Incidence Of Positive Skin Reactions Research Articles

Comparative assessment of the acute skin irritation potential of detergent formulations using a novel human 4-h patch test method

Predictive skin irritation test methods, which do not require use of animals, are needed for the pre-market assessment of detergent formulations. The utility of a novel and ethical human acute skin irritation patch test method, originally developed for chemical skin irritation assessment, was evaluated. In this IRB-approved method, subjects were patched under occlusion for increasing periods of time up to 4 h in duration. The total incidence of positive skin reactions for test products was compared to a positive control (20% aqueous sodium dodecyl sulfate [SDS]). Acutely irritating formulas were defined as those showing a significantly increased or equal incidence of positive responders compared with that of SDS. The time of exposure required for 50% of subjects to show a positive skin reaction (TR 50 value) was calculated for each product and enabled test product comparisons within and between studies. Using this approach, 24 detergent formulations of various types were tested in seven individual studies. The skin irritation profiles were generally consistent within product types, which could be categorized as follows (by decreasing irritancy): mold/mildew removers (average TR 50 = 0.37 h) > disinfectants/sanitizers (0.64 h) > fabric softener concentrate (1.09 h) = aluminum wash (1.20 h) > 20% SDS (1.81 h) > liquid laundry detergents (3.48 h) > liquid dish detergents (4.16 h) = liquid fabric softeners (4.56 h) = liquid hand soaps (4.58 h) = shampoos (5.40 h) = hard surface cleaners (6.34 h) > powder automatic dish detergents (>16 h) = powder laundry detergents (>16 h). In addition to formulation effects, some seasonal effects were noted; particularly greater winter-time reactivity to 20% SDS and the hard surface cleaner and liquid laundry formulations. These results demonstrate the utility of this patch test method for the comparative skin irritation assessment of these different product types.

Mites and house dust allergy. I. Comparison between house dust and mite (Dermatophagoides pteronyssinus and D. farinae) skin reactivity.

Summary279 patients, most of whom had perennial asthma or perennial rhinitis, were tested intradermally with extracts of Dermatophagoides pteronyssinus and D. farinae in order to ascertain the incidence of positive skin reactions. The great majority of house dust sensitive patients had positive skin reactions to both mite extracts. However, the concordance between house dust and mite extract positive skin reactions, though statistically significant, did not reach the extent found in other countries.Of the three extracts employed, D. pteronyssinus appeared to contain the most potent allergen while its culture medium extract yielded a low percentage of positive skin reactions. These results suggest that, in italy also, mites seem to represent the most important allergenic source of house dust.

Viable Algae in House Dust

HUMAN allergic reactions to algae have been documented1, but so far these disorders have been recognized only after exposure to algae-infested waters. A number of investigators have suggested, however, that air-borne algae constitute a source of respiratory hypersensitivity reactions in susceptible individuals2–4. Viable cultures of algae were obtained from atmospheric samples by van Overeem in 19375. More recently, Gregory et al.6, Schlichting7 and Brown et al.3 confirmed and extended these findings. Air-borne dissemination of algae was suspected as an explanation for the high incidence of positive skin reactions, reaginic antibodies, and positive provocative responses obtained in atopic patients tested with aqueous extracts of various species of green algae4. It seemed that one likely source of air-borne algae would be ordinary house dust and we now report the results of our investigation of this possibility.

66 Immunologic Consequences of Congenital Rubella

The immunologic consequences of maternal rubella have been correlated with the clinical and virologic data accumulated on 350 children followed since the 1964 epidemic. Mothers and their infants with rubella-associated defects have had persistence of rubella serum neutralizing and hemagglutination-inhibition antibodies. Antibody titers among these children have remained at levels ≥ to those in their mothers. In contrast, most children who are clinically normal, despite maternal rubella, have not produced rubella antibody. This relationship of fetal infection to congenital defects and persistent antibody production is supported by a study of 3 sets of twins; 5 of the children have anomalies and antibody, 1 child is normal and has no antibody. Alterations in serum immunoglobulin levels most commonly elevations of IgM and in one instance production of a small molecular weight (approximately 7S) IgM, and a decreased incidence of positive skin reactions to oidiomycin indicate that congenital rubella produces a spectrum of immunologic abnormalities similar to that which it produces in other organs. (SPR)

Role of bacterial flora in upper respiratory tracts of patients with bronchial asthma.

Most allergists agree that there are many patients with bronchial asthma accompanied by bacterial infections, and the infections play some role in asthma. Aggravating effects of bacterial infections is particularly evident in bronchial asthma of older patients and in many cases of status asthmaticus. However, there is no agreement among allergists as to the mechanism of bacterial effects on the asthmatic attacks. Varying explanations were proposed, including bacterial allergy, bronchospasm due to irritative actions of inflammation or bacterial products, and modification of the process or state of the sensitization to allergens in the presence of infection. The purpose of this study was to evaluate the role of bacterial antigens in the patients with bronchial asthma. The present paper is mainly concerned with the age distribution of positive skin reaction to the bacterial antigens. The species of bacteria found in patients’ sputum or nasal mucus have shown little differences from control subjects. Streptococcus viridans and Neisseria were found most frequently, and Hemophylus and others were detected less frequently. In nasal mucus cultures, however, Corynebacteria, Str. viridans and Staphylococcus albus were most dominant. Eight species of these bacteria were selected for testing skin reactions of the asthmatics and control subjects. The incidence of positive immediate skin reactions to the bacterial antigens in the patients was about 40 per cent, and it was significantly higher than that in control subjects. House dust extracts and four air borne fungi gave 60 per cent and 37 per cent positive skin rcactions respectively. The incidence of positive skin reactions to the common inhalant allergens such as house dust, pollen or airborne fungi was studied in different age groups. There was a significant difference in the incidence of the reactions in the different age groups, and the incidence was much higher in younger patients than in older ones. For instance, 82.1 per cent of patients in the first decade and 27.3 per cent of patients in the sixth decade gave positive reactions. However, in the relationship between the incidence of positive immediate skin reactions to the bacterial antigens and the patient’s age at onset of the disease, there was a little, but not a significant difference of the incidence of positive skin reactions in the ages of onset. For instance, 48 per cent of patients in the first decade and 26 per cent of patients in the sixth decade gave positive skin reactions to bacterial antigens.

Results of comparative skin tests with penicilloyl-polylysine and penicillin in patients with penicillin allergy

Intracutaneous tests in 120 patients with a previous history of penicillin allergy yielded positive results with penicilloyl-polylysine in 37 per cent and penicillin G in 15 per cent of patients tested up to twenty years after their reactions. There was an inverse relationship between the incidence of positive skin reactions with either reagent and the time interval at which the tests were performed following an allergic reaction. A higher incidence of positive responses resulted with penicilloyl-polylysine at all time periods, and this difference was highly significant for the period of three months to three years. Of patients with allergic reactions to penicillin tested during the initial three month period, 78 per cent demonstrated skin sensitivity to penicilloyl-polylysine. Since a significant number of patients have negative reactions during this early period, this reagent cannot be used to exclude penicillin as the etiologic agent in an allergic reaction. Marked skin responses to penicillin G, which occurred exclusively following immediate systemic reactions, may not be entirely due to the penicilloyl-determinant group. Alternative possibilities are discussed. It appears that skin test responses to penicillin G may be a more specific index of anaphylactic sensitivity than are cutaneous responses to penicilloyl-polylysine. Evidence is presented to substantiate the immunologic pathogenesis of large local reactions to intramuscularly administered penicillin.

DETECTION OF PENICILLIN HYPERSENSITIVITY WITH PENICILLOYL-POLYLYSINE.

According to recent concepts, the haptenes responsible for penicillin hypersensitivity are penicillin derivatives rather than the penicillin molecule itself. Penicilloyl-polylysine has been administered as a skin test to 1,022 naval recruits to determine correlation between skin reactions and systemic penicillin allergy. Individuals allergic to penicillin had a 35% incidence of positive skin reactions compared to an incidence of 6.8% in nonallergic recruits. A strongly positive skin test carried an almost ninefold greater risk of occurrence of a systemic reaction following penicillin treatment than did a negative skin test. The test was reproducible and penicilloyl-polylysine in the dosages employed was nonsensitizing.

Human skin sensitivity to penicillins G, BT, and O. Demonstration of cross-sensitization

1. 1. Intracutaneous skin tests were performed on 276 persons using penicillins G and BT and on 224 persons using penicillins G and O (AT). 2. 2. The incidence of positive skin reactions to all 3 penicillins showed an increase in persons with previous exposure to penicillin G, and a greater increase in those with a history of previous general reactions to penicillin G. 3. 3. Positive skin tests to all 3 penicillins were observed in persons who denied ever having received penicillin therapy as well as in those who had received therapy. These data suggest that from the clinical standpoint cross-sensitivity to these penicillins exists. 4. 4. A statistically significant number of differential responses were observed when the same persons were skin tested with penicillins G and BT or with penicillins G and O. The number of instances in which these differential responses occurred was small.

An Attempt by Feeding to Induce in Animals Reactivity to Trichinella Spiralis in the Absence of Infection 1

Summary 1. The repeated feeding to guinea pigs and rabbits of killed larvae of Trichinella spiralis, presumably containing denatured (cooked) or undenatured (frozen) antigen, failed to induce reactivity in the animals as measured by skin tests or flocculation tests of the serum. 2. Rabbits are superior to guinea pigs for experiments requiring skin-testing or flocculation of serum after infection with trichinae. 3. The flocculation test gives promise of being a useful test in suspected cases of trichinosis; an objection is that it requires large amounts of dried antigen. 4. This experiment did not afford an explanation for the unusually high incidence of positive skin reactions among patients confined in institutions.

Tobacco allergy and thromboangiitis obliterans

1. 1. A study of the problem of specific hypersensitiveness of the skin to tobacco in 35 typical cases of thromboangiitis obliterans and 35 controls was made. 2. 2. The patients with thromboangiitis obliterans did not show a higher evidence of positive skin reactions than the control group. 3. 3. The high incidence of positive skin reactions to tobacco tests reported by other investigators and interpreted as allergic reactions is considered due to some of the many nonspecific reactions from chemical irritation. 4. 4. Thrombo-angiitis obliterans is not caused by an allergic type of tobacco hypersensitiveness.

Thrombo-angiitis obliterans and typhus (evidence of etiologic relationship): Goodman, Charles: Arch. Surg. 35: 1126, 1937

1.1. A study of the problem of specific hypersensitiveness of the skin to tobacco in 35 typical cases of thromboangiitis obliterans and 35 controls was made.2.2. The patients with thromboangiitis obliterans did not show a higher evidence of positive skin reactions than the control group.3.3. The high incidence of positive skin reactions to tobacco tests reported by other investigators and interpreted as allergic reactions is considered due to some of the many nonspecific reactions from chemical irritation.4.4. Thrombo-angiitis obliterans is not caused by an allergic type of tobacco hypersensitiveness.

Tobacco sensitization in rats : Joseph Harkavy, M.D., New York City. (Abstract)

1.1. A study of the problem of specific hypersensitiveness of the skin to tobacco in 35 typical cases of thromboangiitis obliterans and 35 controls was made.2.2. The patients with thromboangiitis obliterans did not show a higher evidence of positive skin reactions than the control group.3.3. The high incidence of positive skin reactions to tobacco tests reported by other investigators and interpreted as allergic reactions is considered due to some of the many nonspecific reactions from chemical irritation.4.4. Thrombo-angiitis obliterans is not caused by an allergic type of tobacco hypersensitiveness.

Skin reactions to tobacco antigen in smokers and nonsmokers

1. Nonsmokers, Female.—One hundred and twenty-six adult nonsmoking women were tested with five different tobacco antigens: Burley, Coca, Maryland, Virginia, and Xanthis (Turkish). Sixteen, or 12 per cent, were found to give positive skin reactions. Five of the sixteen reacted also to ragweed antigen, and two of the five according to their histories were constitutionally allergic. Eleven of the sixteen, or 9.2 per cent, gave only one-plus or plus minus reactions to tobacco. 2. Smokers, Male.—Of 319 male smokers excluding individuals suffering with thromboangiitis obliterans 65, or 20 per cent, reacted to tobacco. 3. Of the 65 control smokers who reacted to tobacco 18 were normal individuals or patients suffering from miscellaneous disorders. Thirty-one were individuals with coronary artery disease presenting symptoms of angina pectoris. Sixteen were cases with gastric or duodenal ulcer. The incidence of positive skin reactions to tobacco in patients with coronary artery disease or gastroduodenal ulcer is definitely larger than that among normal people or control patients with other diseases. 4. Out of the 103 cases with thromboangiitis obliterans, 89, or 86 per cent, reacted to tobacco.