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Tramontana M, Hansel K, Bianchi L, Sensini C, Malatesta N, Stingeni L. Advancing the understanding of allergic contact dermatitis: from pathophysiology to novel therapeutic approaches. Front Med (Lausanne) 2023; 10:1184289. [PMID: 37283623 PMCID: PMC10239928 DOI: 10.3389/fmed.2023.1184289] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/18/2023] [Indexed: 06/08/2023] Open
Abstract
Allergic contact dermatitis (ACD) is a common inflammatory skin disease that, especially when the condition becomes chronic, has a high impact on the quality of life and represents a significant disease burden. ACD represents a type IV delayed-type hypersensitivity reaction that is triggered by contact with an allergen in previously sensitized individuals through the activation of allergen-specific T cells. In the acute phase, it is characterized by eczematous dermatitis, which presents with erythema, edema, vesicles, scaling, and intense itch. Non-eczematous clinical forms are also described (lichenoid, bullous, and lymphomatosis). Lichenification is the most common clinical picture in the chronic phase if the culprit allergen is not found or eliminated. ACD can be associated with both occupational and non-occupational exposure to allergens, representing approximately 90% of occupational skin disorders along with irritant contact dermatitis. Patch testing with suspected allergens is required for a diagnosis. Metals, especially nickel, fragrance mix, isothiazolinones, and para-phenylenediamine, are the most commonly positive allergens in patients patch tested for suspected ACD. The treatment goal is to avoid contact with the culprit agent and use topical and/or systemic corticosteroid therapy.
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Li YS, Tseng WL, Lu CY. Determination of formaldehyde in the daily living environment using membrane-enhanced water plug coupled extraction following peptide-based greener reaction derivatization. Microchem J 2022. [DOI: 10.1016/j.microc.2022.108357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Boonchai W, Pruksaeakanan C, Wongdama S, Bunyavaree M, Kumpangsin T, Chaiyabutr C. Trends in formaldehyde and formaldehyde-releaser contact allergies as compared with market exposure in Thailand. Contact Dermatitis 2022; 88:18-26. [PMID: 35838492 DOI: 10.1111/cod.14190] [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: 04/10/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Formaldehyde and formaldehyde releasers (FRs) are common preservatives in cosmetics and household products. Their contact allergy trends are decreasing in Europe and America, but trend data for Asia are limited. OBJECTIVES The first objective was to determine the prevalences of and trends in contact allergies to formaldehyde and FRs. The second objective was to establish how often formaldehyde and FRs were mentioned on the labels of products sold in the Thai market. METHODS Twenty years of data on patch test results for formaldehyde and FRs were reviewed. Their frequency of mention on the labels of 5855 products was analyzed. RESULTS The trends in contact allergy to formaldehyde and FRs were decreasing. The overall prevalence of formaldehyde contact allergy was 2.5%. The most common FR to cause contact allergy was quaternium-15. Formaldehyde and FRs were identified as ingredients in 10.2% of the products surveyed. Dimethylol dimethyl hydantoin was the most common FR (5.2%). The highest use of formaldehyde and FRs (15.5%) was in hair care products. CONCLUSIONS Although contact allergy trends in Thailand were decreasing, the proportion of products with FRs remained high. Comprehensive and universal legislation is needed to control the presence of formaldehyde and FRs. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Waranya Boonchai
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chutipon Pruksaeakanan
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supisara Wongdama
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Monthathip Bunyavaree
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Titinun Kumpangsin
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chayada Chaiyabutr
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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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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Kawakami T, Obama T, Sakai S, Takagi M, Takahashi N, Oshima N, Tahara M, Ikarashi Y. Free formaldehyde in non-medical face masks purchased from the Japanese market since the COVID-19 outbreak. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2022; 57:193-197. [PMID: 35240932 DOI: 10.1080/10934529.2022.2047560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
Since the Coronavirus Disease 2019 (COVID-19) pandemic began, people have been wearing face masks for many hours every day. As these face masks are in contact with the skin, it is important to pay more attention to their quality and safety. This study examined the concentration of free formaldehyde in 90 non-medical face masks and related products (33 nonwoven, 30 woven cloth, 12 polyurethane, and 15 related products) because formaldehyde is a common contact allergen in textile products. For products consisting of mixed materials, each material was sampled, resulting in 103 samples for analysis. Free formaldehyde (34-239 μg/g) was found in three cloth masks, which consisted of cotton and polyester, with antibacterial and antiviral labeling. It was confirmed that the detected formaldehyde originated from the mask-finishing treatment by a hydrochloric acid extraction discrimination test. These masks may elicit contact dermatitis if the consumers have already been sensitized to formaldehyde. However, the risk of contact dermatitis caused by formaldehyde in masks may be considered low since the frequency of formaldehyde detection in masks in Japan is low.
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Affiliation(s)
- Tsuyoshi Kawakami
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Tomoko Obama
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Shinobu Sakai
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Mihono Takagi
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Natsuko Takahashi
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Naohiro Oshima
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Maiko Tahara
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
| | - Yoshiaki Ikarashi
- Division of Environmental Chemistry, National Institute of Health Sciences, Kawasaki City, Kanagawa, Japan
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Goossens A, Aerts O. Contact allergy to and allergic contact dermatitis from formaldehyde and -releasers: A clinical review and update. Contact Dermatitis 2022; 87:20-27. [PMID: 35229319 DOI: 10.1111/cod.14089] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/29/2022]
Abstract
This review aims to provide a clinically useful update regarding the role of formaldehyde (FA) and its five main releasers (FRs) quaternium-15, diazolidinyl urea, DMDM hydantoin, imidazolidinyl urea and 2-bromo-2-nitropropane-1,3-diol (bronopol) in contact allergy and allergic contact dermatitis. These ubiquitous preservatives are still often, and sometimes undeclared, present in cosmetics, pharmaceuticals, medical devices, household detergents and chemical (industrial) products. In Europe, the use of free FA and quaternium-15 in cosmetics is forbidden and contact allergy rates have been found to be stable to decreasing. However, FA/FRs still readily provoke localized (e.g., facial/hand), airborne and generalized dermatitis, and may also complicate atopic and stasis dermatitis, or result in nummular dermatitis. Seborrheic-, rosacea- and impetigo-like dermatitis have recently been reported. For a correct diagnosis, FA 2% aq. (0.60 mg/cm2 ) should be used, and particularly the FRs bronopol 0.5% pet. and diazolidinyl urea 2% should be patch tested separately in a baseline series. If sensitization to FA occurs, both FA and FRs should preferably be avoided, except perhaps for bronopol in case it tests negatively. If a patient reacts to one or more FRs (such as bronopol, or diazolidinyl/imidazolidinyl urea), but not to FA, then the specific FR(s) should be avoided. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- An Goossens
- Department of Dermatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and Research group Immunology, INFLA-MED Centre of Excellence, University of Antwerp, Antwerp, Belgium
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Calado R, Gomes T, Matos A, Gonçalo M. Contact Dermatitis to Nail Cosmetics. CURRENT DERMATOLOGY REPORTS 2021. [DOI: 10.1007/s13671-021-00345-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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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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Atwater AR, Petty AJ, Liu B, Green CL, Silverberg JI, DeKoven JG, Belsito DV, Reeder MJ, Sasseville D, Taylor JS, Maibach HI, Zirwas MJ, Marks JG, Zug KA, Fowler JF, Pratt MD, DeLeo VA, Warshaw EM. Contact dermatitis associated with preservatives: Retrospective analysis of North American Contact Dermatitis Group data, 1994 through 2016. J Am Acad Dermatol 2021; 84:965-976. [PMID: 33579596 PMCID: PMC8087451 DOI: 10.1016/j.jaad.2020.07.059] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/28/2020] [Accepted: 07/05/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Preservatives are often necessary components of commercial products. Large-scale North American studies on preservative allergy are limited. OBJECTIVE To evaluate demographics, positive patch test reactions (PPTRs), clinical relevance, and trends for preservatives tested by the North American Contact Dermatitis Group. METHODS We conducted a retrospective cross-sectional analysis of North American Contact Dermatitis Group patch testing results of preservatives from 1994 through 2016. RESULTS A total of 50,799 patients were tested; 11,338 (22.3%) had a PPTR to at least 1 preservative. The most frequent reactions were to methylisothiazolinone 0.2% aqueous (aq) (12.2%), formaldehyde 2% aq (7.8%), formaldehyde 1% aq (7.8%), quaternium-15 2% petrolatum (pet) (7.7%), and methyldibromo glutaronitrile/phenoxyethanol 2% pet (5.1%). Paraben mix 12% pet (1%), iodopropynyl butylcarbamate 0.1% pet (0.4%), benzyl alcohol 1% pet (0.3%), and phenoxyethanol 1% pet (0.2%) had the lowest PPTRs. Linear regression analysis of preservatives tested showed that only methylchloroisothiazolinone/methylisothiazolinone 0.01% aq (parameter estimate, 0.42; 95% CI, 0.17-0.66; P < .005) had a significant increase in PPTRs over time. LIMITATIONS Collected variables are dependent on clinical judgment. Results may be prone to referral selection bias. CONCLUSIONS This large North American study provides insight on preservative PPTRs and trends from 1994 through 2016.
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Affiliation(s)
- Amber Reck Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina.
| | - Amy J Petty
- Duke University School of Medicine, Durham, North Carolina
| | - Beiyu Liu
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina
| | - Cynthia L Green
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina
| | - Jonathan I Silverberg
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Donald V Belsito
- Department of Dermatology, Columbia University Medical Center, New York, New York
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Denis Sasseville
- Division of Dermatology, McGill University Health Centre, Montréal General Hospital, Montréal, Canada
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Howard I Maibach
- Department of Dermatology, University of California Medical School, San Francisco, California
| | - Matthew J Zirwas
- Probity Medical Research, Dermatologists of the Central States, Columbus, Ohio
| | - James G Marks
- Department of Dermatology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
| | - Joseph F Fowler
- Division of Dermatology, University of Louisville, Louisville, Kentucky
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, The Ottawa Hospital, Ottawa, Canada
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Erin M Warshaw
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota; Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
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Hua Y, Ma C, Huang S, Wang R, Chen J, Guo Q, Zhou J, Zhu H, Li W. Toxic effects of formaldehyde and the protective effect of docosahexaenoic acid in Drosophila. Transl Neurosci 2021; 12:351-361. [PMID: 34703626 PMCID: PMC8491587 DOI: 10.1515/tnsci-2020-0186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 12/14/2022] Open
Abstract
Formaldehyde (FA) is a commercially important chemical applied in industry and scientific research. However, FA has a distinct impact on learning and memory. Although the mechanisms of FA toxicity have been well studied, additional research is required to establish the mechanisms of neuroprotection in cases of FA exposure. Docosahexaenoic acid (DHA) is a polyunsaturated fatty acid with a variety of health benefits, including the enhancement of learning and memory. In this study, we investigated the neuroprotective effects of DHA in Drosophila melanogaster that had ingested FA. Our data suggested that DHA enhanced reproductive processes, leading to an increase in the number of eggs, larvae, and adults. Surprisingly, we found that DHA had a mild protective effect against FA-induced impairments in learning and memory.
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Affiliation(s)
- Yanli Hua
- Department of Human Anatomy, Medical College of Soochow University, 199 Ren-Ai Road, Suzhou 215123, PR China
| | - Chao Ma
- Department of Human Anatomy, Medical College of Soochow University, 199 Ren-Ai Road, Suzhou 215123, PR China
| | - Shuyi Huang
- Department of Human Anatomy, Medical College of Soochow University, 199 Ren-Ai Road, Suzhou 215123, PR China
| | - Ruomeng Wang
- Department of Human Anatomy, Medical College of Soochow University, 199 Ren-Ai Road, Suzhou 215123, PR China
| | - Jian Chen
- Department of Human Anatomy, Medical College of Soochow University, 199 Ren-Ai Road, Suzhou 215123, PR China
| | - Qing Guo
- Department of Human Anatomy, Medical College of Soochow University, 199 Ren-Ai Road, Suzhou 215123, PR China
| | - Jiaojiao Zhou
- Department of Human Anatomy, Medical College of Soochow University, 199 Ren-Ai Road, Suzhou 215123, PR China
| | - Hemin Zhu
- Department of Human Anatomy, Medical College of Soochow University, 199 Ren-Ai Road, Suzhou 215123, PR China
| | - Wenjie Li
- Department of Human Anatomy, Medical College of Soochow University, 199 Ren-Ai Road, Suzhou 215123, PR China
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Thetkathuek A, Yingratanasuk T, Ekburanawat W, Jaidee W, Sa-Ngiamsak T. The risk factors for occupational contact dermatitis among workers in a medium density fiberboard furniture factory in Eastern Thailand. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 76:255-265. [PMID: 32924862 DOI: 10.1080/19338244.2020.1819185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study was to determine the occupational exposure to formaldehyde on the medium-density fiberboard (MDF) dust and allergic contact dermatitis among the workers at a furniture factory. Data were collected from 439 subjects using questionnaires and patch testing to evaluate allergic contact dermatitis resulting from formaldehyde on wood dust exposure in the workplace. The geometric mean concentration of formaldehyde on MDF dust that the workers in the production department were exposed to was 2.07 ppm (GSD 4.54). Patch test results revealed that some subjects developed allergy to various substances, including epoxy resin (16.7%) and formaldehyde (5.6%). The odds ratios (95% CI) for contact dermatitis were 3.6 (1.7-7.3) among those with a history of metal allergy, 1.8 (0.6-5.2) whose family members having a history of allergic contact dermatitis. Exposure to MDF dust in the workplace should be reduced, as the current levels of exposure exceed the permissible OSHA standard.
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Affiliation(s)
- Anamai Thetkathuek
- Department of Industrial Hygiene and Safety, Faculty of Public Health, Burapha University, Chonburi, Thailand
| | - Tanongsak Yingratanasuk
- Department of Industrial Hygiene and Safety, Faculty of Public Health, Burapha University, Chonburi, Thailand
| | - Wiwat Ekburanawat
- Department of Industrial Hygiene and Safety, Faculty of Public Health, Burapha University, Chonburi, Thailand
| | - Wanlop Jaidee
- Department of Public Health Foundations, Faculty of Public Health, Burapha University, Chonburi, Thailand
| | - Teerayuth Sa-Ngiamsak
- Department of Industrial Hygiene and Safety, Faculty of Public Health, Burapha University, Chonburi, Thailand
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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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15
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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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Abstract
BACKGROUND Preservatives such as formaldehyde and formaldehyde releasers (F/FRs) are found in personal care products. Studies from Europe and Israel have indicated that products with undeclared F/FRs on product labels may have detectable levels of formaldehyde. OBJECTIVE The aim of the study was to determine the presence of formaldehyde in samples of US personal care products. METHODS Fifty-four baby and adult products were tested with the chromotropic acid method. A blinded investigator graded the color change as mild, moderate, or strong. RESULTS All 8 products declaring F/FRs resulted in a deep purple color change, indicating a strong reaction. Of the 46 products with undeclared F/FRs, 4 (8.6%) were found to release formaldehyde. All 4 resulted in a light purple color change, indicating a mild reaction. CONCLUSIONS Overall, 4 of 54 products (7.4%) had label information, which did not match chromotropic acid method testing results. Clinicians and formaldehyde-allergic individuals should be aware of the limitations of product ingredient labeling in managing allergic contact dermatitis to formaldehyde.
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Abstract
BACKGROUND Patch testing is an important diagnostic tool for the assessment of allergic contact dermatitis (ACD). OBJECTIVE This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2015, to February 28, 2017. METHODS At 13 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ test. RESULTS A total of 5597 patients were tested. There were 3725 patients (66.6%) who had at least 1 positive reaction, and 2798 patients (50.2%) were ultimately determined to have a primary diagnosis of ACD. A total of 572 patients (10.2%) had occupationally related skin disease. There were 10,983 positive allergic reactions. Nickel remained the most commonly detected allergen (17.5%). Methylisothiazolinone, which was added to the screening series for the 2013-2014 cycle, had the second highest positive reaction rate of allergens tested (13.4%). Compared with the previous reporting periods (2013-2014) and (2005-2014), positive reaction rates for the top 35 screening allergens statistically increased for only 1 allergen: hydroxyethyl methacrylate (3.4%; risk ratios, 1.24 [confidence interval, 1.00-1.54] and 1.46 [confidence interval, 1.23-1.73]). Three newly added allergen preparations-ammonium persulfate (1.7%), chlorhexidine (0.8%), and hydroquinone (0.3%)-all had a reaction rate of less than 2%. Twenty-three percent of the tested patients had at least 1 relevant allergic reaction to an allergen not on the NACDG series; 12% of these were occupationally related. T.R.U.E. Test (SmartPractice Denmark, Hillerød, Denmark) would have hypothetically missed one quarter to almost 40% of reactions detected by the NACDG screening series. CONCLUSIONS These results confirm that the epidemic of sensitivity to methylisothiazolinone has continued in North America. Patch testing with allergens beyond a screening tray is necessary for a complete evaluation of occupational and nonoccupational ACD.
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Aerts O, Goossens A. Preservatives. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_85-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lyapina MG, Manov VK, Cekova MP. Contact Sensitization to Formaldehyde in Veterinary Medicine - An Unexplored Field in Occupational Health. Indian J Occup Environ Med 2019; 23:37-41. [PMID: 31040588 PMCID: PMC6477945 DOI: 10.4103/ijoem.ijoem_156_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Veterinary staff and students could be exposed to formaldehyde – a ubiquitous agent, common cause of contact allergy. Aim: To evaluate the incidence of contact sensitization to formaldehyde in exposures in veterinary medicine. Settings and Design: A cross-sectional study was conducted during July–December 2017. Materials and Methods: A total of 206 individuals were included, patch tested with formaldehyde 1.0%/aq – 36 veterinary medicine students, 20 veterinarians, 47 students and 28 trainees of dental medicine, 41 dental professionals, and 35 non-occupationally exposed individuals. Results: The incidence of contact sensitization to formaldehyde among the whole studied population was 48.1%, highest being among the students of veterinary medicine (94.4%) and the veterinarians (85%). With very high significance, the sensitization incidence was higher in the groups of students of veterinary medicine and veterinarians, if compared to the control group (P < 0.001); (P = 0.004), dental professionals (P < 0.001); (P = 0.001), trainees of dental medicine (P < 0.001); (P = 0.005), and students of dental medicine three-fourth year of education (P < 0.001); (P = 0.001). Significantly, higher was the incidence of contact allergy in the control group if compared to those of dental professionals (P = 0.033) and dental students three-fourth year of education (P = 0.028). Conclusions: The exposure to formaldehyde during the education in veterinary medicine and practice could be an important risk factor for the onset of contact sensitization. Stricter preventive measures are needed to reduce veterinary student's and lecturer's exposures. Equipment of dissection tables with local exhaust ventilation system could reduce the concentration of formaldehyde in the gross anatomy laboratory.
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Affiliation(s)
- Maya G Lyapina
- Medical College, Iordanka Filaretova, Medical University, Sofia, Bulgaria
| | - Vasil K Manov
- Department of Internal Noninfectious Diseases, Pathology and Pharmacology, Faculty of Veterinary Medicine, University of Forestry, Sofia, Bulgaria
| | - Mariana P Cekova
- Department of Image and Oral Diagnostics, Faculty of Dental Medicine, Medical University, Sofia, Bulgaria
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Allergic contact dermatitis in preservatives: current standing and future options. Curr Opin Allergy Clin Immunol 2017; 17:263-268. [DOI: 10.1097/aci.0000000000000373] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Contact Allergy Cross-reactions: Retrospective Clinical Data and Review of the Literature. Dermatitis 2017; 28:128-140. [DOI: 10.1097/der.0000000000000254] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Potential Allergens in Disposable Diaper Wipes, Topical Diaper Preparations, and Disposable Diapers. Dermatitis 2016; 27:110-8. [DOI: 10.1097/der.0000000000000177] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hill H, Goldenberg A, Golkar L, Beck K, Williams J, Jacob SE. Pre-Emptive Avoidance Strategy (P.E.A.S.) – addressing allergic contact dermatitis in pediatric populations. Expert Rev Clin Immunol 2016; 12:551-61. [DOI: 10.1586/1744666x.2016.1142373] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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27
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Hauksson I, Pontén A, Isaksson M, Hamada H, Engfeldt M, Bruze M. Formaldehyde in cosmetics in patch tested dermatitis patients with and without contact allergy to formaldehyde. Contact Dermatitis 2015; 74:145-51. [DOI: 10.1111/cod.12493] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 09/08/2015] [Accepted: 09/21/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Inese Hauksson
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 20502 Malmö Sweden
| | - Ann Pontén
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 20502 Malmö Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 20502 Malmö Sweden
| | - Haneen Hamada
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 20502 Malmö Sweden
| | - Malin Engfeldt
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 20502 Malmö Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology; Skåne University Hospital, Lund University; 20502 Malmö Sweden
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