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Additives are now an established part of our packaged food. Some, like colouring agents and flavouring compounds are hardly necessary or even redundant. Others, mainly antimicrobials and antioxidants, are very important. Antioxidants are not only added to food, but also to cosmetics, pharmaceuticals and industrial products. Dodecyl gallate belongs with propyl- and octyl-gallate to the synthetic esters of gallic acid. These lipid-soluble phenols are very effective antioxidants. We found contact allergy in 4 of 10 workers having only limited contact with dodecyl gallate in the very low concentration of 0.05%. It is important to recognize its strong sensitizing capacity. Workers working with dodecyl gallate should avoid direct skin contact.

Subjects with light skin complexion are especially prone to develop melanoma. Furthermore, individuals with large numbers of moles are also at increased risk of developing melanoma. We studied the association between these two markers of melanoma in a group of healthy white people: 116 children 6 to 9 years of age, 78 children 10 to 13 years of age, and 133 medical and nursing students 18 to 30 years of age. Moles were counted on the chest, back, and lower legs. Skin complexion was established with the use of a scoring system based on burning/tanning ability, eye and hair color, and freckling tendency. A multifactorial statistical analysis was performed. Average mole counts increased with age (p less than 0.0001). Male subjects had more nevi on the trunk than female subjects, whereas counts on the lower legs were higher in female than in male subjects (p = 0.0001). Skin complexion was an important denominator of mole proneness; subjects with a light complexion had higher mean counts than those with a dark complexion (p = 0.0001). The present study shows that a significant association exists between skin complexion phenotype and numbers of moles. The pattern of the appearance of pigmented nevi roughly correlates with the sex and site distribution of melanoma.

The ingredients responsible for allergy to cosmetics were determined in 119 patients suffering from cosmetic-related contact dermatitis. Most reactions (56.3%) were caused by skin care products, followed by nail cosmetics (13.4%), perfumes (8.4%), and hair cosmetics (5.9%). Preservatives were most frequently implicated (32.0%), followed by fragrances (26.5%) and emulsifiers (14.3%). By far the most important cosmetic allergen was Kathon CG, (a preservative system containing, as active ingredients, a mixture of methylisothiazolinone and methyl chloroisothiazolinone) reacting in 33 patients (27.7%). Other frequent causes of cosmetic-related contact allergic reactions were toluenesulfonamide/formaldehyde resin in nail hardener and/or nail lacquer (15 patients [12.6%]), and oleamidopropyl dimethylamine, an emulsifier in baby body lotion (13 patients [10.9%]).

13 patients allergic to the cationic emulsifier oleamidopropyl dimethylamine were tested with a series of related amide-amine type surfactants in order to investigate its cross-reaction pattern. With 1 exception, all patients reacted to at least 4 of the test materials. Most reactions were observed to ricinoleamidopropyl dimethylamine lactate and tallowamidopropyl dimethylamine (11 patients, 85%); 9 patients (of 12 tested, 75%) reacted to lauramidopropyl dimethylamine and 6 (46%) to myristamidopropyl dimethylamine. A certain pattern of cross-reactivity was recognised.

Total serum testosterone, free testosterone, sex hormone binding globulin, albumin and dehydroepiandrosterone sulphate were measured in thirty-five men with severe acne. No striking differences were demonstrated between patients and controls in any of the measurements.

58 male patients with therapy-resistant conglobate acne were randomly selected for treatment with isotretinoin 1.0 or 0.5 mg/kg bodyweight. 27 patients received the high-dose regimen and 31 patients the lower dosage. The efficacy of the drug was highly satisfactory in both therapy groups and no differences could be observed between them. Side-effects (dry lips, dry nose, scaling of the skin) were generally well tolerated in both groups, they were more serious in the 1.0-mg/kg group. It is concluded that isotretinoin therapy is very effective in male patients with conglobate acne and that a dosage of 0.5 mg/kg is preferable to higher dosage regimens.

The extent to which severe acne affects patients' personality and emotional life is still undetermined. The personality factors of neuroticism, psychosomatic condition, social extraversion, and self-defensive attitude were tested, as well as the social anxiety, in a group of forty patients with severe acne. They were more neurotic, more concerned about their bodily functions, and had a lower self-defensive attitude than a normal population. Their anxiety level was also significantly elevated. A subgroup of twelve patients with conglobate acne were treated with isotretinoin. After one year, when the disease had been brought under control effectively, they were retested. The personality factors had not changed consistently. A decrease of anxiety, which did not reach a level of significance, was found. We conclude that the personality and emotional life of patients with severe acne are affected. This aspect of their condition should receive proper attention as part of their treatment.

The relationship of acetylation phenotype to skin complexion was studied in 155 healthy Caucasians. Individuals received 500 mg sulphadimidine at 11.00 p.m.; urine was collected eight hours later. The percentage of acetylated sulphadimidine in urine was measured with high performance liquid chromatography. There was a slight but insignificant preponderance of slow acetylators in the dark skin types. It is concluded that slow acetylation phenotype is not correlated with light skin complexion. Therefore, it is unlikely that acetylation of xenobiotic carcinogens plays a dominant role in melanoma risk.

The relationship between contact allergy to formaldehyde and positive patch test reactions to DMDM hydantoin was investigated. 35 formaldehyde-allergic patients were patch tested with serial dilutions of formaldehyde (0.1%-0.3%-1.0% aq.) and DM hydantoin (the non-formaldehyde-containing parent compound of DMDM hydantoin). 21 were also patch tested with MDM hydantoin (1 molecule formaldehyde) in serial dilutions: 7 (33%) reacted to 1 or more concentrations. The other 14 were also tested with DMDM hydantoin (2 molecules formaldehyde) in serial dilutions: 8 (57%) reacted to 1 or more concentrations. Patients patch-test-positive to formaldehyde 0.1% and/or 0.3% tended to show more patch test reactivity to (D)MDM hydantoin than those who reacted only to 1%. Aqueous solutions of (D)MDM hydantoin in concentrations as used in cosmetic products therefore contain enough free formaldehyde to cause dermatitis in a patch test system in some formaldehyde-allergic patients: 12 such patients applied a cream containing 1% DMDM hydantoin to the flexor aspect of the lower arm twice daily for 1 week; 4 (33%) developed dermatitis. The use of a cream containing 0.25% DMDM hydantoin in these 4 patients still caused dermatitis in 1 and provoked itching in another. An increase in the use of DMDM hydantoin in cosmetic products will also inevitable increase the risk of cosmetic dermatitis in consumers allergic to formaldehyde.