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Acta Dermato-Venereologica 12/2011; 92(4):401-3.
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ABSTRACT: Efficacy and steroid sparing effects of pimecrolimus 1% cream in atopic dermatitis have been shown recently, but there is no data on efficacy in long term management of atopic hand dermatitis. This study aims to investigate the efficacy of pimecrolimus 1% cream as maintenance therapy in patients suffering from atopic hand dermatitis.
A double-blind vehicle controlled study in 40 adult patients with atopic hand dermatitis (IGA ≤ 3) comparing the efficacy of twice daily application of pimecrolimus 1% cream given as maintenance treatment versus vehicle over a 8 week period after clinical response (IGA ≤ 2) to a 1-3 week pre-treatment with mometasone fuorate 0.1% was performed. Primary endpoint was the time to relapse (IGA ≥ 3).
Thirty-six out of 40 patients were randomised to receive either pimecrolimus 1% (P) or vehicle cream (V). The number of patients with stable remission in patients randomised to pimecrolimus (53.8%) and vehicle (43.8%) did not achieve statistical significance between the groups (p = 0.41). Subgroup analysis of patients with initially moderate dermatitis (IGA = 3, n = 20) showed a trend towards a better outcome for the pimecrolimus group (stable remission P = 81.8% versus V = 55.6%) (p = 0.244).
Pimecrolimus 1% cream twice daily was not superior to vehicle in the sequential maintenance therapy of atopic hand dermatitis, but efficacy in moderate forms should be investigated in further studies.
Journal der Deutschen Dermatologischen Gesellschaft 11/2011; 10(6):426-33. · 1.47 Impact Factor
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ABSTRACT: Occupational contact allergy is a common problem in the cleaning industry.
To identify the most frequent occupation-associated allergens and time trends in contact allergy in female cleaners.
We analysed the patch test data concerning 803 female cleaners, who were evaluated for occupational contact dermatitis in 45 dermatological departments contributing to the Information Network of Departments of Dermatology (IVDK) from 1996 to 2009. Female patients, except cleaners, with occupational dermatitis (n = 14494) and female controls without occupational dermatitis (n = 64736) patch tested during this time period formed the control groups.
One hundred and fifty-six (19.4%) cleaners had past or present atopic dermatitis. Six hundred and fifty-five (81.6%) cleaners suffered from occupational hand dermatitis. Allergic contact dermatitis was diagnosed in 249 (31%) of the cleaners. As compared with the control group without occupational dermatitis, female cleaners were significantly more often sensitized to occupationally relevant allergens such as rubber additives, especially thiurams [11.6%, 95% confidence interval (CI) 9.1-14.1 vs. 1.5%, 95% CI 1.4-1.6], zinc diethyldithiocarbamate (3.4%, 95% CI 2.1-4.7 vs. 0.4, 95% CI 0.3-0.4), and mercaptobenzothiazole (1.8, 95% CI 0.7-2.9 vs. 0.5, 95% CI 0.4-0.6), as well as formaldehyde (3.4, 95% CI 2.0-4.7 vs. 1.4%, 95% CI 1.3-1.5). No differences were seen in patterns of sensitization to occupational allergens in younger (≤40 years of age) and older (>40 years of age) female cleaners.
Formaldehyde and rubber additives such as thiurams, zinc diethyldithiocarbamate and mercaptobenzothiazole are occupationally relevant allergens in female cleaners. Prevention strategies are needed to address the problem.
Contact Dermatitis 06/2011; 65(3):159-66. · 3.51 Impact Factor
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Christian Joachim Apfelbacher,
Wilhelm Akst,
Sonja Molin,
Jochen Schmitt, Andrea Bauer,
Elke Weisshaar,
Vera Mahler,
Sabine Treichel,
Thomas Ruzicka,
Thomas Luger,
Peter Elsner,
Thomas Ludwig Diepgen
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ABSTRACT: The aim of the CARPE (German acronym: Chronisches Handekzem-Register zum Patienten-Langzeitmanagement; meaning: chronic hand eczema registry on long-term patient management) registry is to investigate characteristics and treatment modalities in patients affected by chronic hand eczema in Germany.
The registry was built up under the auspices of the German Dermatological Society (Deutsche Dermatologische Gesellschaft, DDG). Patients with chronic hand eczema are prospectively assessed by dermatological examination and patient questionnaire. Socio-economic data and data on diagnostics, skin status, severity and treatment of chronic hand eczema and atopy criteria are repeatedly assessed. Here, we present baseline characteristics of the first 515 patients.
53.8 % of the patients were female, mean age was 47.3 years. The average duration of CHE was 7.7 years. 30.4 % had already received inpatient care, 31.2 % had been on sick leave in the past 12 months. 94.5 % had received topical corticosteroids prior to inclusion in the registry, 31.9 % topical calcineurin inhibitors, 38.3 % UV therapy, 28.6 % systemic antihistamines, 36.5 % systemic treatments, 14.9 % systemic corticosteroids, 25.8 % systemic retinoids.
The CARPE project demonstrates the high medical burden and therapeutic challenge of chronic hand eczema and presents first data for health care research. Furthermore, the designed follow-up study will present important data about the natural history and prognosis of this chronic skin disease.
Journal der Deutschen Dermatologischen Gesellschaft 05/2011; 9(9):682-8. · 1.47 Impact Factor
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Annice Heratizadeh,
Claudia Killig,
Margitta Worm,
Stephanie Soost,
Dagmar Simon, Andrea Bauer,
Vera Mahler,
Christian Schuster,
Christiane Szliska,
Yvonne Frambach,
Ricarda Eben,
Thomas Werfel,
Wolfgang Uter,
Axel Schnuch
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ABSTRACT: While the use of methyldibromo glutaronitrile (MDBGN) in leave-on products is clearly associated with high sensitization or elicitation risk, such a clear-cut relation could be questioned with regard to rinse-off products.
The objective of this study was to find a maximum non-eliciting concentration for rinse-off products in MDBGN patch test-positive patients.
We performed a use-related test [repeated open application test (ROAT)] in patients sensitized to MDBGN with a liquid soap containing three concentrations of MDBGN (50, 200, and 400 p.p.m. MDBGN, respectively). The soap at 50 p.p.m. was used twice daily for 4 weeks. If no reaction of the skin was observed, the product with the next higher concentration was used for another 4 weeks, etc.
In total, 32/37 evaluated cases [86.5%; lower exact one-sided 95% confidence limit (CL): 73.7%] did not react to any of the preparations. The remaining reacted as follows: 1/37 reacted to 50 p.p.m., 3/37 to 200 p.p.m., and 1/37 to 400 p.p.m. The cumulative non-response to 50 p.p.m. was 97.3% (lower CL: 87.8%).
The majority of subjects sensitized to MDBGN-tolerated rinse-off products containing a maximum concentration of 400 p.p.m. A concentration in rinse-off products in the range of 50 p.p.m. could be regarded as safe for most individuals already sensitized. These concentrations will presumably prevent induction (sensitization) also.
Contact Dermatitis 06/2010; 62(6):330-7. · 3.51 Impact Factor
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ABSTRACT: Occupational irritant hand dermatitis (OIHD) is an important cause of discomfort in the working population. Different preventive measures are in place but it is not clear how effective these are.
To assess the effect of interventions for preventing OIHD in healthy people who work in occupations where the skin is at risk of damage.
In May 2010, we searched the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLlNE and EMBASE. Conference proceedings, and ongoing trials registers were also searched.
Randomised controlled trials (RCTs) studying the effectiveness of barrier creams, moisturisers, gloves, complex educational interventions, and other interventions for the prevention of OIHD.
Two authors independently assessed the trials and extracted data.
Four RCTs involving 894 participants from different occupations were included. The primary outcome was numbers of new cases.One large RCT of 708 print and dye workers compared 2 barrier creams (containing silicone or hydrocarbon) versus no intervention. Fewer workers using barrier creams developed OIHD than those who did not (39.9% versus 45%, (OR 0.75, 95% CI 0.53 to 1.07. P = 0.11) but this was not statistically significant.In 1 RCT of 54 metal workers less developed OIHD when using an after work emollient or a barrier cream compared to no intervention. There was no statistical difference between the groups at different times of follow-up.One RCT of 111 cleaners and kitchen workers compared a moisturiser (Locobase) versus no intervention using a cross-over design. While using the moisturiser no participant developed OIHD. During the control period with no skin treatment, 19 (20.4%) out of 93 participants developed OIHD.One RCT of 21 hairdressers compared a barrier cream containing aluminium chlorohydrate (Excipial protect) versus its vehicle. No participant developed OIHD while the products were used.Only limited side-effects such as transient itching, stinging, and dryness were reported for the interventions.
Although the findings of this review were generally positive, no statistical significance was reached. We conclude that at present there is insufficient evidence for the effectiveness of most of the interventions used in the primary prevention of OIHD. This does not mean that current measures are necessarily ineffective, as the limited studies to date have been rather small and of poor quality. Larger well designed RCTs are now needed in different workplaces to establish the effectiveness of various preventative strategies.
Cochrane database of systematic reviews (Online) 01/2010; · 5.72 Impact Factor
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ABSTRACT: Although UV exposure is the most important risk factor for cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), a systematic review analyzing the risk of occupational UV exposure is missing.
Based on a systematic literature search in PubMed (until 05/2009) supplemented by hand search, the association between occupational UV exposure and SCC and BCC was analyzed. Literature search and data abstraction was done independently by 2 reviewers. The association between occupational UV exposure and cancer risk is presented as odds ratios (OR).
We identified 25 relevant epidemiologic studies (5 cohort studies, 17 case-control studies, 3 cross-sectional studies). 12 studies described a positive association between occupational UV exposure and risk of SCC with OR > 3 in 6 studies and OR 1.5-2.0 in another 6 studies. 3 studies did not find a relevant association (OR: 1.0-1.4). A significant positive association between occupational UV exposure and BCC was reported in 5 studies; 11 studies did not find a significant association.
The association between occupational UV exposure and SCC is well and consistently documented epidemiologically (approximately 2-fold increased risk), so that the criteria for a new occupational disease are fulfilled. The association with BCC is unclear due to significant methodological limitations in the published studies.
Journal der Deutschen Dermatologischen Gesellschaft 10/2009; 8(4):250-63, 250-64. · 1.47 Impact Factor
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ABSTRACT: The epidermal part of the skin is the major interface between the internal body and the external environment. The skin has a specific physiology and is to different degrees adapted for protection against multiple exogenous stress factors. Clothing is the material with the longest and most intensive contact to human skin. It plays a critical role especially in inflammatory dermatoses or skin conditions with an increased susceptibility of bacterial and fungal infections like atopic dermatitis. Previously, we have shown a dose-dependent antibacterial and antifungal activity of silver-loaded seaweed-based cellulosic fibres.
We studied the mode of action of silver-loaded seaweed-based cellulosic fiber and performed a broad safety assessment. The principal aim was to analyse the effects of wearing the textile on epidermal skin physiology in 37 patients with atopic dermatitis in a controlled, randomized single-blinded in vivo study. Furthermore, the sensitization potential was tested in a patch test in 111 panellists.
We could demonstrate in vitro a dose-dependent scavenging of induced reactive oxygen species by silver-loaded seaweed-based cellulosic fibers. Safety assessment of these fibres showed no detectable release of silver ions. Furthermore, ex vivo assessment after 24 h application both in healthy volunteers and patients with atopic dermatitis by sequential tape stripping and subsequently raster electron microscopy and energy dispersive microanalysis analysis revealed no detectable amounts of silver in any of stratum corneum layers. Serum analysis of silver showed no detectable levels. The in vivo patch testing of 111 volunteers revealed no sensitization against different SeaCell Active (SeaCell GmbH, Rudolstadt, Germany) containing fabrics. The in vivo study on 37 patients with known atopic dermatitis and mild-to-moderate eczema on their arms were randomly assigned to either silver-loaded seaweed fibre T-shirts or to cotton T-shirts for 8 weeks. A significant reduction in Staphylococcus aureus colonization was detectable for the silver T-shirts compared with cotton T-shirts without any changes in non-pathogenic surface bacteria colonization. Furthermore, a more pronounced improvement in barrier function (transepidermal water loss) was observed in mildly involved eczema areas during the first 4 weeks of the study. Stratum corneum hydration and surface pH improved in both treatment groups over time.
The tested silver-loaded seaweed fibre can be regarded as safe and seams to be suited for application in bio-active textiles in atopic dermatitis based on its positive in vivo activity.
Experimental Dermatology 08/2009; 19(8):e9-15. · 3.54 Impact Factor
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ABSTRACT: In a double-blind, placebo-controlled crossover trial, 23 patients consumed 250 ml mare's milk or placebo for 16 weeks. The aim was to examine the effects of mare's milk on the characteristics of atopic dermatitis (AD), on faecal microbiota and on clinical and immunological parameters. The intensity of AD was examined using the Severity Scoring of Atopic Dermatitis (SCORAD) index. During the mare's milk period, the mean SCORAD value of patients (n=23; 17 females, 6 males) decreased from 30.1 to 25.3 after 12 weeks (P<0.05) and to 26.7 after 16 weeks (P<0.1). In a subgroup (n=7) the SCORAD index and especially the pruritus decreased by 30% through the mare's milk period (P<0.01). In this subgroup, the faecal bifidobacteria increased during the mare's milk period from 4.6% to 11.9% of eubacteria (P<0.05). The immunological parameters, except C-reactive protein, were unchanged.
International Journal of Food Sciences and Nutrition 05/2009; 60 Suppl 7:41-52. · 1.15 Impact Factor
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ABSTRACT: A case of a sporotrichoid cutaneous infection caused by Mycobacterium marinum is reported. A 53- year-old male patient presented with red, partly purulent nodular lesions on the back of his left hand, forearm, and upper medial arm that had developed consecutively during the past 4 weeks. A mycobacterial infection with M. marinum was confirmed by molecular methods in a lesional skin biopsy. The patient was treated systemically with rifampicin (750 mg/day) and clarithromycine (1,000 mg/day), and topically with sulmycin (gentamicin sulfate). After 12 weeks of treatment the nodules regressed, leaving behind erythematous patches. M. marinum is a waterborne mycobacterium that commonly infects fish and amphibians worldwide. Transmissions to humans occur occasionally, in most cases as a granulomatous infection localized to the skin, typically following minor trauma to the hands. For this reason, infections are especially common among aquarium keepers.
Acta dermatovenerologica Alpina, Panonica, et Adriatica 04/2009; 18(1):31-4.
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ABSTRACT: An interdisciplinary 'Skin Disease Prevention Programme (SDPP) in the baking, hotel, and catering industries' was established. However, only 30% of the eligible employees suffering from occupational hand dermatitis (OHD) participated in the programme.
The aim of the present study was to increase the participation rate in the SDPP from 30% to 50% by specific recruitment strategies.
Two hundred and twenty five baker and catering trade employees suffering from OHD were included in a prospective controlled intervention study. The employees were invited to take part in the SDPP using (i) a standard invitation letter (n = 40), (ii) a newly developed, personalized, and targeted invitation letter (n = 52), (iii) the new invitation letter and a case report (n = 75), and (iv) the new invitation letter, the case report, and the additional information (n = 58).
The commitment of the employees to join the SDPP increased significantly from 30% to 54% (P < 0.02) in the group receiving the new personalized targeted invitation letter. Neither the additional case report nor the supplementation with additional information concerning the SDPP did further increase the recruitment.
The strategy to personalize and target the new invitation letter was successful to influence the employees' commitment to participate in the SDPP.
Contact Dermatitis 10/2008; 59(3):165-70. · 3.51 Impact Factor
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ABSTRACT: Despite the high prevalence, morbidity, and economic burden of atopic eczema,data on patients' treatment goals and treatment satisfaction are missing.
A cross-sectional study was performed with standardized survey of all adult patients treated between 01/2004 and 03/2006 in the atopic eczema outpatient unit of the Department of Dermatology, TU Dresden, Germany. Assessed were disease-specific characteristics (age at onset, treatment, disease severity, quality of life impact), and aspects of health services research (treatment goals, patients' self-treatment competence, treatment satisfaction). Treatment satisfaction was assessed on a 100 mm visual analog scale with 0 reflecting "very dissatisfied", and 100 "highly satisfied". Based on an a priori model we analyzed the impact of sociodemographic and disease-specific factors on treatment satisfaction (primary endpoint) using multivariate regression modeling.
Of the 267 patients asked to participate, 226 (85 %) agreed. Mean treatment satisfaction was 59.6 (+/- 30.8). Age and sex were not significantly associated with treatment satisfaction. Professional competence of the treating physician was the most important determinant of treatment satisfaction, followed by physician's sensitivity, disease severity, education about the condition, and patient's competence to adjust treatment to disease activity. Reduction of itching and burning, as well as complete clearing of all skin changes, were the most important treatment goals.
For adult patients with atopic eczema the impression of professional competence of the treating physician has highest priority. Disease severity only explains 20 % of the total variance of treatment satisfaction. Comprehensive information about the condition and reinforcement of patients' treatment competence should be better integrated in clinical practice.
Journal der Deutschen Dermatologischen Gesellschaft 07/2008; 6(6):458-65. · 1.47 Impact Factor
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ABSTRACT: Occupational hand dermatitis (OHD) is a common and often chronic condition. Usage of topical corticosteroids is limited in long-term therapy because of potential side-effects. New treatment options are highly appreciated.
To study efficacy and safety of tacrolimus in patients suffering from OHD.
In a prospective, open, multicentre study, 29 patients with OHD of predominantly mild-to-moderate severity were treated with tacrolimus ointment (Protopic 0.1%) during a 4-week active treatment period with twice daily application followed by a 2-month optional treatment period. Efficacy was evaluated by the use of a standardized hand eczema score and by clinical severity rating, conducted on all study visits (screening, baseline and weeks 2, 4, 6, and 12). Adverse events were recorded for safety evaluation.
The hand eczema score declined significantly after 2 weeks of treatment compared with baseline and further declined until the end of the study. Finally, 12 (44%) patients were clear of hand eczema. Worsening of the dermatitis occurred in 2 patients (7%). Clinical grading indicated improvement too. Overall tolerability was good.
Topical tacrolimus might be an efficacious treatment option for chronic OHD. Blinded and randomized controlled studies are necessary to confirm the results of this pilot study.
Contact Dermatitis 06/2008; 58(5):299-306. · 3.51 Impact Factor
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ABSTRACT: Morphological changes in the dermal collagen and elastin fibre network are characteristic for skin ageing and for pathological skin conditions of the dermis.
To characterize pathological and physiological conditions by multiphoton laser scanning tomography (MLT) in vivo, it is necessary to investigate and identify morphological alterations related to ageing.
In vivo MLT was used to image two-photon excited autofluorescence (AF) and second harmonics generation (SHG) in human dermis of 18 volunteers of different ages. Criteria for the evaluation of age-dependent morphological changes in MLT images were fibre tension and morphology, network pattern, clot formation and image homogeneity. These criteria were weighted and a score was calculated.
The resulting MLT-based Dermis Morphology Score is correlated with age (R2 = -0.90) and with the previously published SHG to AF Ageing Index of Dermis (R2 = 0.66). The two groups of young (age 21-38) and old (age 66-84) volunteers showed a significant difference in MLT score values (P < 0.001). Conclusions: We could demonstrate an in vivo relationship between morphological characteristics of human dermis assessed by MLT and age. The present score allows the semi-quantitative evaluation of specific morphological changes of the dermal fibre network in ageing skin by in vivo AF and SHG imaging. This method will be useful for diagnostics of pathological conditions and their differentiation from ageing effects.
Experimental Dermatology 06/2008; 17(6):519-23. · 3.54 Impact Factor
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Acta Dermato Venereologica 02/2008; 88(4):404-5. · 3.18 Impact Factor
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Contact Dermatitis 02/2007; 41(5):293 - 295. · 3.51 Impact Factor
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ABSTRACT: BACKGROUND: We describe a 20-year old woman with retarded healing after a melanoma excision. After short time application of several creams containing antiseptic, antibiotic and anti-inflammatory ingredients she developed a severe contact dermatitis. Patch testing revealed sensitizations against corticosteroids, an antibiotic and quinoline. CONCLUSION: In our case multiple relevant contact sensitizations appeared within a short period of two months after excision of a malignant tumour.
Skin Research and Technology 09/2005; 11(3):218-9. · 1.71 Impact Factor
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ABSTRACT: Characteristic features of atopic diseases (AD) are immigration and local activation of eosinophils. Reorganization of the cytoskeleton modulates the function of leukocytes and is a prerequisite for the motility response. In this work, the regulation of actin polymerization has been investigated by flow cytometry using NBD-phallacidin and right angle light scatter measurements in purified eosinophils isolated from patients with atopic dermatitis and normal individuals. Stimulation of eosinophils with chemotaxins such as complement fragment C5a (C5a), CC chemokine RANTES/ CCL5 and platelet activating factor (PAF) induced a reversible polymerization of actin. Normodense eosinophils purified from patients with AD showed a decreased chemotaxin-induced actin response as compared to normodense eosinophils from healthy subjects and hypodense eosinophils from patients. Stimulation of eosinophils with Th2-cytokines such as interleukin-3 (IL-3), interleukin-5 (IL-5), granulocyte-macrophage colony-stimulating factor (GM-CSF) did not exert a significant effect on actin polymerization. However, pretreatment with IL-3, IL-5 or GM-CSF potentiated the chemotaxin-induced actin polymerization and graded the differential responsiveness between normodense and hypodense eosinophils. We demonstrate a different actin responsiveness in eosinophils from atopic patients and healthy subjects which could be overcome by modulating effects of Th2-cytokines.
International Journal of Molecular Medicine 01/2005; 14(6):1055-60. · 1.98 Impact Factor
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Andrea Bauer,
Daniela Kelterer,
Reinhard Bartsch,
Anja Schlegel,
James Pearson,
Martina Stadeler,
Peter Kleesz,
Romano Grieshaber,
Rainer Schiele,
Peter Elsner,
Hywel Williams
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ABSTRACT: The objective of this controlled intervention study was to quantify the efficacy of skin protection (SP) measures and ultraviolet B (UVB) hardening in the prevention of hand dermatitis in bakers' apprentices.
SP measures were compared against UVB hardening in a controlled clinical trial of 94 apprentices. The apprentices were assigned to the intervention arms class-wise. Bakers' apprentices involved in a previous follow-up study served as additional controls representing no intervention. The apprentices were interviewed and examined in a standardised way at the beginning of the training and at 4 monthly follow-ups. Transepidermal water loss (TEWL) was measured at the back of the hands.
Demographic profile and atopy criteria were equally distributed in the two intervention arms and the control group. Point prevalence of hand dermatitis after 6 months was highest in the controls (29.1%) followed by the UVB (19.4%) and the SP group (13.3%). UVB hardening and SP measures reduced hand dermatitis prevalence by 9.7% (95%CI: -8.5 to 28.1) and 15.7% (95%CI: -2.4 to 33.9), respectively. Application of SP measures reduced the odds ratios (ORs) for hand dermatitis 0.8-fold (95%CI: 0.17-3.70) and 0.33-fold (95%CI: 0.09-1.23) compared with the UVB group and the controls, respectively. These clinical trends were confirmed by statistically significant differences in TEWL values. TEWL values were consistently higher in the UVB group than in the SP group ( P=0.002).
This study provided evidence, based on significant differences in TEWL levels, that general SP measures may be more effective than UV light hardening of the skin, which in turn was more effective than no intervention. This trend was supported by the frequency of development of clinical hand dermatitis, although differences did not reach statistical significance. A multi-centre trial is recommended to confirm the efficacy of SP measures in a larger randomised study.
Archiv für Gewerbepathologie und Gewerbehygiene 10/2002; 75(7):491-9. · 1.89 Impact Factor
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Johannes Geier,
Peter J. Frosch,
Axel Schnuch,
Monika Agathos, Andrea Bauer,
Jochen Brasch,
Gisela Gaber,
Petra Gottlöber,
Jürgen Grabbe,
Martin Hartmann,
U. T. A. Jappe,
Martin Kaatz,
Dieter Lübbe,
Claudia Pirker,
Olaf Gefeller
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ABSTRACT: Thiuram mix is tested in the standard series at a test concentration of 1% pet. The single thiurams (DPTD, TMTD, TMTM, TETD), however, are usually tested at 0.25% pet. in Germany. In other countries, the individual components of thiuram mix are tested at 1% pet. The German Contact Dermatitis Research Group (DKG) compared both patch test concentrations in 530 patients in order to find out if (i) a significant number of positive patch tests are missed by testing at the lower concentration, (ii) problems with irritant test reactions occur by increasing the test concentration to 1%, and (iii) the sensitivity of the thiuram mix rises when the breakdown test is done with the higher concentration. Slightly more positive reactions were seen with the higher concentration, but this increase did not reach statistical significance. The reaction index, as a measure for the relation of positive to irritant and/or questionable reactions, remained unchanged for the individual thiurams. The sensitivity of the mix also did not change when the breakdown test was performed with 1% pet. instead of 0.25% pet. Thus, we conclude that both concentrations are of equal diagnostic value in patch testing.
Contact Dermatitis 06/2002; 46(5):258 - 261. · 3.51 Impact Factor
