Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden.
Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland.
Contact Dermatitis. 2024 Jul;91(1):45-53. doi: 10.1111/cod.14553. Epub 2024 Apr 11.
Allergic contact dermatitis (ACD) from rubber glove usage is usually caused by rubber additives such as the accelerators. However, in analyses of the suspected gloves, ordinary rubber allergens are not always found. Accelerator-free rubber gloves are available, but some patients with accelerator allergy do not tolerate them and might also be patch test positive to them.
To identify and chemically characterize a new allergen, 2-cyanoethyl dimethyldithiocarbamate (CEDMC), in rubber gloves. We describe two patient cases: patient 1 that led us to the identification of CEDMC and patient 2 with occupational ACD caused by CEDMC.
The patients were examined with patch testing including baseline and rubber series, and their own rubber gloves. High-performance liquid chromatography (HPLC) was used for chemical analysis of rubber gloves. The allergen was synthesized and identified by nuclear magnetic resonance, mass spectrometry and infrared spectrometry, and tested on patient 2.
CEDMC was identified by HPLC in a nitrile glove associated with hand eczema in patient 1. Patient 2 whose nitrile gloves contained CEDMC was patch test positive to CEDMC.
CEDMC is a new contact allergen in nitrile gloves and probably forms during vulcanization from residual monomer acrylonitrile and rubber additives.
橡胶手套引起的过敏性接触性皮炎（ACD）通常是由橡胶添加剂（如促进剂）引起的。然而，在对可疑手套进行分析时，并不总是能发现普通的橡胶过敏原。虽然有不含促进剂的橡胶手套，但一些对促进剂过敏的患者不能耐受它们，并且对它们的斑贴试验也呈阳性。
鉴定和化学表征橡胶手套中的一种新型过敏原——2-氰乙基二甲二硫代氨基甲酸酯（CEDMC）。我们描述了两例患者病例：患者 1 导致我们发现了 CEDMC，患者 2 则因 CEDMC 导致职业性 ACD。
对患者进行斑贴试验检查，包括基线和橡胶系列检查，以及自身橡胶手套检查。采用高效液相色谱法（HPLC）对橡胶手套进行化学分析。通过核磁共振、质谱和红外光谱对过敏原进行合成和鉴定，并对患者 2 进行了测试。
在与患者 1 手部湿疹相关的丁腈手套中，通过 HPLC 鉴定出 CEDMC。对含有 CEDMC 的丁腈手套的患者 2 进行斑贴试验，结果呈阳性。
CEDMC 是丁腈手套中的一种新型接触过敏原，可能是在硫化过程中由残留单体丙烯腈和橡胶添加剂形成的。
