Summary
A strong positive, allergic patch-test reaction was elicited in 15 patients with an established allergy for a particular allergen. Patches with a marginally irritating concentration of sodium lauryl sulfate (SLS) were applied at fixed distances. The SLS patch situated adjacent to the allergic reaction was significantly enhanced in 12 of 15 patients (P<0.01) compared to more distant SLS reactions (‘spillover’). Only quantitative differences were observed in the histologic pictures of the different types of reaction. The infiltrate consisted of lymphocytes and histiocytes, mainly located perivascular in the upper dermis.
T-cell subsets were assessed with monoclonal antibodies using an immunoperoxidase technique. The distribution of the different T cells was the same for both reaction types.
T cells located outside the perivascular infiltrates (e.g., in the epidermal vesicles) were OKT-8-positive (cytotoxic/suppressor T lymphocytes). Immunofluorescence examination did not show different patterns for the allergic or ‘enhanced toxic’ reactions with regard to the presence of immunoglobulins and complement.
The ‘spillover’ phenomenon may cause falsepositive patch-test reactions.
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References
Achten G, Oleffe J (1966) Tests épicutanés et dermatoses professionelles. Etude histologique. Bull Soc Fr Dermatol Syph 73:49–52
Asherson GL, Allwood GG, Mayhew B (1973) Contact senstivity in the mouse. Movement of T-blasts in the draining lymph nodes to sites of inflammation. Immunology 25:485–494b
Avrameas S, Ternynck T (1971) Peroxidase labeled antibody and Fab conjugates with enhanced intracellular penetration. Immunochemistry 8:1175–1179
Bandmann H-J (1960) Beitrag zur Histopathologie allergischer epicutaner Testreaktionen. Hautarzt 11:310–318
Bandmann H-J, Agathos M (1981) Das “Angry Back Syndrome”-Untersuchungsergebnisse mit Sequenztestungen, Wiederholungstestungen und dem Cocarden-(Target-)Test. Hautarzt [Suppl V] 32:97–104
Björnberg A (1968) Skin reactions to primary irrtants in patients with hand eczema. Isacsons, Göteborg
Boorsma DM, Streefkerk JG (1976) Peroxidase-conjugate chromatography. Isolation of conjugates prepared with glutaraldehyde or periodate using polyacrylamide-agarose gel. J Histochem Cytochem 24:481–486
Bruynzeel DP, van Ketel WG, von Blomberg-van der Flier M, Scheper RJ (1982) Angry back or the excited skin syndrome—a prospective study. J Am Acad Dermatol (in press)
Cormane R (1974) B and T cells in dermatitis. Mayo Clin Proc 49:531–536
Dvorak HF, Mihm MC, Dvorak AM (1976) Morphology of delayed-type hypersensitivity reactions in man. J Invest Dermatol 67:391–401
Kligman AM, Epstein W (1975) Updating the maximization test for identifying contact allergens. Contact Dermatitis 1:231–239
Lachapelle JM (1973) Comparative histopathology of allergic and irritant patch test reactions in man. Arch Belg Dermatol 28:83–92
Lindberg M, Forslind B (1981) The effects of occlusion of the skin on the Langerhans cell and the epidermal mononuclear cells. Acta Derm Venereol (Stockh) 61:201–205
Lindberg M, Johannsson A, Forslind B (1982) The effect of occlusive treatment on human skin: An electron microscopic study on epidermal morphology as affected by occlusion and dansyl chloride. Acta Derm Venereol (Stockh) 62:1–5
van der Lugt L, Veninga TS (1981) Nonspecific hypersensitivity of the skin. Dermatologica 162:438–443
Maibach HI (1981) The E.S.S. — Excited skin syndrome (alias the “angry back”). In: Ring J, Burg G (eds) New trends in allergy. Springer, Berlin Heidelberg New York, pp 208–221
Mitchell JC (1975) The angry back syndrome: Eczema creates eczema. Contact Dermatitis 1:193–194
Mitchell JC (1977) Multiple concomitant positive patch test reactions. Contact Dermatitis 3:315–320
Nater JP, Hoedemaker PhJ (1976) Histological differences between irritant and allergic patch test reactions in man. Contact Dermatitis 2:247–253
Nieboer C (1981) Immunofluorescence patterns in sun-exposed and not-sun-exposed skin of healthy individuals. Acta Derm Venereol (Stockh) 61:471–479
Rantuccio F, Sinisi D, Scardigno A, Conte A (1978) Histologic aspects of patch test reactions in allergic contact dermatitis. Contact Dermatitis 4:338–342
Reitamo S, Tolvanen E, Konttinen YT, Käyhkö K, Förström L, Salo OP (1981) Allergic and toxic contact dermatitis: Inflammatory cell subtypes in epicutaneous test reactions. Br J Dermatol 105:521–527
Rostenberg A (1959) Predictive procedures for eczematous hypersensitivity. AMA Arch Indust Health 20:181–193
Skoog M-L (1980) Measurement and differentiation of the cellular infiltrate in experimental toxic contact dermatitis. Acta Derm Venereol (Stockh) 60:239–244
Toews GB, Bergstresser PR, Streilein JW, Sullivan S (1980) Epidermal Langerhans' cell density determines whether contact hypersensitivity of unresponsiveness follows skin painting with DNFB. J Immunol 124:445–453
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Bruynzeel, D.P., Nieboer, C., Boorsma, D.M. et al. Allergic reactions, ‘spillover’ reactions, and T-Cell subsets. Arch Dermatol Res 275, 80–85 (1983). https://doi.org/10.1007/BF00412879
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DOI: https://doi.org/10.1007/BF00412879