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Meteorological influence on NaOH irritation varies with body site

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Abstract

Background

Dry air and cold weather have been shown to influence skin irritability. There is conflicting evidence concerning seasonal variability of irritant patch test results and there are no data concerning the influence of season on NaOH-induced irritation.

Patients and methods

A Swift Modified Alkaline Resistance Test (SMART) was carried out simultaneously on the volar forearm (FA) and the back of the hand (BOH) of 554 consecutive individuals (277 female, median age 36 years; 277 male, median age 42 years) who had previously had an occupational skin disease. The test comprises two challenges with 0.5 M NaOH each for 10 min. The clinical outcome in each patient was related to standardized data on the local ambient temperature (T) and absolute humidity (AH) on the day of examination obtained from the German Meteorological Service.

Results

Of the 554 patients, 212 (38.3%) showed a positive reaction on the FA, and 126 (22.7%) a positive reaction on the BOH. An atopic skin disposition significantly increased the odds for a positive clinical reaction on both the FA (OR 4.8, 95% CI 3.0–7.8) and the BOH (OR 3.1, 95% CI 1.8–5.5). In a logistic regression analysis a significant association between low T and AH, respectively, and clinical reactivity to NaOH on the BOH was found. The odds of a positive reaction were increased by 3.9 (95% CI 2.1–7.6) for an ambient T of ≤6°C and by 2.9 (95% CI 1.6–5.7) for an AH of ≤8 mg l−1. The effects of AH and T on the reactivity on the BOH were even more pronounced in atopic individuals. In contrast, there was no significant association between the test outcome on the FA and climatic parameters. Furthermore, the test outcome showed no significant association with duration of healing of hand eczema or eczema at other sites before the investigation. Moreover, there were no associations detectable between previous wet work load and NaOH reactivity on both the BOH and FA.

Conclusions

Unlike skin challenge with sodium lauryl sulphate, challenge with NaOH on a body area not directly exposed to environmental factors (FA) seems robust against seasonal influences. Furthermore, a NaOH test in this location (FA) may provide supporting evidence to help identify individuals with atopic skin. On the BOH, seasonal effects were demonstrated. Thus, when interpreting NaOH challenges on the BOH it would seem helpful to take ambient meteorological parameters into consideration.

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References

  1. Burckhardt W (1947) Neue Untersuchungen über die Alkaliempfindlichkeit der Haut. Dermatologica 94:8–96

    Google Scholar 

  2. John SM (2001) Klinische und experimentelle Untersuchungen zur Diagnostik in der Berufsdermatologie. Konzeption einer wissenschaftlich begründeten Qualitätssicherung in der sozialmedizinischen Begutachtung. In: Schwanitz HJ (ed) Studien zur Prävention in Allergologie, Berufs- und Umweltdermatologie. Universitätsverlag Rasch, Osnabrück

  3. John SM, Schwanitz HJ (2005) Functional skin testing: the SMART-procedures. In: Chew A-L, Maibach HI (eds) Handbook of irritant dermatitis. Springer, Berlin Heidelberg New York (in press)

  4. Tupker R (2003) Prediction of irritancy in the human skin irritancy model and occupational setting. Contact Dermatitis 49:61–69

    Article  CAS  PubMed  Google Scholar 

  5. Uter W (2004) Physical causes: heat, cold, and other atmospheric factors. In: Kanerva L, Elsner P, Wahlberg J, et al (eds) Condensed handbook of occupational dermatology. Springer, Berlin Heidelberg, pp 87–94

    Google Scholar 

  6. Tupker RA, Willis C, Berardesca E, et al (1997) Guidelines on sodium lauryl sulfate (SLS) exposure tests. A report from the standardization group of the European society of contact dermatitis. Contact Dermatitis 37:53–69

    CAS  PubMed  Google Scholar 

  7. Tupker R, Coenraads P, Fidler V, et al (1995) Irritant susceptibility and weal and flare reactions to bioactive agents in atopic dermatitis. II. Influence of season. Br J Dermatol 133:365–370

    CAS  PubMed  Google Scholar 

  8. Agner T, Serup J (1989) Seasonal variation of skin resistance to irritants. Br J Dermatol 121:323–328

    CAS  PubMed  Google Scholar 

  9. Basketter DA, Griffiths HA, Wang XM, et al (1996) Individual, ethnic and seasonal variability in irritant susceptibility of skin: the implications for a predictive human patch test. Contact Dermatitis 35:208–213

    CAS  PubMed  Google Scholar 

  10. Löffler H, Happle R (2003) Influence of climatic conditions on the irritant patch test with sodium lauryl sulphate. Acta Derm Venereol 83:338–341

    Article  PubMed  Google Scholar 

  11. Uter W, Gefeller O, Schwanitz HJ (1998) An epidemiological study of the influence of season (cold and dry air) on the occurrence of irritant skin changes of the hands. Br J Dermatol 138:266–272

    Article  CAS  PubMed  Google Scholar 

  12. Uter W, Hegewald J, Pfahlberg A, et al (2003) The association between ambient air conditions (temperature and absolute humidity), irritant sodium lauryl sulfate patch test reactions and patch test reactivity to standard allergens. Contact Dermatitis 49:97–102

    Article  CAS  PubMed  Google Scholar 

  13. Locher G (1962) Permeabilitätsprüfung der Haut Ekzemkranker und Hautgesunder für den neuen Indikator Nitrazingelb «Geigy», Modizifierung der Alkaliresistenzprobe, pH-Verlauf in der Tiefe des stratum corneum. Dermatologica 124:159–182

    CAS  PubMed  Google Scholar 

  14. Schwanitz HJ (1988) Atopic palmoplantar eczema. Springer, Berlin Heidelberg New York London Paris Tokyo

    Google Scholar 

  15. Hanifin J, Rajka G (1980) Diagnostic features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh) 47:75–82

    Google Scholar 

  16. Wilhelm KP, Pasche F, Surber C, et al (1990) Sodium hydroxide-induced subclinical irritation. A test for evaluating stratum corneum barrier function. Acta Derm Venereol 70:463–467

    CAS  PubMed  Google Scholar 

  17. Kolbe L, Kligman AM, Stoudemayer T (1998) The sodium hydroxide erosion assay: a revision of the alkali resistance test. Arch Dermatol Res 290:382–387

    Article  CAS  PubMed  Google Scholar 

  18. Berndt U, Hinnen U, Iliev D, et al (1999) Is occupational irritant contact dermatitis predictable by cutaneous bioengineering methods? Results of the Swiss metalworkers’ eczema study (PROMETES). Dermatology 198:351–354

    Article  CAS  PubMed  Google Scholar 

  19. Grunewald AM, Gloor M, Gehring W, et al (1995) Damage to the skin by repetitive washing. Contact Dermatitis 32:225–232

    CAS  PubMed  Google Scholar 

  20. Hachem J, Crumrine D, Fluhr J (2003) pH directly regulates epidermal permeability barrier homeostasis, and stratum corneum integrity/cohesion. J Invest Dermatol 121:345–353

    Article  CAS  PubMed  Google Scholar 

  21. Kurz R, Ummenhofer B (1982) Der Einfluß der Teststelle auf die Alkaliresistenz. Zbl Hautkr 57:1019–1027

    CAS  Google Scholar 

  22. Cua AB, Wilhelm KP, Maibach HI (1990) Cutaneous sodium lauryl sulphate irritation potential: age and regional variability. Br J Dermatol 123:607–613

    CAS  PubMed  Google Scholar 

  23. Frosch PJ (2001) Clinical aspects of irritant contact dermatitis. In: Rycroft RJG, Menné T, Frosch PJ, et al (eds) Textbook of contact dermatitis, 3rd edn. Springer, Berlin Heidelberg New York, pp 347–366

    Google Scholar 

  24. Charbonnier V, Morrison BM, Paye M, et al (2001) Subclinical, non-erythematous irritation with an open assay model (washing): sodium lauryl sulfate (SLS) versus sodium laureth sulfate (SLES). Food Chem Toxicol 39:279–286

    Article  CAS  PubMed  Google Scholar 

  25. Ummenhofer B (1980) Zur Methodik der Alkaliresistenzprüfung. Dermatosen 28:104–109

    CAS  Google Scholar 

  26. Uter W, Geier J, Land M, et al (2001) Another look at seasonal variation in patch test results. A multifactorial analysis of surveillance data of the IVDK. Information Network of Departments of Dermatology. Contact Dermatitis 44:146–152

    Article  CAS  PubMed  Google Scholar 

  27. Rogers J, Harding C, Mayo A, et al (1996) Stratum corneum lipids: the effect of ageing and the seasons. Arch Dermatol Res 288:765–770

    Article  CAS  PubMed  Google Scholar 

  28. Löffler H, Aramaki J, Effendy I (2001) Response to thermal stimuli is increased in skin pretreated with sodium lauryl sulfate. Acta Derm Venereol 81:395–397

    Article  PubMed  Google Scholar 

  29. Björnberg A (1968) Skin reactions to primary irritants in patients with hand eczema. Isaacsons, Göteburg

    Google Scholar 

  30. Bangha E, Hinnen U, Elsner P (1996) Irritancy testing in occupational dermatology: comparison between two quick tests and the acute irritation induced by sodium lauryl sulphate. Acta Derm Venereol 76:450–452

    CAS  PubMed  Google Scholar 

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Acknowledgements

We thank Roswitha Cremer, Dr. Klaus Bucher and Professor Dr. Gerd Jendritzky of the German Meteorological Service (Deutscher Wetterdienst, DWD), Offenbach and Freiburg, Germany, for their kind cooperation in providing meteorological data, and Marcel Mackiewicz of the IMBE for his skilful data management.

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Authors and Affiliations

  1. Department of Dermatology, Environmental Medicine, Health Theory, University of Osnabrueck, Sedanstr. 115, 49090, Osnabrueck, Germany

    Swen Malte John

  2. Department of Medical Informatics, Biometry and Epidemiology, University Erlangen/Nuernberg, Germany

    Wolfgang Uter

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  1. Swen Malte John
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  2. Wolfgang Uter
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Correspondence to Swen Malte John.

Additional information

This paper is dedicated to our wise academic teacher Professor Dr. med. Dr. phil. Hans Joachim Schwanitz who died unexpectedly on 20 June 2004.

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John, S.M., Uter, W. Meteorological influence on NaOH irritation varies with body site. Arch Dermatol Res 296, 320–326 (2005). https://doi.org/10.1007/s00403-004-0523-y

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  • DOI: https://doi.org/10.1007/s00403-004-0523-y

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