1
|
Pesqué D, Planella-Fontanillas N, Borrego L, Sanz-Sánchez T, Zaragoza-Ninet V, Serra-Baldrich E, Miquel-Miquel FJ, Silvestre-Salvador JF, Córdoba-Guijarro S, Sánchez-Gilo A, Mercader-García P, Navarro-Triviño FJ, Ortiz-de-Frutos FJ, Tous-Romero F, Rodríguez-Serna M, Melé-Ninot G, Barrabés-Torrella C, Ruiz-González I, Pastor-Nieto MA, Carrascosa-Carrillo JM, Gómez-de-la-Fuente E, Sánchez-Pedreño-Guillén P, Sánchez-Pérez J, Pereyra-Rodríguez JJ, Gatica-Ortega ME, González-Pérez R, Pujol RM, Descalzo MÁG, García-Doval I, Giménez-Arnau AM. Patch test results to the Spanish baseline patch test series according to age groups: A multicentric prospective study from 2019 to 2023. Contact Dermatitis 2024. [PMID: 39394969 DOI: 10.1111/cod.14702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 08/08/2024] [Accepted: 09/12/2024] [Indexed: 10/14/2024]
Abstract
INTRODUCTION Patch test results may be influenced by age-related factors. However, there is still discordant evidence between age and patch test results. OBJECTIVES We aim to evaluate the patch test results reflecting skin sensitisation, their relevance and association with clinical features by age group. METHODS Prospective multicentric study of all patients patch tested with the Spanish baseline series in participating centres. Age groups were pre-defined as children (0- to 11-years), adolescents (12- to 18-years), young adults (19- to 30-years), middle-aged adults (31- to 65-years) and older adults (≥66-years). Occurrence of sensitisation, relevance and clinical features were compared by age group. Factors associated with skin sensitisation were investigated with multivariate logistic regression. RESULTS A total of 13 368 patients were patch-tested. Differences in positive patch test results and relevance by age were detected with the highest proportion in middle-aged adults. Age-related trend differences were found for nickel, potassium dichromate, caines, colophony, Myroxylon pereirae resin, 2-hydroxyethyl methacrylate and limonene hydroperoxide. The multivariate logistic analysis (adjusted for sex, atopic dermatitis, body location and occupational dermatitis) showed an association between the age group of 31-65 (OR: 1.41, 95% CI: 1.26-1.58) and above 66-years (OR: 1.15, 95% CI: 1.01-1.32) with a higher proportion of positive results, compared with young adults. CONCLUSIONS Positive patch test results vary according to age, with the highest occurrence in middle-aged adults. Most haptens did not present age-related differences, reinforcing the use of baseline series regardless of age.
Collapse
Affiliation(s)
- David Pesqué
- Servicio de Dermatología, Hospital del Mar Research Institute, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Nidia Planella-Fontanillas
- Servicio de Dermatología, Hospital del Mar Research Institute, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Leopoldo Borrego
- Servicio de Dermatología, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Tatiana Sanz-Sánchez
- Servicio de Dermatología, Hospital Universitario Infanta Sofía, Universidad Europea, Madrid, Spain
| | | | | | | | | | | | - Araceli Sánchez-Gilo
- Servicio de Dermatología, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
| | - Pedro Mercader-García
- Servicio de Dermatología, Hospital General Universitario José María Morales Meseguer, Murcia, Spain
| | | | | | | | | | - Gemma Melé-Ninot
- Servicio de Dermatología, Hospital Universitari Sagrat Cor, Grupo Quirónsalud, Barcelona, Spain
| | | | | | - María Antonia Pastor-Nieto
- Servicio de Dermatología, Hospital Universitario de Guadalajara, Guadalajara, Spain
- Servicio de Dermatología, Hospital Fundación Jiménez-Díaz, Madrid, Spain
| | | | | | | | | | - José Juan Pereyra-Rodríguez
- Servicio de Dermatología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
- Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain
| | | | - Ricardo González-Pérez
- Servicio de Dermatología, Hospital Universitario Araba, Universidad del País Vasco, Vitoria-Gasteiz, Spain
| | - Ramon Maria Pujol
- Servicio de Dermatología, Hospital del Mar Research Institute, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Ignacio García-Doval
- Unidad de Investigación, Academia Española de Dermatología y Venereología, Madrid, Spain
- Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Ana María Giménez-Arnau
- Servicio de Dermatología, Hospital del Mar Research Institute, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| |
Collapse
|
2
|
Narayanan D, Rogge M. Cheilitis: A Diagnostic Algorithm and Review of Underlying Etiologies. Dermatitis 2024; 35:431-442. [PMID: 38422211 DOI: 10.1089/derm.2023.0276] [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: 03/02/2024]
Abstract
Cheilitis, or inflammation of the lips, is a common reason for dermatologic consultation. The inflammation can include the vermillion lip, vermillion border, and surrounding skin, and can present with an acute or chronic course. There are many etiologies, including irritant and allergic contact dermatitis, atopic cheilitis, actinic cheilitis, infectious etiologies, nutritional deficiencies, drug-induced cheilitis, and rare etiologies, including granulomatous cheilitis, cheilitis glandularis, plasma cell cheilitis, lupus cheilitis, and exfoliative cheilitis. Distinguishing among the various etiologies of cheilitis is clinically difficult, as many causes may produce similar erythema and superficial desquamation of mucosal skin. In addition, patients report dryness, redness, irritation, burning, fissuring, and itch in many of the underlying causes. Thus, the specific etiology of cheilitis is often difficult to diagnose, requiring extensive testing and treatment trials. In this review, we summarize the various types of cheilitis, synthesizing novel cases, clinical presentations, histopathology, epidemiology, and advancements in diagnostic methods and therapeutics. We provide a diagnostic algorithm aimed to assist clinicians in the management of cheilitis.
Collapse
Affiliation(s)
- Deepika Narayanan
- From the Department of Dermatology, John P. and Kathrine G. McGovern Medical School at the University of Texas Health Science Center, Houston, Texas, USA
| | - Megan Rogge
- From the Department of Dermatology, John P. and Kathrine G. McGovern Medical School at the University of Texas Health Science Center, Houston, Texas, USA
| |
Collapse
|
3
|
Yu J, Milam EC. Comorbid Scenarios in Contact Dermatitis: Atopic Dermatitis, Irritant Dermatitis, and Extremes of Age. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:2243-2250. [PMID: 39244336 DOI: 10.1016/j.jaip.2024.04.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/09/2024] [Accepted: 04/22/2024] [Indexed: 09/09/2024]
Abstract
Contact dermatitis (allergic and irritant) occurs when the skin encounters haptens that elicit a T cell-mediated hypersensitivity reaction (allergic) or a nonimmunologic, toxic reaction (irritant). Patch testing is the reference standard for diagnosing allergic contact dermatitis (ACD), although positive results are not always relevant. Therefore, the definitive diagnosis of ACD requires an astute clinician able to connect the results of patch testing appropriately with the clinical history and the cutaneous examination findings. Comorbid conditions such as atopic dermatitis can confound the accurate diagnosis of ACD because of the similarities in clinical presentation. Furthermore, both extremes of age can further challenge the diagnostic specificity of ACD owing to the maturing immune system and the space limitations present when the very young are patch tested. The goal of this Continuing Medical Education article is to discuss the challenges of diagnosing ACD in patients with unique comorbidities such as atopic dermatitis, given the morphologic similarities, and when to patch test these patients. Diagnosis of ACD will also be discussed in very young patients with a focus on patch test allergen selection despite the limited geographic space. The most common allergens reported in very young and old patients will also be discussed.
Collapse
Affiliation(s)
- JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
| | - Emily C Milam
- Department of Dermatology, NYU Langone Medical Center, NYU Grossman School of Medicine, New York, NY
| |
Collapse
|
4
|
Sukakul T, Bruze M, Svedman C. Fragrance Contact Allergy - A Review Focusing on Patch Testing. Acta Derm Venereol 2024; 104:adv40332. [PMID: 39140486 PMCID: PMC11334351 DOI: 10.2340/actadv.v104.40332] [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: 03/11/2024] [Accepted: 06/27/2024] [Indexed: 08/15/2024] Open
Abstract
Fragrance materials are widely used in various types of products in daily life and many of them can be contact sensitizers. Contact allergy to fragrances has been reported to be common worldwide. Unlike other groups of contact allergens such as metals and preservatives, fragrance materials in consumer products can be present as single fragrance chemicals or in the form of mixtures known as natural complex substances. Due to the complexity of the fragrance materials and the high number of fragrance substances known to cause contact sensitization, selecting suitable materials for patch testing is challenging. Emerging fragrance markers have been additionally introduced in different baseline series for screening to enhance the rate of fragrance contact allergy detection. Moreover, there have been continual updates on basic knowledge, clinical perspectives, sources of exposure, and regulations on the use of fragrance materials. Avoiding pitfalls while performing patch testing with fragrance test materials is also crucial and should not be overlooked. Therefore, this review aims to update knowledge to provide a high-quality holistic approach to fragrance contact allergy diagnosis and management.
Collapse
Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| |
Collapse
|
5
|
Brumley C, Banks T, Arora P, Ophaug S. Are "clean" products safe for children? An analysis of contact allergens in "clean" children's products from a popular retailer. Pediatr Dermatol 2024; 41:651-653. [PMID: 38676435 DOI: 10.1111/pde.15633] [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: 02/13/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Considering consumer trends toward the use of "clean" personal care products and increasing recognition of childhood allergic contact dermatitis, we sought to characterize the allergen profile of such children's products. METHODS Ingredients of baby washes/shampoos, bubble baths, and moisturizers identified using the "Clean Baby" filter on Target®'s online marketplace were analyzed for relevant pediatric contact allergens. RESULTS Product compositions declared fragrance in 82% of products, Compositae in 46%, cocamidopropyl betaine in 45%, glucosides in 37%, propylene glycol in 12%, lanolin in 1%, and no allergens in 9%-methylisothiazolinone and formaldehyde were not found. CONCLUSION Children are greatly impacted by atopic dermatitis and skin barrier dysfunction, which underscores a need for greater public awareness of sensitizing and irritating ingredients, particularly regarding pediatric personal care products.
Collapse
Affiliation(s)
- Caroline Brumley
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Tyra Banks
- Burnett School of Medicine at Texas Christian University, Fort Worth, Texas, USA
| | - Puneet Arora
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Solveig Ophaug
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
| |
Collapse
|
6
|
Sukakul T, Bruze M, Mowitz M, Kiuru A, Svedman C. Allergic Contact Dermatitis to Linalool Hydroperoxides: Pitfalls in the Diagnostic Process-Findings from a Repeated Open Application Test Study. Dermatitis 2024; 35:373-379. [PMID: 38386591 DOI: 10.1089/derm.2023.0286] [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: 02/24/2024]
Abstract
Background: Increasing trends of oxidized linalool contact allergy have been reported. However, the impact of reactivity and dose in eliciting allergic contact Dermatitis caused by linalool hydroperoxides is insufficiently investigated. Objectives: To perform repeated open application tests (ROATs) using the real-world concentrations of linalool hydroperoxides in patients and control participants. Materials and Methods: Patients who previously had a positive (patients) and a negative (controls) patch test reaction to linalool hydroperoxides 1.0% in petrolatum were patch tested with a dilution series of linalool hydroperoxides preparations and asked to perform ROAT twice daily with 3 concentrations of linalool hydroperoxides creams and a negative control cream for 28 days. The creams contain 44, 140, and 440 PPM of linalool hydroperoxides, representing real-world doses reported in consumer products. Results: Of all 47 participants, 31 were linalool hydroperoxides contact allergy patients, and 16 were controls. One patient had a positive ROAT reaction in the area where cream at the highest concentration of linalool hydroperoxides was applied for 28 days. Conclusions: Repeated exposure to creams containing linalool hydroperoxides at real-life concentrations could rarely elicit an allergic reaction on intact skin after 4 weeks.
Collapse
Affiliation(s)
- Thanisorn Sukakul
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Mowitz
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Anna Kiuru
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| |
Collapse
|
7
|
Brumley C, Arora P, Hylwa SA. Characterization of Pediatric Patch Testing: A Retrospective Review, 2020-2023. Dermatitis 2024. [PMID: 38913333 DOI: 10.1089/derm.2024.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Background: Recent evidence shows similar rates of allergic contact dermatitis (ACD) among children and adults despite children accounting for less than 10% of patch testing subjects. With a need for in-depth analyses of pediatric ACD, we herein characterize a pediatric cohort at a large North American patch testing center. Methods: A retrospective chart review was conducted for 135 patients ages 1-17 years who underwent patch testing from July 2020 from August 2023. Data were stratified by age 1-5, 6-11, and 12-17 years. Significance-Prevalence Index Numbers (SPIN) were calculated. Results: A total of 86% were sensitized, 40% had a relevant reaction, and positivity rates were equal between males and females. Top allergens by SPIN differed with age, but overall were linalool hydroperoxides (SPIN = 11.01), propylene glycol (10.30), limonene hydroperoxides (10.27), fragrance mix I (5.62), and lanolin (4.90). In total, 14% of the top allergens were not represented on the North American Contact Dermatitis Group standard series. Of those tested to personal products, 45% had positive reactions and 72% of which were relevant. Conclusions: Emulsifiers and fragrances were the most relevant allergen categories, with the impact of emulsifiers not previously reported. ACD may affect males and females equally in this population. Supplemental allergens and personal products tested "as-is" contribute to conclusive pediatric patch testing.
Collapse
Affiliation(s)
- Caroline Brumley
- From the Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Puneet Arora
- From the Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Sara A Hylwa
- From the Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- Department of Dermatology, Hennepin Healthcare, Minneapolis, Minnesota, USA
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
8
|
Slodownik D, Bar J, Daniely D. Trends in contact sensitization, results, and implications from a contact dermatitis clinic in Israel. Contact Dermatitis 2024; 90:556-565. [PMID: 38368629 DOI: 10.1111/cod.14524] [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: 08/23/2023] [Revised: 12/18/2023] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND The baseline series includes common allergens, evolves over time, and differs by location. Our study aims to characterize allergen sensitization trends among the Israeli population during the last two decades, compare our results to American and European registries, as well as to highlight significant allergens in additional series outside the European baseline series (OEBS). METHODS We analysed patch test results of 2086 patients from a designated contact dermatitis clinic in Tel Aviv between 2019 and 2022, compared them to European and North American registries and to 2156 patch test results conducted in Israel two decades ago. RESULTS 38.6% of patients had at least one positive reaction to an allergen in the European baseline series (EBS), nickel sulphate (14.6%), fragrance mix I (4.6%), and Methylchloroisothiazolinone methylisothiazolinone (MCI/MI; 3.7%) were the most common among them. N-Isopropyl N-Phenyl-4-Phenylenediamine (NIPPD; 0%), Propolis (0.1%), Sesquiterpene lactone mix (0.1%), and Budesonide (0.1%) elicited a sensitization frequency significantly lower than the proposed threshold for baseline inclusion. Chi-square test revealed a statistically significant decrease (p < 0.05) in the sensitization frequency of fragrance mix I, Formaldehyde, Potassium dichromate, Neomycin sulphate, Myroxylon pereirae, Sesquiterpene lactone, and NIPPD during the last two decades. The overall sensitization frequency to the majority of allergens was lower in our cohort in comparison to the North American and European registries. CONCLUSIONS MCI/MI and 2-hydroxyethyl methacrylate-2 (HEMA) are common, relevant allergens, with high SPIN (significance and prevalence index number) and should be better regulated by the authorities. While among the EBS, NIPPD, Propolis, Sesquiterpene lactone, and Budesonide usually do not elicit a positive reaction and therefore should be reconsidered in baseline series, among the OEBS, Chloramphenicol, Quaternium 15, Propyl gallate, and Amerchol L101 have elicited high SPIN values and should be vigilantly examined in the suitable clinical scenario. Significantly lower sensitization frequency to propolis raises the possibility of a protective effect due to early oral exposure among the Israeli population.
Collapse
Affiliation(s)
- Dan Slodownik
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan Bar
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
| | - Danny Daniely
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
9
|
Johnson H, Aquino MR, Snyder A, Collis RW, Franca K, Goldenberg A, Sui JY, Eichenfield DZ, Kozy BJ, Chen JK, Shope C, Goldminz AM, Yu J. Prevalence of allergic contact dermatitis in children with and without atopic dermatitis: A multicenter retrospective case-control study. J Am Acad Dermatol 2023; 89:1007-1014. [PMID: 37768237 DOI: 10.1016/j.jaad.2023.06.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND As both allergic contact dermatitis and atopic dermatitis (AD) have similar clinical presentations and are characterized by spongiotic dermatitis on skin biopsy, many children with AD are not referred for patch testing and allergic contact dermatitis is underdiagnosed. OBJECTIVE To provide updated prevalence data of common contact allergens in children with and without AD. METHODS This is a retrospective case-control study using the Pediatric Allergic Contact Dermatitis Registry from 2018 to 2022. RESULTS A total of 912 children were included (615 with AD and 297 without AD). Children with AD were more likely to have a longer history of dermatitis (4.1 vs 1.6 years, P < .0001), have seen more providers (2.3 vs 2.1, P = .003), have greater than 1 positive patch test (PPT) result (P = .005), have a greater number of PPT results overall (2.3 vs 1.9, P = .012), and have a more generalized distribution of dermatitis (P = .001). PPT to bacitracin (P = .030), carba mix (P = .025), and cocamidopropyl betaine (P = .0007) were significantly increased in children with AD compared to those without AD. LIMITATIONS Technical variation between providers and potential for misclassification, selection, and recall biases. CONCLUSION Children with AD are significantly more likely to have PPT reactions and should be referred for evaluation of allergic contact dermatitis and obtain patch testing.
Collapse
Affiliation(s)
- Hadley Johnson
- School of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota; Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marcella R Aquino
- Department of Pediatrics, Division of Allergy & Immunology, Hasbro Children's Hospital, Providence, Rhode Island; Division of Allergy & Immunology, Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Alan Snyder
- Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina
| | - Reid W Collis
- Department of Dermatology, Washington University School of Medicine, St. Louis, Missouri
| | - Katlein Franca
- Dr Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Alina Goldenberg
- Dermatologist Medical Group of North County, San Diego, California; Department of Medicine, University of California San Diego, San Diego, California
| | - Jennifer Y Sui
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California; Department of Dermatology, UC San Diego, La Jolla, California
| | - Dawn Z Eichenfield
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California; Department of Dermatology, UC San Diego, La Jolla, California
| | - Brittany J Kozy
- Division of Pediatric Dermatology, Nationwide Children's Hospital, Columbus, Ohio
| | - Jennifer K Chen
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Chelsea Shope
- Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina
| | - Ari M Goldminz
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
10
|
Silverberg JI, Patel N, Warshaw EM, Maibach HI, Belsito DV, DeKoven JG, Zug KA, Taylor JS, Sasseville D, DeLeo VA, Pratt MD, Reeder MJ, Atwater AR, Fowler JF, Houle MC. Patch testing with Cobalt in Children and Adolescents: North American Contact Dermatitis Group experience, 2001 to 2018. Contact Dermatitis 2022; 87:420-429. [PMID: 35801686 DOI: 10.1111/cod.14185] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/12/2022] [Accepted: 07/05/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) to cobalt is more common in children and adolescents than adults. However, detailed information on sites and sources of cobalt ACD are limited. OBJECTIVES To assess trends in positive and clinically relevant patch test reactions to cobalt in children and associated patient characteristics, common sources, and body sites affected. METHODS A retrospective analysis of children (<18 years) patch tested to cobalt by the North American Contact Dermatitis Group between 2001-2018. RESULTS Of 1,919 children patch tested, 228 (11.9%) and 127 (6.6%) had a positive/allergic or currently relevant patch test reaction to cobalt, respectively. The most common primary body sites affected were scattered generalized (30.0%), face, not otherwise specified (NOS, 10.6%), and trunk (10.1%). Patients with allergic and currently relevant allergic patch test reactions were more likely to have a primary site of trunk (P=.0160 and P=.0008) ears (P=.0005 and P<.0001). Affected body site(s) varied by cobalt source among patients with currently relevant reactions, especially for less common sources. The most commonly identified sources of cobalt included jewelry, belts, and clothing. CONCLUSIONS Positive patch test reactions to cobalt were common in children. Most common body site was scattered generalized and the sources of cobalt varied by body site. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Jonathan I Silverberg
- Department of Dermatology, George Washington University School of Medicine, Washington D.C., USA; Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nisha Patel
- Department of Dermatology, George Washington University School of Medicine, Washington, DC, USA
| | - Erin M Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, MN.,Department of Dermatology, University of Minnesota, Minneapolis, MN.,Department of Dermatology, Minneapolis Veterans Affairs Medical Center
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | | | - Denis Sasseville
- Division of Dermatology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, CA
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ontario, Canada
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, NC
| | | | - Marie-Claude Houle
- Division of Dermatology, Centre Hospitalier Universitaire (CHU) de Québec, Laval University, Quebec, Canada
| |
Collapse
|