Department of Dermatology, University Hospital Gent, 9000, Ghent, Belgium.
Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, 205 02, Malmö, Sweden.
Contact Dermatitis. 2018 Jan;78(1):12-17. doi: 10.1111/cod.12886. Epub 2017 Oct 17.
In 2015 and 2016, female patients in Flanders consulted a dermatologist because they developed skin lesions after wearing a specific brand of canvas shoes.
To identify the culprit allergen in the shoes.
Eighteen young females aged 14-22 years presented with itching and erythematous to purple-coloured eczematous lesions on both feet. They were patch tested by 10 dermatologists with the European baseline series. Some patients underwent testing with additional series. Pieces of the shoe fabrics were tested in 11 of 18 patients. Chemical analysis of the shoe materials was performed. Finally, patients were tested with a thin-layer chromatogram of the shoe extracts and dilutions of the suspected rubber compound.
All 18 patients showed positive reactions to thiuram mix. Ten of 11 patients reacted to a piece of shoe fabric. Chemical analysis showed the presence of dimethylthiocarbamylbenzothiazole sulfide (DMTBS). No thiurams were detected. Four patients tested with the chromatogram developed positive reactions to DMTBS. Positive reactions to low concentrations were observed in the 4 patients tested with a DMTBS dilution series; one patient reacted to 0.00001% in acetone.
DMTBS, the culprit allergen, is a component formed during rubber vulcanization that probably cross-reacts with the thiuram mix.
2015 年和 2016 年，弗拉芒地区的女性患者因穿着某一特定品牌帆布鞋而出现皮肤损伤，前往皮肤科就诊。
确定鞋内的致敏原。
18 名 14-22 岁的年轻女性双脚出现瘙痒、红斑至紫色湿疹样病变，10 位皮肤科医生对其进行了 10 项斑贴试验，部分患者还进行了其他系列试验。18 名患者中有 11 名进行了鞋织物的测试，化学分析了鞋材，最后对鞋提取物和可疑橡胶化合物的稀释液进行了薄层色谱分析和患者测试。
18 名患者对硫代氨基甲酸盐混合物均呈阳性反应，11 名患者中有 10 名对鞋织物的一片有反应。化学分析显示二甲基硫代羰酰基苯并噻唑硫化物（DMTBS）的存在。未检测到硫代氨基甲酸盐。4 名患者对色谱图中 DMTBS 呈阳性反应，4 名患者对 DMTBS 稀释系列的低浓度呈阳性反应，1 名患者在丙酮中对 0.00001%呈阳性反应。
DMTBS 是一种形成于橡胶硫化过程中的变应原，可能与硫代氨基甲酸盐混合物发生交叉反应。
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