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Isaksson M, Hagvall L, Glas B, Lagrelius M, Lidén C, Matura M, Nyman G, Stenberg B, Svedman C, Bruze M. Suitable test concentration of cobalt and concomitant reactivity to nickel and chromium: A multicentre study from the Swedish Contact Dermatitis Research Group. Contact Dermatitis 2020; 84:153-158. [PMID: 32996589 DOI: 10.1111/cod.13710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/17/2020] [Accepted: 09/27/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND In Sweden, cobalt chloride 0.5% has been included in the baseline series since the mid-1980s. A recent study from Stockholm showed that cobalt chloride 1% petrolatum (pet.) was more suitable than 0.5%. Cobalt chloride at 1.0% has been patch tested for decades in many European countries and around the world. OBJECTIVES To study the suitability of patch testing to cobalt 1.0% vs 0.5% and to analyze the co-occurrence of allergy to cobalt, chromium, and nickel. RESULTS Contact allergy to cobalt was shown in 90 patients (6.6%). Eighty (5.9%) patients tested positive to cobalt 1.0%. Thirty-seven of the 90 patients (41.1%) with cobalt allergy were missed by cobalt 0.5% and 10 (0.7%) were missed by cobalt 1.0% (P < .001). No case of patch test sensitization was reported. Allergy to chromium was seen in 2.6% and allergy to nickel in 13.3%. Solitary allergy to cobalt without nickel allergy was shown in 61.1% of cobalt-positive individuals. Female patients had larger proportions of positive reactions to cobalt (P = .036) and nickel (P < .001) than males. CONCLUSION The results speak in favor of replacing cobalt chloride 0.5% with cobalt chloride 1.0% pet. in the Swedish baseline series, which will be done 2021.
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Affiliation(s)
- Marléne Isaksson
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Lina Hagvall
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Bo Glas
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | - Maria Lagrelius
- Institute of Environmental Medicine, Karolinska Institutet and Centre for Occupational and Environmental Medicine, Stockholm, Sweden
| | - Carola Lidén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mihaly Matura
- Institute of Environmental Medicine, Karolinska Institutet and Centre for Occupational and Environmental Medicine, Stockholm, Sweden.,Department of Dermatology, Skaraborg's Hospital, Skövde, Sweden
| | - Gunnar Nyman
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Berndt Stenberg
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | - Cecilia Svedman
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
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