Is Contact Allergy to Disperse Dyes and Related Substances Associated With Textile Dermatitis?

K. Ryberg; A. Goossens; M. Isaksson; B. Gruvberger; E. Zimerson; F. Nilsson; J. Björk; M. Hindsén; M. Bruze

Disclosures

The British Journal of Dermatology. 2009;160(1):107-115. 

In This Article

Material and Methods

Study Population

The study population consisted of 982 patients with dermatitis, consecutively patch tested at the Department of Occupational and Environmental Dermatology, Malmö University Hospital, Malmö, Sweden from February to December 2005, and at the Department of Dermatology, Contact Allergy Unit, University Hospital, K.U. Leuven, Belgium from August 2004 to November 2005. A total of 858 patients answered a questionnaire and were patch tested. The remaining 124 patients were not asked to answer the questionnaire because of a high workload during consultation hours. Demographic data on all the patch tested patients are shown in  Table 1 .

Questionnaire

A questionnaire on past or present skin problems related to textiles and exposure to textile dyes and chemically related substances was answered by the patients. The questions asked in the present study are shown in Figure 2. The test personnel interviewed the patients, and the answers were filled in prior to the patch test application. The wording of the questions did not allow any distinction between rash and itch (sign and symptoms). The term 'skin problems' is used here to describe both the signs and symptoms reported by the patients. Not all the questions were answered by all the patients; therefore the denominator varies.

Figure 2.

The questions from the questionnaire used in the study.

Patch Testing

As the patch testing of the patients followed the routine of the respective departments, Finn Chambers® (Ø 8 mm, Epitest Ltd, Tuusula, Finland) on Scanpor® tape (Norgesplaster A/S, Vennesla, Norway) were used for the patch tests in Malmö, whereas Van der Bend Square Chambers® (Brielle, the Netherlands) applied on the back with Micropore(™) (3M Health Care, Borken, Germany) and fixed with Mefix® (Mölnlycke Health Care, Göteborg, Sweden) were used in Leuven. The test chambers were left on the back for 48 h and readings followed the guidelines of the International Contact Dermatitis Research Group.[9] Readings were performed in Malmö on day 3 or 4 and on day 7 or 8, and in Leuven on days 2 and 4 and sometimes on day 7. Only the patch test reactions registered on day 3 or 4 were used for registration in the present study.

The patients were all patch tested with the baseline patch test series of the respective departments. The baseline series used in the Malmö department was purchased from Chemotechnique Diagnostics, Vellinge, Sweden. It included formaldehyde 1.0% in water, PPD 1% w/w in petrolatum (pet.) and BRM 0.6% w/w (pet.), consisting of three components, N,N'-diphenyl-1,4-phenylenediamine, N-cyclohexyl-N'-phenyl-1,4-phenylenediamine and N-isopropyl-N'-phenyl-1,4-phenylenediamine. The department in Leuven bought their baseline patch test series, including PPD 1% w/w (pet.) and formaldehyde 1% in water, from Trolab, Reinbek, Germany. The BRM 0.6% w/w (pet.) used in Leuven was made by Chemotechnique Diagnostics. The TDM and the eight separate components in the mix were temporarily included in the baseline series of both centres. The composition of the dye mix was identical to a mix used previously by Dr Francisco Brandão, Almada, Portugal (personal communication) and consisted of DB 35, DY 3, DO 1 and 3, DR 1 and 17, all 0.5% w/w (pet.), in addition to DB 106 and DB 124, both 0.1% w/w (pet.), giving a total concentration of 3.2% w/w. The dyes were bought from Chemotechnique Diagnostics, and the test preparations were made at the department in Malmö. The mix and the test preparations of the eight dyes were made from the same batches.

Statistical Analysis

The results were analysed using SPSS version 12.0 (SPSS Inc., Chicago, IL, U.S.A.). Fisher's exact test and logistic regression were used and we regarded two-sided P < 0.05 as statistically significant. Odds ratios (OR), 95% confidence intervals (CI) and P-values for a positive answer to the question about having textile-related skin problems were calculated in a multiple logistic regression analysis with age, sex, childhood eczema, occupation and contact allergies as possible predictors. The model was simplified step-by-step by removal of those terms that were least significant in a likelihood-ratio test, unless the removal of an insignificant term changed the remaining effect estimates by 10%, until only significant or otherwise important terms remained.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....