Contact dermatitis in students practicing sports: incidence of rubber sensitisation

Abstract

Background-Over the last few years, changes in cutaneous homoeostasis resulting from sports activities have been reported. In particular, alterations in sweating mechanisms, the hydrolipid barrier, and surface bacterial flora, together with exposure to atmospheric conditions and the need to use medicaments, detergents, and other topical substances, predispose subjects to allergic contact dermatitis. Objective-To evaluate the incidence of allergic contact dermatitis in a group of young people practising sports activities. Methods-Patch tests were performed to confirm the diagnosis of irritant or allergic dermatitis; in addition, the radioallergoabsorbent test (RAST) to latex was evaluated in the group studied. Results-Allergic contact dermatitis caused by thiourams (23.3%) and mercaptobenzothiazole (20.9%) was prevalent. Other haptens, such as benzocaine and nickel, which are contained in clothing, equipment, topical medicaments, and creams used for massage, were also allergenic. In two cases, RAST positivity to latex was registered. Conclusions-The results suggest that close contact with sports equipment may increase the incidence of allergic contact dermatitis. Students practising certain sports may have "professional" allergic contact dermatitis to additives used in the production of rubber. (Br J Sports Med 2001;35:100-102) Keywords: skin; allergic contact dermatitis; latex; patch test; equipment; thiourams The increased exposure of human skin to the environment as the result of sports activities alters its barrier function against external agents. Firstly, the skin becomes the target of many stresses related to both physical exercise and the special clothing used in various sports, often more traditional than practical. In addition, physical exercise causes changes in the hydrolipid film and the skin pH, which tends to rise when its buVer systems, including lactic acid, glutamic acid and aspartic acid, undergo changes. Moreover, increased sweating associated with reduced opportunity for evaporation in sports attire such as the suits worn by fencers and the fire resistant overalls worn by racing drivers modifies the defensive capacity of the skin, altering the hydrolipid barrier and surface microbial flora. 1At the same time, exposure to sun and other atmospheric conditions triggers a series of reactions such as dissolution of molecular bonds, formation of oxygen free radicals, production of peroxidase, and denaturation of some protein structures.2 Finally, frequent washing and the use of medicaments and other topical substances alter the normal physiological skin balance in athletes, increasing the possibility for allergising substances to penetrate and therefore increasing the incidence of irritant contact dermatitis (ICD) or allergic contact dermatitis (ACD). The onset of ICD, especially after contact with solvents or other aggressive organic substances, may be aggravated by hyperhydrosis. ACD is elicited after contact and re-exposure to the same sensitising agent, with contributions from variou...

Contact dermatitis in athletes

“…One study of young fishermen presenting with ACD revealed an increased sensitivity to both nickel and mercaptobenzothiazole. 35 One case report noted that a graphite fishing rod caused unilateral palmar dermatitis in a fisherman after several hours of contact with the rod. 36 The fisherman's patch test was positive for IPPD.…”

“…33 The dermatitis may occur almost immediately or up to 48 hours after wearing the mask; N-isopropyl-N-phenylpara-phenylenediamine or IPPD, used as a rubber antioxidant, represent the most common sensitizing agents in mask burn. [33][34][35] FISHING Sports fishermen risk acquiring ACD most commonly on the hands from either the fishing rod or bait. One study of young fishermen presenting with ACD revealed an increased sensitivity to both nickel and mercaptobenzothiazole.…”

“…35 Like swimmers and divers, surfers can develop allergic contact sensitization to wetsuits. In one case, a windsurfer developed a recurring dermatitis of the trunk and proximal extremities that appeared to occur under purple but not pink segments of her suit.…”

Exercise with latex sport bands represents a risk for latex allergic patients

“…However, regarding IgE mediated allergies, rubber also represents a health threat. When being present in bound form, e.g., in scuba diving gear, latex allergens themselves or rubber processing additives may cause hypersensitivity contact dermatitis [13,23]. Since the 1980s, latex is increasingly used in gymnastic bands.…”

“…Due to its physicomechanical properties, latex is an important material for sport equipment. Indeed, sporadically delayed type contact dermatitis was observed in students using latex sport equipment [13]. Only recently athletic trainers were advised of the possibility of immediate type allergic reactions upon latex exposure during exercise, and the usage of latex-free alternatives was suggested [14].…”