Gloves

Abstract

Contact allergy to protective gloves is common, especially in occupational settings, and should be considered in all cases of patients with hand dermatitis. Gloves induce contact allergy by two mechanisms: immediate and delayed contact allergy. Immediate allergy usually manifests as contact urticaria and is mostly due to the proteins in natural rubber latex (NRL) gloves. Leather gloves are one significant cause of allergic contact dermatitis due to chromium, whereas rubber gloves induce contact allergy due to various rubber additives: thiurams, dithiocarbamates and benzothiazoles are the main sensitizers in rubber. NRL contact urticaria is diagnosed by prick testing or determination of specific IgE in the serum. The diagnosis of delayed glove allergy, however, requires patch testing. The European baseline series contains the main sensitizers. Common additional tests are using pieces of the suspected glove material and aimed testing with a rubber additive series. Plastic glove allergy is not extremely rare, and most reported cases have been due to polyvinyl chloride (PVC) gloves. The diagnosis of plastic glove allergy is difficult. Commercial patch test preparations only rarely reveal the allergen, and the diagnosis usually requires patch testing with the individual components of the gloves.