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Preservatives:
| • | thimerosal vaccines, eyedrops, contact lens solution |
formaldehyde releasing preservatives:
| • | imidazolidinyl urea (the most commonly used cosmetic preservative after parabens) |
Rubber Allergy
| • | pure rubber can cause contact urticaria, but most contact dermatitis from rubber is caused by additives |
type I reaction to latex:
| • | especially health care professionals and spina bifida patients |
| • | foods that cross react = banana, avocado, passion fruit, kiwi and chestnut |
| • | mnemonic - "you put your banana into a latex condom, when you get passion (fruit) about a girls chest(nut)" |
additives (allergens) in rubber include:
| • | thiuram – found in adhesives, lubricating oils, paints, insecticides, fungicides (cross reacts with disulfiram) |
allergic to elastic but patch test negative: thought to be result of oxidants of some sensitizers by washing with bleach (with sodium hypochlorite)
NEOPRENE:
| • | mouse pads/ keyboard pads (and goggles, wet suits, orthopedic devices) |
| • | patch test allergan = thioureas (NOT on TRUE test) |
Nickel Dermatitis
| • | clinical – e.g. recalcitrant hand dermatitis |
advise nickel allergic patients:
| • | stainless steel or titanium jewelry only (not “hypoallergenic” jewelry because patients cross react with other metals) |
| • | give patient dimethylglyoxime (empowers them) – test anything “silver appearing” (including cabinet handles, doorknobs etc…) then try to minimize exposure to anything testing positive |
| • | take 200mg of vitamin C with each meal (reduces nickel absorption in the diet) |
| • | orthopedic prosthetics – very unusual to cause a problem; if a question – use ceramic or titanium prosthesis |
Fragrance allergy
| • | any positive fragrance patch test, then avoid fragrance altogether (rather than specific ingredients) |
| • | look for “fragrance free” not “unscented” (often contains a masking fragrance) |
| • | Riehl's dermatitis frequently due to fragrance |
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