Kanerva L, Estlander T
Section of Dermatology, Finnish Institute of Occupational Health, Helsinki, Finland.
Am J Contact Dermat. 1998 Sep;9(3):196-8.
Several chemicals are capable of inducing contact leukoderma. Here we report on a dental nurse who had been investigated elsewhere at a dermatology clinic 2.8 years earlier because of suspected occupational fingertip dermatitis. She had been patch tested on her upper arm with dental acrylic resins "as is." These strong concentrations of patch test substances caused a severe allergic reaction in the upper arm, and the patch test sites have remained vitiliginous for 2.8 years. Active sensitization did not take place because the patient had been sensitized earlier as shown by the allergic 2-day readings with acrylics during the first patch test session. It is assumed that acrylates induced contact vitiligo, but the dental acrylics may have also contained other chemicals (eg, hydroquinone or phenolic substances) capable of causing vitiligo. The main point to be learned from the present results is that dental acrylics should never be patch tested "as is." We also discourage the practice of use tests, open tests, or repeated open patch tests with undiluted dental acrylics because of the risk of active sensitization from single exposure.
有几种化学物质能够诱发接触性白斑。在此，我们报告一名牙科护士的病例，2.8年前她因疑似职业性指尖皮炎在其他地方的皮肤科诊所接受检查。她的上臂曾用牙科丙烯酸树脂“原样”进行斑贴试验。这些高浓度的斑贴试验物质在上臂引起了严重的过敏反应，且斑贴试验部位白癜风样改变已持续2.8年。由于在首次斑贴试验期间用丙烯酸进行的2天过敏读数显示患者先前已致敏，所以未发生主动致敏。据推测，丙烯酸酯诱发了接触性白癜风，但牙科丙烯酸树脂可能还含有其他能够导致白癜风的化学物质（如对苯二酚或酚类物质）。从目前的结果中应吸取的主要教训是，牙科丙烯酸树脂绝不应“原样”进行斑贴试验。我们也不鼓励使用未稀释的牙科丙烯酸树脂进行使用试验、开放试验或重复开放斑贴试验，因为单次接触有主动致敏的风险。
