Tosylamide/formaldehyde resin - a consideration in the atopic toddler
12
Tosylamide/formaldehyde resin Tosylamide/formaldehyde resin - - a a consideration in the atopic toddler consideration in the atopic toddler Sarah Stechschulte B.A.^ & Sharon E. Jacob M.D.* Sarah Stechschulte B.A.^ & Sharon E. Jacob M.D.* ^MSIV, University of Miami ^MSIV, University of Miami *Voluntary Clinical Associate Professor, University of Miami *Voluntary Clinical Associate Professor, University of Miami Jacob SE, Stechschulte SA. Contact Dermatitis 2008 May;58(5):31 Jacob SE, Stechschulte SA. Contact Dermatitis 2008 May;58(5):31 2 2 - - 3. 3.
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Transcript of Tosylamide/formaldehyde resin - a consideration in the atopic toddler
Tosy
lam
ide/
form
alde
hyde
res
in
Tosy
lam
ide/
form
alde
hyde
res
in --
a a co
nsid
erat
ion
in t
he a
topi
c to
ddle
rco
nsid
erat
ion
in t
he a
topi
c to
ddle
r
Sara
h St
echs
chul
te B
.A.^
&
Shar
on E
. Jac
ob M
.D.*
Sara
h St
echs
chul
te B
.A.^
&
Shar
on E
. Jac
ob M
.D.*
^M
SIV,
Uni
vers
ity o
f M
iam
i^
MSI
V, U
nive
rsity
of
Mia
mi
*Vol
unta
ry C
linic
al A
ssoc
iate
Pro
fess
or,
Uni
vers
ity o
f M
iam
i *V
olun
tary
Clin
ical
Ass
ocia
te P
rofe
ssor
, U
nive
rsity
of
Mia
mi
Jaco
b SE
, Ste
chsc
hulte
SA.
Co
ntac
t D
erm
atiti
s 20
08 M
ay;5
8(5)
:31
Jaco
b SE
, Ste
chsc
hulte
SA.
Co
ntac
t D
erm
atiti
s 20
08 M
ay;5
8(5)
:31 22
-- 3.3.
Wha
t is
Tos
ylam
ide/
form
alde
hyde
W
hat
is T
osyl
amid
e/fo
rmal
dehy
de
Res
in?
Res
in?
!!A
subs
tanc
e ad
ded
to n
ail v
arni
sh t
o ai
d in
A
subs
tanc
e ad
ded
to n
ail v
arni
sh t
o ai
d in
ad
hesi
on o
f va
rnis
h to
the
nai
l, w
hile
ad
hesi
on o
f va
rnis
h to
the
nai
l, w
hile
im
prov
ing
rigid
ity, s
hine
, and
flo
w o
f im
prov
ing
rigid
ity, s
hine
, and
flo
w o
f ap
plic
atio
n (1
).ap
plic
atio
n (1
).
Sign
ifica
nce
of T
SFR
Sign
ifica
nce
of T
SFR
!!Yo
uths
are
exp
erim
entin
g m
ore
with
nai
l Yo
uths
are
exp
erim
entin
g m
ore
with
nai
l co
smet
ics
at y
oung
er a
ges,
allo
win
g ea
rly
cosm
etic
s at
you
nger
age
s, a
llow
ing
early
se
nsiti
zatio
n w
ith t
he c
hem
ical
(2)
.se
nsiti
zatio
n w
ith t
he c
hem
ical
(2)
.
!!Pr
eval
ence
of
sens
itiza
tion
in y
oung
Pr
eval
ence
of
sens
itiza
tion
in y
oung
ch
ildre
n is
not
kno
wn
child
ren
is n
ot k
now
n
Case
Case
!!A
4A
4 --ye
ar o
ld b
lack
His
pani
c fe
mal
e ye
ar o
ld b
lack
His
pani
c fe
mal
e pr
esen
ted
to t
he C
onta
ct D
erm
atiti
s Cl
inic
pr
esen
ted
to t
he C
onta
ct D
erm
atiti
s Cl
inic
w
ith e
yelid
der
mat
itis
and
wor
seni
ng
with
eye
lid d
erm
atiti
s an
d w
orse
ning
at
opic
fle
xura
l der
mat
itis
atop
ic f
lexu
ral d
erm
atiti
s
!!O
lder
sis
ter
foun
d to
pai
nt c
hild
Old
er s
iste
r fo
und
to p
aint
chi
ld�� s
tod
dler
s s
todd
lers
na
ils
nails
��on
initi
al c
onsu
ltatio
n el
iciti
ng
on in
itial
con
sulta
tion
elic
iting
en
viro
nmen
tal h
isto
ryen
viro
nmen
tal h
isto
ry
Obt
ain
deta
iled
envi
ronm
enta
l his
tory
O
btai
n de
taile
d en
viro
nmen
tal h
isto
ry
!!Pe
rson
al h
ygie
ne p
rodu
cts:
sha
mpo
o, s
oaps
, Pe
rson
al h
ygie
ne p
rodu
cts:
sha
mpo
o, s
oaps
, lo
tions
, cre
ams,
dia
per
balm
s, &
dia
per
wip
es (
3).
lotio
ns, c
ream
s, d
iape
r ba
lms,
& d
iape
r w
ipes
(3)
.
!!M
edic
al &
med
icam
ent
hist
ory
(3).
Med
ical
& m
edic
amen
t hi
stor
y (3
).
!!Fa
mily
mem
ber
pers
onal
hyg
iene
pro
duct
s,
Fam
ily m
embe
r pe
rson
al h
ygie
ne p
rodu
cts,
fr
eque
nt t
oys/
play
thin
gs, h
ouse
war
es, a
nd
freq
uent
toy
s/pl
ayth
ings
, hou
sew
ares
, and
ho
useh
old
prod
ucts
(3)
.ho
useh
old
prod
ucts
(3)
.
Whi
ch c
hild
ren
shou
ld b
e pa
tch
test
ed?
Whi
ch c
hild
ren
shou
ld b
e pa
tch
test
ed?
!!Th
ose
with
unc
ontr
olla
ble
or w
orse
ning
Th
ose
with
unc
ontr
olla
ble
or w
orse
ning
ch
roni
c de
rmat
itis
of g
reat
er t
han
two
mon
ths
chro
nic
derm
atiti
s of
gre
ater
tha
n tw
o m
onth
s du
ratio
n (3
).du
ratio
n (3
).
!!Fa
ilure
to
impr
ove
follo
win
g st
anda
rd
Failu
re t
o im
prov
e fo
llow
ing
stan
dard
tr
eatm
ent
prot
ocol
s (3
).tr
eatm
ent
prot
ocol
s (3
).
!!Th
ose
with
eye
lid/h
and
invo
lvem
ent
(4).
Thos
e w
ith e
yelid
/han
d in
volv
emen
t (4
).
Whi
ch c
hem
ical
s sh
ould
we
patc
h W
hich
che
mic
als
shou
ld w
e pa
tch
test
with
?te
st w
ith?
!!Th
ose
with
hig
h cl
inic
al s
uspi
cion
(pr
ior
Thos
e w
ith h
igh
clin
ical
sus
pici
on (
prio
r ex
posu
re t
o al
lerg
en d
efin
itive
ly id
entif
ied)
expo
sure
to
alle
rgen
def
initi
vely
iden
tifie
d)
!!A
cust
omiz
ed s
et o
f al
lerg
ens
is m
ade
for
A cu
stom
ized
set
of
alle
rgen
s is
mad
e fo
r ea
ch p
atie
nt b
ased
on
the
child
each
pat
ient
bas
ed o
n th
e ch
ild�� s
exp
osur
e s
expo
sure
hi
stor
y (3
).hi
stor
y (3
).
Rel
atio
nshi
p to
the
cas
eRel
atio
nshi
p to
the
cas
e
!!Ba
sed
on t
he e
valu
atio
n an
d fa
ilure
of im
prov
emen
t Ba
sed
on t
he e
valu
atio
n an
d fa
ilure
of im
prov
emen
t du
ring
the
avoi
danc
e pe
riod,
the
chi
ld w
as p
atch
du
ring
the
avoi
danc
e pe
riod,
the
chi
ld w
as p
atch
te
sted
with
sel
ecte
d ch
emic
als
from
Um
iam
i te
sted
with
sel
ecte
d ch
emic
als
from
Um
iam
i Pe
diat
ric s
tand
ard
(3)
Pedi
atric
sta
ndar
d (3
)
!!A
clin
ical
ly r
elev
ant
patc
h te
st r
eact
ion
was
fou
nd
A cl
inic
ally
rel
evan
t pa
tch
test
rea
ctio
n w
as f
ound
to
tos
ylam
ide/
form
alde
hyde
res
in [
1+]
to t
osyl
amid
e/fo
rmal
dehy
de r
esin
[1+
]
Anal
ysis
of
resu
ltsAn
alys
is o
f re
sults
!!Th
e ch
ildTh
e ch
ild�� s
nai
ls r
egul
arly
pai
nted
by
her
olde
r si
ster
s na
ils r
egul
arly
pai
nted
by
her
olde
r si
ster
!!Th
e ch
ild u
sed
nails
to
scra
tch
her
eyel
ids
&
The
child
use
d na
ils t
o sc
ratc
h he
r ey
elid
s &
�� ato
pic
atop
ic�� a
reas
area
s
!!D
isco
ntin
ued
use
of T
SFR
prod
ucts
by
all m
embe
rs o
f th
e D
isco
ntin
ued
use
of T
SFR
prod
ucts
by
all m
embe
rs o
f th
e fa
mily
res
ulte
d in
con
side
rabl
e im
prov
emen
t of
bot
h th
e fa
mily
res
ulte
d in
con
side
rabl
e im
prov
emen
t of
bot
h th
e ch
ildch
ild�� s
eye
lids
and
s ey
elid
s an
d �� a
topi
cat
opic
�� are
as.
area
s.
Dis
cuss
ion
poin
tsD
iscu
ssio
n po
ints
!!A
stat
istic
ally
sig
nific
ant
asso
ciat
ion
betw
een
A st
atis
tical
ly s
igni
fican
t as
soci
atio
n be
twee
n TS
FR a
nd e
yelid
der
mat
itis
has
prev
ious
ly b
een
TSFR
and
eye
lid d
erm
atiti
s ha
s pr
evio
usly
bee
n re
cogn
ized
(5,
6).
reco
gniz
ed (
5,6)
.
!!Th
is c
ase
reve
als
the
impo
rtan
ce o
f co
nsid
erin
g Th
is c
ase
reve
als
the
impo
rtan
ce o
f co
nsid
erin
g TS
FR w
hen
eval
uatin
g a
todd
ler.
TSFR
whe
n ev
alua
ting
a to
ddle
r.
Conc
lusi
onCo
nclu
sion
!!W
e be
lieve
tha
t th
e pa
tient
We
belie
ve t
hat
the
patie
nt�� s
scr
atch
ing
of h
er
s sc
ratc
hing
of he
r at
opic
der
mat
itis
with
TSF
R v
arni
shed
nai
ls
atop
ic d
erm
atiti
s w
ith T
SFR v
arni
shed
nai
ls
play
ed a
rol
e in
her
rea
ctio
n to
the
che
mic
al.
play
ed a
rol
e in
her
rea
ctio
n to
the
che
mic
al.
!!W
e re
com
men
d th
at c
hild
ren
unab
le t
o W
e re
com
men
d th
at c
hild
ren
unab
le t
o ov
erco
me
the
need
to
scra
tch
shou
ld n
ot h
ave
over
com
e th
e ne
ed t
o sc
ratc
h sh
ould
not
hav
e th
eir
finge
rnai
ls v
arni
shed
.th
eir
finge
rnai
ls v
arni
shed
.
Refe
renc
esRe
fere
nces
1)O
rton
D I
, Wilk
inso
n J
D. C
osm
etic
alle
rgy:
inci
denc
e, d
iagn
osis
, an
d m
anag
emen
t. A
m J
Clin
Der
mat
ol 2
004:
5:
327�
337.
2)W
hite
I R
. Alle
rgic
con
tact
der
mat
itis.
In:
Tex
tboo
k of
Ped
iatr
ic
Der
mat
olog
y, 2
nd e
ditio
n, H
arpe
r J
I, P
rose
N S
, Ora
nje
A P
(eds
): C
ambr
idge
, Bla
ckw
ell P
ublis
hing
Inc
, 200
6.3)
Jaco
b SE
, Bur
k CJ
, Con
nelly
EA.
Pat
ch t
estin
g: a
noth
er s
tero
id-
spar
ing
agen
t to
con
side
r in
chi
ldre
n. P
edia
tr D
erm
atol
200
8 Ja
n-Fe
b; 2
5(1)
:81-
7.4)
Beat
tie P
E, G
reen
C, L
owe
G, L
ewis
-Jon
es M
S. W
hich
chi
ldre
n sh
ould
we
patc
h te
st?
Clin
Exp
Der
mat
ol 2
007:
32:
6�11
.5)
Amin
K A
, Bel
sito
D V
. The
aet
iolo
gy o
f ey
elid
der
mat
itis:
a 1
0-ye
ar r
etro
spec
tive
anal
ysis
. Co
ntac
t D
erm
atiti
s 20
06:
55:
280�
285.
6)G
uin
J D
. Ey
elid
der
mat
itis:
a r
epor
t of
215
pat
ient
s. C
onta
ct
Der
mat
itis
2004
: 50
: 87
�90.
