Allergen content of patient problem and nonproblem gloves: Relationship to allergen-specific patch-test findings

Background: Identification of putative contact allergen and source material is often done by a combination of patch testing and manufacturer-supplied product information. The accuracy of the identification of allergen-source material and level of allergen in that allergen-source material is not known. Objective: The objectives of the study were to survey the chemical allergen content of glove allergic contact dermatitis (ACD) patient-identified problem and nonproblem gloves and to evaluate the ability of the patient to discriminate between problem and nonproblem gloves. Methods: Gloves from patch-tested rubber allergen - positive ACD patients were analyzed for species and amount of rubber allergen. Results: Approximately half the subjects were able to correctly identify their problem and nonproblem gloves. Correct association of a glove with ACD was directly related to patch-test reaction severity and inversely related to the number of glove brands being used by the patient. Of note, thiurams were not detected in any of the gloves examined. Conclusions: Although patch testing is invaluable in identifying individual allergen sensitivities, the identification of the ACDcausative specific chemical allergen and source material remains problematic. All glove brands used within days prior to and during an ACD episode should be considered potential sources of the contact allergen.