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Thresholds for Contact Allergy to a Rubber Accelerator : TETD—Determined by Serial Dilution Patch Testing and a Simulated Glove-Use Model

Kursawe Larsen, Christoffer ; Johansen, Jeanne D. ; Zachariae, Claus ; Svedman, Cecilia LU ; Bergendorff, Ola LU ; Mortz, Charlotte G. and Schwensen, Jakob F.B. (2025) In Contact Dermatitis 93(2). p.138-147
Abstract

Background: Rubber accelerators found in rubber gloves may cause contact allergy and thus allergic contact dermatitis. Objectives: To investigate which doses of tetraethylthiuram disulfide (TETD) elicit allergic contact dermatitis by patch testing and in a repeated occluded application test simulating glove use. Patients and Methods: A multicentre study was conducted. Eight patients with contact allergy to TETD and eight controls comprised the study group. Doses of TETD 1% (400 μg/cm2), 0.33% (130 μg/cm2), 0.11% (44 μg/cm2), 0.037% (15 μg/cm2), 0.012% (4.9 μg/cm2), 0.0041% (1.6 μg/cm2) and pure vehicle (petrolatum) were used for the patch test. Doses of TETD 1% (39... (More)

Background: Rubber accelerators found in rubber gloves may cause contact allergy and thus allergic contact dermatitis. Objectives: To investigate which doses of tetraethylthiuram disulfide (TETD) elicit allergic contact dermatitis by patch testing and in a repeated occluded application test simulating glove use. Patients and Methods: A multicentre study was conducted. Eight patients with contact allergy to TETD and eight controls comprised the study group. Doses of TETD 1% (400 μg/cm2), 0.33% (130 μg/cm2), 0.11% (44 μg/cm2), 0.037% (15 μg/cm2), 0.012% (4.9 μg/cm2), 0.0041% (1.6 μg/cm2) and pure vehicle (petrolatum) were used for the patch test. Doses of TETD 1% (39 μg/cm2), 0.33% (13 μg/cm2), 0.11% (4.3 μg/cm2) and pure vehicle (99:1 ethanol: water) were used for the repeated occluded application test. Results: Three patients (3/8) reacted to the lowest TETD dose of 0.0041% (1.6 μg/cm2) in the patch test. All patients reacted to all doses of TETD in the repeated occluded application test, none to the vehicle. The patch test dose of TETD that elicited allergic contact dermatitis in 10% of the patients (ED10) was estimated to be 0.75 μg/cm2. Conclusion: A content of 0.75 μg/cm2 TETD in rubber gloves may elicit allergic contact dermatitis. We suggest that future studies investigating contact allergy to rubber accelerators should base their methodology on the repeated occluded application test design presented in this study. Trial Registration: ClinicalTrial.gov identifier: NCT06042309.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
allergic contact dermatitis, contact allergy, repeated occluded application test, rubber accelerator, TETD, tetraethylthiuram disulfide, ZDEC, zinc diethyldithiocarbamate
in
Contact Dermatitis
volume
93
issue
2
pages
10 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:40375756
  • scopus:105005222781
ISSN
0105-1873
DOI
10.1111/cod.14817
language
English
LU publication?
yes
id
4513bdfa-75eb-4a80-a11d-c795be9b6672
date added to LUP
2025-09-29 11:15:32
date last changed
2025-10-14 11:22:11
@article{4513bdfa-75eb-4a80-a11d-c795be9b6672,
  abstract     = {{<p>Background: Rubber accelerators found in rubber gloves may cause contact allergy and thus allergic contact dermatitis. Objectives: To investigate which doses of tetraethylthiuram disulfide (TETD) elicit allergic contact dermatitis by patch testing and in a repeated occluded application test simulating glove use. Patients and Methods: A multicentre study was conducted. Eight patients with contact allergy to TETD and eight controls comprised the study group. Doses of TETD 1% (400 μg/cm<sup>2</sup>), 0.33% (130 μg/cm<sup>2</sup>), 0.11% (44 μg/cm<sup>2</sup>), 0.037% (15 μg/cm<sup>2</sup>), 0.012% (4.9 μg/cm<sup>2</sup>), 0.0041% (1.6 μg/cm<sup>2</sup>) and pure vehicle (petrolatum) were used for the patch test. Doses of TETD 1% (39 μg/cm<sup>2</sup>), 0.33% (13 μg/cm<sup>2</sup>), 0.11% (4.3 μg/cm<sup>2</sup>) and pure vehicle (99:1 ethanol: water) were used for the repeated occluded application test. Results: Three patients (3/8) reacted to the lowest TETD dose of 0.0041% (1.6 μg/cm<sup>2</sup>) in the patch test. All patients reacted to all doses of TETD in the repeated occluded application test, none to the vehicle. The patch test dose of TETD that elicited allergic contact dermatitis in 10% of the patients (ED<sub>10</sub>) was estimated to be 0.75 μg/cm<sup>2</sup>. Conclusion: A content of 0.75 μg/cm<sup>2</sup> TETD in rubber gloves may elicit allergic contact dermatitis. We suggest that future studies investigating contact allergy to rubber accelerators should base their methodology on the repeated occluded application test design presented in this study. Trial Registration: ClinicalTrial.gov identifier: NCT06042309.</p>}},
  author       = {{Kursawe Larsen, Christoffer and Johansen, Jeanne D. and Zachariae, Claus and Svedman, Cecilia and Bergendorff, Ola and Mortz, Charlotte G. and Schwensen, Jakob F.B.}},
  issn         = {{0105-1873}},
  keywords     = {{allergic contact dermatitis; contact allergy; repeated occluded application test; rubber accelerator; TETD; tetraethylthiuram disulfide; ZDEC; zinc diethyldithiocarbamate}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{138--147}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Contact Dermatitis}},
  title        = {{Thresholds for Contact Allergy to a Rubber Accelerator : TETD—Determined by Serial Dilution Patch Testing and a Simulated Glove-Use Model}},
  url          = {{http://dx.doi.org/10.1111/cod.14817}},
  doi          = {{10.1111/cod.14817}},
  volume       = {{93}},
  year         = {{2025}},
}