Stability of thiuram disulfides in patch test preparations and formation of asymmetric disulfides.

The thiuram mix used in patch testing originally contains 4 compounds. However, chemical analysis of the test preparation revealed that several new compounds are spontaneously formed during storage. The structures of these compounds have been determined and the rate of their formation has been studied in buffer solution at pH 7.4. After a few hours, a large amount of mixed disulfides are formed in solutions originally containing only symmetric disulfides. The impact on the test result of the formation of asymmetric disulfides has been investigated by testing on thiuram-sensitive volunteers with different preparations of mixed thiuram disulfides. In our study, the formation of new asymmetric thiuram disulfides from the original symmetric thiuram disulfides in the test preparation had no influence on the result of the patch testing. However, as the chemical analysis showed that the mix composition changes during the period when the preparations are used, and differs between suppliers, the question is raised as to whether it is acceptable to use test preparations with a composition that is different from that labelled on the protocol.