title: Triphenylguanidine, a new (old?) rubber accelerator detected in surgical gloves that may cause allergic contact dermatitis.
abstract: BACKGROUND
  Rubber accelerators are common contact allergens in healthcare personnel, owing to exposures from medical gloves.
  
  
  OBJECTIVE
  To analyse glove extracts used for patch testing for the presence of guanidine-type accelerators, and to describe the results of patch testing with triphenylguanidine (TPG) in 2 cases of contact allergy and with TPG added to the rubber series.
  
  
  METHODS
  Gas chromatography-mass spectrometry and liquid chromatography with ultraviolet detection were used for analysis of glove extracts. Patch tests were performed with guanidine accelerators detected in the extracts.
  
  
  RESULTS
  TPG, an accelerator not previously reported as being present in rubber gloves, was found in the glove extracts. Patch testing with TPG showed relevant contact allergic reactions in patients with hand dermatitis caused by rubber gloves.
  
  
  CONCLUSIONS
  Chemical analysis of extracts for patch testing is important in the identification of new possible allergens. In this case, a rubber accelerator previously not reported as a possible contact allergen was found in extracts of surgical gloves.
authors.affiliation: Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, S-205 02, Malmö, Sweden.
authors.forename: Jakob
authors.initials: J
authors.lastname: Dahlin
authors.forename: Ola
authors.initials: O
authors.lastname: Bergendorff
authors.forename: Hilde K
authors.initials: HK
authors.lastname: Vindenes
authors.forename: Monica
authors.initials: M
authors.lastname: Hindsén
authors.forename: Cecilia
authors.initials: C
authors.lastname: Svedman
mesh_terms: D000328:Adult; D002853:Chromatography, Liquid; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D005932:Gloves, Surgical / Q000009:adverse effects*; D006146:Guanidines / Q000009:adverse effects* / Q000032:analysis; D006229:Hand Dermatoses / Q000139:chemically induced* / Q000175:diagnosis; D006282:Health Personnel; D006801:Humans; D008875:Middle Aged; D010328:Patch Tests; D012408:Rubber / Q000009:adverse effects / Q000737:chemistry
chemical_list: D006146:Guanidines; D012408:Rubber
keywords: GC-MS; accelerator; allergic contact dermatitis; diphenylguanidine; glove; rubber; triphenylguanidine