Two sensitizing oxidation products of p-phenylenediamine patch tested in patients allergic to p-phenylenediamine.

Background: The results from a previous study indicated the presence of several possible sensitizers formed during oxidation of the potent sensitizer p-phenylenediamine (PPD) to which PPD-sensitized patients might react, in various patterns.

Objectives: To extract and analyse a yellow spot from a thin-layer chromatogram with oxidized PPD, to which 6 of 14 (43%) PPD-positive patients had reacted in a previous study, in order to identify potential sensitizer(s) and to patch test this/these substance(s) in the 14 PPD-positive patients.

Methods: The yellow spot was extracted from a thin-layer chromatogram of oxidized PPD, and two substances, suspected to be allergens, were identified by analysis with gas chromatography mass spectrometry (GCMS). The 14 PPD-positive patients, who had been previously tested with the thin-layer chromatogram of oxidized PPD, participated in the investigation, and were tested with dilutions of the two substances.

Results: GCMS analysis identified 4-nitroaniline and 4,4'-azodianiline in the yellow spot. Of the 14 PPD-positive test patients, 5 (36%) reacted to 4-nitroaniline and 9 (64%) reacted to 4,4'-azodianiline.

Conclusion: The results show that 4-nitroaniline and 4,4'-azodianiline, formed during oxidation of PPD, are potent sensitizers. PPD-sensitized patients react to a high extent to concentrations equimolar to PPD of 4-nitroaniline and 4,4'-azodianiline.