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Newton J, Ogunremi O, Paulsen RT, Lien M, Sievers M, Greenway Bietz M. A cross-sectional review of contact allergens in popular self-tanning products. Int J Womens Dermatol 2024; 10:e134. [PMID: 38332994 PMCID: PMC10852387 DOI: 10.1097/jw9.0000000000000134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/17/2023] [Indexed: 02/10/2024] Open
Abstract
Background In recent years, self-tanners have become a well-liked alternative to sun tanning and tanning bed usage, as strikingly similar results can be achieved without the harmful side effects of ultraviolet exposure. Objective The aim of this study is to investigate the presence and prevalence of potential allergens in the most popular self-tanning products. Methods Five major retailers in the United States were evaluated, from which 17 different brands and 44 unique self-tanning products were analyzed. The ingredients in each self-tanning product were compared with 80 and 36 notable contact allergens taken from the North American Contact Dermatitis Group and Food and Drug Administration-approved T.R.U.E (Thin-Layer Rapid Use Epicutaneous Patch Test), respectively. Results We found that contact allergens are frequently present in self-tanning products; allergens especially common are propylene glycol, linalool, polysorbate, d-limonene, benzyl alcohol, tocopherol (vitamin E), fragrances, and other scented botanicals. On average, each self-tanner we analyzed contained 11.86 allergens. Limitations The limitation is that commercial names could not be eliminated from the analysis, introducing potential bias. Conclusion While self-tanning products are a safer alternative to tanning bed use or sunbathing, consumers and clinicians alike must be aware that they may cause an allergic reaction of the skin for some users.
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Affiliation(s)
- Jazmin Newton
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
| | - Oluwafunke Ogunremi
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
| | - Riley T. Paulsen
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
| | - Molly Lien
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
| | - Meaghan Sievers
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
| | - Mandi Greenway Bietz
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
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2
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Huang C, Chiang SYV, Gawkrodger DJ. The contribution of metal allergy to the failure of metal alloy implants, with special reference to titanium: Current knowledge and controversies. Contact Dermatitis 2024; 90:201-210. [PMID: 38148670 DOI: 10.1111/cod.14481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 12/28/2023]
Abstract
After almost three-quarters of a century during which contact dermatologists have often struggled to comprehend the relationship between metal allergy and failure of metal-alloy containing implant, it is possible to say that a relationship does exist, particularly for cobalt and chromium, but also for nickel. There is still debate as to whether allergy develops as a consequent of failure but thenceforth contributes to it, or whether sensitisation starts first and induces failure secondarily-opinion probably favours the first. Metal-on-polypropylene articulations were associated with few metal allergic problems but now are less favoured by orthopaedists due to plastic wear products causing osteolysis and pseudotumour formation through local inflammation. New metal alloys are regularly being introduced such that interested dermatologists need to stay on top of the situation. The jury is still out as to whether the recent favouring of titanium-containing alloys will confirm them to be more inert allergenically. Case reports do show some clinical reactions to titanium-containing implants and patch test series have inferred sometimes quite a high background rate of allergy, but interpretation must be tempered by the awareness that titanium salts on patch testing have a tendency to cause irritant reactions. Blood monitoring of metal ion values is now recommended in certain situations after joint replacement and increasing levels may be an indication that allergy with joint failure can develop, in which case patch testing is indicated, and suggested series are available. Predictive patch testing, whilst generally not recommended in the past, has been introduced into some protocols often by non-dermatologists, such that it is now needed for temporo-mandibular joint and Nuss bar insertion, and it can be anticipated that this may become more commonplace in the future. One of the major current deficits for patch testers is standardised guidance on which preparation or preparations to use for suspected titanium allergy. One suggestion is 0.5% titanium sulphate in petrolatum, though experience in at least one centre suggests the use of a battery of titanium salts might be desirable.
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Affiliation(s)
- Chenghao Huang
- Calderdale Royal Hospital, Calderdale and Huddersfield NHS Foundation Trust, Halifax, UK
| | - Shu Yu Vanessa Chiang
- Calderdale Royal Hospital, Calderdale and Huddersfield NHS Foundation Trust, Halifax, UK
| | - David J Gawkrodger
- Department of Dermatology, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK
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Hon KL, Leung AKC, Cheng JWCH, Luk DCK, Leung ASY, Koh MJA. Allergic Contact Dermatitis in Pediatric Practice. Curr Pediatr Rev 2024; 20:478-488. [PMID: 37365784 DOI: 10.2174/1573396320666230626122135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/10/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) is prevalent among pediatric population, adolescent and young adults. Patients with ACD experience a lot of sociopsychological and qualityof- life (QoL) difficulties. Children and their caregivers alike are vulnerable to the burden of ACD. OBJECTIVES We have, in this paper, provided an overview of ACD and discussed common and unusual causes of ACD. METHODS We performed an up-to-date literature review in the English language on "allergic contact dermatitis" via PubMed Clinical Queries, using the keywords "allergic contact dermatitis" in August 2022. The search included meta-analyses, randomized controlled trials, clinical trials, casecontrol studies, cohort studies, observational studies, clinical guidelines, case series, case reports, and reviews. The search was restricted to English literature and children. RESULTS ACD may be acute or chronic and it affects more than 20% of children and adults with significant quality-of-life impairments. ACD is manifested by varying degrees of cutaneous edema, vesiculation, and erythema. The hypersensitivity reaction is one of the most prevalent forms of immunotoxicity in humans. Localized acute ACD lesions can be managed with high-potency topical steroids; if ACD is severe or extensive, systemic corticosteroid therapy is often required to provide relief within 24 hours. In patients with more severe dermatitis, oral prednisone should be tapered over 2-3 weeks. Rapid discontinuation of corticosteroids can result in rebound dermatitis. Patch testing should be performed if treatment fails and the specific allergen or diagnosis remains unknown. CONCLUSION ACD is common and can be a physically, psychologically, and economically burdensome disease. Diagnosis of ACD is primarily based on history (exposure to an allergen) and physical examination (morphology and location of the eruption). Skin patch test can help determine the causative allergen. Allergen avoidance is the cornerstone of management. Topical mid- or highpotency corticosteroids are the mainstay of treatment for lesions on less than 20% of the body area. Severe cases of ACD may require treatment with systemic corticosteroids.
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Affiliation(s)
- Kam Lun Hon
- Department of Paediatrics, CUHKMC, The Chinese University of Hong Kong, Hong Kong, China
| | - Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - James W C H Cheng
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Kwun Tong, Hong Kong, China
| | - David C K Luk
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Kwun Tong, Hong Kong, China
| | - Agnes S Y Leung
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Mark J A Koh
- Department of Dermatology, KK Women's and Children's Hospital, Bukit Timah Road, Singapore
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Bangalore-Kumar A, Jin MF, Kunkel H, Sathe N, Hall MR, Drage LA, Youssef M, Yang YW, Yiannias JA, Killian J, Davis MDP. Results of Patch Testing to Botanicals: Review of the Mayo Clinic Experience Over 2 Decades (1997-2017). Dermatitis 2024; 35:43-48. [PMID: 38011689 DOI: 10.1089/derm.2023.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background: Botanicals are increasingly incorporated into skincare products. Although allergic contact dermatitis due to botanicals is recognized, data describing the prevalence of positive patch tests to botanicals are sparse. Objective: To report the Mayo Clinic experience of patch testing to selected botanical products in the standard, extended standard, fragrance, and plant series. Methods: IRB-approved retrospective study of the Mayo Clinic experience with patch testing to botanicals from 1997 to 2017. Results: In total, 12,169 people were patch tested to botanicals in the standard, extended standard, fragrance, and plant series; 4032 were men and 8137 were women. The mean age of the population tested was 54 (standard deviation 17.7) years. Almost 11% (1320/12,169) of the patch-tested population exhibited positive reactions to at least 1 botanical agent. Myroxylon pereirae resin 25% was the most common positive allergen in the series. Patients who had positive reactions to at least 1 botanical agent were more (19.8%) likely to have a positive reaction to at least 1 additional botanical than those patients who did not have any positive tests. Most patients presented with generalized involvement (334) or involvement of the hands (284) or face (232). Conclusion: Physicians should be aware of the high prevalence of allergic contact dermatitis and patch test positivity associated with botanical products.
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Affiliation(s)
| | - Mauricio F Jin
- Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Hilary Kunkel
- From the Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Nishad Sathe
- Departments of Internal Medicine and Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Matthew R Hall
- Department of Dermatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Lisa A Drage
- From the Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Molly Youssef
- From the Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Yul W Yang
- Department of Dermatology, Mayo Clinic, Scottsdale, Arizona, USA
| | - James A Yiannias
- Department of Dermatology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Jill Killian
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark D P Davis
- From the Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
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de Oliveira MJS, Bezerra MVF, Loiola RA, de Lima GS, da Rocha GHO, de Oliveira RTD, Barioni ÉD. Effects of slime toy poisoning in children and teenagers. REVISTA PAULISTA DE PEDIATRIA 2023; 41:e2021357. [DOI: 10.1590/1984-0462/2023/41/2021357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/29/2022] [Indexed: 11/16/2022]
Abstract
Abstract Objective: The aim of this study was to identify which types of skin reactions are associated with slime toys and which of their ingredients are most frequently involved in cases of poisoning. Data source: Between January and July 2021, articles were selected using PubMed, SciELO, and LILACS databases. The following descriptors were used: (dermatitis OR rash OR eczema OR inflammation) AND slime. Inclusion criteria were articles available in full, in either Portuguese, English, or Spanish, published between January 2000 and July 31, 2021, and articles reporting cases of contact dermatitis or eczema potentially or directly attributed to slime toys. Articles not meeting these criteria and duplicate texts in the databases were excluded. Data synthesis: In total, 65 publications were identified, of which 16 were included in this review. This resulted in a total of 22 children (2 males, 20 females), aged between 4 and 13 years, who were reportedly intoxicated by slime toys, most of these being linked to homemade preparations. Studies reported the occurrence of contact or allergic dermatitis on hands, fingers, nails, forearms, and cheeks. The most allergenic and/or irritant ingredients included liquid detergent and soap. Additionally, patch tests identified positive reactions to methylisothiazolinone and methylchloroisothiazolinone, the preservatives used by chemical industries on preparation of glue, soap, detergents, etc. Conclusions: Although slime toys might be important for improving motor development and parental relationships, homemade slime toy recipes include several allergenic and irritant ingredients which might be exposed to vulnerable children and cause intoxications. Therefore, homemade slime toys preparations should be used cautiously and under the supervision of adults.
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Metal Allergy: State-of-the-Art Mechanisms, Biomarkers, Hypersensitivity to Implants. J Clin Med 2022; 11:jcm11236971. [PMID: 36498546 PMCID: PMC9739320 DOI: 10.3390/jcm11236971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Metal allergy is mainly an environmental disorder which can cause allergic contact dermatitis. Environmental metal exposures include jewelry, everyday metal items, mobile phones, leather, metal-rich food and implants, including stents or anchors. While consumer exposure is liable for the majority of metal hypersensitivity cases, the significance of occupational exposure to metals remains relevant. Although the most common metal allergens are nickel, chromium, and cobalt; however, lately, gold, palladium, titanium, and some others have also attracted attention. This review highlights advances in metal allergy mechanisms, biomarkers for potential patients' stratification as well as biological treatments. The most recent evidence of human exposure to metal for risk assessment is discussed, as well as the relationship between the occurrence of metal hypersensitivity and implanted devices, including non-characteristic symptoms. The latest data on the diagnosis of metal hypersensitivity are also reported.
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Fonacier L, Frankel D, Mawhirt S. Contact allergens for the allergist. Ann Allergy Asthma Immunol 2022; 128:629-644. [PMID: 35346877 DOI: 10.1016/j.anai.2022.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The objective of this article is to provide an overview and describe typically encountered skin contact allergens implicated in allergic contact dermatitis (ACD). DATA SOURCES Published literature obtained through textbooks, online PubMed, and Google Scholar database searches, author photography, and adapted figures were used. STUDY SELECTIONS Studies on the evaluation of ACD and specific skin contact allergens were selected, with a focus on original research articles and clinical reviews. RESULTS Major classifications of common contact allergens include the following: (1) fragrances, (2) preservatives, (3) excipients, (4) rubber chemicals, (5) textile dyes, (6) topical medications, and (6) metals and other biomedical device components. The dermatitis distribution can aid in identifying the suspected contact allergen culprit. Certain contact allergens have features that are important to consider in the patch testing (PT) interpretation; these include possible irritant reactions, false-negative reactions or missed detection, and delayed reactions. Fragrances, preservatives, and excipients are culprits in personal products and facial or neck dermatitis. Patch testing with fragrances, preservatives, and patient-supplied products requires careful interpretation. Hand or foot dermatitis may be attributed to rubber chemicals or textile dyes. The management of topical corticosteroid contact allergy is guided on the basis of structural group classifications. Metal sensitization has been associated with dermatitis or biomedical device complications. CONCLUSION Each skin contact allergen has unique characteristics with regard to the dermatitis clinical presentation and potential PT nuances. These features are critical to recognize in the evaluation of ACD and PT interpretation and clinical relevance, leading to an accurate diagnosis.
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Affiliation(s)
- Luz Fonacier
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, New York University Langone Hospital-Long Island, Mineola, New York; New York University Long Island School of Medicine, Mineola, New York.
| | - David Frankel
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, New York University Langone Hospital-Long Island, Mineola, New York
| | - Stephanie Mawhirt
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, New York University Langone Hospital-Long Island, Mineola, New York; New York University Long Island School of Medicine, Mineola, New York
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Effects of Fisetin on Allergic Contact Dermatitis via Regulating the Balance of Th17/Treg in Mice. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9222541. [PMID: 35437448 PMCID: PMC9013294 DOI: 10.1155/2022/9222541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/16/2022] [Accepted: 03/21/2022] [Indexed: 11/18/2022]
Abstract
Background. Allergic contact dermatitis (ACD) is a form of chronic cutaneous inflammatory disease of immunological origin that has adverse impacts on patient quality of life, underscoring the need for the development of safe and effective therapeutic agents to treat affected individuals. Fisetin is a Chinese herbal preparation that reportedly exhibits antitumor, antioxidant, antimicrobial, anticoagulatory, and antimalarial activity. In the current report, the immunomodulatory activity of fisetin was appraised by assessing its impact on balance between regulatory T (Treg) and Th17 cells in an ACD model. Methods. BALB/c mice (
) were randomized into control, ACD model, CTX positive control (20 mg/kg), and fisetin treatment groups (three dose levels: 2, 4, or 8 mg/kg). ACD induction was achieved by sensitizing mice on the shaved ventral abdomen via the application of 5% DNFB (50 μL) on days 1 and 2, followed by rechallenge in the right ear with 5% DNFB (20 μL) on day 5. Beginning on day 1, immunized mice were intraperitoneally injected with the appropriate fisetin dose (in saline) once per day for 7 days. On day 7, ear swelling, transcription factor expression, Th17/Treg cell populations, and cytokine production were assessed in vivo. Results. Fisetin treatment significantly suppressed ear swelling and associated inflammatory cell infiltration, besides reducing the production of Th17 cytokines (IL-17, TNF-α, and IL-6) and the expression of the Th17 lineage transcription factor RORγt while simultaneously enhancing Treg-specific cytokine production (TGF-β and IL-10) and the expression of the Treg lineage transcription factor Foxp3, thereby restoring the Th17/Treg cell in ACD mice. Conclusions. These data indicate that fisetin exhibits immunomodulatory activity and can alter the Th17/Treg cell balance, highlighting its potential value as a treatment drug for ACD.
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Patch testing: Uses, systems, risks/benefits, and its role in managing the patient with contact dermatitis. Clin Dermatol 2021; 39:580-590. [PMID: 34809764 DOI: 10.1016/j.clindermatol.2021.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Patch testing is the gold standard diagnostic tool for cell-mediated type IV hypersensitivity reactions like allergic contact dermatitis. Sensitized individuals have primed antigen-specific T lymphocytes that cause a reaction when antigens are applied to the skin owing to prior sensitization. Patch testing can be used in the adult and pediatric populations, but it is contraindicated in patients with a known history of severe allergic reactions to suspected allergens, generalized active dermatitis, or extensive eczema. Patch test systems can be a comprehensive panel (70-80 allergens), but they can also be targeted and limited to a more common allergen series (35 allergens). The decision for allergen selection should be based on an accurate patient history, physical examination, and availability of allergens. Measurement and interpretation of the test results requires training and experience, as well as consideration of relevance and clinical history. Patch testing is generally considered safe with just a few known complications: excited skin syndrome, active sensitization, and rarely anaphylaxis or other cutaneous complications. Appropriately pretesting patient education can help to mitigate some of these complications. Based on patch testing results, patients should be educated regarding proper allergen avoidance measures to resolve symptoms of allergic contact dermatitis.
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Li H, Lim E, Ang G, Lim ZQ, Cai MH, Loh JA, Ng C, Seetoh P, Tian E, Goh LB. Qualitative and quantitative analysis of Arnebiae Radix and Dictamni Cortex and efficacy study of herbal extracts on allergic contact dermatitis using 3D human reconstructed epidermis. CHINESE HERBAL MEDICINES 2021; 13:556-564. [PMID: 36119360 PMCID: PMC9476703 DOI: 10.1016/j.chmed.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/21/2021] [Accepted: 09/05/2021] [Indexed: 12/02/2022] Open
Abstract
Objective To evaluate the quality of Arnebiae Radix (AR) and Dictamni Cortex (DC) and study the efficacy of herbal extracts of these two herbs on the treatment of allergic contact dermatitis (ACD). Methods Qualitative and quantitative analysis of effective components was performed using High Performance Thin Layer Chromatography (HPTLC), High Performance Liquid Chromatography (HPLC), and HPLC-Quadrupole Time of Flight-Mass Spectrometry (HPLC-QTOF-MS). In vitro allergic ACD 3D model was established by incubating 3D reconstructed human epidermis (RHE) with skin sensitizer, potassium dichromate. A total of 65 gene expression that were associated with ACD, which included 24 antioxidant responsive element (ARE) and 41 SENS-IS genes were quantified by qRT-PCR. More than or equal to 10 ARE genes and 18 SENN-IS genes were induced by 1.3-fold, demonstrating the successful establishment of in vitro ACD model. Oil extracts of AR and DC were applied on the in vitro ACD model to study the efficacy. Results Batch 3 of AR and batch 2 of DC showed presence of all active ingredients with the highest concentrations. Active ingredients of the herbs were extracted using a special oil and formulated into herbal oil extracts. The herbal oil extracts were able to down regulate the induced genes in the in-vitro ACD skin model, bringing the tissue back to homeostatic status. Conclusion The oil extracts showed the potent efficacy of using AR and DC in ACD treatment. The combination study will be done to optimize the formulation ratio which will be developed into a topical cream.
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Readability, Quality, and Timeliness of Patient Online Health Resources for Contact Dermatitis and Patch Testing. Dermatitis 2021; 33:155-160. [PMID: 34570732 DOI: 10.1097/der.0000000000000789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Contact dermatitis (CD) causes significant impact on patient quality of life. It is the most common occupational skin disease, accounting for more than US $1 billion of medical costs. Patch testing (PT) is the criterion standard for diagnosis of allergic CD. Patients are increasingly using the Internet to obtain health information; however, the readability, quality, and timeliness of online health resources for CD and PT are unknown. OBJECTIVE The objective was to determine the readability, quality, and timeliness of the most frequently accessed patient online health resources for CD and PT. METHODS A Google search was performed on March 20, 2021, using the terms "contact dermatitis," "contact eczema," "patch testing," and "patch test." Websites were evaluated using several well-validated tools/criteria. RESULTS Contact dermatitis and PT websites had only 2 of the 48 websites combined that met the recommended sixth-grade reading level for patients, with the majority characterized as "very poor" to "fair" quality. There was no correlation found between quality and readability of the CD and PT websites. CONCLUSIONS There is a need for improvement of online CD and PT health resources. Dermatologists should take the lead to vet websites and enhance online resources to improve patient care.
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Abstract
Allergic contact dermatitis is a prevalent burdensome condition affecting millions of Americans. Patch testing, the criterion-standard allergic contact dermatitis diagnostic tool, is underused by US dermatologists. Incorporating patch testing into modern dermatology practices is achievable with utilization of accurate resources and sustainable support. This review focuses on the basics of patch testing and provides practical pearls to assist novice providers in establishing a contact dermatitis specialty practice.
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13
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Li Y, Li L. Contact Dermatitis: Classifications and Management. Clin Rev Allergy Immunol 2021; 61:245-281. [PMID: 34264448 DOI: 10.1007/s12016-021-08875-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 01/04/2023]
Abstract
Contact dermatitis (CD) is a common inflammatory skin disease caused by exposure to contact allergens and irritants. It is also the most common reason of occupational dermatitis and contributes greatly to hand dermatitis and facial dermatitis. Besides the two major forms of contact dermatitis: allergic contact dermatitis and irritant contact dermatitis, other subtypes of CD have been recognized including immediate skin reactions, photoinduced contact dermatitis, systemic contact dermatitis, and non-eczematous contact dermatitis. CD is a great imitator which can mimic many kinds of skin diseases, such as atopic dermatitis, lichen planus, and angioedema. For the diagnosis of CD, a complete medical history, including occupational history, is very important. It can give a clue of CD and provide a list of suspected substances. Besides the well-known diagnostic test, patch testing, there are many other diagnostic tests can be used to help diagnosis of CD and identify the causative allergens, including photopatch test, skin tests for detecting of immediate contact reactions, serum allergen-specific IgE test, and qualitative and quantitative testing of allergen in the suspected materials patients exposed to and challenge test. Before the treatment, the suspected irritants or allergens should be avoided completely. This includes both the removal of the patient from the environment that contains those substances and the promotion of the metabolism and expulsion of the allergens that have been absorbed by the body. In addition, it is also important to restore the skin barrier and reduce skin inflammation through multiple treatments, such as emollients, topical corticosteroids, and antihistamines, as well as systemic corticosteroids and immunosuppressants. Early and appropriate treatments are important to prevent further deterioration and persistence of the skin condition.
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Affiliation(s)
- Yan Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Linfeng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
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Brown C, Yu J. Pediatric Allergic Contact Dermatitis. Immunol Allergy Clin North Am 2021; 41:393-408. [PMID: 34225896 DOI: 10.1016/j.iac.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Allergic contact dermatitis (ACD) affects up to 20% of adults and children, although children are infrequently patch tested. Available data suggest that children and adults, with or without atopic dermatitis, have the same prevalence of ACD. Patch testing is the gold standard for evaluation of ACD. The Pediatric Baseline Series was recently published by expert consensus for use in pediatric patch testing, with additional allergens tested as guided by history. This article examines methods of patch testing and up-to-date data on pediatric ACD. The top allergens are reviewed, and avoidance strategies are discussed.
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Affiliation(s)
- Christen Brown
- Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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15
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Fan PS, Sun MJ, Qin D, Yuan CS, Chen XG, Liu Y. Nanosystems as curative platforms for allergic disorder management. J Mater Chem B 2021; 9:1729-1744. [PMID: 33475131 DOI: 10.1039/d0tb02590a] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Allergy, IgE-mediated inflammatory disorders including allergic rhinitis, asthma, and conjunctivitis, affects billions of people worldwide. Conventional means of allergy management include allergen avoidance, pharmacotherapy, and emerging therapies. Among them, chemotherapeutant intake via oral, intravenous, and intranasal routes is always the most common mean. Although current pharmacotherapy exhibit splendid anti-allergic effects, short in situ retention, low bioavailability, and systemic side effects are inevitable. Nowadays, nanoplatforms have provided alternative therapeutic options to obviate the existing weakness via enhancing the solubility of hydrophobic therapeutic agents, achieving in situ drug accumulation, exhibiting controlled and long-time drug release at lesion areas, and providing multi-functional therapeutic strategies. Herein, we highlight the clinical therapeutic strategies and deal with characteristics of the nanoplatform design in allergy interventions via intratracheal, gastrointestinal, intravenous, and ocular paths. The promising therapeutic utilization in a variety of allergic disorders is discussed, and recent perspectives on the feasible advances of nanoplatforms in allergy management are also exploited.
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Affiliation(s)
- Peng-Sheng Fan
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, P. R. China.
| | - Meng-Jie Sun
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, P. R. China.
| | - Di Qin
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, P. R. China.
| | - Cong-Shan Yuan
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, P. R. China.
| | - Xi-Guang Chen
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, P. R. China.
| | - Ya Liu
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, P. R. China.
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16
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Bernard P, Saguet T, Do QT, Himbert F. Development of Hinoline® as a natural preservative for cosmetic product using bioinspiration and Greenpharma Database. J Appl Microbiol 2021; 131:2793-2807. [PMID: 33998748 DOI: 10.1111/jam.15139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/07/2021] [Accepted: 05/10/2021] [Indexed: 11/26/2022]
Abstract
AIMS The cosmetic industry needs new preservatives that are effective, natural, safe, cost effective, sustainable and compliant with regulatory standards. This necessity has posed challenges requiring obligations, bioinformatics and bioinspiration as driving forces. METHODS AND RESULTS Twenty natural extracts were selected from the Greenpharma Database with parameter filters corresponding to development constraints and antimicrobial properties. We confirmed using minimum inhibition concentration (MIC) assays that eight of the extracts have good bactericidal properties and that one has a high antifungal activity. The latter was purified hinokitiol, a bioproduct from Aomori Hiba wood. This substance provides high resistance against putrefaction; for instance, old Japanese temples were made of Aomori Hiba wood. The combination of hinokitiol with levulinic acid, another bioproduct, demonstrated complementary antimicrobial activities and synergistic effects in MIC studies and measurements according to Kull synergy index. Further, the mixture Hinoline® was tested at 2% in challenge tests and fulfilled criteria A of different standards. It also exerted complementary preservative effects with potassium sorbate and beneficial effects in unbalanced skin microbiota. CONCLUSION Hinoline, a new effective preservative from renewable bioresources, was developed. SIGNIFICANCE AND IMPACT OF THE STUDY This study accelerates the development of a preservative solution for cosmetics selected from Greenpharma Database, through bioinspiration and the identification of cost-effective investments and resources.
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Affiliation(s)
- P Bernard
- R&D Department, Greenpharma S.A.S, Orléans, France
| | | | - Q T Do
- R&D Department, Greenpharma S.A.S, Orléans, France
| | - F Himbert
- R&D Department, Greenpharma S.A.S, Orléans, France
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17
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Brar KK. A review of contact dermatitis. Ann Allergy Asthma Immunol 2020; 126:32-39. [PMID: 33091591 DOI: 10.1016/j.anai.2020.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/30/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To familiarize the reader with the mechanisms and causes of contact dermatitis. DATA SOURCES Recent research articles, relevant review articles, and case series/reports in English from PubMed database, mostly from 2010 onwards. STUDY SELECTIONS Most data were in the form of retrospective studies. Efforts were made to include clinical trials; however, for newer allergens and data on biologics, case series and case reports were included. Older studies regarding the mechanism were included if they were of particular importance. RESULTS An understanding of this review should enable the reader to approach the patient with unknown dermatitis with a better understanding of the cause and management. CONCLUSION Clinical suspicion for relevant allergens combined with the interpretation of patch tests are important in the diagnosis and treatment of patients with contact dermatitis.
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Affiliation(s)
- Kanwaljit K Brar
- Allergy and Immunology, Department of Pediatrics, Hassenfeld Children's Hospital, NYU Langone Health, New York, New York.
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18
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Abstract
The American Contact Dermatitis Society Core Allergen series was introduced in 2013 and updated in 2017. Changes in our recommended allergens are again necessary, taking into account data from the American Contact Dermatitis Society's Contact Allergen Management Program top 100 allergens from 2018. For the updated series, we removed methyldibromoglutaronitrile and added new haptens: Lyral, Limonene, Linalool, carmine, benzyl salicylate, disperse yellow 3, jasmine, peppermint, pramoxine, shellac, and lauryl polyglucose (glucosides). These additional allergens should increase the yield of relevant positive reactions for our patients.
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19
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Coppola-Fasick G, Nazario S. Recurrent otitis externa owing to allergic contact dermatitis to topical medications. Ann Allergy Asthma Immunol 2020; 125:616-617. [PMID: 32711030 DOI: 10.1016/j.anai.2020.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Giannina Coppola-Fasick
- Allergy and Immunology Section, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Sylvette Nazario
- Allergy and Immunology Section, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
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20
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Baruffi FY, Venkatesh KP, Nelson KN, Powell A, Santos DM, Ehrlich A. Systemic Contact Dermatitis: A review. Dermatol Clin 2020; 38:379-388. [DOI: 10.1016/j.det.2020.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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21
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A Hands-on Approach to Contact Dermatitis and Patch Testing. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:1883-1893. [DOI: 10.1016/j.jaip.2020.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 01/28/2020] [Accepted: 02/13/2020] [Indexed: 12/16/2022]
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22
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Systemic contact dermatitis to inhaled and intranasal corticosteroids. Ann Allergy Asthma Immunol 2020; 125:103-105. [PMID: 32289523 DOI: 10.1016/j.anai.2020.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/22/2020] [Accepted: 04/02/2020] [Indexed: 11/23/2022]
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Abstract
Allergic contact dermatitis is common, resulting in considerable morbidity. Diagnosis is based on a thorough history, physical examination, and patch testing. Several commercially available panels of patch testing are currently used. Allergens are found in a wide variety of daily products, occupational exposures, and foods. The mainstay of treatment is avoidance of the allergen, and databases like Contact Allergen Management Program and Contact Allergen Replacement Database help patients to select products that do not contain allergens to which they are sensitized. Topical corticosteroids can be used to treat exacerbations, but should be avoided in long-term treatment.
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Affiliation(s)
- Stacy Nassau
- Department of Internal Medicine, Section of Allergy and Immunology, NYU Winthrop University Hospital, 120 Mineola Boulevard, Suite 410, Mineola, NY 11501, USA.
| | - Luz Fonacier
- Department of Internal Medicine, Section of Allergy and Immunology, NYU Winthrop University Hospital, 120 Mineola Boulevard, Suite 410, Mineola, NY 11501, USA
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Aye A, Song YJ, Jeon YD, Jin JS. Xanthone suppresses allergic contact dermatitis in vitro and in vivo. Int Immunopharmacol 2020; 78:106061. [DOI: 10.1016/j.intimp.2019.106061] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/14/2019] [Accepted: 11/14/2019] [Indexed: 12/30/2022]
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25
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Dong YM, Liao LY, Li L, Yi F, Meng H, He YF, Guo MM. Skin inflammation induced by ambient particulate matter in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 682:364-373. [PMID: 31125750 DOI: 10.1016/j.scitotenv.2019.05.155] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/29/2019] [Accepted: 05/11/2019] [Indexed: 06/09/2023]
Abstract
Most published studies on particulate matter (PM) concerning PM2.5 and PM10 have focused on PM-induced effects on the respiratory system (particularly lung) and cardiovascular system effects. However, epidemiological and mechanistic studies suggest that PM2.5 and PM10 also affects the skin, which is a key health issue. In this study, we first reviewed the current status of PM2.5 and PM10 in China, including relevant regulations, concentration levels, chemical components, and emission sources. Next, we summarized the association between PM2.5 and PM10 or its representative components, in relation to skin inflammation as well as inflammatory skin diseases, such as atopic dermatitis, acne, eczema, and skin aging. Finally, we determined the mechanism of oxidative stress or programmed cell death induced through PM, which can provide useful information for future research on PM-induced skin inflammation.
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Affiliation(s)
- Yin-Mao Dong
- Key Laboratory of Cosmetics, China National Light Industry, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China; Beijing Key Laboratory of Plant Resources Research and Development, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China
| | - Lian-Ying Liao
- Key Laboratory of Cosmetics, China National Light Industry, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China; Beijing Key Laboratory of Plant Resources Research and Development, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China
| | - Li Li
- Key Laboratory of Cosmetics, China National Light Industry, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China; Beijing Key Laboratory of Plant Resources Research and Development, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China
| | - Fan Yi
- Key Laboratory of Cosmetics, China National Light Industry, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China; Beijing Key Laboratory of Plant Resources Research and Development, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China
| | - Hong Meng
- Key Laboratory of Cosmetics, China National Light Industry, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China; Beijing Key Laboratory of Plant Resources Research and Development, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China
| | - Yi-Fan He
- Key Laboratory of Cosmetics, China National Light Industry, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China; Beijing Key Laboratory of Plant Resources Research and Development, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China
| | - Miao-Miao Guo
- Key Laboratory of Cosmetics, China National Light Industry, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China; Beijing Key Laboratory of Plant Resources Research and Development, Beijing Technology and Business University, No. 11/33, Fucheng Road, Haidian District, Beijing 100048, PR China.
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Nedorost ST, Raffi J, Brar K, Jacob SE. Art of prevention: The importance of feeding traditions. Int J Womens Dermatol 2019; 5:378-380. [PMID: 31909161 PMCID: PMC6938930 DOI: 10.1016/j.ijwd.2019.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/17/2019] [Accepted: 03/25/2019] [Indexed: 01/01/2023] Open
Affiliation(s)
- S T Nedorost
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - J Raffi
- Department of Dermatology, University of California, Irvine and University of California, San Francisco, San Francisco, California
| | - K Brar
- Department of Pediatrics, Division of Allergy & Immunology, National Jewish Health, Denver, Colorado
| | - S E Jacob
- Department of Dermatology, Loma Linda University, Loma Linda, California
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Lio PA. The many faces of eczema and its treatments. Ann Allergy Asthma Immunol 2019; 120:553-554. [PMID: 29891117 DOI: 10.1016/j.anai.2018.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Peter A Lio
- Medical Dermatology Associates of Chicago, Chicago, Illinois.
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Experience in patch testing: A 6-year retrospective review from a single academic allergy practice. Ann Allergy Asthma Immunol 2019; 122:502-507. [PMID: 30851460 DOI: 10.1016/j.anai.2019.02.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 02/10/2019] [Accepted: 02/28/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Patch testing is the "gold standard" to identify culprit allergen(s) causing allergic contact dermatitis (ACD), but there are limited studies of patch testing from allergy practice settings. OBJECTIVE We sought to explore patch test findings in a large academic allergy practice, including patch testing results, history of atopy, location of dermatitis, and referral source. We also wanted to determine whether patch testing using an extended panel, such as the North American screening series, compared with a limited series, such as the Thin-Layer Rapid-Use Epicutaneous (T.R.U.E.) Test, increased the sensitivity. METHODS A retrospective chart review was conducted of patients referred for patch testing over a 6-year period. RESULTS A total of 585 patients (mean age 48.7 years, 71.6 % female) underwent patch testing over the 6-year period, of which 369 (63%) had a positive test. Of those who tested positive, 202 (55%) reported a history of atopy. The extremities were the most commonly involved site, followed by the head/neck and trunk. The 5 most common positive allergens were nickel sulfate, gold sodium thiosulfate, methylchloroisothiazolinone, thimerosal, and bacitracin. Three hundred fourteen (53.6%) patients were positive to at least 1 allergen on TRUE testing. Extended screening series identified an additional 10.8% of patients with positive tests who were negative to T.R.U.E. test allergens. CONCLUSION Patch testing is a valuable diagnostic tool for the practicing allergist and provides early identification of culprit allergens in ACD. Performing an extended screening series such as the North American Contact Dermatitis Group (NACDG) or supplemental panel of allergens increased sensitivity when compared with a limited series.
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Sivam A, Tankersley M. Allergic Contact Dermatitis to Henna Tattoo with Negative Patch to p-phenylenediamine (PPD). THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:288-289. [PMID: 30598181 DOI: 10.1016/j.jaip.2018.10.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Anita Sivam
- University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tenn.
| | - Mike Tankersley
- University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tenn
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30
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A Patch Testing Initiative for the Investigation of Allergic Contact Dermatitis in a UK Allergy Practice: A Retrospective Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:89-95. [DOI: 10.1016/j.jaip.2018.08.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/01/2018] [Accepted: 08/27/2018] [Indexed: 11/20/2022]
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32
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Brar KK, Leung DYM. Eczema complicated by allergic contact dermatitis to topical medications and excipients. Ann Allergy Asthma Immunol 2018; 120:599-602. [PMID: 29702202 DOI: 10.1016/j.anai.2018.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/20/2018] [Accepted: 04/20/2018] [Indexed: 11/17/2022]
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