Contact Dermatitis. 2000 Oct;43(4):235-7.

An outbreak of occupational textile dye dermatitis from Disperse Blue 106.
Mota F, Silva E, Varela P, Azenha A, Massa A.

Dermatology Department, Hospital Geral Santo António, Braga, Portugal.

PMID: 11011934 [PubMed - indexed for MEDLINE

Azenha, A

Massa, A

Mota, F

Silva, E

Varela, P

Contact Dermatitis

English

MOTA, F.

SILVA, E.

VARELA, P.

AZENHA, A.

MASSA, A.

Repositório Científico do Centro Hospitalar do Porto

An outbreak of occupational textile dye dermatitis from Disperse Blue 106

Repositório Comum

Contact Dermatitis 2000: 43: 235SHORT COMMUNICATIONSpatient developed occupational dermatitis from butyleneglycol in a soap (9, 10). 2 large-scale group studies, in-cluding 364 and 272 patients, give frequencies of contactallergy to 1,3-butylene glycol of 0.4% and 1.1%, respec-tively, of patients tested (1, 2).Although 1,3-butylene glycol has been considered asafe cosmetic ingredient and a rare contact allergen, wesuggest that allergy to it would be reported more fre-quently if it were tested regularly. 1,3-butylene glycol(5% aq.) is now being added to the Belgian cosmeticsseries to evaluate the incidence of positive tests and theincidence of possible cross-reactivity with propylene gly-col, the latter having been present in the Belgian stan-dard series since 1993. 5% aq. has been proposed as opti-mal for patch testing by Matsunaga et al. (1), though wedid not observe irritant reactions to 10% aq. in 20 con-trol subjects.References1. Matsunaga K, Sugai T, Katoh J, Hayakawa R, KozukaT, Itoh J, Tsuyuki S, Hosono K. Group study on contactsensitivity of 1,3-butylene glycol. Environ Dermatol 1997:4: 195–201.An outbreak of occupational textile dye dermatitis from Disperse Blue 106Francisco Mota1, Elvira Silva1, Paulo Varela1, Angelo Azenha2 and Anto´nio Massa1Dermatology Departments: 1Hospital Geral Santo Anto´nio (HGSA), Rua D. Manuel II, 4050-345 Porto,2Hospital S. Marcos, Braga, PortugalKey words: textile dyes; allergic contact dermatitis; patch tests; occupational; Disperse Blue 106; Disperse Blue 124;thin-layer chromatography; cross-sensitivity. C Munksgaard, 2000.Textile dyes can be responsible for as many as 5.8% ofsensitizations detected in contact dermatitis clinics(1–3), but occupational sensitization is rarely reported.Patients and Methods5 women, aged 25 to 34 years, worked in a ready-to-wearshop and presented with 3-month histories of eczema ofthe axillae, neck, upper extremities, anterior abdominalwall, and, sometimes, the face. The garment suspectedTable 1. Disperse dye mixes used in the Portuguese standardseries8% mix 3.2% mixDisperse Orange 1 1% pet. 0.5% pet.Disperse Orange 3 1% pet. 0.5% pet.Disperse Yellow 3 1% pet. 0.5% pet.Disperse Red 1 1% pet. 0.5% pet.Disperse Red 17 1% pet. 0.5% pet.Disperse Blue 35 1% pet. 0.5% pet.Disperse Blue 106 1% pet. 0.1% pet.Disperse Blue 124 1% pet. 0.1% pet.2. Sugiura M, Hayakawa R. Contact dermatitis due to 1,3-butylene glycol. Contact Dermatitis 1997: 37: 90.3. Fisher A A. Reactions to popular cosmetic humectants.Part III. Glycerin, propylene glycol, and butylene glycol.Cutis 1980: 26: 243–244.4. Fisher A A. Contact Dermatitis, 4th edition. Baltimore:Williams and Wilkins, 1995: 285.5. Yashiro K, Mishimoto M. A case of contact dermatitis dueto 1,3-butylene glycol and trisodiumhydroxyethyl ethylene-diamine triacetate. Environ Dermatol 1999: 6 (suppl 1): 59.6. Okada Y, Noda H, Matsunaga K, Hamamatsu T, Kawash-ima R. Cosmetic dermatitis in 1991. Skin Research 1993:35: 75–80.7. Matsunaga K, Kato C, Takeuchi M, Kato Y. Allergic con-tact dermatitis from 1,3-butylene glycol. The Allergy inPractice 1994: 14: 492–495.8. Fujimoto Y, Hayakawa R, Suzuki M, Ogino Y, Kato Y,Hanamura A, Sato A, Hirose O. A case with contact der-matitis due to 1,3-butylene glycol. Environ Dermatol 1994:1: 106–110.9. Xie Z, Hayakawa R, Sugiura M, Kato Y, Takeuchi Y.Causes of 15 cases with occupational contact dermatitis inthe secondary industries. Environ Dermatol 1999: 6: 22–25.10. Xie Z, Hayakawa R, Sugiura M, Kato Y, Takeuchi Y.Causative agents and prognosis of 66 patients with occu-pational contact dermatitis. Environ Dermatol 1999: 6:133–141.was a dark blue smock, introduced as a working uni-form in the last 4 months and worn by about 200 em-ployees.All 5 patients were patch tested with the Portuguesestandard series, which includes 2 mixes of 8 disperse dyes(Table 1) (4). They were also tested with pieces of thesuspected garment and a modified and extended textileseries, including 33 dyes. Patch testing was performedwith Finn ChambersTM on ScanporTM tape, with read-ings according to ICDRG recommendations.To characterize the suspected garment, textile fibercomposition was obtained from the manufacturer, andthin-layer chromatographic (TLC) analysis was per-formed on a sample of the smock.ResultsAll 5 patients had positive reactions to both disperse dyemixes (Table 1), as well as to pieces of the smock, andsubsequently to Disperse Blue 106 and 124. Furtherpatch test results and patient characteristics are sum-marized in Table 2.TLC of the garment sample identified 2 azo dyes, Dis-perse Blue 106 and Disperse Red 1. Textile fiber compo-Contact Dermatitis 2000: 43: 236 SHORT COMMUNICATIONSTable 2. Patient clinical data and patch test resultsAgePatient no. (years) Sites Standard series Dyes positive1 34 axillae fragrance mix DB 106neck Myroxylon Pereirae DB 124upper chest MCIpiMIhands (dorsum) dye mix 3.2%eyelids dye mix 8%piece of garment2A 25 axillae nickel DB 106neck dye mix 3.2% DB 124upper chest dye mix 8% DY 3abdominal wall piece of garment DR 1 and DR 17face DB 35DY 9 and DY 643B 34 neck nickel DB 106hands (dorsum) dye mix 3.2% DB 124antecubital fold dye mix 8% DB 7forearm piece of garment4A,B 34 neck dye mix 3.2% DB 106forearm dye mix 8% DB 124piece of garment DB 75B 34 neck nickel DB 106fists formaldehyde DB 124dye mix 3.2%dye mix 8%piece of garmentDBΩDisperse Blue; DRΩDisperse Red; DYΩDisperse Yellow.A (Patient nos. 2 and 4): personal history of atopy.B (Patient nos. 3 to 5): less extensive dermatitis, due to protective sweatshirt underneath the suspected garment.sition, as submitted by the manufacturer, was a mixtureof synthetic acetate and polyamide.DiscussionOnly around 30 disperse dyes are implicated in about90% of reported textile dye dermatitis (1). Disperse Blue106 was 1st reported in 1985 as causing textile allergyin 9 patients (5), dark blouses being the offending gar-ment (5, 6). Other reports have since been published im-plicating blue synthetic garments containing such dye (3,7–9).The chromatographic analysis performed identifiedDisperse Blue 106. The simultaneous reaction in all pa-tients to the weaker, but similar, allergen, Disperse Blue124, is seen as a cross-reaction (6, 10), though patientssensitized to Disperse Blue 124 do not always cross-reactwith Disperse Blue 106 (11, 12).Our results confirm the inability of PPD to serve as ascreening allergen for azo dye allergy (6–13). Patient no.2 (Table 2) showed positive reactions to 8 dyes of 4 dif-ferent chemical classes (5 azo, 1 anthraquinone, 1 nitro-arylamine and 1 quinoline), which could be interpretedeither as multisensitization or as excited skin syndrome.Patient no. 2 also had a positive patch test to DisperseYellow 64, for which only 1 previous reference was found(14). Patient no. 5 had a positive reaction to formalde-hyde, but no reaction to any of the resins included in thetextile series.To the best of our knowledge, this is the 1st report ofoccupational sensitization to Disperse Blue 106.References1. Hatch K L, Maibach H I. Textile dye dermatitis. J AmAcad Dermatol 1995: 32: 631–639.2. Seidenari S, Manzini B M, Danese P. Contact sensitizationto textile dyes: description of 100 subjects. Contact Derma-titis 1991: 24: 253–258.3. Sherertz E F. Clothing dermatitis: practical aspects for theclinician. Am J Contact Dermatitis 1992: 3: 55–64.4. Sousa-Basto A, Azenha A. Textile dye mixes: useful screen-ing tests for textile dye allergy. Contact Dermatitis 1994:30: 189.5. Menezes-Branda˜o F, Altermatt C, Pecegueiro M, BordaloO, Foussereau J. Contact dermatitis to Disperse Blue 106.Contact Dermatitis 1985: 13: 80–84.6. Hausen B M, Menezes-Branda˜o F. Disperse Blue 106, astrong sensitizer. Contact Dermatitis 1986: 15: 102–103.7. Hausen B M. Contact allergy to Disperse Blue 106 andBlue 124 in black ‘‘velvet’’ clothes. Contact Dermatitis1993: 28: 169–173.8. Hausen B M, Kulenkamp D, Börries M. Kontakallergieauf blaue dispersionsfarbstoffe in schwarzen ‘‘samt-leg-gins’’. Art Dermatol 1991: 17: 337–340.9. Dejobert Y, Martin P, Thomas P, Bergoend H. Multipleazo dye sensitization revealed by the wearing of a black‘‘velvet’’ body. Contact Dermatitis 1985: 33: 276–277.10. Menezes-Branda˜o F, Hausen B M. Cross reaction betweenDisperse Blue dyes 106 and 124. Contact Dermatitis 1987:16: 289–290.

Institutional repository of Hospital de Braga

Contact Dermatitis 2000: 43: 235SHORT COMMUNICATIONSpatient developed occupational dermatitis from butyleneglycol in a soap (9, 10). 2 large-scale group studies, in-cluding 364 and 272 patients, give frequencies of contactallergy to 1,3-butylene glycol of 0.4% and 1.1%, respec-tively, of patients tested (1, 2).Although 1,3-butylene glycol has been considered asafe cosmetic ingredient and a rare contact allergen, wesuggest that allergy to it would be reported more fre-quently if it were tested regularly. 1,3-butylene glycol(5% aq.) is now being added to the Belgian cosmeticsseries to evaluate the incidence of positive tests and theincidence of possible cross-reactivity with propylene gly-col, the latter having been present in the Belgian stan-dard series since 1993. 5% aq. has been proposed as opti-mal for patch testing by Matsunaga et al. (1), though wedid not observe irritant reactions to 10% aq. in 20 con-trol subjects.References1. Matsunaga K, Sugai T, Katoh J, Hayakawa R, KozukaT, Itoh J, Tsuyuki S, Hosono K. Group study on contactsensitivity of 1,3-butylene glycol. Environ Dermatol 1997:4: 195–201.An outbreak of occupational textile dye dermatitis from Disperse Blue 106F M1, E S1, P V1, A A2  A́ M1Dermatology Departments: 1Hospital Geral Santo António (HGSA), Rua D. Manuel II, 4050-345 Porto,2Hospital S. Marcos, Braga, PortugalKey words: textile dyes; allergic contact dermatitis; patch tests; occupational; Disperse Blue 106; Disperse Blue 124;thin-layer chromatography; cross-sensitivity. C Munksgaard, 2000.Textile dyes can be responsible for as many as 5.8% ofsensitizations detected in contact dermatitis clinics(1–3), but occupational sensitization is rarely reported.Patients and Methods5 women, aged 25 to 34 years, worked in a ready-to-wearshop and presented with 3-month histories of eczema ofthe axillae, neck, upper extremities, anterior abdominalwall, and, sometimes, the face. The garment suspectedTable 1. Disperse dye mixes used in the Portuguese standardseries8% mix 3.2% mixDisperse Orange 1 1% pet. 0.5% pet.Disperse Orange 3 1% pet. 0.5% pet.Disperse Yellow 3 1% pet. 0.5% pet.Disperse Red 1 1% pet. 0.5% pet.Disperse Red 17 1% pet. 0.5% pet.Disperse Blue 35 1% pet. 0.5% pet.Disperse Blue 106 1% pet. 0.1% pet.Disperse Blue 124 1% pet. 0.1% pet.2. Sugiura M, Hayakawa R. Contact dermatitis due to 1,3-butylene glycol. Contact Dermatitis 1997: 37: 90.3. Fisher A A. Reactions to popular cosmetic humectants.Part III. Glycerin, propylene glycol, and butylene glycol.Cutis 1980: 26: 243–244.4. Fisher A A. Contact Dermatitis, 4th edition. Baltimore:Williams and Wilkins, 1995: 285.5. Yashiro K, Mishimoto M. A case of contact dermatitis dueto 1,3-butylene glycol and trisodiumhydroxyethyl ethylene-diamine triacetate. Environ Dermatol 1999: 6 (suppl 1): 59.6. Okada Y, Noda H, Matsunaga K, Hamamatsu T, Kawash-ima R. Cosmetic dermatitis in 1991. Skin Research 1993:35: 75–80.7. Matsunaga K, Kato C, Takeuchi M, Kato Y. Allergic con-tact dermatitis from 1,3-butylene glycol. The Allergy inPractice 1994: 14: 492–495.8. Fujimoto Y, Hayakawa R, Suzuki M, Ogino Y, Kato Y,Hanamura A, Sato A, Hirose O. A case with contact der-matitis due to 1,3-butylene glycol. Environ Dermatol 1994:1: 106–110.9. Xie Z, Hayakawa R, Sugiura M, Kato Y, Takeuchi Y.Causes of 15 cases with occupational contact dermatitis inthe secondary industries. Environ Dermatol 1999: 6: 22–25.10. Xie Z, Hayakawa R, Sugiura M, Kato Y, Takeuchi Y.Causative agents and prognosis of 66 patients with occu-pational contact dermatitis. Environ Dermatol 1999: 6:133–141.was a dark blue smock, introduced as a working uni-form in the last 4 months and worn by about 200 em-ployees.All 5 patients were patch tested with the Portuguesestandard series, which includes 2 mixes of 8 disperse dyes(Table 1) (4). They were also tested with pieces of thesuspected garment and a modified and extended textileseries, including 33 dyes. Patch testing was performedwith Finn ChambersTM on ScanporTM tape, with read-ings according to ICDRG recommendations.To characterize the suspected garment, textile fibercomposition was obtained from the manufacturer, andthin-layer chromatographic (TLC) analysis was per-formed on a sample of the smock.ResultsAll 5 patients had positive reactions to both disperse dyemixes (Table 1), as well as to pieces of the smock, andsubsequently to Disperse Blue 106 and 124. Furtherpatch test results and patient characteristics are sum-marized in Table 2.TLC of the garment sample identified 2 azo dyes, Dis-perse Blue 106 and Disperse Red 1. Textile fiber compo-Contact Dermatitis 2000: 43: 236 SHORT COMMUNICATIONSTable 2. Patient clinical data and patch test resultsAgePatient no. (years) Sites Standard series Dyes positive1 34 axillae fragrance mix DB 106neck Myroxylon Pereirae DB 124upper chest MCIπMIhands (dorsum) dye mix 3.2%eyelids dye mix 8%piece of garment2A 25 axillae nickel DB 106neck dye mix 3.2% DB 124upper chest dye mix 8% DY 3abdominal wall piece of garment DR 1 and DR 17face DB 35DY 9 and DY 643B 34 neck nickel DB 106hands (dorsum) dye mix 3.2% DB 124antecubital fold dye mix 8% DB 7forearm piece of garment4A,B 34 neck dye mix 3.2% DB 106forearm dye mix 8% DB 124piece of garment DB 75B 34 neck nickel DB 106fists formaldehyde DB 124dye mix 3.2%dye mix 8%piece of garmentDBΩDisperse Blue; DRΩDisperse Red; DYΩDisperse Yellow.A (Patient nos. 2 and 4): personal history of atopy.B (Patient nos. 3 to 5): less extensive dermatitis, due to protective sweatshirt underneath the suspected garment.sition, as submitted by the manufacturer, was a mixtureof synthetic acetate and polyamide.DiscussionOnly around 30 disperse dyes are implicated in about90% of reported textile dye dermatitis (1). Disperse Blue106 was 1st reported in 1985 as causing textile allergyin 9 patients (5), dark blouses being the offending gar-ment (5, 6). Other reports have since been published im-plicating blue synthetic garments containing such dye (3,7–9).The chromatographic analysis performed identifiedDisperse Blue 106. The simultaneous reaction in all pa-tients to the weaker, but similar, allergen, Disperse Blue124, is seen as a cross-reaction (6, 10), though patientssensitized to Disperse Blue 124 do not always cross-reactwith Disperse Blue 106 (11, 12).Our results confirm the inability of PPD to serve as ascreening allergen for azo dye allergy (6–13). Patient no.2 (Table 2) showed positive reactions to 8 dyes of 4 dif-ferent chemical classes (5 azo, 1 anthraquinone, 1 nitro-arylamine and 1 quinoline), which could be interpretedeither as multisensitization or as excited skin syndrome.Patient no. 2 also had a positive patch test to DisperseYellow 64, for which only 1 previous reference was found(14). Patient no. 5 had a positive reaction to formalde-hyde, but no reaction to any of the resins included in thetextile series.To the best of our knowledge, this is the 1st report ofoccupational sensitization to Disperse Blue 106.References1. Hatch K L, Maibach H I. Textile dye dermatitis. J AmAcad Dermatol 1995: 32: 631–639.2. Seidenari S, Manzini B M, Danese P. Contact sensitizationto textile dyes: description of 100 subjects. Contact Derma-titis 1991: 24: 253–258.3. Sherertz E F. Clothing dermatitis: practical aspects for theclinician. Am J Contact Dermatitis 1992: 3: 55–64.4. Sousa-Basto A, Azenha A. Textile dye mixes: useful screen-ing tests for textile dye allergy. Contact Dermatitis 1994:30: 189.5. Menezes-Brandão F, Altermatt C, Pecegueiro M, BordaloO, Foussereau J. Contact dermatitis to Disperse Blue 106.Contact Dermatitis 1985: 13: 80–84.6. Hausen B M, Menezes-Brandão F. Disperse Blue 106, astrong sensitizer. Contact Dermatitis 1986: 15: 102–103.7. Hausen B M. Contact allergy to Disperse Blue 106 andBlue 124 in black ‘‘velvet’’ clothes. Contact Dermatitis1993: 28: 169–173.8. Hausen B M, Kulenkamp D, Börries M. Kontakallergieauf blaue dispersionsfarbstoffe in schwarzen ‘‘samt-leg-gins’’. Art Dermatol 1991: 17: 337–340.9. Dejobert Y, Martin P, Thomas P, Bergoend H. Multipleazo dye sensitization revealed by the wearing of a black‘‘velvet’’ body. Contact Dermatitis 1985: 33: 276–277.10. Menezes-Brandão F, Hausen B M. Cross reaction betweenDisperse Blue dyes 106 and 124. Contact Dermatitis 1987:16: 289–290.

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An outbreak of occupational textile dye dermatitis from Disperse Blue 106

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Repositório Científico do Centro Hospitalar do Porto

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Institutional repository of Hospital de Braga