Unexpected Lessons in Dermatotoxicology: De minimis Magnesium++

May 1, 2010 | Contact Author | By: Hongbo Zhai, MD, and Howard I. Maibach, MD, University of California
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Title: Unexpected Lessons in Dermatotoxicology: De minimis Magnesium++
toxic shock syndromex
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Keywords: toxic shock syndrome

Abstract: Traditional dermatotoxicologic investigations focus on dermatitis as well as potential systemic effects but rarely have they focused on trace ions. The following lesson opens new avenues of thought and investigation for intimate care product developers, since the trace ions described may dramatically impact the end product.

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H Zhai and HI Maibach, A dermatological view—Unexpected lessons in dermatotoxicology: De minimis magnesium++, Cosm & Toil 125(5) 33-34 (May 2010)

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Traditional dermatotoxicologic investigations focus on dermatitis as well as potential systemic effects but rarely have they focused on trace ions. The following lesson opens new avenues of thought and investigation for intimate care product developers, since the trace ions described may dramatically impact the end product.

Toxic Shock Syndrome

Toxic shock syndrome (TSS), a rare but potentially fatal illness, is caused by toxins produced by bacteria and is characterized by the sudden onset of fever, chills, vomiting, diarrhea, muscle aches and rash. It can rapidly progress to severe and intractable hypotension and multisystem dysfunction. Desquamation, particularly on the palms and soles, can occur 1–2 weeks after the onset of the illness. TSS was first reported in children of both sexes in 1978 and subsequently brought to the public’s attention when it became associated with menstruating women using tampons.

In 1980, an outbreak of TSS occurred involving mostly young women who had been using one brand of superabsorbent tampons. How the tampons caused TSS is partially understood; it has been hypothesized that when a superabsorbent tampon is left in place for a prolonged period of time, the tampon becomes a bacteria breeding ground. Others have suggested that the tampon’s superabsorbent fibers can abrade the vagina surface, making it possible for bacteria or their toxins to enter the bloodstream. However, the tampon brand associated with the original TSS epidemic in the 1980s was voluntarily taken off the market by the manufacturer and afterwards, the number of TSS cases declined dramatically.

Most TSS cases are caused by the Staphylococcus aureus bacteria but can also result from toxins produced by streptococcus bacteria. While TSS often occurs in menstruating women, it can also affect men, children and postmenopausal women. In fact, one third of all cases of TSS occur in men. Other risk factors for TSS include skin wounds and surgery.

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Figure 1. Effect of concentration of magnesium ion on concentration of TSST-1

Figure 1. Effect of concentration of magnesium ion on concentration of TSST-1

Shown here is the effect of the concentration of magnesium ion on the concentration of TSST-1. The tampon fibers caused the epidemic TSS bound Mg++ and therefore strikingly increased toxin productio.n

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