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Summary   Background  Isocyanates are used in polyurethane production. Dermal exposure to isocyanates can induce contact allergy. The most common isocyanate is diphenylmethane diisocyanate used for industrial purposes. The isomer diphenylmethane‐4,4′‐diisocyanate (4,4′‐ MDI ) is used in patch testing. Diphenylmethane‐4,4′‐diamine (4,4′‐ MDA ) is its corresponding amine. Concurrent reactions to 4,4′‐ MDI  and 4,4′‐ MDA  have been reported, as have concurrent reactions to 4,4′‐ MDI  and dicyclohexylmethane‐4,4′‐diisocyanate (4,4′‐ DMDI ).    Objectives  To investigate the sensitization capacities and the cross‐reactivity of 4,4′‐ MDI , 4,4′‐ MDA , 4,4′‐ DMDI , and dicyclohexylmethane‐4,4′‐diamine (4,4′‐ DMDA ).    Methods  The guinea‐pig maximization test ( GPMT ) was used.    Results  The  GPMT  showed sensitizing capacities for all investigated substances: 4,4′‐ MDI , 4,4′‐ MDA , 4,4′‐ DMDI , and 4,4′‐ DMDA  (all  p  &lt; 0.001). 4,4′‐ MDI ‐sensitized animals showed cross‐reactivity to 4,4′‐ MDA  ( p  &lt; 0.001) and 4,4′‐ DMDI  (all  p  &lt; 0.05). 4,4′‐ MDA ‐sensitized animals showed cross‐reactivity to 4,4′‐ DMDA  ( p  = 0.008).    Conclusion  All of the investigated substances were shown to be strong sensitizers. Animals sensitized to 4,4′‐ MDI  showed cross‐reactivity to 4,4′‐ MDA  and 4,4′‐ DMDI , supporting previous findings in the literature. The aromatic amine 4,4′‐ MDA  showed cross‐reactivity to the aliphatic amine 4,4′‐ DMDA .

contact dermatitis

Sensitization and cross‐reactivity patterns of contact allergy to diisocyanates and corresponding amines: investigation of diphenylmethane‐4,4′‐diisocyanate, diphenylmethane‐4,4′‐diamine, dicyclohexylmethane‐4,4′‐diisocyanate, and dicylohexylmethane‐4,4′‐diamine