Research letter
Polysensitisation to rubber additives and dyes in shoes and clothes
D. Pacheco
, A.R. Travassos, J. Antunes, R. Silva, M.S. Marques
Corresponding author
Clínica Universitaria de Dermatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte (CHLN), Lisbon, Portugal
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Pacheco, A.R. Travassos, J. Antunes, R. Silva, A. Lopes, M.S. Marques" "autores" => array:6 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Pacheco" ] 1 => array:2 [ "nombre" => "A.R." "apellidos" => "Travassos" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Antunes" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Silva" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Lopes" ] 5 => array:2 [ "nombre" => "M.S." 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Mori, P. Restani, N. Pucci, C. Ballabio, F. Uberti, E. Penas, E. Novembre" "autores" => array:7 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Mori" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Restani" ] 2 => array:2 [ "nombre" => "N." "apellidos" => "Pucci" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Ballabio" ] 4 => array:2 [ "nombre" => "F." "apellidos" => "Uberti" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Penas" ] 6 => array:2 [ "nombre" => "E." "apellidos" => "Novembre" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0301054612002947?idApp=UINPBA00004N" "url" => "/03010546/0000004100000005/v1_201310020117/S0301054612002947/v1_201310020117/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Research letter</span>" "titulo" => "Polysensitisation to rubber additives and dyes in shoes and clothes" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "350" "paginaFinal" => "352" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "D. Pacheco, A.R. Travassos, J. Antunes, R. Silva, M.S. Marques" "autores" => array:5 [ 0 => array:4 [ "nombre" => "D." "apellidos" => "Pacheco" "email" => array:1 [ 0 => "pachecocas@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A.R." "apellidos" => "Travassos" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Antunes" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Silva" ] 4 => array:2 [ "nombre" => "M.S." "apellidos" => "Marques" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Clínica Universitaria de Dermatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte (CHLN), Lisbon, Portugal" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Many allergens are involved in contact dermatitis of clothing and footwear. Shoes include rubbers, dyes, glues and leather, and a wide range of components, which depend on the epidemiological and geographical situation of the individual.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> In textiles, the azo dyes are mainly responsible for acute clinical reactions requiring medical intervention,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> while synthetic resins mainly cause chronic reactions.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Other substances used in their manufacture, such as vulcanisation accelerators, elastic, and decorative objects occasionally cause allergy.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A 56-year-old Caucasian male patient, bus driver, admitted after widespread eczema, predominantly acral, which was confirmed on histological examination. He received outpatient treatment with betamethasone, and subsequently he was readmitted for microbial eczema of the feet that spread through the trunk and the extensor surface of the upper and lower limbs. He was treated with prednisolone 20<span class="elsevierStyleHsp" style=""></span>mg and flucloxacillin, as well as washing with potassium permanganate. Mycological examination of scales of the feet was negative. In his profession, he wore shoes with black rubber soles and a dark blue suit of synthetic fabric which we later discovered was part of his uniform. He denied personal and family history of atopy.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The patch test was performed with the basic adopted by GPEDC (<span class="elsevierStyleUnderline">G</span>rupo <span class="elsevierStyleUnderline">P</span>ortuguês de <span class="elsevierStyleUnderline">E</span>studo das <span class="elsevierStyleUnderline">D</span>ermites de <span class="elsevierStyleUnderline">C</span>ontacto) and shoes series (both from Chemotechnique diagnostics 2009 (Malmö, Sweden)).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Analysing the results obtained, IPPD is an anti-ozonant for the vulcanisation of black rubber and, also related with shoes, 1,3-diphenylguanidine and n-dodecyl mercaptan are vulcanisation accelerators of natural and synthetic rubber, respectively. The Disperses Blue 106 and D. Orange 1 are clothing dyes, as well as D. Orange 3, D. Yellow 3, D. Red 1, D. Blue 3, also commonly used in socks, and Acid Yellow 36 which is regularly used in shoes. There was no reaction to PPD.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In order to better understand the patient's reaction and to evaluate the use of the uniform (dark blue synthetic fabric) without any other material composition we carried out a patch test series of textile dyes (textile dyes and resins) using fragments of the individual clothes (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>)</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">N-isopropyl-N′-phenyl-p-phenylenediamine (IPPD) is an anti-ozonant of rubber vulcanisation and the major allergen of black rubber, and was assumed to be responsible for the onset of the feet eczema, once the patient was wearing shoes with black rubber soles.</p><p id="par0035" class="elsevierStylePara elsevierViewall">1,3-Diphenylguanidine is also a vulcanisation accelerator for natural rubber as well as n-dodecyl mercaptan for synthetic rubber, since both components exist in the shoes, it could explain a concomitant sensitisation process due to their different chemical structures. 1,3-Diphenylguanidine can be an irritant substance in the patch tests and may give false positive reactions. In our case the result was a delayed reaction to this component as seen in the increase response comparing the reading at D2 and D4.</p><p id="par0040" class="elsevierStylePara elsevierViewall">IPPD has structural similarity to PPD and may therefore cross-react with it,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> and in this case it is not proved. Allergy to textile dyes can be caused by the allergen transfer to the skin or by the formation of metabolites after epidermal penetration.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a> The final colour is often obtained from the combination of several dyes. The colour of the culprit dye often bears no relationship to the colour of the offending garment. Thus, a blue suit caused dermatitis from a disperse yellow dye used as one component of the final blue colour. The dyes are classified according to their applications. The main allergenic dyes are the dispersed ones, and they come from the azoic (azo) anthraquinone and nitroarylamine (nitro) chemical classes.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The dispersed azo compounds are only partially soluble in water and they are used for dyeing synthetic fibres such as polyesters, acrylics, acetates and sometimes the nylon socks. They are never used in natural fibres.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> They are characterised by a double bond N<span class="elsevierStyleGlyphdbnd"></span>N. This bond has the distinction that in vivo it can be broken down into two amines, which can then be metabolised into haptens.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The disperse yellow-3, disperse orange-1 and disperse red-1, and also disperse blue 106 and 124 are azo dyes. Disperse orange 3 is a dye used in some socks, 66% patients sensitised to this component also react to the PPD, and this can happen by the metabolic conversion of textile dyes in the skin to PPD.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> They also react to solvent yellow 1 which contains 4-aminoazobenzene and p-dimethyl-4-aminoazobenzene. Azo dyes are characterised by R1<span class="elsevierStyleGlyphsbnd"></span>N<span class="elsevierStyleGlyphdbnd"></span>N<span class="elsevierStyleGlyphsbnd"></span>R2 chemical structures. The rupture of the azoic dye bond is interpreted as a concomitant reaction and not like a cross-reaction, although the allergen formed is the same in both cases.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,9</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In this patient, the possibility of concomitant reaction or cross-reactivity with disperse dyes has facilitated sensitisation to azo and anthraquinones, whose structures contain a core metabolised benzene which can form PPD.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Was thought that dye nitroarylamine (nitro) is a co-sensitisation because it is a different one of the chemical classes of the disperse dyes.6</p><p id="par0060" class="elsevierStylePara elsevierViewall">The patient is recommended to avoid wearing clothes of synthetic fibres in direct contact with the skin and especially for dark colours, and with black rubber shoes also.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Patients’ data protection</span><p id="par0065" class="elsevierStylePara elsevierViewall">Confidentiality of Data. The authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in that study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Right to privacy and informed consent</span><p id="par0070" class="elsevierStylePara elsevierViewall">Right to privacy and informed consent. The authors have obtained the informed consent of the patients and/or subjects mentioned in the article. The author for correspondence is in possession of this document.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Protection of human subjects and animals in research</span><p id="par0075" class="elsevierStylePara elsevierViewall">Protection of human and animal subjects. The authors declare that the procedures followed were in accordance with the regulations of the responsible Clinical Research Ethics Committee and in accordance with those of the World Medical Association and the Helsinki Declaration.</p></span></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients’ data protection" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Right to privacy and informed consent" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Protection of human subjects and animals in research" ] ] ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">D2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">D4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Basic series</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IPPD 0.1% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Disperse Blue 106 (1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PPD 1% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">− \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Disperse Orange 1 (1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Shoe series</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>D. Orange 3 (1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>D. Yellow 3 (1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>D. Red 1 (1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>D. Blue 3 3 (1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diphenylguanidine (1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acid Yellow 36 (1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dodecyl mercaptan (0.1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Textile dyes and resins</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>4-Aminoazobenzene (0.25% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Disperse blue-124 (1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Disperse yellow-9 (1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">+ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Disperse black-1 (1% pet) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fragment of blue suit (as is) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">− \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fragment of blue socks(as is) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">− \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab400632.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Readings at 48 and 96<span class="elsevierStyleHsp" style=""></span>h of the following series: basic, textile, fragments of the individual clothes and shoes.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Textiles and shoes" ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:5 [ "edicion" => "6th ed." "titulo" => "Fisher's contact dermatitis" "fecha" => "2008" "editorial" => "Bc Decker Inc." "editorialLocalizacion" => "Hamilton, Ontario" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Shoe allergens: retrospective analysis of cross-sectional data from the North American contact dermatitis group, 2001–2004" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.M. Warshaw" 1 => "S.E. Schram" 2 => "D.V. Belsito" 3 => "V.A. DeLeo" 4 => "J.F. Fowler Jr." 5 => "H.I. 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Fleming" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Invest Dermatol" "fecha" => "1948" "volumen" => "10" "paginaInicial" => "281" "paginaFinal" => "291" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18907867" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary irritants and sensitizers used in fabrication of footwear" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "L. Edward Gaul" 1 => "G.B. Underwood" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Arch Derm Syphilol" "fecha" => "1949" "volumen" => "60" "numero" => "Pt I" "paginaInicial" => "649" "paginaFinal" => "675" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15391426" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contact dermatitis to PPD rubber in Maleki shoes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B.J. Leppard" 1 => "B. Parhizgar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Contact Dermatitis" "fecha" => "1977" "paginaInicial" => "91" "paginaFinal" => "93" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contact dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.D. Johansen" 1 => "P.J. Frosch" 2 => "J.-P. Lepoittevin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "5th ed." "fecha" => "2011" "editorial" => "Springer" "editorialLocalizacion" => "Berlin" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chimie des colorants vestimentaries" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.P. Lepoittevin" 1 => "C. Le Coz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Progrès en Dermato-allergologié" "paginaInicial" => "133" "paginaFinal" => "142" "serieFecha" => "1999" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cross-sensitizations between azo-dyes and para-amino compounds. A study of 236 azo-dye sensitive subjects" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Seidenari" 1 => "L. Mantovani" 2 => "B.M. Manzini" 3 => "M. Pignatti" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Contact Dermatitis" "fecha" => "1997" "volumen" => "36" "paginaInicial" => "91" "paginaFinal" => "96" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9062744" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Textile dye dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. 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McFadden" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Contact Dermatitis" "fecha" => "2003" "volumen" => "48" "paginaInicial" => "248" "paginaFinal" => "250" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12868964" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03010546/0000004100000005/v1_201310020117/S0301054612002212/v1_201310020117/en/main.assets" "Apartado" => array:4 [ "identificador" => "5550" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Research letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03010546/0000004100000005/v1_201310020117/S0301054612002212/v1_201310020117/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0301054612002212?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 14 | 14 | 28 |
| 2024 September | 27 | 21 | 48 |
| 2024 August | 18 | 16 | 34 |
| 2024 July | 20 | 9 | 29 |
| 2024 June | 41 | 13 | 54 |
| 2024 May | 39 | 8 | 47 |
| 2024 April | 30 | 4 | 34 |
| 2024 March | 54 | 6 | 60 |
| 2024 February | 65 | 3 | 68 |
| 2024 January | 82 | 15 | 97 |
| 2023 December | 43 | 6 | 49 |
| 2023 November | 57 | 8 | 65 |
| 2023 October | 64 | 14 | 78 |
| 2023 September | 37 | 2 | 39 |
| 2023 August | 44 | 2 | 46 |
| 2023 July | 51 | 4 | 55 |
| 2023 June | 36 | 5 | 41 |
| 2023 May | 66 | 11 | 77 |
| 2023 April | 42 | 17 | 59 |
| 2023 March | 66 | 11 | 77 |
| 2023 February | 47 | 19 | 66 |
| 2023 January | 38 | 7 | 45 |
| 2022 December | 53 | 5 | 58 |
| 2022 November | 51 | 12 | 63 |
| 2022 October | 46 | 13 | 59 |
| 2022 September | 35 | 16 | 51 |
| 2022 August | 53 | 8 | 61 |
| 2022 July | 37 | 9 | 46 |
| 2022 June | 16 | 7 | 23 |
| 2022 May | 31 | 9 | 40 |
| 2022 April | 27 | 12 | 39 |
| 2022 March | 28 | 10 | 38 |
| 2022 February | 30 | 5 | 35 |
| 2022 January | 33 | 7 | 40 |
| 2021 December | 29 | 9 | 38 |
| 2021 November | 20 | 5 | 25 |
| 2021 October | 32 | 15 | 47 |
| 2021 September | 40 | 9 | 49 |
| 2021 August | 23 | 6 | 29 |
| 2021 July | 27 | 7 | 34 |
| 2021 June | 19 | 5 | 24 |
| 2021 May | 16 | 7 | 23 |
| 2021 April | 49 | 16 | 65 |
| 2021 March | 30 | 6 | 36 |
| 2021 February | 16 | 6 | 22 |
| 2021 January | 10 | 3 | 13 |
| 2020 December | 1 | 1 | 2 |
| 2020 July | 0 | 1 | 1 |
| 2018 February | 1 | 1 | 2 |
| 2018 January | 7 | 0 | 7 |
| 2017 December | 10 | 1 | 11 |
| 2017 November | 7 | 6 | 13 |
| 2017 October | 7 | 4 | 11 |
| 2017 September | 7 | 9 | 16 |
| 2017 August | 12 | 2 | 14 |
| 2017 July | 7 | 2 | 9 |
| 2017 June | 8 | 22 | 30 |
| 2017 May | 12 | 11 | 23 |
| 2017 April | 10 | 3 | 13 |
| 2017 March | 9 | 27 | 36 |
| 2017 February | 4 | 1 | 5 |
| 2017 January | 11 | 1 | 12 |
| 2016 December | 14 | 6 | 20 |
| 2016 November | 20 | 4 | 24 |
| 2016 October | 10 | 4 | 14 |
| 2016 September | 18 | 6 | 24 |
| 2016 August | 18 | 7 | 25 |
| 2016 July | 3 | 2 | 5 |
| 2016 June | 11 | 10 | 21 |
| 2016 May | 6 | 1 | 7 |
| 2016 April | 14 | 17 | 31 |
| 2016 March | 15 | 15 | 30 |
| 2016 February | 12 | 13 | 25 |
| 2016 January | 12 | 10 | 22 |
| 2015 December | 9 | 6 | 15 |
| 2015 November | 8 | 6 | 14 |
| 2015 October | 15 | 8 | 23 |
| 2015 September | 14 | 6 | 20 |
| 2015 August | 6 | 1 | 7 |
| 2015 July | 4 | 2 | 6 |
| 2015 June | 3 | 1 | 4 |
| 2015 May | 6 | 2 | 8 |
| 2015 April | 5 | 8 | 13 |
| 2015 March | 4 | 2 | 6 |
| 2015 February | 1 | 0 | 1 |
| 2015 January | 32 | 2 | 34 |
| 2014 December | 23 | 4 | 27 |
| 2014 November | 8 | 6 | 14 |
| 2014 October | 20 | 8 | 28 |
| 2014 September | 29 | 6 | 35 |
| 2014 August | 1 | 0 | 1 |
| 2014 July | 0 | 1 | 1 |
| 2014 May | 1 | 0 | 1 |
| 2014 March | 38 | 15 | 53 |
| 2014 February | 46 | 12 | 58 |
| 2014 January | 28 | 19 | 47 |
| 2013 December | 30 | 17 | 47 |
| 2013 November | 22 | 12 | 34 |
| 2013 October | 19 | 10 | 29 |
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