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Contact leukoderma caused by patch testing with dental acrylics

L Kanerva1, T Estlander

  • 1Section of Dermatology, Finnish Institute of Occupational Health, Helsinki, Finland.

American Journal of Contact Dermatitis : Official Journal of the American Contact Dermatitis Society
|September 24, 1998
PubMed
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Dental acrylics applied undiluted during patch testing can cause permanent skin depigmentation (vitiligo). This case highlights the risks of direct skin exposure to concentrated dental materials, emphasizing safer testing methods for occupational dermatitis.

Area of Science:

  • Dermatology
  • Occupational Health
  • Toxicology

Background:

  • Contact leukoderma, a form of skin depigmentation, can be induced by various chemicals.
  • Occupational fingertip dermatitis is a common concern for healthcare professionals, including dental nurses.

Observation:

  • A dental nurse developed persistent vitiligo on her upper arm following patch testing with undiluted dental acrylic resins.
  • The patch test reaction occurred at the site of application, indicating a direct chemical effect.

Findings:

  • The patient had pre-existing sensitization to acrylics, as evidenced by earlier patch test reactions.
  • It is hypothesized that acrylates in dental acrylics induced contact vitiligo, potentially exacerbated by other components like hydroquinone.

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Implications:

  • Dental acrylics should never be patch tested in their undiluted form ('as is') due to the risk of inducing vitiligo.
  • Use tests, open tests, or repeated open patch tests with undiluted dental acrylics are discouraged to prevent active sensitization and adverse reactions.