas lavender has been associated with irritant dermatitis, allergic contact dermatitis, and photodermatitis, it is anticipated that with increasing exposure, more patients will experience these complications. Most cases of allergic contact dermatitis have been reported as being due to occupational exposures through massage and aromatherapy. One study of the Japanese population demonstrated an increased incidence of contact dermatitis from lavender (from 1.1% to 13.9% over 8 years). It is important that clinicians recognize lavender as a potential allergen.

Suzuki Kayoko Hirokawa Keiko Yagami Akiko Matsunaga Kayoko

Although there are many reported cases of immediate allergy after ingestion of foods containing cochineal, there are few reports of allergic contact dermatitis from carmine. We present a rare case of allergic contact dermatitis due to carmine. A 52-year-old female presented with an itchy erythema on her cheeks at the site where blush had been applied. Patch-tested with her cosmetics, she showed a positive reaction to the blush (30% in petrolatum) and to 0.2% (but not 0.1%) carmine in petrolatum. In this case, the optimum patch-test concentration of carmine was 0.2% in petrolatum.

Word Andrew P. Nezafati Kaveh A. Cruz Ponciano D.

Wong Jillian W. Harris KaLynne Powell Douglas

Soo Park Joon Hun Chung Ki Jung Lee Min Chung Hyun

Bassi Andrea D'Erme AngeloMassimiliano Gola Massimo Ricci Luca Francalanci Stefano

Oliveira Ana Rosmaninho Aristóteles Lobo Inês Selores Manuela