In July 2001, the EU Nickel Directive came into full force to protect European citizens against nickel allergy and dermatitis. Prior to this intervention, Northern European governments had already begun to regulate consumer nickel exposure. According to part 2 of the EU Nickel Directive and the Danish nickel regulation, consumer items intended to be in direct and prolonged contact with the skin were not allowed to release more than 0.5 µg nickel/cm2/week. It was considered unlikely that nickel allergy would disappear altogether as a proportion of individuals reacted below the level defined by the EU Nickel Directive. Despite this, the EU Nickel Directive part 2 was expected to work as an operational limit that would sufficiently protect European consumers against nickel allergy and dermatitis. This review presents the accumulation of epidemiological studies that evaluated the possible effect of this major public health intervention. Also, it evaluates recent exposure assessment studies that have been performed using the dimethyl glyoxime test. It is concluded that the EU Nickel Directive has started to change the epidemiology of nickel allergy in Europe but it should be revisited to better protect consumers and workers since nickel allergy and dermatitis remain very frequent.

To study the length of exposure time required to elicit para-phenylenediamine (PPD) allergic reactions, patients known to be allergic to PPD were recruited and patch tested. A group of 7 patients were patch tested with 1% PPD in pet. for 15 min, 30 min and for 120 min. The remaining 9 patients were patch tested with 1%, 0.3%, 0.1% and 0.01% PPD for 15 min, 30 min and for 120 min each. With exposure for 120 min, 11 of 16 subjects reacted to 1% PPD and 2 of 9 reacted to 0.01%. With exposure of 15 min, 6 of 16 reacted to 1% PPD and 0 of 9 reacted to 0.01% PPD. This study showed marked inter-individual variability in eliciting a reaction to the PPD molecule on patch testing, with regard to both the exposure time and the concentration required.

One-hundred and sixty-eight cases of dermatitis herpetiformis were reviewed to compare the clinical response to and incidence of side-effects from dapsone and sulphamethoxypyridazine. Thirty-seven received sulphamethoxypyridazine (0.25-1.5 g/day) as a single agent therapy at some stage during their care and 161 had dapsone only (50-450 mg/day). Thirty of these patients received both drugs, but at different times. Both were highly effective in controlling the skin disease in 97% of patients on dapsone and 89% on sulphamethoxypyridazine. While 36 (22%) of dapsone-treated subjects had intolerable side effects warranting a change in therapy, this occurred in only five (13.5%) of those treated with sulphamethoxypyridazine. Sulphamethoxypyridazine was also effective as a single agent in three patients with linear IgA disease who had suffered adverse effects from dapsone, and in 10 out of 15 patients with oral and cutaneous lesions of cicatricial pemphigoid.

The objective of this work was to carry out a clinicopathological study to ascertain whether clinical and histopathologic differences existed between oral lichen planus OLP patients with and without metal restorations. The predominant clinical form in both groups was reticular white, with no statisically significant differences between the forms associated or not with metal. The histological variables showed no statistically significant differences between the groups.

Sensitization to fragrance is believed to occur mainly outside the workplace. This study addresses the frequency of fragrance allergy in patch test patients of differing occupations during a 15 year period. The occupation most strongly associated with fragrance allergy in both sexes was health care work (positive tests in 11.7% of males and 10.4% of females). Retired individuals also had high rates of fragrance allergy (11.6% of males and 14.5% of females), and the prevalence of sensitization increased with advancing age. Health care workers and metal workers had statistically significantly higher rates of allergy to eugenol than did workers in other occupations. Food handlers had significantly higher rates of allergy to cinnamal and cinnamic alcohol. These findings suggest that sensitization to fragrance occurs more frequently in an occupational setting than is generally understood and could have implications for preventive measures.