Hostynek J J, Wilhelm K P, Cua A B, Maibach H I
Department of Dermatology, School of Medicine, University of California, San Francisco 94143-0989.
Contact Dermatitis. 1990 Nov;23(5):316-24. doi: 10.1111/j.1600-0536.1990.tb05165.x.
The recommended concentration for patch testing with sodium hypochlorite [NaOCl] (bleach) is 1%, generally obtained by diluting commercial bleach. In doing so, other active (potentially irritant) components of bleach, especially hypochlorous acid [HOCl] and sodium hydroxide [NaOH], are neglected. Magnitudes of potential irritant species other than NaOCl, such as alkalinity, are ordinarily not labeled on the product, though they may vary considerably between brands. Thus, patch testing with 1% hypochlorite obtained by diluting different brand bleaches can potentially elicit non-specific irritant responses, also depending upon the test volume applied. In this study, skin irritation induced by 24-h patch testing with 20 microliters or 100 microliters, with constant NaOCl concentration (1%) and different NaOH concentrations (0.01-1.0%), was studied in adult human volunteers, by means of visual scores and skin color reflectance measurements. No irritation was elicited by application of 20 microliters 1% OCl-, independent of the NaOH concentration. However, all solutions induced significant irritation in a volume of 100 microliters. Skin reactions did not show a straight pH dose response, a maximum reaction being seen to the solution containing 0.1% NaOH. Skin surface pH values had increased when monitored immediately after removal of the patch material. However, 24 h later, baseline values were again reached at most sites, demonstrating an efficient buffering capacity of human skin, even after challenge with alkaline solutions of pH 13.4. We suggest that a non-irritant concentration for diagnostic patch testing for allergic contact dermatitis with an aluminum chamber, using 17 microliters to 20 microliters test volume, could be as high as 1% NaOCl and 1% NaOH.
次氯酸钠[NaOCl]（漂白剂）斑贴试验的推荐浓度为1%，通常通过稀释市售漂白剂获得。这样做时，漂白剂的其他活性（潜在刺激性）成分，特别是次氯酸[HOCl]和氢氧化钠[NaOH]被忽略了。除NaOCl外的潜在刺激性物质的含量，如碱度，通常不会在产品上标明，尽管不同品牌之间可能有很大差异。因此，用稀释不同品牌漂白剂得到的1%次氯酸盐进行斑贴试验，可能会引发非特异性刺激性反应，这也取决于所应用的测试体积。在本研究中，通过视觉评分和皮肤颜色反射率测量，在成年人类志愿者中研究了在次氯酸钠浓度恒定（1%）和氢氧化钠浓度不同（0.01 - 1.0%）的情况下，用20微升或100微升进行24小时斑贴试验所引起的皮肤刺激。应用20微升1% OCl-不会引起刺激，与氢氧化钠浓度无关。然而，所有溶液在100微升的体积下均引起了明显的刺激。皮肤反应未显示出直接的pH剂量反应，含0.1% NaOH的溶液出现了最大反应。去除贴片材料后立即监测时，皮肤表面pH值升高。然而，24小时后，大多数部位再次达到基线值，表明即使在用pH值为13.4的碱性溶液激发后，人类皮肤仍具有有效的缓冲能力。我们建议，对于使用铝制腔室进行过敏性接触性皮炎诊断斑贴试验，当测试体积为17微升至20微升时，非刺激性浓度的次氯酸钠和氢氧化钠可能高达1%。
