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Fully finished and polymerized plastics seldom cause an allergic contact dermatitis, whereas fully "cured" rubber articles do so quite frequently. Of the antioxidants used to prolong the life of the rubber, monobenzyl ether of hydroquinone (which can depigment skin) and phenyl-beta-naphthylamine are the most common sensitizers. The accelerators, mercaptobenzothiazole, tetramethyl thiuram monosulfide and diphenyguanidine, and the peptizer, thio-beta napthal, are the chemicals causing most of the dermatitides attributable to rubber. Two other accelerators, disulfuram (Antabuse) and thiuram, will produce itching, erythema and urticaria in those exposed who ingest alcohol. Thiuram is also used as a lawn fungicide (Tersan). Occasionally bleach will activate a rubber accelerator, zinc dibenzyl dithiocarbamated (ZDC) to become highly allergenic (ref.).
Rubber-glove dermatitis can be a trial for surgeons who should switch to "eudermic" surgical gloves (B.F. Goodrich Industrial Products Company), Nuprene gloves (Pioneer Rubber Company) or latex or plastic gloves. Parke-Davis will send samples of eudermic gloves on request. Other sources of gloves for surgeons are The Original Brown Mill Gloves (Seamless) and Elastyren gloves (V. K. Gloves) made in Denmark.
Warner's or Vanity Fair Spandex garments (without rubber or accelerator) are safe for use. If rubber dress-shield dermatitis is the problem, Kleinert's non-rubber dress shields are available. Elastic in hair nets may cause dermatitis, and ribbons or wrap-around hair nets may have to be substituted. Where an eruption is due to a rubber condom, Fourex (Schmidt) fish-skins can be substituted.
Adhesive tape can cause a miliaria-like occlusion of poral openings, although true contact dermatitis spreads beyond the margin of the contact with the tape. If this occurs, Dermicel tape (Johnson & Johnson), Steristrips or Micropore Surgical Tape (3M) can be substituted, or spray-on "Bandaid."
For toupees and ileostomy stoma irritated by other rubber cements, Duo brand surgical adhesive (Johnson & Johnson) is well tolerated by many.
Latex cements are used in the shoe and textile trade. Vulcanizing solutions come in two solutions which, when mixed, seal punctures. It takes a few hours to cure, and sensitization can occur from the various chemicals. Nonvulcanizing rubber solutions are used in the shoe industry and automobile trimmings and can cause dermatitis.
Non-rubber Adhesives
These are chiefly synthetic resin adhesives which can sensitize, although fish glues generally do not. Glues made from cotton (e.g., cellulose acetate) are not sensitizers, and neither is collodion. Vegetable gums such as karaya, acacia and tagacanth are sensitizers.
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Rhett Drugge, M.D.
Last update: February 2, 1997