Contact dermatitis due to para-tertiary-butylphenol-formaldehyde resin in a wetsuit

Screening for skin-sensitizing allergens among patients with clinically suspected allergic contact dermatitis

Objectives:

To detect common skin-sensitizing agents among patients experiencing allergic contact dermatitis (ACD).

Methods:

This was a retrospective study of 152 patients with clinically suspected ACD who underwent patch testing in an allergy clinic at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between January 2012 and February 2015. Of these patients, only 74 (48%) patients reacted to one or more contact allergens. This group of patients included 58 (78.4%) women and 16 (21.6%) men (mean age: 37.8±13.8 years). Patch testing was performed using the thin-layer rapid-use epicutaneous patch test panels.

Results:

Nickel sulfate was the most common sensitizing agent, with 26 (35.1%) patients yielding a positive result; followed by p-phenylenediamine in 17 (22.9%), butyl-tetra-phenol formaldehyde in 12 (16.2%), gold sodium thiosulfate in 10 (13.5%), and thimerosal in 6 (8.1%) patients. Nickel reactivity was significantly higher among women (41.4%) than among men (12.5%) (p<0.0001). Similarly, gold reactivity among women (15.5%) was also higher than among men (6.2%) (p≤0.02).

Conclusion:

The high level of skin sensitization due to nickel, PPD, and gold in patients with ACD emphasizes the need for measures to decrease exposure to these sensitizing agents.

Bra-associated allergic contact dermatitis: p-tert-butylphenol formaldehyde resin as the culprit

P-tert-butylphenol formaldehyde resin (PTBPFR) is recognized as a significant source of allergic contact dermatitis in adults and children in association with athletic gear, shoes, and neoprene. To our knowledge, this is the first case report of allergic contact dermatitis with PTBPFR associated with padded foam bras.

Aquatic sports dermatoses: part 1. In the water: freshwater dermatoses

The first of this three-part series on water-related dermatoses involving the athlete will include sports occurring with the majority of time spent in the water. These sports include swimming, diving, scuba, snorkeling and water polo. Numerous authors have described dermatologic conditions commonly seen in swimmers. This series provides an updated and comprehensive review of these water dermatoses. In order to organize the vast number of skin conditions related to water exposure, we divided the skin conditions into groupings of infectious and organism-related dermatoses, irritant and allergic dermatoses and miscellaneous dermatoses. The vast majority of skin conditions involving the water athlete result from chemicals and microbes inhabiting each environment. When considering the effects of swimming on one's skin, it is also useful to differentiate between exposure to freshwater (lakes, ponds and swimming pools) and exposure to saltwater. This review will serve as a guide for dermatologists, sports medicine physicians and other medical practitioners in recognition and treatment of these conditions.

Hand/face/neck localized pattern: sticky problems--resins

Plastic resin systems have an increasingly diverse array of applications but also induce health hazards, the most common of which are allergic and irritant contact dermatitis. Contact urticaria, pigmentary changes, and photoallergic contact dermatitis may occasionally occur. Other health effects, especially respiratory and neurologic signs and symptoms, have also been reported. These resin systems include epoxies, the most frequent synthetic resin systems to cause contact dermatitis, (meth)acrylics, polyurethanes, phenol-formaldehydes, polyesters, amino resins (melamine-formaldehydes, urea-formaldehydes), polyvinyls, polystyrenes, polyolefins, polyamides and polycarbonates. Contact dermatitis usually occurs as a result of exposure to the monomers and additives in the occupational setting, although reports from consumers, using the raw materials or end products periodically surface. Resin- and additive-induced direct contact dermatitis usually presents on the hands, fingers, and forearms, while facial, eyelid, and neck involvement may occur through indirect contact, eg, via the hands, or from airborne exposure. Patch testing with commercially available materials, and in some cases the patient's own resins, is important for diagnosis. Industrial hygiene prevention techniques are essential to reduce contact dermatitis when handling these resin systems.

Contact dermatitis in athletes

Athletes face numerous hazards in their daily activities. An athlete's skin, in particular, endures repeated exposure to trauma, heat, moisture, and numerous allergens and chemicals. These factors combine with other unique and less well-defined genetically predisposing factors in the athlete's skin to cause both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD). As with other cases of contact dermatitis, these eruptions in athletes present as a spectrum of acute to subacute to chronic dermatitis. Recognizing the unique environmental irritants and allergens encountered by athletes is paramount to facilitate appropriate therapy and prevention. This review comprehensively examines the literature on contact dermatitis in athletes. The different types of contact dermatitis have been classified under sport-specific subheadings. Furthermore, within each subheading, both ACD and ICD types are discussed.