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Introduction: The medical leech (Hirudo medicinalis) has been used throughout the centuries and continues to be used today, mainly in reconstructive surgery and microsurgery. Easy access to these animals may entail an improper use of this therapeutic method by patients as a form of self-treatment., Case Report: A man who presented with skin erythema and oedema due to the application of a medical leech., Discussion: Infection is considered the most common complication of hirudotherapy, even though bacteriological examination of leech applied by the patient showed neither bacterial nor parasitic infection. The skin lesions were probably of allergic origin; whether this reaction was due to substances released from the leech or as a consequence of reusing the same leech, remains to be determined.

Background: Patch testing is an essential procedure in the investigation of eczema in children., Objectives: To analyse the frequency of contact hypersensitivity and allergic contact dermatitis among Polish children with eczema., Patients/methods: During an allergy screening programme involving 9320 children aged 7 and 16 years, 12.6% reported symptoms of chronic/recurrent eczema. From this group, a representative sample of 229 eczema children underwent patch testing: 96 children aged 7 years and 133 teenagers aged 16 years. Patch testing was with 10 allergens: methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), nickel sulfate, mercury ammonium chloride, thimerosal, cobalt chloride, potassium dichromate, lanolin, fragrance mix I, Myroxylon pereirae (balsam of Peru), and colophonium., Results: 49.4% tested children were found patch test (PT) positive. 43.8% of 7 year olds with eczema were PT positive, with sensitization to nickel sulfate (30.2%), thimerosal (10.4%), cobalt chloride (8.3%), fragrance mix I (7.3%), MCI/MI (6.3%), potassium dichromate (6.3%), M. pereirae (3.1%), mercury ammonium chloride (2.3%), and colophonium (1.0%). 52.6% teenagers were PT positive, with sensitization to nickel sulfate (23.3%), thimerosal (27.8%), cobalt chloride (10.5%), potassium dichromate (6.0%), mercury ammonium chloride (2.3%), M. pereirae (1.5%), and MCI/MI (0.8%). The final diagnosis of allergic contact dermatitis was confirmed in 36% of 7 year olds and 26% of 16 year olds., Conclusions: Every second child with eczema is PT positive, whereas every third child is finally diagnosed with allergic contact dermatitis.

The authors present the major sources of formaldehyde, and discuss the incidence of contact allergy to this compound in Poland and throughout the world. The attention was turned to an increasing trend in the incidence of allergy in question, as well as to the problem of cross-sensitization to other chemical compounds of the aldehyde group (glyoxal, glutaraldehyde, succinaldehyde and cinnamic aldehyde).

Effects of different concentrations of Emulgol EN-BIO C/88 oil on rabbit skin were studied. Experiments were carried out to examine oil irritancy to the skin and the inner surface of the ear skin subjected to a 24-hour closed exposure and repeated open exposure for 10 days, respectively. The data obtained have shown that 5 and 10 per cent emulsions of Emulgol EN-BIO C/88 produce mild skin irritation, while a 50 per cent emulsion and concentrate cause irritation of moderate degree. This means that the irritating potential of Emulgol depends on its concentration in oil-water emulsion. It is concluded that EN-BIO C/88 oil should be used in a 5 per cent concentration in industry.

The incidence of dermatoses and allergy to metals (Cr, Co, Ni) was determined in 1782 workers exposed to cement, waste fly ash and asbestos cement. They were also exposed to reclaimed (used), mineral oils. Dermatitis was found in 23.6% of the subjects, and oil acne in 11.2%. Allergy to chromium was found in 23% of the subjects; the % of definitely positive patch test results (the total of positive +(+) and strongly positive +(+)+ was, however, 8.6%. Allergy to cobalt was found in 13.4% of the subjects examined (definite in 3.1%). Allergy to nickel was found in 2.7% of the subjects (definite in 1.1%). The risks of occurrence of occupational skin disease and allergy to metals in subjects exposed to ash were found to be lower than in subjects exposed to cement, and were similar to those in subjects exposed to asbestos cement. Overall chromium, cobalt and nickel contents in ash and asbestos were higher than in cement. Soluble chromium compound content in ash was lower than in cement from European countries and similar to that in American cement.

In a group of 100 consecutive patients with eczema all those hypersensitive to nickel had also hypersensitivity to palladium. Allergy to the latter element was never found in patients with negative tests for nickel. The clinical importance of this combined allergy is discussed.

In patients with allergic changes hospitalized in the years 1984-1988 in the Department a careful history was obtained for detection of correlations between the appearance of skin lesions and contact with plants. In patients with a positive history patch tests were done with a panel of routine allergens and leaves and/or flowers of certain plants. Positive tests with various plants were obtained in 14 cases. In 6 patients reporting contact with primrose positive tests were obtained with flowers and leaves of this plant, four of five tobacco planters tested who had eczematous lesions of the hands, aave also positive results of the test with tobacco leaves, and in three children reporting contact with butter-cup changes were observed resembling dermatitis pratensis bullosa. In one case allergy to parsnip was demonstrated. It is stressed that plants may give rise to contact dermatitis as well as to allergic-toxic changes.

Dermatological examination and patch tests with 34 rubber components were carried out in 114 tire manufacturers, 78 women and 36 men aged 29 years on average, with a mean duration of work in the plant 7 years. For correct interpretation of the obtained results patch tests with the same components were done in two control groups that is in 120 healthy subjects and 120 patients with contact dermatitis. Patch tests with proper concentrations of the studied components were evaluated after 48, 72 and 96 hours. Positive patch tests were found most frequently with antioxidants--16.6% (including IPPD--8.6%), followed by vulcanization accelerators--10.6%, and other rubber components--11.4% in all. During about 3 years of follow-up in 4 manufacturers contact allergic eczema was noted and polyvalent hypersensitivity to antioxidants and vulcanization accelerators without clinical manifestations of this hypersensitivity was diagnosed in 3 other subjects.

Dermatological examination and patch tests were done in 114 manufacturers of tires, 78 women and 36 men, mean age 29 years, working in Stomil Plant. Patch tests included 15 substances in panels Standard I and II (excluding rubber components). The study demonstrated hypersensitivity to nickel and formalin (4.3% each), chromium and cobalt (3.5% each), and turpentine (2.6%), while hypersensitivity to other allergens was observed sporadically. A comparative analysis of the results of patch tests with antigens "Standard I and II" in confectioners and healthy and allergic persons showed that the per cent of positive tests in rubber industry workers was higher than in healthy subjects, and much lower than in patients with contact dermatitis.

The frequency of positive results of patch tests with nickel was analysed in 1044 patients with positive results of patch tests examined because of suspected occupational diseases in the years 1977-1988. More frequent presence of allergy to nickel was demonstrated in women (21.8%) than men (6.9%), and it was found that the allergy to this metal has increased sixfold in women in the period 1985-1988 in relation to the period 1977-1980. A particularly high increase of the allergy to nickel in women was observed in the last year (69.4%). This increase of allergy was noted not only in young women but also in middle-aged ones. In women monovalent allergy to nickel and bivalent allergy to nickel and cobalt prevailed, while in men bivalent allergy to nickel and chromium was most frequent. The problems of diagnosis and expertise in occupational diseases in women with allergy to nickel present in metal jewelry and working in contact with metals in occupation are discussed.

Dermatological examinations in workers of the Dwelling Houses Factory were performed 1-5 years apart. On the whole 1011 subjects have been examined. The most frequent professional disease was oil acne brought about by the contact with anti-adhesive oils. The effects of the kind of anti-adhesive oils, the post at work (degree of exposure to the contact with oil) as well as the work period on the acne changes have been analyzed. It was found that the most acnogenic preparation was formol, then ceramic oil while isoform proved to be much less active. It was shown that the longer the work period the more decreased the oil acne morbidity. A low percentage of allergic contact eruption (1.8%) is probably related to the highly mechanized production cycle.

Dermatological examination was performed and epidermal tests using a routine set of allergens and metals (Cr, Co, Ni, Al, Cu, Ag, Zn, Hg, Fe) on 112 workers of power plants and thermal-electric power stations working at the stands characterized by a heavy dustiness (electro-filters operation, ash removal, deslagging, carburizing) and at the stands where dustiness was not so heavy but instead exposure to machine oils and greases (retors' operators, electromechanics, assemblers and welders) was remarkable. It was found that occupational exposure to chemicals resulted in skin inflammation in 7.1% of the examined persons. Machine oils and greases induced skin inflammation in 2.7% and occupational acne in 5.3% of workers. It was also observed that chromium compounds were the primary allergen in workers exposed to dusts (13.4% of sensitized persons) and in workers exposed to industrial greases and oils (8.0% of sensitized persons). Allergy to cobalt compounds prevailed among persons exposed to smears and oils. Single positive results of epidermal tests with the use of copper and silver were obtained. Moreover, data concerning the microelements content in fly-ashes are presented. Information on the frequency of the incidence of occupational skin diseases, sickness absenteeism due to dermatoses and on personal safety equipment which should be used by the workers of power industry plants are provided.

Three groups of patients suffering from eczema, exposed to cement, have been examined. Altogether there were 293 subjects. No particularly strong sensitizing properties of the Polish cement have been found. This, however, calls for confirmation. Differences, hitherto unknown, between masons and concretors have been found at the middle stage of eczema incubation and at middle age when occupational skin lesions occur, indicating a clearly higher allergy risk in concretors. On the other hand the sensitivity to particular metals has been similar in all building workers and did not differ from that in other countries.

Star anise oil in 2 and 1% concentrations produced active sensitization in 5% of test subjects, and positive patch tests in 36 and 34%, respectively, of consecutive patients with dermatitis. A comparison of the results of tests with balsams and other essential oils showed that star anise oil does not give cross-reactions and pseudo cross-sensitivity. Patients positive to this oil are frequently positive to anethole and to other constituents of this oil: alpha-pinene, limonene and safrole. In tests with star anise oil it is noteworthy that a 1% concentration is strongly irritant, and 0.5% reveals sensitivity in only one fifth of the actively sensitized subjects. It is possible that the cause of false negative patch tests might be similar in the case of some other allergens.

A series of 250 consecutive patients with dermatitis and positive patch tests to chromate was divided into three groups: nonoccupational dermatitis (94), occupational dermatitis caused by chromate (132) and occupational dermatitis caused by allergens other than chromate (24). Only 17.2% of patients did not report harmful effects from chromium-tanned leather. Shoes were most often not tolerated. The role of matches in the development of chromate dermatitis is discussed. Observations on ash, household detergents, textiles, wood, tattooing, cement, galvanizing solutions, printer's ink, welding fumes, corrosion inhibitors and oils are described as causes of chromate dermatitis in Poland, as well as the localization of dermatitis and relevance of patch test reactions.

The frequency of dermatitis, oil acne and allergies to chromium, cobalt and nickel in persons exposed to cement, fly-ashes and asbestos cement was studied. The metal content in these materials was assessed. It was demonstrated that the risk of dermatitis and allergy to metals, and especially to chromium, is higher in persons manufacturing prefabricated building products of cement than in those manufacturing them of fly-ashes and asbestos cement, and the risk is similar in persons making products out of fly-ashes and asbestos cement.

The frequency of positive patch tests to 13 rubber accelerators in Poland was recorded. Of particular interest was the relatively large group of patients positive to several, mostly chemically unrelated, accelerators. The mechanism of this multiple sensitivity is discussed. Positive tests to N-isopropyl-N-phenyl-p-phenylenediamine were observed in more than half of the patients reacting to several aromatic amines. Anamnesis indicated that in the case of cross-reactions to many aromatic amines, none of the patients positive to N-isopropyl-N-phenyl-p-phenylenediamine had complained of a reaction to rubber products.

In 61 textile materials of cotton, wool and synthetic fibre formaldehyde was determined using colour tests with acetylacetone and chromotropic acid. Full agreement of the results of both tests was demonstrated. In 61 studied materials formaldehyde was demonstrated in 44 samples and in 17 samples it was absent. Formaldehyde was present in materials submitted to end-use finish. The possibility was showed also of formaldehyde passage from the finished materials into materials not containing it following their storage together. Frequent washing and ironing of materials after finish may lead to formaldehyde loss from the materials. The usefulness is stressed of colour tests for the diagnosis and prevention of formaldehyde-induced clothing-related eczema.

Two hundred consecutive patients and 50 subjects positive to balsams were tested with the 35 essential oils most frequently used in Polish cosmetics. The frequency of sensitivity to the particular oils is noted and the index of sensitization calculated as the amount of oil/kg used annually for the production of Polish cosmetics per one patient positive to this oil. The correlation of positive tests to essential oils with positive tests to four balsams of the standard series is shown.