Bendewald, Margo J.

Background: Allergic contact dermatitis from rubber chemicals is increasingly recognized. Objective: To review the results of patch testing with rubber allergens from January 1, 2000, through December 31, 2007. Methods: Patients who underwent patch testing with a specialized series of rubber allergens were identified. Results: In total, 773 patients (64.2% female; mean age, 48.6 years) were patch-tested with a rubber series (27 allergens), and 739 (95.6%) were concomitantly patch-tested with a standard allergen series. Commonly affected sites of dermatitis were the hand (49.7%), foot (15.9%), leg (12.0%), and arm (10.9%). The most common occupations were health care worker (16.3%) and homemaker (6.5%); 11.3% were retired. The rate of allergic reaction to at least one rubber allergen was 245 of 773 (31.7%). The allergens that most commonly yielded positive reactions were 4,4-dithiodimorpholine 1% (28/286 [9.8%]), thiuram mix (56/739 [7.6%]), and diphenylguanidine 1% (57/759 [7.5%]). Conclusion: Rubber is a frequent cause of allergic contact dermatitis. Patch testing with a rubber series improved the ability to diagnose allergic contact dermatitis caused by rubber.

Background: Delayed hypersensitivity reactions to natural rubber latex (NRL) have been recognized. These reactions may contribute to allergic contact dermatitis. We therefore have undertaken patch testing of patients with NRL if they are suspected to have allergic contact dermatitis to rubber. Objective: To review results of patch testing with NRL (January 1, 2000, through December 31, 2007). Methods: Patients suspected of having allergic contact dermatitis from rubber who underwent patch testing with NRL were identified retrospectively. For safety reasons, patients with immediate hypersensitivity to NRL were excluded from patch testing. Results: Of 148 patients patch-tested with NRL, 3 (2.0%) had an allergic patch-test reaction. Conclusions: NRL is as common a cause of allergic contact dermatitis as many of the other allergens included in a specialized rubber allergen series. Patients suspected to be allergic to rubber should be patch-tested with NRL (provided they do not have type 1 hypersensitivity to NRL).