Kanerva L, Jolanki R, Estlander T
Section of Dermatology, Institute of Occupational Health, Helsinki, Finland.
Contact Dermatitis. 1991 Apr;24(4):293-300. doi: 10.1111/j.1600-0536.1991.tb01725.x.
In addition to previously presented patients with allergic contact dermatitis from cycloaliphatic epoxy resins (ERs), during 1974-1990, we have seen 4 patients with allergic contact dermatitis (ACD) caused by products containing uncured non-diglycidyl-ether-of-bisphenol-A ER. The patients were negative on patch testing with the standard ER based on diglycidyl ether of bisphenol A (DGEBA-ER). The following non-DGEBA-ERs were included in the causative agents: heterocyclic dimethylhydantoin ER, phenol novolak ER, and brominated ER. We were unable to specify the type of ER in an epoxy primer used by the 4th patient. Apart from the ACD caused by the brominated ER, 1 of the patients also had IgE-mediated occupational rhinitis caused by methyl hexahydrophthalic anhydride (MHHPA), an epoxy hardener. The diagnosis was verified by positive prick tests and specific IgE determinations with MHHPA. Intense rhinitis evoked by a bronchial challenge with MHHPA confirmed the diagnosis. We stress the importance of performing patch testing with the relevant epoxy resins to which the patient has been exposed, in addition to patch testing with the standard ER.
除了之前报告的患有脂环族环氧树脂(ERs)过敏性接触性皮炎的患者外,在1974年至1990年期间,我们还见到了4例由含有未固化的非双酚A二缩水甘油醚ER的产品引起的过敏性接触性皮炎(ACD)患者。这些患者对基于双酚A二缩水甘油醚(DGEBA-ER)的标准ER进行斑贴试验呈阴性。致病因素包括以下非DGEBA-ERs:杂环二甲基乙内酰脲ER、酚醛清漆ER和溴化ER。我们无法确定第4例患者使用的环氧底漆中ER的类型。除了由溴化ER引起的ACD外,其中1例患者还患有由环氧固化剂甲基六氢邻苯二甲酸酐(MHHPA)引起的IgE介导的职业性鼻炎。通过对MHHPA进行阳性点刺试验和特异性IgE测定来证实诊断。用MHHPA进行支气管激发试验引起的强烈鼻炎证实了诊断。我们强调,除了用标准ER进行斑贴试验外,对患者接触过的相关环氧树脂进行斑贴试验的重要性。