An attempt to improve diagnostics of contact allergy due to epoxy resin systems. First results of the multicentre study EPOX 2002
Identifieur interne : 000855 ( Main/Corpus ); précédent : 000854; suivant : 000856An attempt to improve diagnostics of contact allergy due to epoxy resin systems. First results of the multicentre study EPOX 2002
Auteurs : Johannes Geier ; Holger Lessmann ; Uwe Hillen ; Uta Jappe ; Heinrich Dickel ; Patrick Koch ; Peter J. Frosch ; Axel Schnuch ; Wolfgang UterSource :
- Contact Dermatitis [ 0105-1873 ] ; 2004-11.
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Abstract
Epoxy resin systems (ERSs) are a frequent cause of occupational allergic contact dermatitis. Sensitization occurs not only to the resins, but also to hardeners and reactive diluents. However, only a fraction of the ERS components currently in use are available for patch testing. With the multicentre study EPOX 2002, we attempted to improve diagnostics in this field by patch testing with components currently used in ERSs. During the first study period (October 2002 to July 2003), in addition to commercially available ERS patch test substances, 16 study substances (1 resin, 9 hardeners and 6 reactive diluents) were patch tested in 70 patients with suspected contact allergy due to ERSs and 22 patients with a prior positive patch test reaction to epoxy resin (ER) in the standard series. Most frequently, allergic reactions to ER based on diglycidyl ether of bisphenol A and F were observed (55.2% and 43.7%, respectively). Agreement between positive reactions to both resins, which can be explained by immunological cross‐sensitization and/or coexposure, was substantial [Cohen's kappa 0.65 (95% CI: 0.49–0.80)]. Among the reactive diluents, 1,6‐hexanediol diglycidyl ether (1,6‐HDDGE) and 1,4‐butanediol diglycidyl ether (1,4‐BDDGE) were the most frequent allergens, with 19.5% and 18.4% positive reactions, respectively. Although agreement between positive reactions to 1,6‐HDDGE and 1,4‐BDDGE was even better than with the 2 resins, the sample size is considered too small to decide reliably whether 1,6‐HDDGE alone could serve as a marker allergen for both. Allergic reactions to p‐tert‐butylphenyl glycidyl ether and to phenyl glycidyl ether (PGE) occurred in 11.5% of the patients tested, with only moderate agreement. All patients positive to cresyl glycidyl ether (6.8%) also reacted to PGE. Of the hardeners tested, m‐xylylene diamine was the most frequent allergen (13.8%), followed by isophorone diamine (5.7%). No reactions were observed to several substances, the test concentration of which may have been too low and will be increased in the future.
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DOI: 10.1111/j.0105-1873.2004.00465.x
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">An attempt to improve diagnostics of contact allergy due to epoxy resin systems. First results of the multicentre study EPOX 2002</title><author><name sortKey="Geier, Johannes" sort="Geier, Johannes" uniqKey="Geier J" first="Johannes" last="Geier">Johannes Geier</name><affiliation><mods:affiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</mods:affiliation></affiliation></author><author><name sortKey="Lessmann, Holger" sort="Lessmann, Holger" uniqKey="Lessmann H" first="Holger" last="Lessmann">Holger Lessmann</name><affiliation><mods:affiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</mods:affiliation></affiliation></author><author><name sortKey="Hillen, Uwe" sort="Hillen, Uwe" uniqKey="Hillen U" first="Uwe" last="Hillen">Uwe Hillen</name><affiliation><mods:affiliation>Department of Dermatology, University of Essen, Essen,</mods:affiliation></affiliation></author><author><name sortKey="Jappe, Uta" sort="Jappe, Uta" uniqKey="Jappe U" first="Uta" last="Jappe">Uta Jappe</name><affiliation><mods:affiliation>Department of Dermatology, University of Heidelberg, Heidelberg,</mods:affiliation></affiliation></author><author><name sortKey="Dickel, Heinrich" sort="Dickel, Heinrich" uniqKey="Dickel H" first="Heinrich" last="Dickel">Heinrich Dickel</name><affiliation><mods:affiliation>Department of Dermatology, Environmental Medicine, and Health Theory, University of Osnabrück, Osnabrück,</mods:affiliation></affiliation></author><author><name sortKey="Koch, Patrick" sort="Koch, Patrick" uniqKey="Koch P" first="Patrick" last="Koch">Patrick Koch</name><affiliation><mods:affiliation>Department of Dermatology, University of Saarland, Homburg/Saar,</mods:affiliation></affiliation></author><author><name sortKey="Frosch, Peter J" sort="Frosch, Peter J" uniqKey="Frosch P" first="Peter J." last="Frosch">Peter J. 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First results of the multicentre study EPOX 2002</title><author><name sortKey="Geier, Johannes" sort="Geier, Johannes" uniqKey="Geier J" first="Johannes" last="Geier">Johannes Geier</name><affiliation><mods:affiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</mods:affiliation></affiliation></author><author><name sortKey="Lessmann, Holger" sort="Lessmann, Holger" uniqKey="Lessmann H" first="Holger" last="Lessmann">Holger Lessmann</name><affiliation><mods:affiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</mods:affiliation></affiliation></author><author><name sortKey="Hillen, Uwe" sort="Hillen, Uwe" uniqKey="Hillen U" first="Uwe" last="Hillen">Uwe Hillen</name><affiliation><mods:affiliation>Department of Dermatology, University of Essen, Essen,</mods:affiliation></affiliation></author><author><name sortKey="Jappe, Uta" sort="Jappe, Uta" uniqKey="Jappe U" first="Uta" last="Jappe">Uta Jappe</name><affiliation><mods:affiliation>Department of Dermatology, University of Heidelberg, Heidelberg,</mods:affiliation></affiliation></author><author><name sortKey="Dickel, Heinrich" sort="Dickel, Heinrich" uniqKey="Dickel H" first="Heinrich" last="Dickel">Heinrich Dickel</name><affiliation><mods:affiliation>Department of Dermatology, Environmental Medicine, and Health Theory, University of Osnabrück, Osnabrück,</mods:affiliation></affiliation></author><author><name sortKey="Koch, Patrick" sort="Koch, Patrick" uniqKey="Koch P" first="Patrick" last="Koch">Patrick Koch</name><affiliation><mods:affiliation>Department of Dermatology, University of Saarland, Homburg/Saar,</mods:affiliation></affiliation></author><author><name sortKey="Frosch, Peter J" sort="Frosch, Peter J" uniqKey="Frosch P" first="Peter J." last="Frosch">Peter J. Frosch</name><affiliation><mods:affiliation>Department of Dermatology, Klinikum Dortmund and University of Witten/Herdecke, and</mods:affiliation></affiliation></author><author><name sortKey="Schnuch, Axel" sort="Schnuch, Axel" uniqKey="Schnuch A" first="Axel" last="Schnuch">Axel Schnuch</name><affiliation><mods:affiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</mods:affiliation></affiliation></author><author><name sortKey="Uter, Wolfgang" sort="Uter, Wolfgang" uniqKey="Uter W" first="Wolfgang" last="Uter">Wolfgang Uter</name><affiliation><mods:affiliation>Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Contact Dermatitis</title><idno type="ISSN">0105-1873</idno><idno type="eISSN">1600-0536</idno><imprint><publisher>Munksgaard International Publishers</publisher><pubPlace>Oxford, UK; Malden, USA</pubPlace><date type="published" when="2004-11">2004-11</date><biblScope unit="volume">51</biblScope><biblScope unit="issue">5‐6</biblScope><biblScope unit="page" from="263">263</biblScope><biblScope unit="page" to="272">272</biblScope></imprint><idno type="ISSN">0105-1873</idno></series><idno type="istex">75892147F2A4097DC1050DC56AD66BDE5C57D04E</idno><idno type="DOI">10.1111/j.0105-1873.2004.00465.x</idno><idno type="ArticleID">COD465</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0105-1873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>1,4‐butanediol diglycidyl ether</term><term>1,6‐hexanediol diglycidyl ether</term><term>DGEBA‐R</term><term>DGEBF‐R</term><term>contact allergy</term><term>cresyl glycidyl ether</term><term>epoxy resin</term><term>hardeners</term><term>isophorone diamine</term><term>m‐xylylene diamine</term><term>occupational</term><term>phenyl glycidyl ether</term><term>p‐tert‐butylphenyl glycidyl ether</term><term>reactive diluents</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Epoxy resin systems (ERSs) are a frequent cause of occupational allergic contact dermatitis. Sensitization occurs not only to the resins, but also to hardeners and reactive diluents. However, only a fraction of the ERS components currently in use are available for patch testing. With the multicentre study EPOX 2002, we attempted to improve diagnostics in this field by patch testing with components currently used in ERSs. During the first study period (October 2002 to July 2003), in addition to commercially available ERS patch test substances, 16 study substances (1 resin, 9 hardeners and 6 reactive diluents) were patch tested in 70 patients with suspected contact allergy due to ERSs and 22 patients with a prior positive patch test reaction to epoxy resin (ER) in the standard series. Most frequently, allergic reactions to ER based on diglycidyl ether of bisphenol A and F were observed (55.2% and 43.7%, respectively). Agreement between positive reactions to both resins, which can be explained by immunological cross‐sensitization and/or coexposure, was substantial [Cohen's kappa 0.65 (95% CI: 0.49–0.80)]. Among the reactive diluents, 1,6‐hexanediol diglycidyl ether (1,6‐HDDGE) and 1,4‐butanediol diglycidyl ether (1,4‐BDDGE) were the most frequent allergens, with 19.5% and 18.4% positive reactions, respectively. Although agreement between positive reactions to 1,6‐HDDGE and 1,4‐BDDGE was even better than with the 2 resins, the sample size is considered too small to decide reliably whether 1,6‐HDDGE alone could serve as a marker allergen for both. Allergic reactions to p‐tert‐butylphenyl glycidyl ether and to phenyl glycidyl ether (PGE) occurred in 11.5% of the patients tested, with only moderate agreement. All patients positive to cresyl glycidyl ether (6.8%) also reacted to PGE. Of the hardeners tested, m‐xylylene diamine was the most frequent allergen (13.8%), followed by isophorone diamine (5.7%). No reactions were observed to several substances, the test concentration of which may have been too low and will be increased in the future.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Johannes Geier</name><affiliations><json:string>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</json:string></affiliations></json:item><json:item><name>Holger Lessmann</name><affiliations><json:string>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</json:string></affiliations></json:item><json:item><name>Uwe Hillen</name><affiliations><json:string>Department of Dermatology, University of Essen, Essen,</json:string></affiliations></json:item><json:item><name>Uta Jappe</name><affiliations><json:string>Department of Dermatology, University of Heidelberg, Heidelberg,</json:string></affiliations></json:item><json:item><name>Heinrich Dickel</name><affiliations><json:string>Department of Dermatology, Environmental Medicine, and Health Theory, University of Osnabrück, Osnabrück,</json:string></affiliations></json:item><json:item><name>Patrick Koch</name><affiliations><json:string>Department of Dermatology, University of Saarland, Homburg/Saar,</json:string></affiliations></json:item><json:item><name>Peter J. Frosch</name><affiliations><json:string>Department of Dermatology, Klinikum Dortmund and University of Witten/Herdecke, and</json:string></affiliations></json:item><json:item><name>Axel Schnuch</name><affiliations><json:string>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</json:string></affiliations></json:item><json:item><name>Wolfgang Uter</name><affiliations><json:string>Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>1,4‐butanediol diglycidyl ether</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>1,6‐hexanediol diglycidyl ether</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>contact allergy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cresyl glycidyl ether</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>DGEBA‐R</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>DGEBF‐R</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>epoxy resin</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>hardeners</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>isophorone diamine</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>m‐xylylene diamine</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>occupational</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>phenyl glycidyl ether</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>p‐tert‐butylphenyl glycidyl ether</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>reactive diluents</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Epoxy resin systems (ERSs) are a frequent cause of occupational allergic contact dermatitis. Sensitization occurs not only to the resins, but also to hardeners and reactive diluents. However, only a fraction of the ERS components currently in use are available for patch testing. With the multicentre study EPOX 2002, we attempted to improve diagnostics in this field by patch testing with components currently used in ERSs. During the first study period (October 2002 to July 2003), in addition to commercially available ERS patch test substances, 16 study substances (1 resin, 9 hardeners and 6 reactive diluents) were patch tested in 70 patients with suspected contact allergy due to ERSs and 22 patients with a prior positive patch test reaction to epoxy resin (ER) in the standard series. Most frequently, allergic reactions to ER based on diglycidyl ether of bisphenol A and F were observed (55.2% and 43.7%, respectively). Agreement between positive reactions to both resins, which can be explained by immunological cross‐sensitization and/or coexposure, was substantial [Cohen's kappa 0.65 (95% CI: 0.49–0.80)]. Among the reactive diluents, 1,6‐hexanediol diglycidyl ether (1,6‐HDDGE) and 1,4‐butanediol diglycidyl ether (1,4‐BDDGE) were the most frequent allergens, with 19.5% and 18.4% positive reactions, respectively. Although agreement between positive reactions to 1,6‐HDDGE and 1,4‐BDDGE was even better than with the 2 resins, the sample size is considered too small to decide reliably whether 1,6‐HDDGE alone could serve as a marker allergen for both. Allergic reactions to p‐tert‐butylphenyl glycidyl ether and to phenyl glycidyl ether (PGE) occurred in 11.5% of the patients tested, with only moderate agreement. All patients positive to cresyl glycidyl ether (6.8%) also reacted to PGE. Of the hardeners tested, m‐xylylene diamine was the most frequent allergen (13.8%), followed by isophorone diamine (5.7%). No reactions were observed to several substances, the test concentration of which may have been too low and will be increased in the future.</abstract><qualityIndicators><score>8</score><pdfVersion>1.3</pdfVersion><pdfPageSize>595 x 782 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>14</keywordCount><abstractCharCount>2070</abstractCharCount><pdfWordCount>5898</pdfWordCount><pdfCharCount>39045</pdfCharCount><pdfPageCount>10</pdfPageCount><abstractWordCount>311</abstractWordCount></qualityIndicators><title>An attempt to improve diagnostics of contact allergy due to epoxy resin systems. First results of the multicentre study EPOX 2002</title><genre><json:string>article</json:string></genre><host><volume>51</volume><pages><total>10</total><last>272</last><first>263</first></pages><issn><json:string>0105-1873</json:string></issn><issue>5‐6</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1600-0536</json:string></eissn><title>Contact Dermatitis</title><doi><json:string>10.1111/(ISSN)1600-0536</json:string></doi></host><publicationDate>2004</publicationDate><copyrightDate>2004</copyrightDate><doi><json:string>10.1111/j.0105-1873.2004.00465.x</json:string></doi><id>75892147F2A4097DC1050DC56AD66BDE5C57D04E</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/75892147F2A4097DC1050DC56AD66BDE5C57D04E/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/75892147F2A4097DC1050DC56AD66BDE5C57D04E/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/75892147F2A4097DC1050DC56AD66BDE5C57D04E/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">An attempt to improve diagnostics of contact allergy due to epoxy resin systems. 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First results of the multicentre study EPOX 2002</title><author><persName><forename type="first">Johannes</forename><surname>Geier</surname></persName><note type="correspondence"><p>Correspondence:</p></note><affiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</affiliation></author><author><persName><forename type="first">Holger</forename><surname>Lessmann</surname></persName><affiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</affiliation></author><author><persName><forename type="first">Uwe</forename><surname>Hillen</surname></persName><affiliation>Department of Dermatology, University of Essen, Essen,</affiliation></author><author><persName><forename type="first">Uta</forename><surname>Jappe</surname></persName><affiliation>Department of Dermatology, University of Heidelberg, Heidelberg,</affiliation></author><author><persName><forename type="first">Heinrich</forename><surname>Dickel</surname></persName><affiliation>Department of Dermatology, Environmental Medicine, and Health Theory, University of Osnabrück, Osnabrück,</affiliation></author><author><persName><forename type="first">Patrick</forename><surname>Koch</surname></persName><affiliation>Department of Dermatology, University of Saarland, Homburg/Saar,</affiliation></author><author><persName><forename type="first">Peter J.</forename><surname>Frosch</surname></persName><affiliation>Department of Dermatology, Klinikum Dortmund and University of Witten/Herdecke, and</affiliation></author><author><persName><forename type="first">Axel</forename><surname>Schnuch</surname></persName><affiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</affiliation></author><author><persName><forename type="first">Wolfgang</forename><surname>Uter</surname></persName><affiliation>Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany</affiliation></author></analytic><monogr><title level="j">Contact Dermatitis</title><idno type="pISSN">0105-1873</idno><idno type="eISSN">1600-0536</idno><idno type="DOI">10.1111/(ISSN)1600-0536</idno><imprint><publisher>Munksgaard International Publishers</publisher><pubPlace>Oxford, UK; Malden, USA</pubPlace><date type="published" when="2004-11"></date><biblScope unit="volume">51</biblScope><biblScope unit="issue">5‐6</biblScope><biblScope unit="page" from="263">263</biblScope><biblScope unit="page" to="272">272</biblScope></imprint></monogr><idno type="istex">75892147F2A4097DC1050DC56AD66BDE5C57D04E</idno><idno type="DOI">10.1111/j.0105-1873.2004.00465.x</idno><idno type="ArticleID">COD465</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2004</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Epoxy resin systems (ERSs) are a frequent cause of occupational allergic contact dermatitis. Sensitization occurs not only to the resins, but also to hardeners and reactive diluents. However, only a fraction of the ERS components currently in use are available for patch testing. With the multicentre study EPOX 2002, we attempted to improve diagnostics in this field by patch testing with components currently used in ERSs. During the first study period (October 2002 to July 2003), in addition to commercially available ERS patch test substances, 16 study substances (1 resin, 9 hardeners and 6 reactive diluents) were patch tested in 70 patients with suspected contact allergy due to ERSs and 22 patients with a prior positive patch test reaction to epoxy resin (ER) in the standard series. Most frequently, allergic reactions to ER based on diglycidyl ether of bisphenol A and F were observed (55.2% and 43.7%, respectively). Agreement between positive reactions to both resins, which can be explained by immunological cross‐sensitization and/or coexposure, was substantial [Cohen's kappa 0.65 (95% CI: 0.49–0.80)]. Among the reactive diluents, 1,6‐hexanediol diglycidyl ether (1,6‐HDDGE) and 1,4‐butanediol diglycidyl ether (1,4‐BDDGE) were the most frequent allergens, with 19.5% and 18.4% positive reactions, respectively. Although agreement between positive reactions to 1,6‐HDDGE and 1,4‐BDDGE was even better than with the 2 resins, the sample size is considered too small to decide reliably whether 1,6‐HDDGE alone could serve as a marker allergen for both. Allergic reactions to p‐tert‐butylphenyl glycidyl ether and to phenyl glycidyl ether (PGE) occurred in 11.5% of the patients tested, with only moderate agreement. All patients positive to cresyl glycidyl ether (6.8%) also reacted to PGE. Of the hardeners tested, m‐xylylene diamine was the most frequent allergen (13.8%), followed by isophorone diamine (5.7%). No reactions were observed to several substances, the test concentration of which may have been too low and will be increased in the future.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>1,4‐butanediol diglycidyl ether</term></item><item><term>1,6‐hexanediol diglycidyl ether</term></item><item><term>contact allergy</term></item><item><term>cresyl glycidyl ether</term></item><item><term>DGEBA‐R</term></item><item><term>DGEBF‐R</term></item><item><term>epoxy resin</term></item><item><term>hardeners</term></item><item><term>isophorone diamine</term></item><item><term>m‐xylylene diamine</term></item><item><term>occupational</term></item><item><term>phenyl glycidyl ether</term></item><item><term>p‐tert‐butylphenyl glycidyl ether</term></item><item><term>reactive diluents</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2004-11">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/75892147F2A4097DC1050DC56AD66BDE5C57D04E/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Munksgaard International Publishers</publisherName><publisherLoc>Oxford, UK; Malden, USA</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1600-0536</doi><issn type="print">0105-1873</issn><issn type="electronic">1600-0536</issn><idGroup><id type="product" value="COD"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="CONTACT DERMATITIS">Contact Dermatitis</title></titleGroup></publicationMeta><publicationMeta level="part" position="11005"><doi origin="wiley">10.1111/cod.2004.51.issue-5-6</doi><numberingGroup><numbering type="journalVolume" number="51">51</numbering><numbering type="journalIssue">5‐6</numbering></numberingGroup><coverDate startDate="2004-11">November 2004</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="0026300" status="forIssue"><doi origin="wiley">10.1111/j.0105-1873.2004.00465.x</doi><idGroup><id type="unit" value="COD465"></id></idGroup><countGroup><count type="pageTotal" number="10"></count></countGroup><titleGroup><title type="tocHeading1">Original Articles</title></titleGroup><eventGroup><event type="firstOnline" date="2004-12-09"></event><event type="publishedOnlineFinalForm" date="2004-12-09"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.15 mode:FullText source:FullText result:FullText" date="2010-07-19"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-16"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-16"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="263">263</numbering><numbering type="pageLast" number="272">272</numbering></numberingGroup><correspondenceTo><i>Johannes Geier, MD</i>
<i>IVDK an der Universitäts‐Hautklinik</i>
<i>von‐Siebold‐Str. 3</i>
<i>37075 Göttingen</i>
<i>Germany</i>
<i>Tel: +49 551 39 89 84</i>
<i>Fax: +49 551 39 60 95</i>
<i>e‐mail: </i><email>jgeier@ivdk.org</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:COD.COD465.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Accepted for publication 28 September 2004</unparsedEditorialHistory><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="5"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="51"></count><count type="wordTotal" number="4632"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">An attempt to improve diagnostics of contact allergy due to epoxy resin systems. First results of the multicentre study EPOX 2002</title><title type="shortAuthors">Geier et al.</title><title type="short">Epox 2002: First Study Period</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" corresponding="yes"><personName><givenNames>Johannes</givenNames><familyName>Geier</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>Holger</givenNames><familyName>Lessmann</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a2"><personName><givenNames>Uwe</givenNames><familyName>Hillen</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a3"><personName><givenNames>Uta</givenNames><familyName>Jappe</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a4"><personName><givenNames>Heinrich</givenNames><familyName>Dickel</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a5"><personName><givenNames>Patrick</givenNames><familyName>Koch</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a6"><personName><givenNames>Peter J.</givenNames><familyName>Frosch</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1"><personName><givenNames>Axel</givenNames><familyName>Schnuch</familyName></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a7"><personName><givenNames>Wolfgang</givenNames><familyName>Uter</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</unparsedAffiliation></affiliation><affiliation xml:id="a2"><unparsedAffiliation>Department of Dermatology, University of Essen, Essen,</unparsedAffiliation></affiliation><affiliation xml:id="a3"><unparsedAffiliation>Department of Dermatology, University of Heidelberg, Heidelberg,</unparsedAffiliation></affiliation><affiliation xml:id="a4"><unparsedAffiliation>Department of Dermatology, Environmental Medicine, and Health Theory, University of Osnabrück, Osnabrück,</unparsedAffiliation></affiliation><affiliation xml:id="a5"><unparsedAffiliation>Department of Dermatology, University of Saarland, Homburg/Saar,</unparsedAffiliation></affiliation><affiliation xml:id="a6"><unparsedAffiliation>Department of Dermatology, Klinikum Dortmund and University of Witten/Herdecke, and</unparsedAffiliation></affiliation><affiliation xml:id="a7" countryCode="DE"><unparsedAffiliation>Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">1,4‐butanediol diglycidyl ether</keyword><keyword xml:id="k2">1,6‐hexanediol diglycidyl ether</keyword><keyword xml:id="k3">contact allergy</keyword><keyword xml:id="k4">cresyl glycidyl ether</keyword><keyword xml:id="k5">DGEBA‐R</keyword><keyword xml:id="k6">DGEBF‐R</keyword><keyword xml:id="k7">epoxy resin</keyword><keyword xml:id="k8">hardeners</keyword><keyword xml:id="k9">isophorone diamine</keyword><keyword xml:id="k10"><i>m</i>‐xylylene diamine</keyword><keyword xml:id="k11">occupational</keyword><keyword xml:id="k12">phenyl glycidyl ether</keyword><keyword xml:id="k13"><i>p</i>‐tert‐butylphenyl glycidyl ether</keyword><keyword xml:id="k14">reactive diluents</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p>Epoxy resin systems (ERSs) are a frequent cause of occupational allergic contact dermatitis. Sensitization occurs not only to the resins, but also to hardeners and reactive diluents. However, only a fraction of the ERS components currently in use are available for patch testing. With the multicentre study EPOX 2002, we attempted to improve diagnostics in this field by patch testing with components currently used in ERSs. During the first study period (October 2002 to July 2003), in addition to commercially available ERS patch test substances, 16 study substances (1 resin, 9 hardeners and 6 reactive diluents) were patch tested in 70 patients with suspected contact allergy due to ERSs and 22 patients with a prior positive patch test reaction to epoxy resin (ER) in the standard series. Most frequently, allergic reactions to ER based on diglycidyl ether of bisphenol A and F were observed (55.2% and 43.7%, respectively). Agreement between positive reactions to both resins, which can be explained by immunological cross‐sensitization and/or coexposure, was substantial [Cohen's kappa 0.65 (95% CI: 0.49–0.80)]. Among the reactive diluents, 1,6‐hexanediol diglycidyl ether (1,6‐HDDGE) and 1,4‐butanediol diglycidyl ether (1,4‐BDDGE) were the most frequent allergens, with 19.5% and 18.4% positive reactions, respectively. Although agreement between positive reactions to 1,6‐HDDGE and 1,4‐BDDGE was even better than with the 2 resins, the sample size is considered too small to decide reliably whether 1,6‐HDDGE alone could serve as a marker allergen for both. Allergic reactions to <i>p</i>‐tert‐butylphenyl glycidyl ether and to phenyl glycidyl ether (PGE) occurred in 11.5% of the patients tested, with only moderate agreement. All patients positive to cresyl glycidyl ether (6.8%) also reacted to PGE. Of the hardeners tested, <i>m</i>‐xylylene diamine was the most frequent allergen (13.8%), followed by isophorone diamine (5.7%). No reactions were observed to several substances, the test concentration of which may have been too low and will be increased in the future.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>An attempt to improve diagnostics of contact allergy due to epoxy resin systems. First results of the multicentre study EPOX 2002</title></titleInfo><titleInfo type="abbreviated"><title>Epox 2002: First Study Period</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>An attempt to improve diagnostics of contact allergy due to epoxy resin systems. First results of the multicentre study EPOX 2002</title></titleInfo><name type="personal"><namePart type="given">Johannes</namePart><namePart type="family">Geier</namePart><affiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</affiliation><description>Correspondence: </description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Holger</namePart><namePart type="family">Lessmann</namePart><affiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Uwe</namePart><namePart type="family">Hillen</namePart><affiliation>Department of Dermatology, University of Essen, Essen,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Uta</namePart><namePart type="family">Jappe</namePart><affiliation>Department of Dermatology, University of Heidelberg, Heidelberg,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Heinrich</namePart><namePart type="family">Dickel</namePart><affiliation>Department of Dermatology, Environmental Medicine, and Health Theory, University of Osnabrück, Osnabrück,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Patrick</namePart><namePart type="family">Koch</namePart><affiliation>Department of Dermatology, University of Saarland, Homburg/Saar,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Peter J.</namePart><namePart type="family">Frosch</namePart><affiliation>Department of Dermatology, Klinikum Dortmund and University of Witten/Herdecke, and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Axel</namePart><namePart type="family">Schnuch</namePart><affiliation>Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Wolfgang</namePart><namePart type="family">Uter</namePart><affiliation>Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Munksgaard International Publishers</publisher><place><placeTerm type="text">Oxford, UK; Malden, USA</placeTerm></place><dateIssued encoding="w3cdtf">2004-11</dateIssued><edition>Accepted for publication 28 September 2004</edition><copyrightDate encoding="w3cdtf">2004</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">5</extent><extent unit="references">51</extent><extent unit="words">4632</extent></physicalDescription><abstract lang="en">Epoxy resin systems (ERSs) are a frequent cause of occupational allergic contact dermatitis. Sensitization occurs not only to the resins, but also to hardeners and reactive diluents. However, only a fraction of the ERS components currently in use are available for patch testing. With the multicentre study EPOX 2002, we attempted to improve diagnostics in this field by patch testing with components currently used in ERSs. During the first study period (October 2002 to July 2003), in addition to commercially available ERS patch test substances, 16 study substances (1 resin, 9 hardeners and 6 reactive diluents) were patch tested in 70 patients with suspected contact allergy due to ERSs and 22 patients with a prior positive patch test reaction to epoxy resin (ER) in the standard series. Most frequently, allergic reactions to ER based on diglycidyl ether of bisphenol A and F were observed (55.2% and 43.7%, respectively). Agreement between positive reactions to both resins, which can be explained by immunological cross‐sensitization and/or coexposure, was substantial [Cohen's kappa 0.65 (95% CI: 0.49–0.80)]. Among the reactive diluents, 1,6‐hexanediol diglycidyl ether (1,6‐HDDGE) and 1,4‐butanediol diglycidyl ether (1,4‐BDDGE) were the most frequent allergens, with 19.5% and 18.4% positive reactions, respectively. Although agreement between positive reactions to 1,6‐HDDGE and 1,4‐BDDGE was even better than with the 2 resins, the sample size is considered too small to decide reliably whether 1,6‐HDDGE alone could serve as a marker allergen for both. Allergic reactions to p‐tert‐butylphenyl glycidyl ether and to phenyl glycidyl ether (PGE) occurred in 11.5% of the patients tested, with only moderate agreement. All patients positive to cresyl glycidyl ether (6.8%) also reacted to PGE. Of the hardeners tested, m‐xylylene diamine was the most frequent allergen (13.8%), followed by isophorone diamine (5.7%). No reactions were observed to several substances, the test concentration of which may have been too low and will be increased in the future.</abstract><subject lang="en"><genre>Keywords</genre><topic>1,4‐butanediol diglycidyl ether</topic><topic>1,6‐hexanediol diglycidyl ether</topic><topic>contact allergy</topic><topic>cresyl glycidyl ether</topic><topic>DGEBA‐R</topic><topic>DGEBF‐R</topic><topic>epoxy resin</topic><topic>hardeners</topic><topic>isophorone diamine</topic><topic>m‐xylylene diamine</topic><topic>occupational</topic><topic>phenyl glycidyl ether</topic><topic>p‐tert‐butylphenyl glycidyl ether</topic><topic>reactive diluents</topic></subject><relatedItem type="host"><titleInfo><title>Contact Dermatitis</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0105-1873</identifier><identifier type="eISSN">1600-0536</identifier><identifier type="DOI">10.1111/(ISSN)1600-0536</identifier><identifier type="PublisherID">COD</identifier><part><date>2004</date><detail type="volume"><caption>vol.</caption><number>51</number></detail><detail type="issue"><caption>no.</caption><number>5‐6</number></detail><extent unit="pages"><start>263</start><end>272</end><total>10</total></extent></part></relatedItem><identifier type="istex">75892147F2A4097DC1050DC56AD66BDE5C57D04E</identifier><identifier type="DOI">10.1111/j.0105-1873.2004.00465.x</identifier><identifier type="ArticleID">COD465</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Munksgaard International Publishers</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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