Wyss M, Elsner P, Wüthrich B, Burg G
Department of Dermatology, University Hospital Zurich, Switzerland.
Contact Dermatitis. 1993 Mar;28(3):154-6. doi: 10.1111/j.1600-0536.1993.tb03377.x.
During the last decade, there have been many reports of immediate-type hypersensitivity to natural latex, resulting in contact urticaria, generalized allergic reactions such as urticaria and Quincke's edema, and asthmatic or anaphylactic reactions. Moreover, delayed-type hypersensitivity to rubber additives such as thiuram and carbamate derivatives is acknowledged to be the main cause of dermatitis in patients working with rubber gloves. We here report on a patient who developed severe dermatitis on his hands and forearms 3 months after he had started working with rubber gloves. Patch tests with rubber additives, skin prick tests and RAST to natural latex were negative. However, a delayed type of hypersensitivity to latex could be shown by a positive patch test. To our knowledge this is the 1st case reported of an isolated contact dermatitis from natural latex without contact urticaria to latex or hypersensitivity to rubber additives. We therefore propose that not only patch tests with rubber additives, but also skin prick and patch tests with latex should be performed in contact dermatitis patients working with rubber gloves.
在过去十年间，有许多关于对天然乳胶速发型超敏反应的报道，这种反应会导致接触性荨麻疹、全身性过敏反应，如荨麻疹和昆克水肿，以及哮喘或过敏反应。此外，对橡胶添加剂如秋兰姆和氨基甲酸盐衍生物的迟发型超敏反应被认为是使用橡胶手套的患者发生皮炎的主要原因。我们在此报告一名患者，他在开始使用橡胶手套工作3个月后，双手和前臂出现严重皮炎。对橡胶添加剂进行的斑贴试验、皮肤点刺试验以及对天然乳胶的放射性变应原吸附试验均为阴性。然而，通过阳性斑贴试验可显示对乳胶的迟发型超敏反应。据我们所知，这是首例报道的仅因天然乳胶引起的接触性皮炎，而无乳胶接触性荨麻疹或对橡胶添加剂过敏的病例。因此，我们建议，对于使用橡胶手套的接触性皮炎患者，不仅应进行橡胶添加剂斑贴试验，还应进行乳胶皮肤点刺试验和斑贴试验。
