ゴム皮膚炎の臨床的観察—特にゴムおよび加硫促進剤の貼布成績

CLINICAL STUDIES ON RUBBER DERMATITIS

緒言

　ゴム皮膚炎，ゴム湿疹はゴム工場で発生する職業性のものと，ゴム製品の使用によつて発生する非職業性のものとに大別される。職業性のものの発生頻度は米国では1〜3％，独では1％^1），非職業性のものはHerrman^2）によると接触皮膚炎8000例の約8％といわれている。ゴム製品に配合される無機，有機の化学物質の数は実に1000〜1500種及ぶが，ゴム皮膚炎の主な原因物質としてSchwartz et al^3）によると多数の加硫促進剤accelerators，老化防止剤antioxidantsが注目されている。ゴム製品の使用の際，上記の物質が発汗などにより溶出して刺激性またはアレルギー性の皮膚炎を発生する。ゴム製品の種類も多種多様で，衣類用ゴム（靴下，ソックス，ストッキング，靴下止め，ズボン吊り，ブラジャー，パンティ，エプロン，コルセット，ヘアーネット，ドレスシールド，汗除け），履物用ゴム（革靴，長靴，サンダル，草履，ズック），保護用ゴム（手袋，指サック，コンドーム，麻酔用マスク，防塵用マスク，毒ガス用マスク，眼鏡），その他（マットレス，カーペット，テーブルクロス，ゴムホース，クッション，ラバースポンジ，ラバーフォーム，オムツカバー，氷枕，消ゴム，玩具，ステトスコープ，雨衣，潜水服）があげられる。接着剤などを原因とするゴム皮膚炎の臨床像は複雑で診断の困難な場合も少なくない。著者は10年間に経験した職業性の4例を含む42例のゴム皮膚炎の臨床的観察とゴム製品，加硫促進剤の貼布成績ならびにゴム皮膚炎の原因としての加硫促進剤の意義について報告する。

Clinical analysis was performed in 42 cases of rubber dermatitis, which included 4 cases of an industrial dermatosis. The results were as follows ; I. Statistics.

(1) The ages of onset ranged from 2 to 74, with the highest incidence in the second decade.

(2) They were composed of 12 cases of male and 30 of female. Ratio of sex diference was 1 to 2.5, male and female respectively.

(3) There has been an increase in indidence since 1963. It was due to the wide use of rubber gloves for the protection from detergents.

(4) The condition started mainly in spring and summer, when sweating increased. The cases with a negative patch test using rubber gave a positive result with an immersion test using substances dissolved in sweat. These results suggest that sweating is an important factor to produce rubber dermatitis.

(5) Rubbers of clothes and gloves were the main causes for this dermatitis.

(6) Mast of the cases showed the acute eczematous lesions, while the nummular eczema-or lichen planus-like lesions were rare.

(7) In the accompanying dermatitis leather or sunlight was the main cause. Sometimes a detergent, metal bracelet of a watch or nylons also made associated dermatitis.

II. Clinical Laboratory Test.

(1) A patch test with some kind of rubber was positive in 31 of 39 cases. All cases with a negative patch test gave a positive result by an immersion test with the substance

(2) A patch test with 34 kinds of sulfuration activators was positive in 12 of 16 cases. Main contactants were mercaptobenzothiazole, tetramethylthiuram di-or monosulfide and diphenylguanidine.

(3) Seven cases showed polyvalent positive patch tests. Some of them were able to be regarded as a group reaction by the derivatives from one kind of sulfuration activator. But others showed positive polyvalent reactions with more than two different kinds of chemicals which were difficult to make explanation by the concept of group reaction.