Hazards of urocanic acid as a cosmetic ingredient.

Certain commercially available cosmetic products have been found to contain the ingredient urocanic acid. We have shown that the solar irradiation in vitro of one such lotion resulted in the formation of cis urocanic acid. The irradiated lotion, when applied topically to the skin of hairless mice, systemically suppressed the normal contact hypersensitivity reaction to 2,4-dinitrofluorobenzene by 68%. In addition, mice exposed to a minimally erythemal dose of ultraviolet B (280-320 nm) radiation, normally sub-immunosuppressive, showed a 56% suppression of the contact hypersensitivity reaction if they were irradiated through the topically applied cosmetic lotion.     

Active sensitization caused by 2-hydroxyethyl methacrylate, 2-hydroxypropyl methacrylate, ethyleneglycol dimethacrylate and N,N-dimethylaminoethyl methacrylate

A 45-year-old orthodontist became sensitized during patch tests with (meth)acrylates. Retesting showed that the sensitizing acrylics were methacrylates, namely 2-hydroxyethyl methacrylate, 2-hydroxypropyl methacrylate, ethylene glycol dimethacrylate and N,N -dimethylaminoethyl methacrylate. Acrylates are stronger sensitizers than methacrylates, but the present report indicates that also methacrylates may sensitize at the patch test concentrations used. Accordingly, it may be necessary to use lower (meth)acrylate concentrations for patch testing.     

Hazards of steroid therapy in hepatic failure

Three patients with extensive skin disease and liver failure are described. Two were treated with large amounts of topical corticosteroids and one with a small oral dose of betamethasone. The former two patients developed Addisonian crises when they failed to apply the topical steroids and all three patients developed aseptic necrosis of bone. This report emphasizes that the hazards of steroid therapy may be increased in patients with hepatic failure.     

Contact dermatitis to methyl methacrylate

2 cases of contact dermatitis to methyl methacrylate monomer are presented. The patients are nurses who mixed bone cement at orthopedic operations. During the procedure, they used 2 pairs of gloves (latex). Butyl rubber gloves are recommended for methyl methacrylate monomer to avoid sensitization and/or cumulative irritant contact dermatitis on the hands.     

Polymethyl methacrylate microspheres in collagen

Artecoll was developed about 20 years ago and underwent a number of production changes until it recently became FDA approved under the new name of Artefill. This product contains 20% polymethyl methacrylate (PMMA) microspheres with a diameter of 30 to 40 microm, which are suspended in a 3.5% atelo-collagen solution. The PMMA microspheres are now purified and no longer have an electrostatic charge, which in part was the cause for the early granulomatous reactions. Further, PMMA has long been known as bone cement and has been used in cosmetic surgery with a very good safety record. PMMA microspheres are biologically inert and nondegradable. The treatment results are therefore permanent and technical errors as well as incorrect injections will last. Due to the early record of granuloma formation, there is still a debate as to whether this product-as well as all other permanent fillers-should be injected for cosmetic reasons or not. With proper indications, excellent injection techniques, and realistic expectations as to what can be expected, this product has now proved to be one of the superior permanent filler substances.     

Occupational methacrylate and acrylate allergy from glues

Background:  Glues and sealants are important causes of methacrylate and acrylate allergy.
Aim:  This study aimed to analyse patterns of allergic patch test reactions to acrylic monomers in relation to exposure in patients sensitized from glues.
Patients/Methods:  We screened the patch test files at the Finnish Institute of Occupational Health from 1994 to 2006 for allergic reactions in the 'Methacrylate series' and analysed the clinical records of sensitized patients. Only patients who had handled acrylic glues at work were included.
Results:  10 patients had allergic reactions to acrylic monomers and had been sensitized from glues at work. 9 of them had used anaerobic sealants, 3 cyanoacrylate-based instant adhesives, and 1 patient a bi-component instant adhesive. All the patients reacted to 2-hydroxyethyl methacrylate (2-HEMA) and ethyleneglycol dimethacrylate (EGDMA); reactions to 2-hydroxypropyl methacrylate, triethyleneglycol dimethacrylate, and tetrahydrofurfuryl methacrylate were also common. The first 4 methacrylates were found in the glues used by the patients. Ethyl cyanoacrylate (ECA) gave no reactions, but 1 patient reacted weakly to her own ECA-based glue.
Conclusion:  2-HEMA and EGDMA are good screeners for contact allergy to anaerobic sealants and also detected a single case deriving from bi-component acrylic glue.     

Occupational allergic contact dermatitis from ethyl cyanoacrylate

Glues based on cyanoacrylates are widely used as contact adhesives for metal, glass, rubber, plastics and textiles, as well for biological materials, including binding tissues and sealing wounds in surgery. In this paper, an apprentice cobbler with an occupational allergic contact dermatitis from an ethyl cyanoacrylate glue, in which the major monomer was shown to be the sensitizer, is reported. Initial patch testing with the cyanoacrylate glue dissolved in acetone with the Finn Chamber (aluminium) technique yielded false-negative reactions. Positive test reactions were obtained with the same preparations using Van der Bend chambers. With petrolatum as vehicle for the glue, there was no difference between Finn Chamber technique and Van der Bend chamber technique. The role of aluminium in the false-negative reactions is discussed.