Allergic Contact Dermatitis of Styrenic Thermoplastic Elastomers and Latex Sheets in Humans

Main Article Content

Kallaya Yanpiset
Poohglin Tresukosol
Rosalarin Santhawachart
Jeeraphat Jantarat
Supatchai Sutimuntanakul
Choltacha Harnirattisai
Theeralaksna Suddhasthira
Anon Chaisuriyathepkul


Objective: to compare the incidence of allergic contact dermatitis between styrenic thermoplastic elastomers (S-TPEs) and latex sheets in patients scheduled for endodontic treatment by patch testing.

Material and method: A total of 100 subjects were tested with the substances in S-TPEs group (S-TPEs sheet, Styrene isoprene styrene-SIS, Styrene butylene styrene-SBS, dye powder) and latex group (latex sheet, thiuram-mix, mercapto-mix, mercaptobenzothiazole, zinc diethyldithiocarbamate-ZDEC, zinc dibutyldithiocarbamate-ZDBC). The reactions were evaluated at 48 and 96 hours after application of the test materials to the skin of the upper arm.

Results: For the S-TPEs group, none of the subjects showed positive allergic reactions to S-TPEs sheet and its compositions at 48 and 96 hours. For the latex group, seven subjects (7%) had positive allergic reactions to latex sheet at 48 hours, and one (1%) at 96 hours. One subject (1%) showed reactions to thiuram-mix, mercapto-mix, and mercaptobenzothiazole at 48 and 96 hours, one subject (1%) reacted to thiuram-mix, and one subject (1%) reacted to ZDEC at 96 hours. Upon comparison between positive allergic reactions of S-TPEs and latex sheets, a significant difference was demonstrated at 48 hours (p<0.05), but not at 96 hours.

Conclusion: S-TPEs sheet did not cause allergic contact dermatitis, while latex sheet did in a number of subjects. 


Download data is not yet available.

Article Details

How to Cite
Yanpiset K, Tresukosol P, Santhawachart R, Jantarat J, Sutimuntanakul S, Harnirattisai C, Suddhasthira T, Chaisuriyathepkul A. Allergic Contact Dermatitis of Styrenic Thermoplastic Elastomers and Latex Sheets in Humans. M Dent J [Internet]. 2016 Dec. 22 [cited 2023 Dec. 8];37(1):47-63. Available from:
Original articles


1. Rietschel RL, Fowler JF. Rubber. In: Rietschel RL, Fowler JF. Rubber editors. Fisher’s Contact Dermatitis, 6th ed. Ontario: BC Decker; 2008. p. 581-604.
2. Scott G. Isolation. In: Walton E, Torabinejad M editors. Principles and Practice of Endodontics, 3rd ed. Pennsylvania: WS Sauders; 2002. p. 118-29.
3. Bhuva B, Chong BS, Patel S. Rubber dam in clinical practice. Endodontic Practice Today. 2008; 2(2): 131-41.
4. Svee TA, Powers J, Ladd G, Meyer. Tensile and tear properties of dental dam. Journal of Endodontics. 1996; 22(5): 253-6.
5. Taylor JS, Erkek E. Latex allergy: diagnosis and management. Dermatologic Therapy 2004; 17(4):289- 301.
6. Sussman G, Gold M. Guidelines for the Management of Latex Allergies and Safe Latex Use in Health Care Facilities [document on internet]. American college of Allergy, Asthma & Immunology (ACAAI).1996 [cited 2016-Jan-28]. Available from: http://
7. Kahn SL, Podjasek JO, Dimitropoulos VA, Brown CW Jr. Nature rubber latex allergy. Disease-a-Month. 2016; 62(1):5-17.
8. Syed M, Chopra R, Sachdev V. Allergic reaction to dental materials- a systemic review. J Clin Diagn Res. 2015; 9(10):4-9.
9. Turjanmaa K. Incidence of immediate allergy to latex gloves in hospital personnel. Contact Dermatitis. 1987; 17(5): 270-5.
10. Heese A, Peters KP, Koch HU. Type I allergies to latex and the aeroallergic problem. European Journal of Surgery .1997; (579): 19-22.
11. Valks R, Conde-Salazar L, Cuevas M. Allergic contact urticaria from natural rubber latex in healthcare and non-healthcare workers. Contact Dermatitis.2004; 50(4): 222-4.
12. Boonchai W, Sirikudta W, Iamtharachai P, Kasemsarn P. Latex glove-related symptoms among health care workers: a self-report questionnaire-based survey. Dermatitis. 2014; 25(3):135-9.
13. Grieco T, Faina V, Dies L, Milana M, Silvestri E, Calvieri S. Latex sensitization in elderly: allergological study and diagnostic protocol. Immunity&Ageing 2014; 11(1): 7.
14. Wilkinson SM, Beck MH. Allergic contact dermatitis from latex rubber. British Journal of Dermatology .1996; 134(1): 910-4.
15. De Groot H, de Jong NW, Duijster E et al. Prevalence of natural rubber latex allergy (type I and type IV) in laboratory workers in The Netherlands. Contact Dermatitis. 1998; 38(3): 159-63.
16. Gottlober P, Gall H, Peter RU. Allergic contact dermatitis from natural latex. American Journal of Contact Dermatitis. 2001; 12(3): 135-8.
17. Sommer S, Wilkinson SM, Beck MH, English JS, Gawkrodger DJ, Green C. Type IV hypersensitivity reactions to natural rubber latex: results of a multicentre study. British Journal of Dermatology. 2002; 146(1): 114-7.
18. Pontén A, Dubnika I. Delayed reactions to reusable protective gloves. Contact Dermatitis. 2009; 60(4): 227-9.
19. Bergendroff O, Presson C, Hansson C. Extraction of haptens from solid products and their delivery to the skin, exemplified by dithiocarbamates from rubber glove. Contact Dermatitis. 2005; 53(1): 22-6.
20. Bergendroff O, Presson C, Hansson C. High-performance liquid chromatography analysis of rubber allergens in protective gloves used in healthcare. Contact Dermatitis. 2006; 55(4): 210-5.
21. Bergendroff O, Presson C, Ludtke A, Hansson C. Chemical changes in rubber allergens vulcanization. Contact Dermatitis. 2007; 57(3): 152-7.
22. Pontén A, Hamnerius N, Bruze M et al. Occupational allergic contact dermatitis caused by sterile non-latex protective gloves: clinical investigation and chemical analyses. Contact Dermatitis. 2013; 68(2):103-10.
23. Blinkhorn AS, Leggate EM. An allergic reaction to rubber dam. British Dental Journal. 1984; 156(11): 402-3.
24. Field EA, Longman LP, al-Sharkawi M, King CM. An immediate (type I) hypersensitivity reaction placement of a dental rubber dam. European Journal of Prosthodontics and Restorative Dentistry. 1997; 5(2): 75-8.
25. Kleier DJ, Shibilski K. Management of the latex hypersensitive patient in the endodontic office. Journal of Endodontics. 1999; 25(12): 825-8.
26. De Andrade ED, Ranali J, Volpato MC, de Oliveira MM. Allergic reaction after rubber dam placement. Journal of Endodontics. 2000; 26(3): 182-3.
27. Warshaw EM. Latex allergy. Journal of the American Academy Dermatology. 1998; 39(1): 98-106.
28. Sunay H, Tanalp J, Güler N, Bayirli G. Delayed type allergic reaction following the use of nonlatex rubber dam endodontic treatment. International of Endodontics Journal. 2006; 39(7): 576-80.
29. Baeck M, Cawet B, Tennstedt D, Goossens A. Allergic contact dermatitis caused by latex (natural rubber)-free gloves in healthcare workers. Contact Dermatitis. 2013; 68(1):54-5.
30. Holden G, Legge N, Quirk R, Schrieder H, editors. Thermoplastic Elastomers, 2nd ed. Ohio: Hanser/Gardner; 1996.p. 1-13, 48-71.
31. Seadan M. Thermoplastic Elastomers. In: the rubber international magazine 2004: 29-33.
32. Pravewongvout N. Tensile and tear properties of styrenic thermoplastic elastomer rubber dam sheet. Diploma [Dissertation]. Bangkok: Mahidol University; 2007.
33. Calvert KC. Latex dipping. In: Polymer Latices and their application. New York: Macmillan Inc.; 1982. p.174-205.
34. Styrene-butadiene and styrene-isoprene block copolymers (SBR).Encyclopaedia Britannica [document on internet]. Encyclopaedia Britannica Inc; 1997. [cited 2015 May 1]. Available from: URL:
35. Styrene-isoprene-styrene. Encyclopaedia Britannica [document on internet]. Encyclopaedia Britannica Inc; 1997. [cited 2015 May 1]. Available from: URL:
36. Reid J, Callis P, Patterson C editors. Rubber dam in clinical. London: Quintessence Publishing; 1991. p. 14-18.
37. Miri S, Pourpak Z, Zarinara A, et al. Prevalence of type I allergy to natural rubber latex and type IV allergy to latex and rubber additives in operating room staff with glove-related symptoms. Allergy Asthma Proceeding 2008; 29(2): 224.