Lepoittevin Contact Dermatitis

5. Auflage 2010
ISBN: 978-3-642-03827-3
Verlag: Springer
Format: PDF
Kopierschutz: Wasserzeichen (»Systemvoraussetzungen)

E-Book, Englisch, 1252 Seiten

The fifth edition delivers up-to-date coverage of every conceivable aspect in modern-day management of contact dermatitis. Leading experts have thoroughly updated the previous edition, while adding new chapters on genetics, the skin barrier, respiratory symptoms to chemicals and an extensive section on prevention. Both irritant and allergic contact dermatitis are covered with special emphasis on immunological mechanisms, molecular aspects of sensitizers, atypical clinical forms, reactions to medicaments, occupational and environmental aspects. The comprehensive yet approachable text is supplemented by numerous color illustrations and tables. Core messages and case reports highlight the most important information and help in gaining better understanding of the topic and greater competence in daily practice. An extensive dictionary of allergens gives quick access to specific information.

Autoren/Hrsg.

Lepoittevin, Jean-Pierre

Inhaltsverzeichnis

1;Preface to the Fifth Edition;6
2;Contents;7
3;1: Historical Aspects;12
3.1;1.1 Introduction;12
3.2;1.2 Historical Aspects of Patch Testing;13
3.2.1;1.2.1 The Pre-Jadassohn Period;13
3.2.2;1.2.2 Josef Jadassohn, the Father of Patch Testing in Dermatology;13
3.2.3;1.2.3 Jean-Henri Fabre’s Experiments;14
3.2.4;1.2.4 A General Overview of Patch Testing During the Period 1895–1965;15
3.2.5;1.2.5 Bruno Bloch’s Pioneering Work in Basel and in Zurich;15
3.2.6;1.2.6 The Influence of Poul Bonnevie in Scandinavian Countries;16
3.2.7;1.2.7 A Controversial Period: The Pros and Cons of a Standard Series;17
3.2.8;1.2.8 Marion Sulzberger, the Initiator of Patch Testing in North America and Alexander Fisher, a World Leader in the Field of C;17
3.2.9;1.2.9 The Founding of Groups;17
3.2.10;1.2.10 The Founding of the European Environmental and Contact Dermatitis Research Group (EECDRG) and the European Society of Co;18
3.2.11;1.2.11 Dermatochemistry and Contact Dermatitis;18
3.2.12;1.2.12 Recent Advances in the Management of Patch Testing;18
3.3;1.3 Historical Aspects of Prick Testing;19
3.4;References;19
4;Part 1: Basic Features;21
4.1;2: Genetics and Individual Predispositions in Contact Dermatitis;22
4.1.1;2.1 General Introduction;23
4.1.2;2.2 Genetic Factors in Allergic Contact Dermatitis1;23
4.1.2.1;2.2.1 Early Studies in the Genetics of Contact Allergy;24
4.1.2.1.1;2.2.1.1 Experimental Sensitization;24
4.1.2.1.2;2.2.1.2 Family Studies;25
4.1.2.1.3;2.2.1.3 Twin Studies;25
4.1.2.1.4;2.2.1.4 Studies of Immunogenetic Markers;26
4.1.2.2;2.2.2 In Search of the Phenotype of Contact Allergy: Polysensitization;26
4.1.2.3;2.2.3 Polymorphisms in Allergic Contact Dermatitis;27
4.1.2.3.1;2.2.3.1 Tumor Necrosis Factor (TNF);28
4.1.2.3.1.1;Studies of TNF Polymorphisms in ACD (See Table 2.4);28
4.1.2.3.2;2.2.3.2 Interleukin-16;31
4.1.2.3.2.1;Studies of IL-16 Polymorphisms in ACD;31
4.1.2.3.3;2.2.3.3 N-Acetyltransferase 1 and 2 (NAT1/NAT2);31
4.1.2.3.3.1;Studies of NAT: Polymorphisms in ACD;32
4.1.2.3.4;2.2.3.4 Glutathione Transferases M1 and T1 (GSTM1 and GSTT1);33
4.1.2.3.4.1;Studies of GSTM1 and GSTT1 Polymorphisms in ACD;34
4.1.2.3.5;2.2.3.5 Manganese Superoxide Dismutase;34
4.1.2.3.5.1;Studies of the MnSOD Polymorphisms in ACD;34
4.1.2.3.6;2.2.3.6 Angiotensin-Converting Enzyme;35
4.1.2.3.6.1;Studies of the ACE Polymorphisms in ACD;35
4.1.2.3.7;2.2.3.7 Filaggrin;35
4.1.2.3.7.1;Studies of FLG Mutations in ACD;35
4.1.2.3.8;2.2.3.8 General Remarks on the Study of “Candidate Gene” Polymorphisms in ACD;36
4.1.3;2.3 Irritant Contact Dermatitis;37
4.1.3.1;2.3.1 Individual Variability in Irritant Responses in Healthy Individuals;38
4.1.3.2;2.3.2 Predisposition Related to Specific Phenotypes;39
4.1.3.2.1;2.3.2.1 Atopic Dermatitis;39
4.1.3.2.2;2.3.2.2 Sex;40
4.1.3.2.3;2.3.2.3 Age;40
4.1.3.2.4;2.3.2.4 Ethnicity;40
4.1.3.2.5;2.3.2.5 Other Skin Diseases;41
4.1.3.2.6;2.3.2.6 Regional Differences;41
4.1.3.2.7;2.3.2.7 Skin Type;41
4.1.3.2.8;2.3.2.8 Body Mass Index;41
4.1.3.3;2.3.3 Genetic Predisposing Factors;42
4.1.4;References;43
4.2;3: Mechanisms of Irritant and Allergic Contact Dermatitis;52
4.2.1;3.1 Introduction;52
4.2.2;3.2 Irritant Contact Dermatitis;52
4.2.2.1;3.2.1 Skin Barrier Perturbation Can Lead to Irritant Contact Dermatitis;52
4.2.2.2;3.2.2 Pathogenesis of Acute Irritant Contact Dermatitis;53
4.2.2.3;3.2.3 Development of Chronic Irritant Contact Dermatitis;55
4.2.2.4;3.2.4 Genetic Risk Factors in Irritant Contact Dermatitis and Atopic Dermatitis;56
4.2.2.5;3.2.5 Cellular Immunological Changes in Irritant Contact Dermatitis;56
4.2.3;3.3 Introduction Allergic Contact Dermatitis;57
4.2.3.1;3.3.1 Binding of Contact Allergens to Skin Components;59
4.2.3.1.1;3.3.1.1 Chemical Nature of Contact Allergens;59
4.2.3.1.2;3.3.1.2 Hapten Presentation by Langerhans Cells (LC);60
4.2.3.1.3;3.3.1.3 Pre and Prohaptens;60
4.2.3.2;3.3.2 Hapten-Induced Activation of Allergen-Presenting Cells;61
4.2.3.2.1;3.3.2.1 Physiology of Langerhans Cells;61
4.2.3.2.2;3.3.2.2 Hapten-Induced LC Activation;61
4.2.3.3;3.3.3 Recognition of Allergen-Modified Langerhans’ Cells by Specific T Cells;63
4.2.3.3.1;3.3.3.1 Homing of Naive T Cells Into Lymph Nodes;63
4.2.3.3.2;3.3.3.2 Activation of Hapten-Specific T Cells;64
4.2.3.4;3.3.4 Proliferation and Differentiation of Specific T Cells;66
4.2.3.4.1;3.3.4.1 T-Cell Proliferation;66
4.2.3.4.2;3.3.4.2 T-Cell Differentiation;66
4.2.3.4.3;3.3.4.3 Cytokine Environment;67
4.2.3.4.4;3.3.4.4 Nature of the Allergen;68
4.2.3.4.5;3.3.4.5 Neuroendocrine Factors;68
4.2.3.5;3.3.5 Systemic Propagation of the Specific T-Cell Progeny;69
4.2.3.5.1;3.3.5.1 T-Cell Recirculation;69
4.2.3.5.2;3.3.5.2 Allergen-Specific T-Cell Recirculation: Options for In Vitro Testing;72
4.2.3.6;3.3.6 The Effector Phase of Allergic Contact Dermatitis;73
4.2.3.6.1;3.3.6.1 Elicitation of ACD;73
4.2.3.6.2;3.3.6.2 Irritant Properties of Allergens;73
4.2.3.6.3;3.3.6.3 Early Phase Reactivity;74
4.2.3.6.4;3.3.6.4 T-Cell Patrol and Specificity of T-Cell Infiltrates;75
4.2.3.6.5;3.3.6.5 Effector T-Cell Phenotypes;75
4.2.3.6.6;3.3.6.6 Downregulatory Processes;76
4.2.3.7;3.3.7 Flare-Up and Retest Reactivity;77
4.2.3.7.1;3.3.7.1 Local Allergen Retention;77
4.2.3.7.2;3.3.7.2 Local T-Cell Retention;77
4.2.3.8;3.3.8 Hyporeactivity: Tolerance and Desensitization;80
4.2.3.8.1;3.3.8.1 Regulation of Immune Responses;80
4.2.3.8.2;3.3.8.2 Cellular Basis of Active Tolerance;81
4.2.3.8.3;3.3.8.3 Regulatory Mechanisms of the Effector Phase;82
4.2.3.8.4;3.3.8.4 Redundancy of Tolerance Mechanisms;83
4.2.3.8.5;3.3.8.5 Induction of Lasting Tolerance Only in Naive Individuals;83
4.2.3.8.6;3.3.8.6 Transient Desensitization in Primed Individuals;83
4.2.4;3.4 Summary and Conclusions;84
4.2.5;References;84
4.3;4: Molecular Aspects in Allergic and Irritant Contact Dermatitis;100
4.3.1;4.1 Introduction;100
4.3.2;4.2 Chemical Interactions;100
4.3.2.1;4.2.1 Weak Interactions;101
4.3.2.2;4.2.2 Strong Interactions;101
4.3.2.3;4.2.3 Heterolytic or Nucleophilic–Electrophilic Reactions;102
4.3.2.4;4.2.4 Homolytic or Radical Reactions;103
4.3.2.5;4.2.5 Coordination Bonds;103
4.3.3;4.3 Chemical Aspects of Allergic Contact Dermatitis;103
4.3.3.1;4.3.1 Reactive Amino Acids;104
4.3.3.2;4.3.2 Reactivity of Haptens;105
4.3.3.3;4.3.3 Mechanisms of Reactions;105
4.3.4;4.4 Modifications of Molecules;107
4.3.4.1;4.4.1 Enzymatic Processes: Prohaptens;107
4.3.4.2;4.4.2 Nonenzymatic Processes: Prehaptens;108
4.3.5;4.5 Haptens and Cross-Allergies;108
4.3.6;4.6 Some Applications of the Chemical Knowledge;109
4.3.6.1;4.6.1 Understanding Cross-Reactions Among Corticosteroids;109
4.3.6.2;4.6.2 Development of Quantitative Structure-Activity Relationships (QSARs);112
4.3.6.2.1;4.6.2.1 Introduction;112
4.3.6.2.2;4.6.2.2 Example of Fragrance Aldehydes;113
4.3.6.2.3;4.6.2.3 Predictive Tests Based on Hapten Reactivity;113
4.3.6.2.3.1;Introduction;113
4.3.6.2.3.2;The Direct Peptide Reactivity Assay (DPRA);114
4.3.7;4.7 Molecular Aspects in Irritant Contact Dermatitis;115
4.3.7.1;4.7.1 Introduction;115
4.3.7.2;4.7.2 Acido-Basic Properties;115
4.3.7.3;4.7.3 Surfactants;115
4.3.7.4;4.7.4 Alkylating Agents;115
4.3.8;4.8 Conclusion;117
4.3.9;References;117
4.4;5: Bio-Guided Fractionation and Identification of Allergens in Complex Mixtures and Products;120
4.4.1;5.1 Introduction;120
4.4.2;5.2 The Principle of Bioassay-Guided Fractionation;121
4.4.3;5.3 The Principle Behind Structure-Activity Relationships in Allergic Contact Dermatitis;122
4.4.4;5.4 Combined Use of Bioassay-Guided Fractionation and SARs to Identify Allergens in Fragrance Complex Mixtures;123
4.4.4.1;5.4.1 General Methodology;124
4.4.4.2;5.4.2 The Case of an Eau de Toilette;124
4.4.4.3;5.4.3 The Case of Oak Moss;125
4.4.5;5.5 Conclusion;127
4.4.6;References;127
4.5;6: Role of the Permeability Barrier in Contact Dermatitis;129
4.5.1;6.1 Introduction;129
4.5.2;6.2 Barrier Physiology;129
4.5.3;6.3 Skin Lipids;131
4.5.4;6.4 Epidermal Proliferation and Differentiation;132
4.5.5;6.5 Tight Junctions and Desmosomal Proteins: A Second-Line Epidermal Barrier;134
4.5.6;6.6 Cytokine Signaling: Regulation of Epidermal Homeostasis and Repair;134
4.5.7;6.7 Experimental Barrier Disruption, Lipids and Protein Modification in Epidermal Differentiation;134
4.5.8;6.8 Barrier Disturbance in Contact Dermatitis;135
4.5.9;6.9 Pathological Skin Barriers: Skin Barrier Function in Dermatoses;135
4.5.10;6.10 Atopic Dermatitis as a Model for the Consequence of a Chronically Disturbed Barrier;135
4.5.11;6.11 Influence of the Permeability Barrier on the Immune System and Contact Dermatitis;136
4.5.12;6.12 Barrier and Patch Testing;138
4.5.13;6.13 Treatment Implications and Approaches: Restoring the Skin’s Protective Function;138
4.5.14;References;140
4.6;7: Immediate Contact Reactions;144
4.6.1;7.1 Introduction;144
4.6.2;7.2 Definitions, Concepts, and Symptoms;145
4.6.3;7.3 Mechanisms and Clinical Aspects of Nonimmunologic Immediate Contact Reactions;145
4.6.3.1;7.3.1 Histamine;145
4.6.3.2;7.3.2 Skin Nerves;146
4.6.3.3;7.3.3 Ultraviolet Light;146
4.6.3.4;7.3.4 Prostanoids;146
4.6.3.5;7.3.5 Molecular Structure;146
4.6.3.6;7.3.6 Agents Producing Nonimmunologic Immediate Contact Reactions;147
4.6.3.7;7.3.7 Tests in Animal Skin;147
4.6.3.8;7.3.8 Tests in Human Skin;148
4.6.3.8.1;7.3.8.1 Open Test;148
4.6.3.8.2;7.3.8.2 Chamber Test;148
4.6.3.8.3;7.3.8.3 Factors to be Considered in Skin Tests;148
4.6.4;7.4 Mechanisms and Clinical Aspects of Immunologic Immediate Contact Reactions;149
4.6.4.1;7.4.1 Induction;149
4.6.4.2;7.4.2 Elicitation;150
4.6.4.3;7.4.3 Agents Producing Immunologic Immediate Contact Reactions;150
4.6.4.4;7.4.4 Tests in Animals;156
4.6.4.5;7.4.5 Tests in Humans;156
4.6.5;References;157
4.7;8: Mechanisms of Phototoxic and Photoallergic Reactions;161
4.7.1;8.1 Introduction;161
4.7.2;8.2 Clinical Aspects of Photoallergic and Phototoxic Reactions;162
4.7.3;8.3 Phototoxicity: General Mechanisms;163
4.7.4;8.4 Some Examples of Specific Agents Capable of Causing Phototoxic Reactions;165
4.7.4.1;8.4.1 Psoralens;165
4.7.4.2;8.4.2 Porphyrins;166
4.7.4.3;8.4.3 Fluoroquinolones;166
4.7.4.4;8.4.4 Nonsteroidal Anti-Inflammatory Drugs;167
4.7.4.5;8.4.5 Amiodarone;167
4.7.5;8.5 Photoallergic Reactions: General Mechanisms;167
4.7.6;References;168
5;Part 2: Pathology;170
5.1;9: Histopathological and Immunohistopathological Features of Irritant and Allergic Contact Dermatitis;171
5.1.1;9.1 Introduction: General Considerations;171
5.1.2;9.2 Histopathological Features of Positive Allergic Patch Test Reactions;172
5.1.2.1;9.2.1 Epidermal Changes;172
5.1.2.2;9.2.2 Dermal Changes;173
5.1.3;9.3 Histopathological Features of Positive Irritant Patch Test Reactions;174
5.1.3.1;9.3.1 Epidermal Changes;175
5.1.3.2;9.3.2 Dermal Changes;176
5.1.4;9.4 Histopathological Criteria for Distinguishing Between Allergic and Irritant Patch Test Reactions in Humans;177
5.1.5;9.5 Comparative Immunohistochemical and Immunocytochemical Characteristics of Allergic and Irritant Patch Test Reactions in;179
5.1.5.1;9.5.1 Epidermal Langerhans Cells in Irritant and Allergic Positive Patch Test Reactions;179
5.1.5.2;9.5.2 Cells of the Infiltrate in Irritant and Allergic Positive Patch Test Reactions: Immunophenotypic Studies;179
5.1.6;9.6 Conclusions;180
5.1.7;References;180
5.2;10: Ultrastructure of Irritant and Allergic Contact Dermatitis;182
5.2.1;10.1 Introduction;182
5.2.2;10.2 Ultrastructural Changes in the Epidermis;183
5.2.2.1;10.2.1 Stratum Corneum;183
5.2.2.2;10.2.2 Viable Keratinocytes;183
5.2.2.2.1;10.2.2.1 Irritant Contact Dermatitis;183
5.2.2.2.2;10.2.2.2 Allergic Contact Dermatitis;186
5.2.2.3;10.2.3 Langerhans Cells;186
5.2.2.3.1;10.2.3.1 Allergic Contact Dermatitis;186
5.2.2.3.2;10.2.3.2 Irritant Contact Dermatitis;187
5.2.3;10.3 Ultrastructural Changes in the Dermis;191
5.2.4;10.4 Ultrastructural Changes in Chronic Contact Dermatitis;193
5.2.5;10.5 Summary;194
5.2.6;References;194
5.3;11: Epidemiology;196
5.3.1;11.1 Introduction;196
5.3.2;11.2 Measures of Disease Frequency;196
5.3.2.1;11.2.1 Source Population;197
5.3.3;11.3 Clinical Epidemiology;197
5.3.3.1;11.3.1 Description of (Patch Test) Patients;198
5.3.3.2;11.3.2 Special Aspects of the Analysis of Patch Test Data;199
5.3.4;11.4 Observational Studies;201
5.3.5;11.5 Case Ascertainment;202
5.3.6;11.6 Incidence and Prevalence of Contact Dermatitis and Contact Sensitisation;204
5.3.6.1;11.6.1 General Population;204
5.3.6.2;11.6.2 Incidence and Prevalence of Notified Occupational Contact Dermatitis;207
5.3.7;11.7 Incidence and Prevalence in Different Work Forces;209
5.3.8;11.8 Special Considerations: Confounding, Atopy, Interactions and Effect Modification;210
5.3.8.1;11.8.1 Classic Articles and Monographs;211
5.3.9;References;212
6;Part 3: Dermatotoxicology;215
6.1;12: Skin Penetration;216
6.1.1;12.1 Introduction;216
6.1.2;12.2 Diffusion;217
6.1.2.1;12.2.1 Fick’s Laws;217
6.1.3;12.3 Three-Compartment Model;217
6.1.4;12.4 The Skin Surface;218
6.1.4.1;12.4.1 Surface Contact;218
6.1.5;12.5 The Skin Barrier;218
6.1.5.1;12.5.1 Corneocytes;218
6.1.5.2;12.5.2 Intercellular Lipid;219
6.1.5.3;12.5.3 Appendages;219
6.1.5.4;12.5.4 Pathways Across the Stratum Corneum;220
6.1.5.5;12.5.5 Inter- and Intraindividual Variation in Skin-Barrier Function;221
6.1.6;12.6 Viable Tissue;221
6.1.6.1;12.6.1 Skin Metabolism;223
6.1.6.2;12.6.2 Resorption;223
6.1.6.3;12.6.3 The Influence of Pathologic Processes on Skin Barrier;224
6.1.6.4;12.6.4 Allergens;225
6.1.7;12.7 Vehicles;225
6.1.8;12.8 Conclusions;225
6.1.9;References;226
6.2;13: Predictive Tests for Irritants and Allergens and Their Use in Quantitative Risk Assessment;229
6.2.1;13.1 Introduction;229
6.2.2;13.2 Definitions;229
6.2.3;13.3 Predictive Tests for Irritants;230
6.2.4;13.4 Predictive Tests for Allergens;231
6.2.5;13.5 Quantitative Risk Assessment;233
6.2.5.1;13.5.1 Summary and Future Perspectives;234
6.2.6;References;237
6.3;14: Allergic Contact Dermatitis in Humans: Experimental and Quantitative Aspects;240
6.3.1;14.1 Introduction;240
6.3.2;14.2 Individual Variation;240
6.3.3;14.3 Exposure-Related Factors;241
6.3.4;14.4 Experimental Human Models;242
6.3.4.1;14.4.1 Serial Dilution Patch Test;242
6.3.4.2;14.4.2 The Repeated Open Application Test;243
6.3.4.3;14.4.3 The Axillary Exposure Test;244
6.3.4.4;14.4.4 The Shampoo Test;245
6.3.4.5;14.4.5 The Liquid Soap Test;245
6.3.4.6;14.4.6 The Finger Immersion Test/Experimental Hand Eczema;246
6.3.5;14.5 The Comparative Approach;247
6.3.6;14.6 Elicitation Data Used in Prevention and Regulations;247
6.3.7;References;248
7;Part 4: Clinical Features;251
7.1;15: Clinical Features;252
7.1.1;15.1 Introduction;252
7.1.2;15.2 The Medical History of the Patient;253
7.1.2.1;15.2.1 History of Hereditary Diseases;253
7.1.2.2;15.2.2 General Medical History;253
7.1.2.3;15.2.3 History of Previous Dermatitis;254
7.1.2.4;15.2.4 Time of Onset;254
7.1.2.5;15.2.5 History of Aggravating Factors;254
7.1.2.6;15.2.6 Course of the Dermatitis;256
7.1.2.7;15.2.7 Types of Symptoms;256
7.1.3;15.3 Clinical Features of Eczematous Reactions;256
7.1.3.1;15.3.1 Acute and Recurrent Dermatitis;256
7.1.3.2;15.3.2 Chronic Dermatitis;259
7.1.3.3;15.3.3 Nummular (Discoid) Eczema;259
7.1.3.4;15.3.4 Secondarily Infected Dermatitis;260
7.1.3.5;15.3.5 Clinical Features of Contact Dermatitis in Specific Groups of Persons;261
7.1.3.5.1;15.3.5.1 Gender;261
7.1.3.5.2;15.3.5.2 Children;261
7.1.3.5.3;15.3.5.3 Elderly Persons;261
7.1.3.5.4;15.3.5.4 Ethnicity;261
7.1.3.5.5;15.3.5.5 Atopy;261
7.1.4;15.4 Identifying the Cause of Contact Dermatitis from the Clinical Pattern;262
7.1.4.1;15.4.1 Clinical Patterns Indicating General Causes of Contact Dermatitis;262
7.1.4.1.1;15.4.1.1 Contact Pattern;262
7.1.4.1.2;15.4.1.2 Streaked Dermatitis in Exposed Areas;264
7.1.4.1.3;15.4.1.3 Airborne Contact Dermatitis;265
7.1.4.1.4;15.4.1.4 Mechanical Dermatitis;266
7.1.4.1.5;15.4.1.5 Hyperkeratotic Eczema;267
7.1.4.1.6;15.4.1.6 Ring Dermatitis;267
7.1.4.1.7;15.4.1.7 Follicular Reactions;267
7.1.4.1.8;15.4.1.8 Connubial and Consort Dermatitis;268
7.1.4.1.9;15.4.1.9 Recurrent Vesicular Hand and/or Foot Dermatitis;268
7.1.4.1.10;15.4.1.10 Fingertip Eczema (Pulpitis);269
7.1.4.1.11;15.4.1.11 Eczema Nails;269
7.1.4.1.12;15.4.1.12 Papular and Nodular Excoriated Lesions;269
7.1.4.1.13;15.4.1.13 Contact Urticaria of the Hands and Lips;270
7.1.4.1.14;15.4.1.14 Clinical Patterns of Systemically Induced Contact Dermatitis;271
7.1.4.2;15.4.2 Characteristic Clinical Patterns of Dermatitis Associated with Specific Substances or Types of Application;271
7.1.4.2.1;15.4.2.1 Cement Ulcerations;271
7.1.4.2.2;15.4.2.2 Pigmented Contact Dermatitis;272
7.1.4.2.3;15.4.2.3 Caterpillar Dermatitis and Irritant Dermatitis from Plants and Animals;272
7.1.4.2.4;15.4.2.4 Head and Neck Dermatitis;272
7.1.4.2.5;15.4.2.5 Dermatitis from Transcutaneous Delivery Systems;272
7.1.4.2.6;15.4.2.6 Berloque Dermatitis;272
7.1.4.2.7;15.4.2.7 Stomatitis Due to Mercury or Gold Allergy;273
7.1.5;15.5 Regional Contact Dermatitis;273
7.1.5.1;15.5.1 Dermatitis of the Scalp;273
7.1.5.2;15.5.2 Dermatitis of the Face and Neck;274
7.1.5.2.1;15.5.2.1 The Lips;277
7.1.5.2.2;15.5.2.2 The Eyes and Eyelids;277
7.1.5.2.3;15.5.2.3 The Ear;278
7.1.5.3;15.5.3 Dermatitis of the Trunk;278
7.1.5.3.1;15.5.3.1 The Axillary Region;279
7.1.5.3.2;15.5.3.2 The Anogenital Region;280
7.1.5.3.3;15.5.3.3 Stoma Dermatitis;281
7.1.5.4;15.5.4 Dermatitis of the Legs;282
7.1.5.5;15.5.5 Dermatitis of the Feet;283
7.1.5.5.1;15.5.5.1 Recurrent, Pruritic, Vesicular, Plantar Dermatitis;283
7.1.5.5.2;15.5.5.2 Hyperkeratotic Plantar Eczema;284
7.1.5.6;15.5.6 Dermatitis of the Arms;284
7.1.5.7;15.5.7 Contact Stomatitis;284
7.1.5.8;15.5.8 Dermatitis Caused by Items Within the Body;285
7.1.6;15.6 Differential Diagnosis;285
7.1.7;15.7 Case Reports;289
7.1.7.1;15.7.1 Case Report 1;289
7.1.7.2;15.7.2 Case Report 2;290
7.1.8;References;291
7.2;16: Clinical Aspects of Irritant Contact Dermatitis;301
7.2.1;16.1 Definition;301
7.2.2;16.2 Clinical Picture;301
7.2.2.1;16.2.1 Chemical Burns;302
7.2.2.2;16.2.2 Irritant Reactions;303
7.2.2.3;16.2.3 Acute Irritant Contact Dermatitis;305
7.2.2.4;16.2.4 Chronic Irritant Contact Dermatitis;312
7.2.3;16.3 Case Report;317
7.2.3.1;16.3.1 Special Forms of Irritation;317
7.2.3.1.1;16.3.1.1 Climatic Factors;317
7.2.3.1.2;16.3.1.2 Aggravation of Endogenous Dermatoses by Friction and Occlusion;318
7.2.4;16.4 Epidemiology;319
7.2.5;16.5 Pathogenesis;321
7.2.5.1;16.5.1 Exogenous Factors;321
7.2.5.2;16.5.2 Endogenous Factors;322
7.2.5.3;16.5.3 Sensitive (Hyperirritable) Skin;323
7.2.6;16.6 Diagnostic Tests and Experimental Irritant Contact Dermatitis;325
7.2.7;16.7 Action of Irritants and Inflammatory Mediators;326
7.2.8;16.8 Quantification of the Irritant Response (Bioengineering Techniques);326
7.2.9;16.9 Therapy and Prevention;327
7.2.10;16.10 Neurosensory Irritation (“Stinging”);329
7.2.10.1;16.10.1 Immediate-Type Stinging;329
7.2.10.2;16.10.2 Delayed-Type Stinging;329
7.2.10.3;16.10.3 Pathogenesis of Stinging and Influencing Factors;330
7.2.11;16.11 Suggested Reading;333
7.2.12;References;333
7.3;17: Systemic Contact Dermatitis;342
7.3.1;17.1 Introduction;342
7.3.2;17.2 Clinical Features;343
7.3.3;17.3 Mechanism;344
7.3.4;17.4 Medicaments;345
7.3.5;17.5 Metals;346
7.3.5.1;17.5.1 Nickel;346
7.3.5.2;17.5.2 Chromium and Cobalt;348
7.3.5.3;17.5.3 Gold;348
7.3.5.4;17.5.4 Mercury;348
7.3.6;17.6 Other Contact Allergens;348
7.3.7;17.7 Risk Assessment-Oriented Studies;349
7.3.8;17.8 Diagnosis;350
7.3.9;17.9 Case Reports;352
7.3.9.1;17.9.1 Case Report 1;352
7.3.9.2;17.9.2 Case Report 2;352
7.3.10;References;352
7.4;18: Phototoxic and Photoallergic Reactions;356
7.4.1;18.1 Introduction;356
7.4.2;18.2 General Mechanisms of Photosensitivity;357
7.4.2.1;18.2.1 Phototoxicity vs. Photoallergy;357
7.4.3;18.3 Clinical Patterns of Photosensitivity;358
7.4.3.1;18.3.1 Acute Manifestations of Photosensitivity;360
7.4.3.1.1;18.3.1.1 Immediate Reactions;360
7.4.3.1.2;18.3.1.2 Acute Phototoxicity, Mimicking Sunburn;360
7.4.3.1.3;18.3.1.3 Acute Photoallergic Eczema;360
7.4.3.2;18.3.2 Subacute Manifestations of Photosensitivity;360
7.4.3.2.1;18.3.2.1 Pseudoporphyria;361
7.4.3.2.2;18.3.2.2 Photoonycholysis;361
7.4.3.2.3;18.3.2.3 Dyschromia;361
7.4.3.2.4;18.3.2.4 Other Clinical Patterns;361
7.4.3.3;18.3.3 Delayed and Late Effects of Photosensitivity;363
7.4.3.3.1;18.3.3.1 Lupus Erythematosus;363
7.4.3.3.2;18.3.3.2 Chronic Actinic Dermatitis;363
7.4.3.3.3;18.3.3.3 Enhancement of Photocarcinogenesis;363
7.4.4;18.4 Main Topical and Systemic Photosensitizers;363
7.4.4.1;18.4.1 UV Filters;364
7.4.4.2;18.4.2 Plants Causing Phytophotodermatitis;365
7.4.4.3;18.4.3 Photosensitive Drugs;366
7.4.4.3.1;18.4.3.1 Antimicrobials;366
7.4.4.3.2;18.4.3.2 Nonsteroidal Anti-Inflammatory Drugs;367
7.4.4.3.2.1;Ketoprofen;367
7.4.4.3.2.2;Piroxicam;368
7.4.4.3.3;18.4.3.3 Other Drugs as Photosensitizers;368
7.4.5;18.5 Conclusions;369
7.4.6;References;369
7.5;19: Pigmented Contact Dermatitis and Chemical Depigmentation;372
7.5.1;19.1 Hyperpigmentation Associated with Contact Dermatitis;372
7.5.1.1;19.1.1 Classification;372
7.5.1.2;19.1.2 Pigmented Contact Dermatitis;373
7.5.1.2.1;19.1.2.1 History and Causative Agents;373
7.5.1.2.2;19.1.2.2 Differential Diagnosis;376
7.5.1.2.3;19.1.2.3 Prevention and Treatment;377
7.5.1.3;19.1.3 Pigmented Cosmetic Dermatitis;378
7.5.1.3.1;19.1.3.1 Signs;378
7.5.1.3.2;19.1.3.2 Causative Allergens;379
7.5.1.3.3;19.1.3.3 Treatment;380
7.5.1.4;19.1.4 Purpuric Dermatitis;382
7.5.1.5;19.1.5 “Dirty Neck” of Atopic Eczema;383
7.5.2;19.2 Depigmentation from Contact with Chemicals;384
7.5.2.1;19.2.1 Mechanism of Leukoderma Due to Chemicals;384
7.5.2.2;19.2.2 Contact Leukoderma Caused Mainly by Contact Sensitization;387
7.5.3;References;387
7.6;20: Hand Eczema;389
7.6.1;20.1 Epidemiology;389
7.6.1.1;20.1.1 Frequency;389
7.6.1.2;20.1.2 Risk Factors;389
7.6.1.3;20.1.3 Validity of Self-Reported Hand Eczema;390
7.6.2;20.2 Aetiology and Morphology;391
7.6.2.1;20.2.1 Allergic Contact Dermatitis;391
7.6.2.2;20.2.2 Irritant Contact Dermatitis;391
7.6.2.3;20.2.3 Atopic Dermatitis;392
7.6.2.4;20.2.4 Contact Urticaria;392
7.6.2.5;20.2.5 Endogenous Forms;392
7.6.2.5.1;20.2.5.1 Vesicular Hand Eczema (Pompholyx);392
7.6.2.5.2;20.2.5.2 Hyperkeratotic Eczema;393
7.6.3;20.3 Severity Assessment;393
7.6.4;20.4 Occupational Hand Eczema;393
7.6.5;20.5 Prognosis;394
7.6.6;20.6 Treatment (Table 20.3);395
7.6.7;20.7 Prevention;396
7.6.7.1;20.7.1 Regulation of Threshold Values for Allergens;396
7.6.7.2;20.7.2 Identification of Risk Groups;396
7.6.7.3;20.7.3 Skin Protection;397
7.6.8;20.8 Quality of Life;397
7.6.9;20.9 Differential Diagnosis;397
7.6.10;References;397
7.7;21: Protein Contact Dermatitis;401
7.7.1;21.1 Introduction;401
7.7.2;21.2 Clinical Features;401
7.7.3;21.3 Causes [2, 4, 5] (Tables 21.1–21.3);402
7.7.4;21.4 Pathogenesis;405
7.7.5;21.5 Diagnostic Tests;405
7.7.6;21.6 Differential Diagnosis;406
7.7.7;21.7 Conclusion;406
7.7.8;References;407
7.8;22: Noneczematous Contact Reactions;408
7.8.1;22.1 Introduction;408
7.8.1.1;22.2 Erythema Multiforme-Like Reaction (Urticarial Papular and Plaque Eruptions);408
7.8.1.1.1;22.2.1 Differentiation from Classical Erythema Multiforme;409
7.8.1.1.2;22.2.2 Causes;410
7.8.1.1.2.1;Woods and Plants;410
7.8.1.1.2.2;Topical Medicaments;410
7.8.1.1.2.3;Metals and Chemicals;411
7.8.2;22.3 Pigmented Purpuric Eruption;412
7.8.3;22.4 Lichen Planus-Like or Lichenoid Eruption;413
7.8.3.1;22.4.1 Histology;414
7.8.3.2;22.4.2 Mechanism;414
7.8.4;22.5 Bullous Eruption;415
7.8.5;22.6 Nodular and Papular Eruption;415
7.8.6;22.7 Granulomatous Eruption;415
7.8.7;22.8 Pustular Eruption;416
7.8.8;22.9 Erythematous and Exfoliative Eruption;416
7.8.8.1;22.9.1 Trichloroethylene;417
7.8.8.2;22.9.2 Methyl Bromide;417
7.8.9;22.10 Scleroderma-Like Eruption;417
7.8.10;22.11 Pigmented Contact Dermatitis;418
7.8.11;22.12 Lymphomatoid Contact Dermatitis;418
7.8.12;22.13 Vascular-Occlusive Contact Dermatitis;419
7.8.13;References;419
7.9;23: Respiratory Symptoms from Fragrances and the Link with Dermatitis;421
7.9.1;23.1 Introduction;421
7.9.2;23.2 Localisation, Prevalence and Severity;422
7.9.3;23.3 Epidemiological Associations;422
7.9.4;23.4 Pathophysiology;423
7.9.4.1;23.4.1 Immunological Mechanisms;423
7.9.4.2;23.4.2 Sensory Mechanisms;424
7.9.4.3;23.4.3 Psychological Mechanisms;424
7.9.5;23.5 Genetic and Environmental Factors;425
7.9.6;23.6 Conclusion;425
7.9.7;23.7 Case Report with a Typical Treatment Strategy;425
7.9.8;23.8 Diagram Summarising the Current View on the Pathogenesis of Respiratory Symptoms from Fragrance Exposure;426
7.9.9;References;426
8;Part 5: Diagnostic Tests;429
8.1;24: Patch Testing;430
8.1.1;24.1 Introduction;430
8.1.1.1;24.1.1 The Purpose of Patch Testing;430
8.1.1.2;24.1.2 Standardization;431
8.1.1.3;24.1.3 Bioavailability;431
8.1.2;24.2 Test Systems;431
8.1.2.1;24.2.1 Original System (Allergen–Patch–Tape);432
8.1.2.1.1;24.2.1.1 Patches;432
8.1.2.1.2;24.2.1.2 Allergens;432
8.1.2.1.3;24.2.1.3 Vehicles;432
8.1.2.1.4;24.2.1.4 Concentrations;433
8.1.2.1.5;24.2.1.5 Tapes;433
8.1.2.1.6;24.2.1.6 Application of Test Preparations to the Patches;433
8.1.2.1.7;24.2.1.7 Suppliers;433
8.1.2.2;24.2.2 Ready-to-Use Systems;433
8.1.2.3;24.2.3 Some Practical Suggestions;434
8.1.2.3.1;24.2.3.1 Storage;434
8.1.2.3.2;24.2.3.2 Sequence of Allergens;434
8.1.2.3.3;24.2.3.3 Testing in Pregnancy;435
8.1.2.3.4;24.2.3.4 Test Sites;435
8.1.2.3.5;24.2.3.5 Removal of Hair;435
8.1.2.3.6;24.2.3.6 Degreasing of Test Site;435
8.1.2.3.7;24.2.3.7 Application of Test Strips;435
8.1.2.3.8;24.2.3.8 Skin Markers;435
8.1.2.3.9;24.2.3.9 Positive Control;435
8.1.2.3.10;24.2.3.10 Instructions;435
8.1.2.3.11;24.2.3.11 Reading;435
8.1.3;24.3 Allergens;435
8.1.3.1;24.3.1 Numbers;435
8.1.3.2;24.3.2 Screening Series;435
8.1.3.3;24.3.3 Variations Concerning Concentration and Vehicle;436
8.1.4;24.4 Baseline Series;436
8.1.4.1;24.4.1 Deciding What to Include in the Baseline Series;437
8.1.5;24.5 Reading and Evaluation of Patch Tests;437
8.1.5.1;24.5.1 Reading: When and How;438
8.1.5.1.1;24.5.1.1 Exposure Time;438
8.1.5.1.2;24.5.1.2 Reading When?;438
8.1.5.1.3;24.5.1.3 Compromise;438
8.1.5.2;24.5.2 Recording of Test Reactions;439
8.1.5.3;24.5.3 Interpretation of Reactions at Test Sites;439
8.1.5.3.1;24.5.3.1 Discrimination Between Allergic and Irritant Reactions;441
8.1.5.3.2;24.5.3.2 Ring-Shaped Test Reactions;441
8.1.5.3.3;24.5.3.3 Ultrastructure;441
8.1.5.3.4;24.5.3.4 Doubtful and One Plus Reactions;441
8.1.5.3.5;24.5.3.5 Cross-Sensitivity;441
8.1.5.4;24.5.4 Relevance;443
8.1.5.5;24.5.5 False-Positive Test Reactions;443
8.1.5.5.1;24.5.5.1 The Compromise (Item 1);444
8.1.5.5.2;24.5.5.2 Excited-Skin Syndrome: “Angry Back” (Items 7 and 8);444
8.1.5.5.3;24.5.5.3 The Patch (Item 11);444
8.1.5.6;24.5.6 False-Negative Test Reactions;444
8.1.5.6.1;24.5.6.1 Common Causes;444
8.1.5.6.2;24.5.6.2 Compound Allergy (Item 6);445
8.1.6;24.6 Ethnic and Climatic Considerations;445
8.1.7;24.7 Effect of Medicaments and Irradiation on Patch Tests;445
8.1.7.1;24.7.1 Corticosteroids;445
8.1.7.2;24.7.2 Antihistamines;446
8.1.7.3;24.7.3 Immunomodulators;446
8.1.7.4;24.7.4 Irradiation;446
8.1.7.5;24.7.5 Seasonal Variations;446
8.1.8;24.8 Complications;446
8.1.8.1;24.8.1 Patch Test Sensitization (Item 1);447
8.1.8.2;24.8.2 Subjective Complaints (Item 4);447
8.1.8.3;24.8.3 Penicillin (Item 9);447
8.1.9;24.9 Open Tests;447
8.1.9.1;24.9.1 Open Test;447
8.1.9.2;24.9.2 Semi-Open Test;447
8.1.10;24.10 Use Tests;448
8.1.10.1;24.10.1 Purpose;448
8.1.10.2;24.10.2 Repeated Open Application Test;448
8.1.11;24.11 Noninvasive Techniques;449
8.1.12;24.12 Quality Control of Test Materials;449
8.1.12.1;24.12.1 Identification and Purity;449
8.1.12.2;24.12.2 Test Preparations Under the Microscope;449
8.1.12.3;24.12.3 Fresh Samples;449
8.1.12.4;24.12.4 Adhesive Tapes;449
8.1.13;24.13 Tests with Unknown Substances;449
8.1.13.1;24.13.1 Warning!;449
8.1.13.2;24.13.2 Strategy;449
8.1.13.3;24.13.3 Test or Not?;450
8.1.13.4;24.13.4 Cosmetics and Similar Products;450
8.1.14;24.14 The Future;450
8.1.15;References;451
8.2;25: Atopy Patch Testing with Aeroallergens and Food Proteins;456
8.2.1;25.1 Introduction;456
8.2.2;25.2 APT Methods and Influence on Reactions;458
8.2.3;25.3 Evaluation of APT Reactions;460
8.2.4;25.4 Predictors, Sensitivity and Specificity of APT;460
8.2.5;25.5 APT with Food Proteins;461
8.2.6;25.6 APT and Atopic Eczema “Intrinsic Type”;462
8.2.7;25.7 Outlook;462
8.2.8;25.8 Classic Article;463
8.2.9;References;463
8.3;26: Patch Testing in Adverse Drug Reactions;466
8.3.1;26.1 Introduction;466
8.3.1.1;26.1.1 Definition and Types of Cutaneous Adverse Drug Reactions;466
8.3.1.2;26.1.2 Main Clinical Patterns of Immune-Mediated CADRs;467
8.3.1.3;26.1.3 Pathomechanisms Involved in Immune-Mediated Drug Eruptions;469
8.3.1.4;26.1.4 T-Cell Involvement in Drug Eruptions;469
8.3.2;26.2 The Workup in the Diagnosis of an Immune-Mediated CADR;470
8.3.2.1;26.2.1 Clinical Diagnosis and Drug Imputation;470
8.3.2.2;26.2.2 Complementary Tests to Confirm Drug Imputation;471
8.3.3;26.3 Patch Testing in CADRs;472
8.3.3.1;26.3.1 The General Value of Patch Testing;472
8.3.3.2;26.3.2 Patch Test Technique;474
8.3.3.3;26.3.3 Material for Patch Testing with Drugs;475
8.3.3.3.1;26.3.3.1 Patch Testing with Pure Drugs;475
8.3.3.3.2;26.3.3.2 Patch Testing with Drugs Used by the Patient;475
8.3.3.4;26.3.4 Safety of Patch Testing;477
8.3.3.5;26.3.5 Specificity of Patch Test Reactions;477
8.3.3.6;26.3.6 Evaluating Cross-Reactivity on Patch Testing;477
8.3.4;26.4 Conclusions: Interpretation of Patch Test Results;478
8.3.5;26.5 Classic Articles and Monographs;478
8.3.6;References;479
8.4;27: Allergens Exposure Assessment;483
8.4.1;27.1 Spot Tests and Chemical Analyses;483
8.4.1.1;27.1.1 Introduction;483
8.4.1.2;27.1.2 pH Measurement;484
8.4.1.3;27.1.3 Spot Tests;484
8.4.1.4;27.1.4 Thin-Layer Chromatography;484
8.4.1.5;27.1.5 Gas Chromatography;484
8.4.1.6;27.1.6 High-Performance Liquid Chromatography;485
8.4.1.7;27.1.7 Atomic Absorption Spectrophotometry;485
8.4.1.8;27.1.8 UV-VIS Spectrophotometry;485
8.4.1.9;27.1.9 Infrared Spectrophotometry;485
8.4.1.10;27.1.10 Mass Spectrometry;485
8.4.1.11;27.1.11 Inductively Coupled Plasma-Mass Spectrometry;486
8.4.1.12;27.1.12 Nuclear Magnetic Resonance Spectroscopy;486
8.4.1.13;27.1.13 Common Chemical Methods Used by Dermatologists;486
8.4.1.13.1;27.1.13.1 Detection of Nickel Ions Released from Metal Objects;486
8.4.1.13.2;27.1.13.2 Detection of Hexavalent Chromium (Chromate);486
8.4.1.13.2.1;Chromate on the Surface of a Solid Object;489
8.4.1.13.2.2;Chromate in Solutions;489
8.4.1.13.2.3;Chromate in Powders Insoluble in Water (E.g. Cement);489
8.4.1.13.3;27.1.13.3 Detection of Epoxy Resin Based on Bisphenol A;490
8.4.1.13.4;27.1.13.4 Detection of Formaldehyde;490
8.4.1.13.4.1;Chromotropic Acid Method;490
8.4.1.13.4.2;Acetylacetone Method;492
8.4.1.14;27.1.14 Summary;493
8.4.2;27.2 Skin Exposure Assessment;493
8.4.2.1;27.2.1 Introduction;493
8.4.2.2;27.2.2 Techniques for the Assessment of Skin Exposure;493
8.4.2.2.1;27.2.2.1 Fluorescent Tracer Technique;494
8.4.2.2.2;27.2.2.2 Removal Techniques;494
8.4.2.2.2.1;Washing, Rinsing and Wiping;494
8.4.2.2.2.2;Tape Stripping;495
8.4.2.2.2.3;Vacuuming;496
8.4.2.2.3;27.2.2.3 Surrogate Skin Sampling;496
8.4.2.2.4;27.2.2.4 Assessment by Observation;496
8.4.2.2.5;27.2.2.5 Biomonitoring;496
8.4.2.3;27.2.3 Analytical Methods;496
8.4.2.4;27.2.4 Application of Results;497
8.4.3;References;497
8.5;28: Skin Tests for Immediate Hypersensitivity;501
8.5.1;28.1 Introduction;501
8.5.2;28.2 Skin Prick Testing;502
8.5.2.1;28.2.1 Material for Testing;502
8.5.2.2;28.2.2 Procedure;504
8.5.2.3;28.2.3 Reading of SPT;504
8.5.3;28.3 Intracutaneous (or Intradermal) Test;505
8.5.3.1;28.3.1 Material for Testing;505
8.5.3.2;28.3.2 Procedure;505
8.5.4;28.4 Scratch-Patch Test (S-P);505
8.5.5;28.5 Skin Application Food Test;505
8.5.6;28.6 Open Application Test;506
8.5.7;28.7 Atopy Patch Testing;506
8.5.8;28.8 Conclusions;506
8.5.9;References;507
8.6;29: Photopatch Testing;508
8.6.1;29.1 Introduction;508
8.6.2;29.2 Indications for Performing Photopatch Tests;509
8.6.2.1;29.2.1 Main Indication;509
8.6.2.2;29.2.2 Other Indications for Photopatch Testing;510
8.6.3;29.3 Photopatch Testing Technique;511
8.6.3.1;29.3.1 How to Perform Photopatch Tests;511
8.6.3.2;29.3.2 When to Perform Photopatch Tests;512
8.6.3.3;29.3.3 Irradiation Source and UV Dose;512
8.6.3.4;29.3.4 Photopatch Testing in Particular Cases (Immunosuppression and Photosensitivity);513
8.6.4;29.4 Reading and Interpretation of Test Results;513
8.6.4.1;29.4.1 Timing of the Readings;513
8.6.4.2;29.4.2 Scoring of the Reactions;513
8.6.4.3;29.4.3 Interpretation of Test Results: Allergy or Photoallergy;514
8.6.4.4;29.4.4 Relevance of Positive Reactions;515
8.6.5;29.5 Allergens for Photopatch Testing (Basic and Additional Series);515
8.6.5.1;29.5.1 UV Filters in the Basic and Additional Tray for Photopatch Testing;517
8.6.5.2;29.5.2 Drugs in the Basic and Additional Tray for Photopatch Testing;517
8.6.5.3;29.5.3 Other Allergens for Photopatch Testing;518
8.6.6;29.6 Conclusions;518
8.6.7;References;519
8.7;30: Noninvasive Techniques for Quantification of Contact Dermatitis;521
8.7.1;30.1 Introduction;521
8.7.2;30.2 Prerequisites and Planning of Study by Noninvasive Techniques;521
8.7.3;30.3 Review of Noninvasive Techniques Relevant to the Study of Contact Dermatitis;522
8.7.3.1;30.3.1 Changes in the Skin Surface;522
8.7.3.2;30.3.2 Epidermal Hydration and Water Barrier Function;523
8.7.3.3;30.3.3 Parameters of Inflammation;524
8.7.4;30.4 Allergic Contact Dermatitis;525
8.7.5;30.5 Irritant Contact Dermatitis;526
8.7.5.1;30.5.1 Edema;527
8.7.5.2;30.5.2 Sensitive Skin and Hyperirritable Skin;527
8.7.6;30.6 Urticarial Wheals;528
8.7.7;References;529
9;Part 6: Allergic Contact Dermatitis Related to Specific Exposures;531
9.1;31: Allergens from the European Baseline Series;532
9.1.1;31.1 Introduction;532
9.1.2;31.2 Nickel;533
9.1.3;31.3 Chromium;537
9.1.4;31.4 Cobalt;539
9.1.5;31.5 Fragrance Mix I & II;539
9.1.6;31.6 Hydroxyisohexyl 3-Cyclohexene Carboxaldehyde (Lyral®);542
9.1.7;31.7 Balsam of Peru;543
9.1.8;31.8 Colophonium;543
9.1.9;31.9 Neomycin;545
9.1.10;31.10 Benzocaine (Ethylaminobenzoate);545
9.1.11;31.11 Clioquinol;546
9.1.12;31.12 Wool Wax Alcohols (Lanolin);546
9.1.13;31.13 Paraben Mix;547
9.1.14;31.14 Formaldehyde;548
9.1.15;31.15 Quaternium-15;550
9.1.16;31.16 Methylchloro- and Methylisothiazolinone (MCI/MI);551
9.1.17;31.17 Para-phenylenediamine;552
9.1.18;31.18 Thiuram Mix;554
9.1.19;31.19 Mercapto Mix and Mercaptobenzothiazole;555
9.1.20;31.20 N-Isopropyl-N-Phenyl-p-Phenylenediamine (IPPD);555
9.1.21;31.21 Epoxy Resin;556
9.1.22;31.22 Para-Tertiary-Butylphenol-Formaldehyde Resin;558
9.1.23;31.23 Primin;559
9.1.24;31.24 Sesquiterpene Lactone Mix (SL Mix);559
9.1.25;31.25 Budesonide;561
9.1.26;31.26 Tixocortol Pivalate;561
9.1.27;31.27 Methyldibromo Glutaronitrile;562
9.1.28;31.28 Ethylenediamine (No Longer Included in the Baseline Series);562
9.1.29;References;563
9.2;32: Cosmetics and Skin Care Products;578
9.2.1;32.1 What are Cosmetics?;578
9.2.2;32.2 Epidemiology of Side Effects from Cosmetics;578
9.2.2.1;32.2.1 The General Population;578
9.2.2.2;32.2.2 Patients Seen by Dermatologists;579
9.2.3;32.3 Clinical Picture;580
9.2.4;32.4 The Products Causing Cosmetic Allergy;580
9.2.5;32.5 The Allergens;580
9.2.5.1;32.5.1 Fragrances;581
9.2.5.2;32.5.2 Preservatives;582
9.2.5.2.1;32.5.2.1 Methylchloroisothiazolinone (and) Methylisothiazolinone;582
9.2.5.2.2;32.5.2.2 Methyldibromo Glutaronitrile;583
9.2.5.2.3;32.5.2.3 Formaldehyde;583
9.2.5.2.4;32.5.2.4 Formaldehyde Donors;583
9.2.5.3;32.5.3 Quaternium-15;584
9.2.5.4;32.5.4 Imidazolidinyl Urea;584
9.2.5.5;32.5.5 Diazolidinyl Urea;584
9.2.5.6;32.5.6 2-Bromo-2-Nitropropane-1,3-Diol (Bronopol);584
9.2.5.7;32.5.7 DMDM Hydantoin;584
9.2.5.7.1;32.5.7.1 Parabens;584
9.2.5.7.2;32.5.7.2 Iodopropynyl Butylcarbamate;584
9.2.5.7.3;32.5.7.3 Miscellaneous Preservatives;585
9.2.5.8;32.5.8 Tosylamide/Formaldehyde Resin;585
9.2.5.9;32.5.9 p-Phenylenediamine and Related Hair Dyes;585
9.2.5.10;32.5.10 Cocamidopropyl Betaine;585
9.2.5.11;32.5.11 UV Filters;586
9.2.5.12;32.5.12 Lanolin and Derivatives;586
9.2.5.13;32.5.13 Glyceryl Thioglycolate;586
9.2.5.14;32.5.14 Propylene Glycol;586
9.2.5.15;32.5.15 Antioxidants;587
9.2.5.16;32.5.16 Miscellaneous Allergens;587
9.2.6;32.6 Diagnostic Procedures;587
9.2.7;32.7 Ingredient Labeling in the European Union;588
9.2.8;References;588
9.3;33: Fragrances;593
9.3.1;33.1 Introduction;593
9.3.2;33.2 Fragrance Ingredients;593
9.3.3;33.3 The Fragrance Formula;594
9.3.4;33.4 Chemistry;594
9.3.5;33.5 Fragrance Contact Allergens;594
9.3.5.1;33.5.1 Fragrance Chemicals;595
9.3.5.2;33.5.2 Oxidation Products;596
9.3.5.3;33.5.3 Fragrance Naturals;597
9.3.6;33.6 Epidemiology of Fragrance Contact Allergy;598
9.3.7;33.7 Clinical Aspects;599
9.3.8;33.8 Exposure to Fragrance Allergens;600
9.3.8.1;33.8.1 Consumer Products;600
9.3.8.2;33.8.2 Occupational Exposure;602
9.3.9;33.9 Diagnosis of Fragrance Contact Allergy;603
9.3.10;33.10 Clinical Relevance and Patient Advice;606
9.3.11;33.11 Other Skin Effects;607
9.3.11.1;33.11.1 Immediate Reactions;607
9.3.11.2;33.11.2 Photoallergy/Phototoxic Reactions;608
9.3.11.3;33.11.3 Irritant Contact Dermatitis;608
9.3.12;33.12 Case Reports;608
9.3.13;References;608
9.4;34: Hair Dyes;614
9.4.1;34.1 Introduction;614
9.4.2;34.2 Clinical Picture;615
9.4.2.1;34.2.1 Allergic Contact Dermatitis;615
9.4.3;34.3 Temporary Black Tattoos;615
9.4.4;34.4 Diagnosis;616
9.4.5;34.5 Immediate Reactions;618
9.4.6;34.6 PPD: The Archetype;618
9.4.6.1;34.6.1 Chemistry;618
9.4.6.2;34.6.2 Immunology;619
9.4.6.3;34.6.3 Epidemiology;619
9.4.6.4;34.6.4 Cross Reactions;619
9.4.6.5;34.6.5 Occupational Allergy to PPD;620
9.4.7;34.7 Substances Other than PPD;620
9.4.7.1;34.7.1 Toluene-2,5-Diamine;621
9.4.7.2;34.7.2 Resorcinol;621
9.4.7.3;34.7.3 Aminophenol;621
9.4.7.4;34.7.4 Henna;621
9.4.7.5;34.7.5 Bleaching Agents;621
9.4.7.5.1;34.7.5.1 Monoethanolamine (MEA);621
9.4.7.6;34.7.6 New Generation of Hair Dyes;622
9.4.8;34.8 Pretesting and Advising Patients;622
9.4.8.1;34.8.1 Pretesting;622
9.4.8.2;34.8.2 Advising Patients;622
9.4.9;34.9 Case Reports;622
9.4.10;References;623
9.5;35: Metals;627
9.5.1;35.1 Introduction;628
9.5.2;35.2 Nickel;629
9.5.2.1;35.2.1 Nickel Use and Exposure;629
9.5.2.2;35.2.2 Quantification of Nickel Exposure;631
9.5.2.3;35.2.3 Patch Testing with Nickel;632
9.5.2.4;35.2.4 Clinical Picture;633
9.5.2.5;35.2.5 Systemic Allergic Contact Dermatitis;634
9.5.2.6;35.2.6 Tolerance to Nickel;634
9.5.2.7;35.2.7 Epidemiology;635
9.5.2.8;35.2.8 Hand Eczema and Nickel Allergy;636
9.5.2.9;35.2.9 Specific Treatment;637
9.5.2.10;35.2.10 Prevention and Legislation;637
9.5.2.11;35.2.11 Suggested Reading;638
9.5.3;35.3 Chromium;638
9.5.3.1;35.3.1 Physicochemical Aspects and Sensitizing Potential;639
9.5.3.2;35.3.2 Chromium Use and Exposure;640
9.5.3.3;35.3.3 Patch Testing with Chromate;642
9.5.3.4;35.3.4 Clinical Picture;643
9.5.3.5;35.3.5 Systemic Contact Dermatitis;643
9.5.3.6;35.3.6 Epidemiology;643
9.5.3.7;35.3.7 Prevention and Legislation;644
9.5.4;35.4 Cobalt;646
9.5.4.1;35.4.1 Cobalt Use and Exposure;646
9.5.4.2;35.4.2 Allergic Contact Dermatitis;647
9.5.4.3;35.4.3 Patch Testing with Cobalt;648
9.5.4.4;35.4.4 Prevention and Legislation;648
9.5.5;35.5 Aluminum;648
9.5.5.1;35.5.1 Allergic Contact Dermatitis;648
9.5.6;35.6 Beryllium;649
9.5.6.1;35.6.1 Allergic Contact Dermatitis;649
9.5.7;35.7 Cadmium;649
9.5.7.1;35.7.1 Allergic Contact Dermatitis;650
9.5.8;35.8 Copper;650
9.5.8.1;35.8.1 Allergic Contact Dermatitis;650
9.5.8.2;35.8.2 Irritant Contact Dermatitis;650
9.5.9;35.9 Gold;650
9.5.9.1;35.9.1 Gold Use and Exposure;651
9.5.9.2;35.9.2 Patch Testing with Gold and Gold Compounds;651
9.5.9.3;35.9.3 Clinical Picture;652
9.5.9.4;35.9.4 Systemic Contact Dermatitis;652
9.5.9.5;35.9.5 Epidemiology;652
9.5.10;35.10 Mercury;653
9.5.10.1;35.10.1 Allergic Contact Dermatitis;653
9.5.11;35.11 Palladium;653
9.5.11.1;35.11.1 Allergic Contact Dermatitis;653
9.5.12;35.12 Platinum;654
9.5.13;35.13 Rhodium;654
9.5.13.1;35.13.1 Allergic Contact Dermatitis;654
9.5.14;35.14 Silver;654
9.5.15;35.15 Tin;655
9.5.16;References;655
9.6;36: Metalworking Fluids;664
9.6.1;36.1 Metalworking Fluids: Usage and Ingredients;664
9.6.2;36.2 Occupational Skin Disease Due to Metalworking Fluids;665
9.6.3;36.3 Irritant Contact Dermatitis Due to Metalworking Fluids;666
9.6.4;36.4 Contact Allergy Due to Metalworking Fluids;666
9.6.5;36.5 Important Allergens in Metalworking Fluids;667
9.6.5.1;36.5.1 Monoethanolamine (MEA), Diethanolamine (DEA), Triethanolamine (TEA) and Diglycolamine;667
9.6.5.2;36.5.2 Colophonium/Abietic Acid;667
9.6.5.3;36.5.3 Fragrances;668
9.6.5.4;36.5.4 Cobalt, Nickel and Dichromate;668
9.6.5.5;36.5.5 Formaldehyde and Formaldehyde Releasers;669
9.6.5.6;36.5.6 Methyldibromo Glutaronitrile (MDBGN) and 2-Phenoxyethanol (PE);669
9.6.5.7;36.5.7 Methylchloroisothiazolinone/Methylisothiazolinone (MCI/MI);669
9.6.5.8;36.5.8 Other Biocides;670
9.6.5.9;36.5.9 p-Aminoazobenzene (PAAB);670
9.6.6;36.6 MWF Patch Test Series;670
9.6.7;36.7 Patch Testing with MWF from the Patient’s Workplace;672
9.6.8;36.8 Preventive Measures;674
9.6.9;References;674
9.7;37: Plastic Materials;678
9.7.1;37.1 Acrylic Plastics;679
9.7.1.1;37.1.1 Applications;679
9.7.1.2;37.1.2 Chemistry;679
9.7.1.3;37.1.3 Skin Exposure;682
9.7.1.4;37.1.4 Skin Hazards;682
9.7.1.4.1;37.1.4.1 Contact Allergy;682
9.7.1.4.2;37.1.4.2 Animal Studies;683
9.7.1.4.3;37.1.4.3 Irritancy;684
9.7.1.5;37.1.5 Prevention;684
9.7.1.6;37.1.6 Patch Testing;684
9.7.2;37.2 Epoxy Plastics;684
9.7.2.1;37.2.1 Applications;685
9.7.2.2;37.2.2 Chemistry;685
9.7.2.2.1;37.2.2.1 Epoxy Resins;685
9.7.2.2.2;37.2.2.2 Curing Agents;686
9.7.2.2.3;37.2.2.3 Reactive Diluents;686
9.7.2.3;37.2.3 Skin Exposure;687
9.7.2.4;37.2.4 Skin Hazards;687
9.7.2.4.1;37.2.4.1 Contact Allergy;687
9.7.2.4.1.1;Epoxy Resins;687
9.7.2.4.2;37.2.4.2 Irritancy;688
9.7.2.5;37.2.5 Patch Testing;688
9.7.2.6;37.2.6 Prevention;688
9.7.3;37.3 Phenol-Formaldehyde Plastics;689
9.7.3.1;37.3.1 Applications;690
9.7.3.2;37.3.2 Chemistry;690
9.7.3.3;37.3.3 Skin Hazards;690
9.7.3.4;37.3.4 Patch Testing;692
9.7.4;37.4 Isocyanates and Polyurethane Plastics;693
9.7.4.1;37.4.1 Applications;693
9.7.4.2;37.4.2 Chemistry;693
9.7.4.3;37.4.3 Skin Exposure;695
9.7.4.4;37.4.4 Skin Hazards;695
9.7.4.4.1;37.4.4.1 Contact Allergy;695
9.7.4.4.2;37.4.4.2 Irritancy;696
9.7.4.5;37.4.5 Patch Testing;696
9.7.4.6;37.4.6 Prevention;697
9.7.4.7;Sec39_37;697
9.7.5;37.5 Other Plastics;697
9.7.5.1;37.5.1 Amino Plastics;697
9.7.5.1.1;37.5.1.1 Skin Hazards from Amino Plastics;697
9.7.5.2;37.5.2 Polyester Plastics;697
9.7.5.2.1;37.5.2.1 Skin Hazards from Polyester Plastics;698
9.7.5.3;37.5.3 Polyvinyl Chloride Plastics;699
9.7.5.3.1;37.5.3.1 Skin Hazards from Polyvinyl Chloride Plastics;699
9.7.5.4;37.5.4 Polystyrene Plastics;699
9.7.5.4.1;37.5.4.1 Skin Hazards from Polystyrene Plastics;699
9.7.5.4.2;37.5.5 Polyolefin Plastics;700
9.7.5.4.3;37.5.5.1 Skin Hazards from Polyolefin Plastics;700
9.7.5.5;37.5.6 Polyamide Plastics;700
9.7.5.5.1;37.5.6.1 Skin Hazards from Polyamide Plastics;700
9.7.5.6;37.5.7 Polycarbonate Plastics;700
9.7.5.6.1;37.5.7.1 Skin Hazards from Polycarbonate Plastics;700
9.7.5.7;37.5.8 Rare Plastics;701
9.7.6;37.6 Plasticizers and Other Additives;701
9.7.6.1;37.6.1 Plasticizers;701
9.7.6.2;37.6.2 Flame Retardants;701
9.7.6.3;37.6.3 Heat Stabilizers;701
9.7.6.4;37.6.4 Antioxidants;701
9.7.6.5;37.6.5 Ultraviolet-Light Absorbers;702
9.7.6.6;37.6.6 Initiators;702
9.7.6.7;37.6.7 Biocides;702
9.7.6.8;37.6.8 Colorants (Dyes and Pigments);702
9.7.6.9;37.6.9 Metals and Metal Salts;702
9.7.6.10;37.6.10 Skin Hazards from Additives;702
9.7.7;References;703
9.8;38: Topical Drugs;712
9.8.1;38.1 Incidence and Prevalence;712
9.8.1.1;38.1.1 Incidence;712
9.8.2;38.2 Factors Predisposing to Medicament Contact Dermatitis;713
9.8.3;38.3 Clinical Patterns of Contact Reactions;714
9.8.3.1;38.3.1 Irritant Contact Dermatitis;714
9.8.3.2;38.3.2 Contact Urticaria;714
9.8.3.3;38.3.3 Other Important Clinical Patterns;715
9.8.3.4;38.3.4 Allergic Contact Dermatitis;716
9.8.4;38.4 Allergens;717
9.8.4.1;38.4.1 Local Anaesthetics;717
9.8.4.2;38.4.2 Antibiotics and Antimicrobials;718
9.8.4.3;38.4.3 Antivirals;719
9.8.4.4;38.4.4 Antimycotics;720
9.8.4.5;38.4.5 Corticosteroids;721
9.8.4.6;38.4.6 Antihistamines;724
9.8.4.7;38.4.7 Non-steroidal Anti-Inflammatory Drugs;725
9.8.4.8;38.4.8 Ingredients of the Vehicles;726
9.8.4.9;38.4.9 Other Allergens;727
9.8.4.10;38.4.10 Transdermal Therapeutic Systems;729
9.8.5;38.5 Sites at Risk;729
9.8.5.1;38.5.1 Ophthalmic and ENT Preparations;729
9.8.5.2;38.5.2 Anogenital Dermatoses;731
9.8.5.3;38.5.3 Stasis Dermatitis and Leg Ulcer Patients;731
9.8.6;38.6 Systemic Contact Dermatitis;732
9.8.7;38.7 Diagnosis and Prognosis;734
9.8.8;38.8 Appendix: Allergens in Medicaments;734
9.8.9;References;738
9.9;39: Dental Materials;746
9.9.1;39.1 Introduction;746
9.9.2;39.2 Dental Personnel;746
9.9.2.1;39.2.1 Irritant Contact Dermatitis;748
9.9.2.2;39.2.2 Clinical Picture of Irritant Contact Dermatitis in Dental Personnel;748
9.9.3;39.3 Dental Patients;748
9.9.3.1;39.3.1 Irritant Contact Stomatitis;748
9.9.3.2;39.3.2 Clinical Picture of Irritant Contact Stomatitis in Dental Patients;748
9.9.4;39.4 Allergic Contact Dermatitis;749
9.9.4.1;39.4.1 Clinical Picture of Allergic Contact Dermatitis in Dental Personnel;749
9.9.5;39.5 Allergic Contact Stomatitis and Cheilitis;749
9.9.5.1;39.5.1 Clinical Picture of Allergic Contact Stomatitis and Cheilitis in Dental Patients;749
9.9.6;39.6 Lichen and Lichenoid Lesions;750
9.9.7;39.7 Causative Agents in Allergic Contact Dermatitis and Stomatitis/Cheilitis;751
9.9.7.1;39.7.1 Acrylics and Other Plastic Chemicals;751
9.9.7.1.1;39.7.1.1 Dental Composite Resins;751
9.9.7.1.2;39.7.1.2 Dentin Bonding Agents are Plastics Without Fillers and are Called Resins;752
9.9.7.1.3;39.7.1.3 Prosthetic Materials: Prostheses;753
9.9.7.1.4;39.7.1.4 Additives in Dental Acrylics-Initiators, Activators, Stabilizers;754
9.9.7.1.5;39.7.1.5 UV-Absorbers;754
9.9.7.1.6;39.7.1.6 Bisphenol A and DGEBA Resin;755
9.9.7.1.7;39.7.1.7 Ethyl Cyanoacrylate Glue;755
9.9.7.1.8;39.7.1.8 Plastic and Fillers Composite;755
9.9.7.1.9;39.7.1.9 Two Materials for Short-term Use;756
9.9.7.1.10;39.7.1.10 Impression Materials and Resin Carriers;756
9.9.7.1.11;39.7.1.11 Resin Carrier;756
9.9.7.1.12;39.7.1.12 Product Analysis of Acrylic Resins;756
9.9.7.2;39.7.2 Rubber and Plastics in Gloves;756
9.9.7.2.1;39.7.2.1 Protective Effect of Medical Gloves;757
9.9.7.3;39.7.3 Metals;757
9.9.7.3.1;39.7.3.1 Aluminum;758
9.9.7.3.2;39.7.3.2 Beryllium;758
9.9.7.3.3;39.7.3.3 Chromium;758
9.9.7.3.4;39.7.3.4 Cobalt;759
9.9.7.3.5;39.7.3.5 Copper;759
9.9.7.3.6;39.7.3.6 Gold;759
9.9.7.3.7;39.7.3.7 Indium;760
9.9.7.3.8;39.7.3.8 Iridium;760
9.9.7.3.9;39.7.3.9 Manganese;760
9.9.7.3.10;39.7.3.10 Mercury;760
9.9.7.3.11;39.7.3.11 Nickel;761
9.9.7.3.12;39.7.3.12 Palladium;761
9.9.7.3.13;39.7.3.13 Platinum;761
9.9.7.3.14;39.7.3.14 Silver;762
9.9.7.3.15;39.7.3.15 Tin;762
9.9.7.3.16;39.7.3.16 Titanium;762
9.9.7.3.17;39.7.3.17 Zinc;762
9.9.7.4;39.7.4 Disinfectants;762
9.9.7.4.1;39.7.4.1 Povidone-Iodine;762
9.9.7.5;39.7.5 Eugenol, Colophony, Carvone;763
9.9.7.5.1;39.7.5.1 Colophony;763
9.9.7.5.2;39.7.5.2 Carvone;763
9.9.7.6;39.7.6 Local Anesthetics;763
9.9.8;39.8 Patch Testing;764
9.9.8.1;39.8.1 Indications for Patch Testing;765
9.9.8.2;39.8.2 Patch Test Sensitization;765
9.9.8.3;39.8.3 Screening for Contact Allergy to Acrylics;766
9.9.9;39.9 Immediate Reactions;767
9.9.9.1;39.9.1 Clinical Picture;767
9.9.9.2;39.9.2 Causative Agents;767
9.9.9.2.1;39.9.2.1 Proteins in Natural Rubber Latex and Corn Starch;767
9.9.9.2.1.1;Corn Starch Powder;767
9.9.9.2.2;39.9.2.2 Gutta-Percha;768
9.9.9.2.3;39.9.2.3 Low-Molecular-Weight Chemicals;768
9.9.9.2.4;39.9.2.4 Local Anesthetics;769
9.9.9.2.5;39.9.2.5 Fibrin Tissue;769
9.9.9.2.6;39.9.2.6 Metals;769
9.9.9.2.7;39.9.2.7 Methacrylates;769
9.9.10;References;769
9.10;40: Clothing;775
9.10.1;40.1 Introduction;775
9.10.2;40.2 Clinical Examination;776
9.10.3;40.3 The Inducers of Dermatitis;777
9.10.3.1;40.3.1 Textile Fibers;777
9.10.3.2;40.3.2 Textile Resins and Formaldehyde;778
9.10.3.3;40.3.3 Textile Dyes;781
9.10.3.3.1;40.3.3.1 Disperse Dyes;781
9.10.3.3.1.1;Anthraquinone Dyes;781
9.10.3.3.1.2;Azo Dyes;784
9.10.3.3.1.2.1;Root;786
9.10.3.3.1.3;Methine, Nitro, and Quinoline Dyes;786
9.10.3.3.2;40.3.3.2 Acid Dyes;786
9.10.3.3.3;40.3.3.3 Basic Dyes;786
9.10.3.3.4;40.3.3.4 Direct Dyes;787
9.10.3.3.5;40.3.3.5 Vat Dyes;788
9.10.3.3.6;40.3.3.6 Fiber Reactive Dyes;788
9.10.3.3.7;40.3.3.7 Sulfur, Solvent, and Nondisperse Azoic Dyes;789
9.10.3.3.8;40.3.3.8 Dye-Fixing and Dye-Coupling Agents;789
9.10.3.4;40.3.4 Rubber;789
9.10.3.4.1;40.3.4.1 Other Components of Garments;789
9.10.3.4.2;40.3.4.2 Cleaners, Softeners, and Other Auxiliaries;790
9.10.4;40.4 Patch Testing;790
9.10.5;40.5 Chemical Analyses;793
9.10.5.1;40.5.1 Identification of Formaldehyde;793
9.10.5.1.1;40.5.1.1 Chromotropic Acid Method;793
9.10.5.1.2;40.5.1.2 Schiff’s Reagent Method;793
9.10.5.1.3;40.5.1.3 Acetylacetone Method;793
9.10.5.2;40.5.2 Identification of Dyes;794
9.10.6;40.6 Patient Advice;795
9.10.7;References;796
9.11;41: Shoes;800
9.11.1;41.1 Introduction;800
9.11.2;41.2 Epidemiology;800
9.11.3;41.3 Risk Factors;800
9.11.4;41.4 Clinical Presentation and Clues Pointing to Allergens;801
9.11.5;41.5 Allergens in Shoes;803
9.11.6;41.6 Hidden Sources of Shoe Allergens;804
9.11.7;41.7 Occupational Dermatitis;804
9.11.8;41.8 Patch Testing for Shoe Allergy;804
9.11.9;41.9 Differential Diagnosis;806
9.11.10;41.10 Prognosis and Outcome;806
9.11.11;41.11 Allergen Substitution;806
9.11.12;41.12 Conclusion;807
9.11.13;41.13 Case Report;807
9.11.14;41.14 Classic Articles;808
9.11.15;References;809
9.12;42: Occupational Contact Dermatitis;812
9.12.1;42.1 Introduction;812
9.12.2;42.2 Definition;812
9.12.3;42.3 Clinical Aspects;814
9.12.4;42.4 Causative Factors;815
9.12.5;42.5 Diagnostic Workup;816
9.12.5.1;42.5.1 History;816
9.12.5.2;42.5.2 Information on Workplace Materials;817
9.12.5.3;42.5.3 Diagnostic Testing;818
9.12.6;42.6 Therapy and Prevention;818
9.12.7;References;819
9.13;43: Occupational Contact Dermatitis: Health Personnel;821
9.13.1;43.1 Introduction;821
9.13.2;43.2 Range of Occupations;821
9.13.3;43.3 Type of Cutaneous Disease;822
9.13.4;43.4 Irritant Contact Dermatitis;822
9.13.5;43.5 Atopy as a Risk Factor;822
9.13.6;43.6 Wet Work;822
9.13.7;43.7 Hand Dermatitis;822
9.13.8;43.8 Nurses, Clinical Assistants and Cleaners;823
9.13.9;43.9 Surgeons;825
9.13.10;43.10 Laboratory Personnel;826
9.13.11;43.11 Other Therapists;827
9.13.12;43.12 Veterinarians;827
9.13.13;43.13 Laboratory Animal Handlers;829
9.13.14;43.14 Conclusion;829
9.13.15;Acknowledgements;829
9.13.16;References;829
9.14;44: Occupational Contact Dermatitis: Chefs and Food Handlers;832
9.14.1;44.1 Epidemiology and Risk Factors of Occupational Skin Diseases in Chefs and Food Handlers;832
9.14.2;44.2 Specific Exposures to Irritants, Contact and Protein Allergens in Chefs and Food Handlers;834
9.14.2.1;44.2.1 Irritants in Food Handling Occupations;834
9.14.2.2;44.2.2 Contact Allergens in Food Handling Occupations;834
9.14.2.3;44.2.3 Elicitors of Phototoxic and Photoallergic Reactions in Food Handling Occupations;840
9.14.2.4;44.2.4 Elicitors of Protein Contact Dermatitis, Immunological Contact Urticaria and Non-immunological Contact Urticaria in Fo;840
9.14.3;44.3 Conclusion for the Treatment of OSD in Chefs and Food Handlers;842
9.14.4;References;842
9.15;45: Occupational Contact Dermatitis: Hairdressers;844
9.15.1;45.1 Epidemiology of Hand Eczema;844
9.15.1.1;45.1.1 Smoking;845
9.15.1.2;45.1.2 Atopic Dermatitis;845
9.15.1.3;45.1.3 Exposure to Allergens;845
9.15.1.3.1;45.1.3.1 Hair Dye;845
9.15.1.3.2;45.1.3.2 Persulfates;845
9.15.1.3.3;45.1.3.3 Hydrogen Peroxide;845
9.15.1.3.4;45.1.3.4 Glyceryl Monothioglycolate;845
9.15.1.3.5;45.1.3.5 Cysteamine Hydrochloride;846
9.15.1.3.6;45.1.3.6 Nickel;846
9.15.1.3.7;45.1.3.7 Fragrance Ingredients;846
9.15.1.3.8;45.1.3.8 Pyrogallol;846
9.15.1.3.9;45.1.3.9 Methyldibromo Glutaronitrile;847
9.15.2;45.2 Gloves;847
9.15.3;45.3 Nail Disorders;847
9.15.4;45.4 Contact Urticaria;847
9.15.5;45.5 Suggestions for a Patch Test Series for Hairdressers;848
9.15.6;45.6 Cancer;849
9.15.7;References;849
9.16;46: Plants and Plant Products;851
9.16.1;46.1 Introduction;851
9.16.2;46.2 Clinical Pictures;852
9.16.2.1;46.2.1 Immediate-Type Reactions;852
9.16.2.1.1;46.2.1.1 Contact Urticaria;852
9.16.2.1.1.1;Nonimmunological Contact Urticaria;852
9.16.2.1.1.2;Immunological (IgE-mediated) Contact Urticaria;852
9.16.2.1.2;46.2.1.2 Protein Contact Dermatitis;853
9.16.2.2;46.2.2 Irritant Contact Dermatitis;854
9.16.2.2.1;46.2.2.1 Mechanical Irritation;854
9.16.2.2.2;46.2.2.2 Chemical Irritation;855
9.16.2.3;46.2.3 Allergic Contact Dermatitis;855
9.16.2.3.1;46.2.3.1 Acute ACD: Acute Eczema;855
9.16.2.3.2;46.2.3.2 Chronic ACD and the Example of “Tulip Fingers”;855
9.16.2.3.3;46.2.3.3 Erythema Multiforme-like and Atypical Dermatitis;857
9.16.2.3.4;46.2.3.4 Airborne Contact Dermatitis;858
9.16.2.4;46.2.4 Photodermatitis (Phytophotodermatitis);859
9.16.2.4.1;46.2.4.1 Phytophototoxicity;859
9.16.2.4.2;46.2.4.2 Phytophotoallergic Contact Dermatitis;860
9.16.3;46.3 Inducers of Dermatitis;862
9.16.3.1;46.3.1 Alliaceae (Onion Family);862
9.16.3.2;46.3.2 Alstroemeriaceae (Alstroemer Family) and Liliaceae (Lily Family);862
9.16.3.3;46.3.3 Amaryllidaceae (Daffodil Family);864
9.16.3.3.1;46.3.3.1 Anacardiaceae, Ginkgoaceae, and Proteaceae;865
9.16.3.3.1.1;Anacardiaceae (Cashew Family);865
9.16.3.3.1.2;Ginkgoaceae (Maidenhair Family);868
9.16.3.3.1.3;Proteaceae;869
9.16.3.3.1.4;Allergens;869
9.16.3.4;46.3.4 Compositae (Asteraceae) and Liverworts;870
9.16.3.4.1;46.3.4.1 Asteraceae/Compositae (Daisy Family);870
9.16.3.4.2;46.3.4.2 Liverworts (Jubulaceae);874
9.16.3.4.3;46.3.4.3 Sesquiterpene Lactone Allergens;874
9.16.3.5;46.3.5 Cruciferae (Cabbage or Mustard Family, Brassicaceae);877
9.16.3.6;46.3.6 Euphorbiaceae (Spurge Family);878
9.16.3.7;46.3.7 Lichens;879
9.16.3.8;46.3.8 Primulaceae (Primrose Family);881
9.16.3.9;46.3.9 Ranunculaceae (Buttercup Family);882
9.16.3.10;46.3.10 Umbelliferae/Apiaceae (Carrot Family), Rutaceae (Rue Family), and Moraceae (Mulberry Family);883
9.16.3.11;46.3.11 Woods;884
9.16.3.11.1;46.3.11.1 American and Australian Woods;885
9.16.3.11.2;46.3.11.2 Asian Woods;886
9.16.3.11.3;46.3.11.3 African Woods;886
9.16.3.11.4;46.3.11.4 European Woods;887
9.16.3.12;46.3.12 Mushrooms;888
9.16.3.13;46.3.13 Ferns;888
9.16.3.14;46.3.14 Miscellaneous Plants;888
9.16.3.14.1;46.3.14.1 Araliaceae (Ginseng, Aralia, Ivy Family);888
9.16.3.14.2;46.3.14.2 Papaveraceae (Poppy Family);888
9.16.3.14.3;46.3.14.3 Guttiferae (St John’s Wort or Mangosteen Family);888
9.16.3.14.4;46.3.14.4 Hydrangeaceae;889
9.16.3.14.5;46.3.14.5 Iridaceae (Iris Family);889
9.16.3.14.6;46.3.14.6 Labiatae (Mint Family);889
9.16.3.14.7;46.3.14.7 Paeoniaceae (Peony Family);889
9.16.3.14.8;46.3.14.8 Solanaceae (Nightshade Family);889
9.16.4;46.4 Diagnosis of Plant Dermatitis;889
9.16.4.1;46.4.1 Raw Plants;890
9.16.4.1.1;46.4.1.1 Plant Identification;890
9.16.4.1.2;46.4.1.2 Prick Tests;890
9.16.4.1.3;46.4.1.3 Patch Tests;890
9.16.4.2;46.4.2 Plant Extracts;891
9.16.4.3;46.4.3 Allergen Identification;891
9.16.4.4;46.4.4 Commercial Allergens;891
9.16.4.5;46.4.5 Photopatch Testing;891
9.16.4.6;46.4.6 Results and Relevance;892
9.16.4.7;46.4.7 Multiple Plant Reactions and Cross-Sensitivity;892
9.16.5;46.5 Prevention and Treatment;892
9.16.5.1;46.5.1 Removal of the Allergens and Irritants;892
9.16.5.2;46.5.2 Barrier Creams;893
9.16.5.3;46.5.3 Gloves;893
9.16.5.4;46.5.4 Acute Dermatitis;893
9.16.5.5;46.5.5 Chronic Dermatitis;893
9.16.5.6;46.5.6 Hyposensitization;893
9.16.6;46.6 Example of Botanical Nomenclature;893
9.16.7;References;894
9.17;47: Pesticides;904
9.17.1;47.1 Introduction;904
9.17.2;47.2 Use of Pesticides and its Limitations;905
9.17.3;47.3 Terminology, Classification, and Formulations;906
9.17.4;47.4 Skin Exposure and Absorption Through Skin;906
9.17.4.1;47.4.1 Prevention of Skin Exposure;907
9.17.5;47.5 Skin Effects of Some Pesticides;908
9.17.5.1;47.5.1 Herbicides and Desiccants;908
9.17.5.2;47.5.2 Insecticides;909
9.17.5.3;47.5.3 Fungicides;909
9.17.5.4;47.5.4 Repellents;910
9.17.5.5;47.5.5 Rodenticides;910
9.17.5.6;47.5.6 Preservatives for the Treatment of Articles and Materials;910
9.17.6;47.6 Patch Testing;910
9.17.7;References;912
9.18;48: Contact Allergy in Children;914
9.18.1;48.1 Introduction;914
9.18.2;48.2 Prevalence and Incidence;914
9.18.2.1;48.2.1 Prevalence of Contact Allergy in an Unselected Population;915
9.18.2.2;48.2.2 Prevalence of Contact Allergy in a Selected Population;915
9.18.2.3;48.2.3 Prevalence in Relation to Genetic Factors;915
9.18.2.4;48.2.4 Prevalence Related to Sex;919
9.18.2.5;48.2.5 Prevalence Related to Age;919
9.18.2.6;48.2.6 Prevalence Related to Origin;919
9.18.2.7;48.2.7 Prevalence in Relation to the Sensitization Source;920
9.18.3;48.3 The Clinical Picture;920
9.18.4;48.4 Allergic Contact Dermatitis and Atopy;921
9.18.5;48.5 Patch Testing in Children;922
9.18.6;48.6 The Most Frequent Allergens in Children;923
9.18.6.1;48.6.1 Metals;923
9.18.6.1.1;48.6.1.1 Nickel;923
9.18.6.1.2;48.6.1.2 Cobalt;924
9.18.6.1.3;48.6.1.3 Potassium Dichromate;924
9.18.6.1.4;48.6.1.4 Mercury;924
9.18.6.1.5;48.6.1.5 Aluminum;924
9.18.6.1.6;48.6.1.6 Palladium;924
9.18.6.1.7;48.6.1.7 Iron;924
9.18.6.1.8;48.6.1.8 Copper;924
9.18.6.1.9;48.6.1.9 Gold;924
9.18.6.2;48.6.2 Pharmaceutical Products;925
9.18.6.3;48.6.3 Cosmetics;926
9.18.7;48.7 Tattoos;927
9.18.7.1;48.8 Toys;927
9.18.7.2;48.9 Electronic Devices;927
9.18.7.3;48.10 Rubber Items;928
9.18.7.4;48.11 Shoes and Clothes;929
9.18.7.5;48.12 Plastic Materials and Resins;929
9.18.7.6;48.13 Plants;930
9.18.7.6.1;48.13.1 Poison Ivy, Poison Oak, Poison Sumac;930
9.18.7.6.2;48.13.3 Urtica urens;930
9.18.7.6.3;48.13.4 Asteraceae or Compositae;930
9.18.7.6.4;48.13.5 Lichens;930
9.18.7.6.5;48.13.6 Gingko Fruit;931
9.18.7.6.6;48.13.7 Dioscorea Batatas Decaisne;931
9.18.7.6.7;48.13.8 Protein Contact Dermatitis;931
9.18.7.6.8;48.13.9 Various Plant Materials;931
9.18.7.7;48.14 “Occupational” Allergens;931
9.18.8;48.15 Is it Advisable to Test with a Shortened Standard Series for Children?;931
9.18.9;48.16 Conclusions;932
9.18.10;References;933
9.19;49: Therapy and Rehabilitation of Allergic and Irritant Contact Dermatitis;939
9.19.1;49.1 Recognize (the Causative Allergic/Irritant Agent);939
9.19.2;49.2 Remove (the Irritant/Allergen);940
9.19.2.1;49.2.1 Preventive Measures;940
9.19.2.2;49.2.2 Elimination Diets;942
9.19.3;49.3 Reduce Inflammation: Pharmacologic Therapy;942
9.19.3.1;49.3.1 Basic Topical Therapy;942
9.19.3.2;49.3.2 Specific Therapies;944
9.19.3.2.1;49.3.2.1 Topical Corticosteroids;944
9.19.3.2.2;49.3.2.2 Topical Calcineurin Inhibitors;945
9.19.3.2.3;49.3.2.3 Retinoids;945
9.19.3.2.4;49.3.2.4 Phototherapy;946
9.19.3.2.5;49.3.2.5 Ionizing Radiation Therapy;947
9.19.3.2.6;49.3.2.6 Systemic Corticosteroids and Immunosuppressive Agents;947
9.19.3.2.7;49.3.2.7 Other Treatment Approaches;949
9.19.4;49.4 Restore the Skin Barrier;949
9.19.4.1;49.4.1 Recovery Time;949
9.19.4.2;49.4.2 The Effect of Moisturizers on Barrier Repair;950
9.19.4.2.1;49.4.2.1 Occlusive Properties;951
9.19.4.2.2;49.4.2.2 Lipids Content;951
9.19.4.2.3;49.4.2.3 Humectants and Other Ingredients;952
9.19.4.2.4;49.4.2.4 pH;953
9.19.4.2.5;49.4.2.5 Additional Data on Moisturizers;953
9.19.4.3;49.4.3 The Influence on the Barrier Repair of the Different Modalities Used in the Treatment of Dermatitis;953
9.19.4.3.1;49.4.3.1 Corticosteroids;954
9.19.4.3.2;49.4.3.2 Calcineurin Inhibitors;954
9.19.4.3.3;49.4.3.3 Phototherapy;954
9.19.4.3.4;49.4.3.4 Retinoids;955
9.19.4.4;49.4.4 Other Factors Influencing Barrier Repair;955
9.19.5;References;955
9.20;50: Prevention of Hand Eczema: Gloves, Barrier Creams and Workers’ Education;960
9.20.1;50.1 Introduction: Trends and Tasks in Dermatological Prevention;960
9.20.1.1;50.1.1 Primary Prevention;962
9.20.1.2;50.1.2 Secondary Prevention;963
9.20.1.3;50.1.3 Tertiary Prevention;965
9.20.2;50.2 Personal Skin Protection;967
9.20.2.1;50.2.1 Protective Gloves;967
9.20.2.1.1;50.2.1.1 Introduction;967
9.20.2.1.2;50.2.1.2 Rules and Regulations;968
9.20.2.1.2.1;Chemical Protective Gloves;968
9.20.2.1.2.2;Medical Gloves (MGs);969
9.20.2.1.3;50.2.1.3 Standard Methods for Testing the Protective Glove Barrier;970
9.20.2.1.3.1;Penetration;970
9.20.2.1.3.2;Permeation;970
9.20.2.1.3.3;Degradation;971
9.20.2.1.4;50.2.1.4 Glove Materials and Manufacturing;971
9.20.2.1.5;50.2.1.5 Unwanted Side Effects of Gloves;972
9.20.2.1.5.1;Selection of the Wrong Glove;972
9.20.2.1.5.2;Internal Contamination of Gloves;972
9.20.2.1.5.3;Occlusion Effects;972
9.20.2.1.5.4;Allergic Contact Dermatitis from Protective Gloves;972
9.20.2.1.6;50.2.1.6 Perspectives;973
9.20.2.1.6.1;Semi-Permeable Gloves;973
9.20.2.1.6.2;Rip Up Gloves for the Work on Shifting Machines;973
9.20.2.1.6.3;“Hypoallergenic” Gloves;973
9.20.2.2;50.2.2 Barrier Creams;973
9.20.2.2.1;50.2.2.1 Study Designs to Prove Effectiveness;974
9.20.2.2.2;50.2.2.2 Usage and Application;975
9.20.2.2.3;50.2.2.3 Strategies;976
9.20.3;50.3 Workers’ Education;977
9.20.3.1;50.3.1 Definitions;983
9.20.3.1.1;50.3.1.1 Health Education;983
9.20.3.1.2;50.3.1.2 Patient Education;983
9.20.3.1.3;50.3.1.3 Eczema School;983
9.20.3.1.4;50.3.1.4 Skin Protection Programme;983
9.20.3.2;50.3.2 Aims and Methods of Educational Programmes;984
9.20.3.3;50.3.3 Theoretical Approaches in Health Educational Skin Protection Programmes;984
9.20.3.4;50.3.4 Professionalization of Health Education;985
9.20.3.5;50.3.5 Systematic Reviews on the Effectiveness of Educational Programmes in Prevention of OCD and Exemplary Studies with Edu;985
9.20.3.6;50.3.6 Further Implications in Health Educational Research in the Specific Field of OCD;986
9.20.4;References;986
9.21;51: Prevention of Allergic Contact Dermatitis: Safe Exposure Levels of Sensitizers;992
9.21.1;51.1 General Aspects of Contact Allergy Epidemics;992
9.21.2;51.2 Industrial Measures to Prevent Contact Allergy Epidemics Prior to Product Marketing;993
9.21.3;51.3 Detection and Surveillance of Contact Allergy Epidemics;993
9.21.4;51.4 Measures to Prevent Contact Allergy Epidemics After Product Marketing;994
9.21.5;References;996
9.22;52: Legislation;998
9.22.1;52.1 Introduction;998
9.22.2;52.2 Cosmetics Directive;998
9.22.2.1;52.2.1 Skin Irritation;1001
9.22.2.2;52.2.2 Skin Corrosivity;1001
9.22.2.3;52.2.3 Eye Irritation;1001
9.22.2.4;52.2.4 Skin Sensitization;1001
9.22.2.5;52.2.5 Dermal Absorption, Percutaneous Penetration;1001
9.22.2.6;52.2.6 Photoirritation;1001
9.22.3;52.3 Detergent Regulations;1001
9.22.4;52.4 REACH and the Dangerous Substances Directive (DSD);1001
9.22.5;52.5 Dangerous Preparations Directive (DPD);1002
9.22.6;52.6 Nickel;1002
9.22.7;52.7 Chromate;1002
9.22.8;References;1003
9.23;53: International Comparison of Legal Aspects of Workers’ Compensation for Occupational Contact Dermatitis;1004
9.23.1;53.1 Introduction;1004
9.23.2;53.2 Occupational Dermatitis in Germany;1005
9.23.2.1;53.2.1 Example A;1007
9.23.2.2;53.2.2 Example B;1007
9.23.2.2.1;53.2.2.1 Comment;1008
9.23.2.3;53.2.3 Example C;1008
9.23.3;53.3 Occupational Contact Dermatitis in Other European Countries, Australia and the USA;1008
9.24;54: Databases and Networks. The Benefit for Research and Quality Assurance in Patch Testing;1027
9.24.1;54.1 Scope;1027
9.24.2;54.2 Patch Test Software;1028
9.24.3;54.3 The Centre of a Multi-Centre Network;1030
9.24.4;54.4 Quality Control in Patch Test Networks;1030
9.24.5;54.5 Surveillance of Contact Allergy;1031
9.24.6;54.6 Detection of New Contact Allergens;1032
9.24.7;54.7 Examples from Existing Databases/Networks;1033
9.24.7.1;54.7.1 Increasing Contact Allergy Frequency;1033
9.24.7.2;54.7.2 Decreasing Contact Allergy Frequency;1034
9.24.7.3;54.7.3 Persisting Contact Allergy Problems;1034
9.24.7.4;54.7.4 Subgroup or Multi-Factorial Analyses;1034
9.24.7.5;54.7.5 Link with Other Data;1035
9.24.8;54.8 Auxiliary Databases;1035
9.24.8.1;54.8.1 Information on Allergens;1035
9.24.8.2;54.8.2 Product Databases;1035
9.24.9;References;1036
9.25;55: Contact Dermatitis Research Groups;1038
9.25.1;55.1 Introduction;1038
9.25.2;55.2 Contact Dermatitis Groups;1039
9.26;56: Patch Test Concentrations and Vehicles for Testing Contact Allergens;1044
9.26.1;References;1078
9.27;57: Patch Testing with the Patients’ Own Products;1079
9.27.1;57.1 Information on the Test Material Before Patch Testing;1080
9.27.1.1;57.1.1 Test Method;1081
9.27.1.1.1;57.1.1.1 Skin Tests;1081
9.27.1.1.2;57.1.1.2 pH;1082
9.27.1.1.3;57.1.1.3 Dilution;1082
9.27.1.2;57.1.2 Control Tests;1084
9.27.2;57.2 Product Categories for Patch Testing;1084
9.27.2.1;57.2.1 Decorative Cosmetics, Sunscreens, Toiletries (Tables 57.4 and 57.5);1084
9.27.2.2;57.2.2 Hairdressing, Depilatory, and Nail Cosmetics (Table 57.6);1085
9.27.2.3;57.2.3 Topical Medicaments;1085
9.27.2.4;57.2.4 Medical Appliances;1085
9.27.2.5;57.2.5 Dental Prosthesis and Other Dental Restorative Materials;1086
9.27.2.6;57.2.6 Disinfecting Agents;1086
9.27.2.7;57.2.7 Clothing;1086
9.27.2.8;57.2.8 Pesticides;1086
9.27.2.9;57.2.9 Detergents for Household Cleaning;1086
9.27.2.10;57.2.10 Food Stuff;1086
9.27.2.10.1;57.2.10.1 Scratch Chamber Testing [26];1086
9.27.2.11;57.2.11 Plants;1087
9.27.2.12;57.2.12 Woods;1087
9.27.2.13;57.2.13 Office Work;1087
9.27.2.14;57.2.14 Construction Materials;1088
9.27.2.15;57.2.15 Paints, Lacquers;1088
9.27.2.16;57.2.16 Greases and Oils;1088
9.27.2.17;57.2.17 Metalworking Fluids;1088
9.27.2.18;57.2.18 Rubber Chemicals;1089
9.27.2.19;57.2.19 Glues and Adhesives;1089
9.27.2.20;57.2.20 Plastic Materials;1090
9.27.2.21;57.2.21 Do Not Test;1090
9.27.3;References;1091
9.28;58: Dictionary of Contact Allergens: Chemical Structures, Sources, and References;1092
9.28.1;1. Abietic acid;1092
9.28.2;2. Acetaldehyde;1093
9.28.3;3. Acid Blue 158;1093
9.28.4;4. Acrylamide;1093
9.28.5;5. Acrylates, Cyanoacrylate, and Methacrylates;1093
9.28.6;6. Acrylonitrile;1101
9.28.7;7. Alachlor®;1101
9.28.8;8. Alantolactone;1101
9.28.9;9. Alkyl Glucosides;1101
9.28.10;10. Allicin;1102
9.28.11;11. Allyl Glycidyl Ether;1102
9.28.12;12. Allyl Isothiocyanate;1102
9.28.13;13. Allylpropyldisulfide;1102
9.28.14;14. Alprenolol;1103
9.28.15;15. Amethocaine;1103
9.28.16;16. p-Amino-N,N-Diethylaniline Sulfate;1103
9.28.17;17. 4-Amino-3-Nitrophenol;1103
9.28.18;18. p-Aminoazobenzene;1104
9.28.19;19. p-Aminodiphenylamine (Hydrochloride);1104
9.28.20;20. Aminoethylethanolamine;1104
9.28.21;21. o-Aminophenol;1104
9.28.22;22. p-Aminophenol;1104
9.28.23;23. Aminophylline;1105
9.28.24;24. N,N-bis-(3-Aminopropyl) Dodecylamine;1105
9.28.25;25. Ammonium Persulfate;1105
9.28.26;26. Ammonium Thioglycolate;1106
9.28.27;27. Amoxicillin;1106
9.28.28;28. Ampicillin;1106
9.28.29;29. Amprolium (Hydrochloride);1107
9.28.30;30. Amyl Cinnamyl Alcohol;1107
9.28.31;31. Amylcinnamaldehyde;1107
9.28.32;32. Anacardic Acids;1107
9.28.33;33. Anethole;1108
9.28.34;34. Anisyl Alcohol;1108
9.28.35;35. Antimony Trioxide;1108
9.28.36;36. Arsenic and Arsenic Salts (Sodium Arsenate);1108
9.28.37;37. Articaine (Hydrochloride);1108
9.28.38;38. Atranol;1109
9.28.39;39. Azaperone;1109
9.28.40;40. Azathioprine;1109
9.28.41;41. Basic Red 22;1110
9.28.42;42. Basic Red 46;1110
9.28.43;43. Befunolol;1110
9.28.44;44. Benomyl;1110
9.28.45;45. Benzalkonium Chloride;1111
9.28.46;46. Benzisothiazolone;1111
9.28.47;47. Benzophenones;1111
9.28.48;48. Benzoyl Peroxide;1112
9.28.49;49. Benzydamine Hydrochloride;1113
9.28.50;50. Benzyl Alcohol;1113
9.28.51;51. Benzyl Benzoate;1113
9.28.52;52. Benzyl Salicylate;1114
9.28.53;53. Benzylpenicillin;1114
9.28.54;54. BHA;1114
9.28.55;55. BHT;1114
9.28.56;56. Bioban CS-1135;1115
9.28.57;57. Bioban® CS-1246;1115
9.28.58;58. Bioban® P-1487;1115
9.28.59;59. Bisphenol A;1115
9.28.60;60. Bisphenol A Diglycidyl Ether (DGEBA);1116
9.28.61;61. o,p-Bisphenol F and p,p-Bisphenol F;1116
9.28.62;62. Bisphenol F Diglycidyl Ether (DGEBF);1116
9.28.63;63. Brominated Epoxy Resin;1117
9.28.64;64. 1-Bromo-3-Chloro-5,5-Dimethylhydantoin;1118
9.28.65;65. Bromohydroxyacetophenone;1118
9.28.66;66. Bronopol;1118
9.28.67;67. Budesonide;1118
9.28.68;68. Bufexamac;1119
9.28.69;69. Buprenorphine;1119
9.28.70;70. 1,4-Butanediol Diglycidyl Ether;1120
9.28.71;71. N-tert-Butyl-bis-(2-Benzothiazole) Sulfenamide;1120
9.28.72;72. Butyl Carbitol;1120
9.28.73;73. p-tert-Butyl Catechol;1120
9.28.74;74. n-Butyl Glycidyl Ether;1121
9.28.75;75. tert-Butyl-Hydroquinone;1121
9.28.76;76. p-tert-Butyl-alpha-Methylhydrocinnamic Aldehyde;1121
9.28.77;77. Butylene Glycol;1121
9.28.78;78. Para-tert-Butylphenol;1122
9.28.79;79. Caffeic Acid Dimethyl Allylic Ester;1122
9.28.80;80. Captafol;1122
9.28.81;81. Captan;1123
9.28.82;82. Carbaryl;1123
9.28.83;83. Carbodiimide;1123
9.28.84;84. Carbofuran;1123
9.28.85;85. Cardols;1123
9.28.86;86. D-3-Carene;1124
9.28.87;87. Carteolol;1124
9.28.88;88. CD1;1124
9.28.89;89. CD2;1125
9.28.90;90. CD3;1125
9.28.91;91. CD4;1125
9.28.92;92. CD6;1126
9.28.93;93. Cefaclor;1126
9.28.94;94. Cephalosporins;1126
9.28.95;95. Cetearyl Isononanoate;1127
9.28.96;96. Chloramphenicol;1127
9.28.97;97. Chlorhexidine (Digluconate);1127
9.28.98;98. 5-Chloro-1-Methyl-4-Nitroimidazole;1127
9.28.99;99. Chloroacetamide;1128
9.28.100;100. Chloroacetophenone;1128
9.28.101;101. Chloroatranol;1128
9.28.102;102. Chlorocresol;1128
9.28.103;103. Chlorophorin;1129
9.28.104;104. Chlorothalonil;1129
9.28.105;105. Chlorpromazine;1129
9.28.106;106. Cinnamal;1129
9.28.107;107. Cinnamyl Alcohol;1130
9.28.108;108. Citral;1130
9.28.109;109. Citronellol;1130
9.28.110;110. Clindamycin;1131
9.28.111;111. Clopidol;1131
9.28.112;112. Cloxacillin;1131
9.28.113;113. Cobalt Naphthenate;1132
9.28.114;114. Cocamidopropyl Betaine;1132
9.28.115;115. Cocamidopropyl Dimethylamine;1132
9.28.116;116. Coconut Diethanolamide;1132
9.28.117;117. Codeine (Phosphate, Hydrochloride);1133
9.28.118;118. Costunolide;1133
9.28.119;119. Coumarin;1133
9.28.120;120. Cresyl Glycidyl Ether;1134
9.28.121;121. Cyclohexanone;1134
9.28.122;122. 2-Cyclohexen-1-one;1134
9.28.123;123. N-Cyclohexyl-2-Benzothiazylsulfenamide;1134
9.28.124;124. N-Cyclohexyl-N-Phenyl-p-Phenylenediamine;1135
9.28.125;125. N-Cyclohexyl-Thiophthalimide;1135
9.28.126;126. Cymene;1135
9.28.127;127. Cymoxanil;1136
9.28.128;128. Dazomet;1136
9.28.129;129. DDT;1136
9.28.130;130. Decyl glucoside;1136
9.28.131;131. Dehydrocostuslactone;1137
9.28.132;132. Deoxylapachol;1137
9.28.133;133. Diallyl Disulfide;1137
9.28.134;134. Diaminodiphenylmethane;1137
9.28.135;135. Diammonium Hydrogen Phosphate;1138
9.28.136;136. Diazodiethylaniline Chloride;1138
9.28.137;137. Diazolidinyl Urea;1138
9.28.138;138. Dibenzothiazyl Disulfide;1138
9.28.139;139. Dibucaine (Hydrochloride);1139
9.28.140;140. Dibutyl Phthalate;1139
9.28.141;141. Dibutylthiourea;1139
9.28.142;142. 4,5-Dichloro-2-n-Octyl-4-Isothiazolin-3-one;1139
9.28.143;143. 1,3-Dichloropropene;1140
9.28.144;144. Dichlorvos;1140
9.28.145;145. N,N-Dicyclohexyl-2-Benzothiazole Sulfenamide;1140
9.28.146;146. Dicyclohexyl Carbodiimide;1140
9.28.147;147. Didecyldimethylammonium Chloride;1141
9.28.148;148. Diethanolamine;1141
9.28.149;149. Diethyl Sebacate;1141
9.28.150;150. Diethyleneglycol Diglycidyl Ether;1141
9.28.151;151. Diethylenetriamine;1142
9.28.152;152. Diethylphthalate;1142
9.28.153;153. Diethylthiourea;1142
9.28.154;154. Diisopropyl Carbodiimide;1142
9.28.155;155. Diisopropylbenzothiazyl-2-Sulfenamide;1142
9.28.156;156. 2,5-Dimercapto-1,3,4-Thiadiazole;1143
9.28.157;157. Dimethoate;1143
9.28.158;158. Dimethoxon;1143
9.28.159;159. 2,6-Dimethoxy-1,4-Benzoquinone;1143
9.28.160;160. (R)-3,4-Dimethoxy-Dalbergione;1144
9.28.161;161. (S)-4,4’-Dimethoxy Dalbergione;1144
9.28.162;162. 5,8-Dimethoxypsoralen;1144
9.28.163;163. Dimethyl Phthalate;1144
9.28.164;164. 4-N,N-(Dimethylamino) Benzenediazonium Chloride;1145
9.28.165;165. 3-Dimethylaminopropylamine;1145
9.28.166;166. Dimethyldiphenylthiuram disulfide;1145
9.28.167;167. Dimethylformamide;1145
9.28.168;168 bis. Dimethyl fumarate;1146
9.28.169;169. 2,4-Dimethylol Phenol;1146
9.28.170;170. 2,6-Dimethylol Phenol;1146
9.28.171;171. Dimethylthiourea;1146
9.28.172;172. Dinitrochlorobenzene;1147
9.28.173;173. Dinitrofluorobenzene;1147
9.28.174;174. 2,4-Dinitrotoluene;1147
9.28.175;175. Dipentamethylenethiuram Disulfide;1147
9.28.176;176. Dipentamethylenethiuram Hexasulfide;1148
9.28.177;177. Dipentamethylenethiuram Tetrasulfide;1148
9.28.178;178. Dipentene;1148
9.28.179;179. Diphencyprone;1148
9.28.180;180. Diphenhydramine (hydrochloride);1149
9.28.181;181. N,N’-Diphenyl-4-Phenylenediamine;1149
9.28.182;182. 1,3-Diphenylguanidine;1149
9.28.183;183. 4,4’-Diphenylmethane-Diisocyanate;1150
9.28.184;184. Diphenylthiourea;1150
9.28.185;185. Disperse Blue 106;1150
9.28.186;186. Disperse Blue 124;1150
9.28.187;187. Disperse Dyes;1151
9.28.188;188. Disperse Orange 3;1151
9.28.189;189. Disperse Orange 31;1151
9.28.190;190. Disperse Red 11;1152
9.28.191;191. Disperse Yellow 3;1152
9.28.192;192. Dithianone;1152
9.28.193;193. Dodecyl Gallate;1152
9.28.194;194. Doxepin;1153
9.28.195;195. Epichlorhydrin;1153
9.28.196;196. Epoxy Resins of the Bisphenol A Type;1153
9.28.197;197. 2,3-Epoxypropyl Trimethyl Ammonium Chloride;1154
9.28.198;198. Estradiol;1154
9.28.199;199. Ethoxyquin;1154
9.28.200;200. Ethyl Alcohol;1154
9.28.201;201. 4-Ethyl-Pyridine;1155
9.28.202;202. Ethylbutylthiourea;1155
9.28.203;203. Ethylene Oxide;1155
9.28.204;204. Ethylenediamine;1155
9.28.205;205. Ethylenethiourea;1156
9.28.206;206. Ethylhexylglycerin;1156
9.28.207;207. Eugenol;1156
9.28.208;208. Euxyl®K 400 (see 284. subentry 1,2-Dibromo-2,4-Dicyanobutane and 322. Phenoxyethanol);1156
9.28.209;209. Famotidine;1157
9.28.210;210. Farnesol;1157
9.28.211;211. Fenvalerate;1157
9.28.212;212. Fluazinam;1157
9.28.213;213. Flutamide;1158
9.28.214;214. Folpet;1158
9.28.215;215. Formaldehyde;1158
9.28.216;216. Frullanolide;1159
9.28.217;217. Furaltadone;1159
9.28.218;218. Furazolidone;1159
9.28.219;219. Geraniol;1160
9.28.220;220. Glutaraldehyde;1160
9.28.221;221. Glyceryl Thioglycolate;1160
9.28.222;222. Glycidyl 1-Naphthyl Ether;1161
9.28.223;223. 3-Glycidyloxypropyltrimethoxysilane;1161
9.28.224;224. Grotan BK;1161
9.28.225;225 bis. HC Blue No. 7;1161
9.28.226;226. HC Yellow No. 7;1162
9.28.227;227. Hexamethylene Diisocyanate;1162
9.28.228;228. Hexamethylenediamine;1162
9.28.229;229. Hexamidine;1162
9.28.230;230. Hexanediol Diglycidyl Ether;1163
9.28.231;231. Hexyl Cinnamic Aldehyde;1163
9.28.232;232. Hydralazine;1163
9.28.233;233. Hydrangenol;1163
9.28.234;234. Hydrazine;1163
9.28.235;235. Hydrocortisone;1164
9.28.236;236. Hydrocortisone 17-Butyrate;1164
9.28.237;237. Hydrogen Peroxide;1164
9.28.238;238. Hydroquinone;1165
9.28.239;239. (S)-4-Hydroxy 4-Methoxydalbergione;1165
9.28.240;240. Hydroxycitronellal;1165
9.28.241;241. Hydroxylamine and Hydroxylammonium Salts;1165
9.28.242;242. Hydroxymethylpentacy­clohexenecarboxaldehyde;1166
9.28.243;243. Hypochlorous Acid and Hypochlorites;1166
9.28.244;244. Imidazolidinyl Urea;1166
9.28.245;245. Iodopropynyl Butylcarbamate;1167
9.28.246;246. Isoeugenol;1167
9.28.247;247. Alpha-Isomethylionone;1168
9.28.248;248. Isophorone Diamine;1168
9.28.249;249. Isopropyl Myristate;1168
9.28.250;250. N-Isopropyl-N-Phenyl-4-Phenylenediamine;1168
9.28.251;251. Ketoprofen;1169
9.28.252;252. Labetalol;1169
9.28.253;253. Lactucin;1169
9.28.254;254. Lactucopicrin;1169
9.28.255;255. Lapachenol;1170
9.28.256;256. Lapachol;1170
9.28.257;257. Lawsone;1170
9.28.258;258. Lidocaine;1171
9.28.259;259. Lilial®;1171
9.28.260;260. Limonene;1171
9.28.261;261. Linalool;1171
9.28.262;262. Linalyl acetate;1172
9.28.263;263. Lincomycin (Hydrochloride Monohydrate);1172
9.28.264;264. Lindane;1172
9.28.265;265. Lyral®;1172
9.28.266;266. Malathion;1172
9.28.267;267. Mancozeb;1173
9.28.268;268. Maneb;1173
9.28.269;269. Melamine and Melamine-Formaldehyde Resins;1173
9.28.270;270. Mercaptobenzothiazole;1174
9.28.271;271. Mercaptobenzothiazole Salts;1174
9.28.272;272. MESNA;1174
9.28.273;273. Metacresol;1175
9.28.274;274. Metanil Yellow;1175
9.28.275;275. Methenamine;1175
9.28.276;276. Methidathion;1175
9.28.277;277. Methiocarb;1176
9.28.278;278. Methomyl;1176
9.28.279;279. (R)-4-Methoxy Dalbergione;1176
9.28.280;280. Methoxy PEG-17/Dodecyl Glycol Copolymer;1176
9.28.281;281. Methoxypsoralens;1177
9.28.282;282. Methyl aminolevulinate;1177
9.28.283;283. Methyl-2,3-Epoxy-3-(4-Methoxyphenyl)Propionate;1177
9.28.284;284. Methyl Gallate;1177
9.28.285;285. Methyl Heptine Carbonate;1178
9.28.286;286. Methyl Octine Carbonate;1178
9.28.287;287. Methyl Salicylate;1178
9.28.288;288. Methyl-Terpyridine;1178
9.28.289;289. 2-Methyl-4,5-Trimethylene-4-Isothiazolin-3-one;1179
9.28.290;290. Methylchloroisothiazolinone;1179
9.28.291;291. Methylchloroisothiazolinone.+.Methylsiothiazolinone (MCI/MI);1179
9.28.292;292. Methyldibromoglutaronitrile;1179
9.28.293;293. Methylhexahydrophthalic Anhydride;1180
9.28.294;294. Methylisothiazolinone;1180
9.28.295;295. Methylol Phenols;1180
9.28.296;296. 1-Methylpyrrolidone;1181
9.28.297;297. Metol (Sulfate);1181
9.28.298;298. Metronidazole (hydrochloride);1181
9.28.299;299. Mevinphos;1181
9.28.300;300. Mezlocilin;1182
9.28.301;301. Monoethanolamine;1182
9.28.302;302. Morphine (Morphine Hydrochloride, Morphine Tartrate);1182
9.28.303;303. 4-Morpholinyl-2-Benzothiazyle Disulfide;1182
9.28.304;304. Morpholinyl Mercaptobenzothiazole;1183
9.28.305;305. Naled;1183
9.28.306;306. 1-Naphthol;1183
9.28.307;307. Naphthol AS;1183
9.28.308;308. Neomycin (Neomycin B Hydrochloride, Neomycin B Sulfate);1184
9.28.309;309. Nicotine;1184
9.28.310;310. 3-Nitro-4-Hydroxyethylaminophenol;1185
9.28.311;311. 2-Nitro-4-Phenylenediamine;1185
9.28.312;312. Nitrofurazone;1185
9.28.313;313. Nitroglycerin;1185
9.28.314;314. Nonoxynols;1186
9.28.315;315. Octocrylene;1186
9.28.316;316. Octyl Gallate;1186
9.28.317;317. 2-n-Octyl-4-Isothiazolin-3-one;1187
9.28.318;318. Olaquindox;1187
9.28.319;319. Oxacillin;1187
9.28.320;320. 7-Oxodehydroabietic Acid;1187
9.28.321;321. Oxprenolol;1188
9.28.322;322. Pantothenol;1188
9.28.323;323. Parabens (Parahydroxybenzoic Acid Esters);1188
9.28.324;324. Paraphenylenediamine;1189
9.28.325;325. Paraquat (Dichloride, Methosulfate);1190
9.28.326;326. Parathion;1190
9.28.327;327. Parthenolide;1190
9.28.328;328. Penicillins;1191
9.28.329;329. Pentachloronitrobenzene;1191
9.28.330;330. Pentadecylcatechol;1191
9.28.331;331. Phenoxyethanol;1191
9.28.332;332. Phenyl Glycidyl Ether;1192
9.28.333;333. Phenyl-Alpha-Naphthylamine;1192
9.28.334;334. Phenyl-Beta-Naphthylamine;1192
9.28.335;335. Phenylephrine (Hydrochloride);1193
9.28.336;336. Phenylethyl Caffeate;1193
9.28.337;337. Phthalic Anhydride;1193
9.28.338;338. Picric Acid;1193
9.28.339;339. Alpha-Pinene;1194
9.28.340;340. Beta-Pinene;1194
9.28.341;341. Piperazine;1194
9.28.342;342. Piroxicam;1194
9.28.343;343. Pivampicillin;1195
9.28.344;344. Polymyxin B (sulfate);1195
9.28.345;345. Potassium Metabisulfite;1196
9.28.346;346. Povidone-Iodine;1196
9.28.347;347. Prilocaine (Hydrochloride);1196
9.28.348;348. Primin;1196
9.28.349;349. Pristinamycin;1197
9.28.350;350. Procaine (Hydrochloride);1197
9.28.351;351. Propacetamol;1197
9.28.352;352. Propargite;1198
9.28.353;353. Propranolol;1198
9.28.354;354. Propyl Gallate;1198
9.28.355;355. Propylene Glycol;1199
9.28.356;356. Propylene Oxide;1199
9.28.357;357. Pseudoephedrine;1199
9.28.358;358. Pyrethroids;1199
9.28.359;359. Pyrethrosin;1200
9.28.360;360. Pyridine;1200
9.28.361;361. Pyrithione;1200
9.28.362;362. Pyrogallol;1201
9.28.363;363. PVP;1201
9.28.364;364. PVP/Eicosene Copolymer;1201
9.28.365;365. PVP/Hexadecene Copolymer;1202
9.28.366;366. Quaternium-15;1202
9.28.367;367. Quaternium-22;1202
9.28.368;368. Ranitidine;1203
9.28.369;369. Resorcinol;1203
9.28.370;370. Silane;1203
9.28.371;371. Sodium Bisulfite;1203
9.28.372;372. Sodium lauryl sulfate;1204
9.28.373;373. Sodium Metabisulfite;1204
9.28.374;374. Sodium Methyldithiocarbamate;1204
9.28.375;CAS Registry Number [137–42–8];1204
9.28.376;375. Sodium Sulfite;1204
9.28.377;376. Solvent Red 23;1205
9.28.378;377. Sorbitan Sesquioleate;1205
9.28.379;378. Spectinomycin;1205
9.28.380;379. Tetrabenzylthiuram Disulfide;1206
9.28.381;380. Tetrabutylthiuram Disulfide;1206
9.28.382;381. Tetrabutylthiuram Monosulfide;1206
9.28.383;382. Tetrachloroacetophenone;1206
9.28.384;383. Tetraethylthiuram Disulfide;1206
9.28.385;384. Tetraethylthiuram Monosulfide;1207
9.28.386;385. Tetraisobutylthiuram Disulfide;1207
9.28.387;386. Tetramethylthiuram Disulfide;1207
9.28.388;387. Tetramethylthiuram Monosulfide;1208
9.28.389;388. Tetrazepam;1208
9.28.390;389. Thebaine;1208
9.28.391;390. Thiabendazole;1209
9.28.392;391. Thimerosal;1209
9.28.393;392. Thiourea;1209
9.28.394;393. Thymoquinone;1209
9.28.395;394. Timolol;1210
9.28.396;395. Tixocortol Pivalate;1210
9.28.397;396. Tocopherol, Tocopheryl Acetate (DI-, D-);1210
9.28.398;397. Toluene-2,5-Diamine;1211
9.28.399;398. Toluene Diisocyanate;1211
9.28.400;399. Tosyl Chloride;1211
9.28.401;400. Triacetin;1211
9.28.402;401. Tribenoside;1212
9.28.403;402. Tributyltin Oxide;1212
9.28.404;403. Trichloroethane;1212
9.28.405;404. Trichloroethylene;1212
9.28.406;405. Triethanolamine;1213
9.28.407;406. Triethylenetetramine;1213
9.28.408;407. Triforine;1213
9.28.409;408. Triglycidyl Isocyanurate;1213
9.28.410;409. N-[3-(Trimethoxysilyl)Propyl]-N-(Vinylbenzyl)Ethylenediamine Monohydrochloride;1214
9.28.411;410. N-(3-Trimethoxysilylpropyl)-Ethylenediamine;1214
9.28.412;411. 2,4,6-Trimethylol Phenol;1214
9.28.413;412. Trimethylthiourea;1215
9.28.414;413. Tulipalin A and Tulipalin B;1215
9.28.415;414. Tuliposide A;1215
9.28.416;415. Tylosin;1215
9.28.417;416. Urushiol;1216
9.28.418;417. Usnic Acid (D-Usnic Acid, l-Usnic Acid);1216
9.28.419;418. Vinylpyridine;1217
9.28.420;419. Virginiamycin;1217
9.28.421;420. Zinc bis-Dibutyldithiocarbamate;1218
9.28.422;421. Zinc bis-Diethyldithiocarbamate;1218
9.28.423;422. Zinc bis-Dimethyldithiocarbamate;1218
9.28.424;423. Zinc Ethylene-bis-Dithiocarbamate;1219
9.28.425;424. Zinc Propylene-bis-Dithiocarbamate;1219
9.28.426;58.1 Introduction;1092
10;Index;1220