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Gracia-Cazaña T, Aguilera J, Navarro-Bielsa A, González S, Lim HW, Gilaberte Y. New trends on personalized sunscreens. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12967. [PMID: 38616500 DOI: 10.1111/phpp.12967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 03/18/2024] [Accepted: 04/02/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND/PURPOSE Nowadays, there are emerging trends in customized and personalized photoprotection, focusing on the innovative approaches to enhance sun protection efficacy tailored to individual needs. METHODS We conducted an electronic search of the following databases: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Skin Group Specialised Skin Register, and TESEO. Specific search terms related to personalized photoprotection and the variables of age, genetic predisposition, skin phototype, photodermatosis, and physiological conditions such as pregnancy, as well as lifestyle habits were used. RESULTS/CONCLUSION The article highlights the challenges and opportunities in adopting personalized photoprotection strategies, aiming to promote skin health and prevent the harmful effects of UV radiation in the era of precision medicine.
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Affiliation(s)
- Tamara Gracia-Cazaña
- Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - José Aguilera
- Department of Dermatology and Medicine, Faculty of Medicine, Photobiological Dermatology Laboratory, Medical Research Center, University of Malaga, Malaga, Spain
| | - Alba Navarro-Bielsa
- Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | | | - Henry W Lim
- Department of Dermatology, Henry Ford Health Systems, Henry Ford Medical Center-New Center One, Detroit, Michigan, USA
| | - Yolanda Gilaberte
- Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
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2
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Tous-Romero F, Giménez-Arnau AM, Sanz-Sánchez T, González Pérez R, Carrascosa-Carrillo JM, Zaragoza-Ninet V, Córdoba-Guijarro S, Gática-Ortega ME, Miquel-Miquel J, Borrego-Hernando L, Ruíz-González I, Serra-Baldrich E, Silvester-Salvador JF, Mercader-García P, Sánchez-Pérez J, Rodríguez-Serna M, Pastor-Nieto A, Hervella-García M, García-Doval I, Ortiz-de Frutos FJ. Allergic contact dermatitis to alkyl glucosides: Epidemiological situation in Spain. J Eur Acad Dermatol Venereol 2023; 37:e334-e337. [PMID: 36153692 DOI: 10.1111/jdv.18595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Fátima Tous-Romero
- Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | | | | | | | | | - Javier Miquel-Miquel
- Dermatology Department, Hospital Universitario Arnau de Vilanova, Valencia, Spain
| | - Leopoldo Borrego-Hernando
- Dermatology Department, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | | | | | | | - Pedro Mercader-García
- Dermatology Department, Hospital General Universitario Jose Mª Morales Meseguer, Murcia, Spain
| | | | | | - Antonia Pastor-Nieto
- Dermatology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | | | - Ignacio García-Doval
- Unidad de Investigación of the Fundación Piel Sana AEDV of the Spanish Academy of Dermatology, Madrid, Spain
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3
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Wilkinson SM, Gonçalo M, Aerts O, Badulici S, Dickel H, Gallo R, Garcia-Abujeta JL, Giménez-Arnau AM, Hamman C, Hervella M, Isaksson M, Johansen JD, Mahler V, Niklasson B, Pigatto P, Ponyai G, Rustemeyer T, Schuttelaar MLA, Spiewak R, Stingeni L, Thyssen JP, Uter W. The European baseline series and recommended additions: 2023. Contact Dermatitis 2023; 88:87-92. [PMID: 36443008 DOI: 10.1111/cod.14255] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/09/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
The European baseline series was last updated in 2019. This article discusses the reasoning behind a further iteration of the series for 2023.
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Affiliation(s)
| | - Margarida Gonçalo
- Clinic of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Olivier Aerts
- University Hospital Antwerp (UZA) and University of Antwerp (UA), Antwerp, Belgium
| | - Sonia Badulici
- Alfa Medical Services, Bucharest, Romania.,Dermato-Aesthetic Institute Dr. Irinel Nedelcu, Bucharest, Romania
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Centre, Ruhr University Bochum, Bochum, Germany
| | - Rosella Gallo
- Clinica Dermatologica-DISSAL-Università di Genova Ospedale Policlinico San Martino, Genova, Italy
| | | | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Pompeu Fabra, Barcelona, Spain
| | - Curt Hamman
- Contact Dermatitis Institute, Phoenix, Arizona, USA
| | - Marcos Hervella
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | | | | | - Paolo Pigatto
- IRCCS Galeazzi Orthopaedic Institute, Milan Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Gyorgyi Ponyai
- Department of Dermatology-Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | | | - Marie L A Schuttelaar
- University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | | | - Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Jacob P Thyssen
- Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen-Nürnberg, Erlangen, Germany
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Abstract
Sensitive skin is characterized by symptoms such as stinging and tingling in response to stimuli that usually do not cause unpleasant sensations. Epidemiological studies show that individuals with sensitive skin are more prone to developing skin allergies, although the link between both conditions is unknown. Aiming to evaluate the presence of allergens in facial-skin products for sensitive skin, a pool of 88 cosmetic products from international brands marketed in pharmacies and parapharmacies was analyzed. A list of allergens identified in product labels was compiled and grouped according to their function. Fragrances were the most common allergens, followed by skin-conditioning agents, surfactants, and preservatives. Fragrances presenting the highest use percentages were linalool, benzyl alcohol, geraniol, and citronellol. Overall, the majority of cosmetic formulations were absent of fragrance allergens, being present only in 7% of products. Other allergens were found in most products (95%). This finding should be interpreted with caution, since many of these compounds are rare sensitizers and studies demonstrating their risk for individuals with sensitive skin are lacking. With this study, useful information for health professionals is provided to support their advice and to help consumers choosing cosmetic products.
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5
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Uter W, Wilkinson SM, Aerts O, Bauer A, Borrego L, Buhl T, Cooper SM, Dickel H, Gallo R, Giménez-Arnau AM, John SM, Navarini AA, Pesonen M, Pónyai G, Rustemeyer T, Schliemann S, Schubert S, Schuttelaar MLA, Valiukevičienė S, Wagner N, Weisshaar E, Gonçalo M. European patch test results with audit allergens as candidates for inclusion in the European Baseline Series, 2019/20 - Joint results of the ESSCA A and the EBS B working groups of the ESCD, and the GEIDAC C. Contact Dermatitis 2022; 86:379-389. [PMID: 35099073 DOI: 10.1111/cod.14059] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND In 2019, a number of allergens (haptens), henceforth, 'the audit allergens,' were considered as potential additions to the European baseline series (EBS), namely, sodium metabisulfite, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, imidazolidinyl urea, Compositae mix II (2.5 or 5% pet), linalool hydroperoxides (lin-OOH), limonene hydroperoxides (lim-OOH), benzisothiazolinone (BIT), octylisothiazolinone (OIT), decyl glucoside, lauryl glucoside; Evernia furfuracea (tree moss), was additionally tested by some departments, too. OBJECTIVES To collect further data on patch test reactivity and clinical relevance of the audit allergens in consecutive patients across Europe. METHODS Patch test data covering the audit allergens in 2019 and 2020 were collected by those departments of the ESSCA testing these, as well as further collaborators from the EBS working group of the ESCD, and the Spanish GEIDAC. As patch test outcome, reactions between day (D) 3 and D5 were considered. RESULTS Altogether n=12403 patients were tested with any of the audit allergen. Positive reactions were most common to lin-OOH 1% pet. (8.74 (8.14-9.37)), followed by lin-OOH 0.5% pet., and lim-OOH 0.3% pet (5.41 (4.95-5.89)). Beyond these terpene hydroperoxides, BIT 0.1% pet. was the second most common allergen with 4.72 (4.2-5.28), followed by sodium metabisulfite 1% pet. (3.75 (3.32-4.23)) and Compositae mix 5% pet. (2.31 (1.84-2.87). For some allergens, clinical relevance was frequently difficult to ascertain. CONCLUSIONS Despite many positive patch test reactions, it remains controversial whether lin- and lim-OOH should be tested routinely, while at least the two preservatives BIT and sodium metabisulfite appear suitable. The present results are a basis for further discussion among the ESCD members and ultimately decision on their implementation into routine testing. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - S Mark Wilkinson
- Dermatology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and Research group Immunology, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Andrea Bauer
- Department of Dermatology, University Allergy Centre, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Leopoldo Borrego
- Complejo Hospitalario Universitario Insular Materno Infantil. Universidad de las Palmas de Gran Canaria, Spain
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Susan M Cooper
- Department of Dermatology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Rosella Gallo
- Clinica Dermatologica, Department of Health Sciences, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Swen M John
- Department of Dermatology and Environmental Medicine, Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute for Occupational Dermatology (NIB), Osnabrück, Germany
| | | | - Maria Pesonen
- Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Györgyi Pónyai
- Semmelweis University, Department of Dermatology, Venerology and Dermatooncology, Budapest, Hungary
| | - Thomas Rustemeyer
- Department of Dermatology-Allergology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Steffen Schubert
- Information Network of Departments of Dermatology, Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Marie-Louise A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nicola Wagner
- Department of Dermatology, University Hospital of Erlangen, University of Erlangen-, Nuremberg, (FAU), Erlangen, Germany
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Margarida Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Baudy A, Dereure O, Du-Thanh A, Raison-Peyron N. Allergic contact dermatitis in response to cetearyl glucoside from a topical drug. Contact Dermatitis 2021; 86:125-127. [PMID: 34628676 DOI: 10.1111/cod.13985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Amandine Baudy
- Department of Dermatology, Université Montpellier, Montpellier, France
| | - Olivier Dereure
- Department of Dermatology, Université Montpellier, Montpellier, France
| | - Aurélie Du-Thanh
- Department of Dermatology, Université Montpellier, Montpellier, France
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7
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Neale H, Garza-Mayers AC, Tam I, Yu J. Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children. J Am Acad Dermatol 2020; 84:235-244. [PMID: 33217510 DOI: 10.1016/j.jaad.2020.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/27/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022]
Abstract
Allergic contact dermatitis (ACD), a delayed hypersensitivity skin reaction to environmental allergens, has a prevalence that is similar in children and adults. However, diagnostic testing for ACD in pediatric populations accounts for less than one tenth of all patch tests. The relative infrequency of pediatric patch testing may be attributed to the difficulty in testing in this population, which includes a smaller surface area for patch test placement and maintaining cooperation during patch testing, especially in younger children. Diagnosis can be difficult in children because the appearance of ACD can mimic other common pediatric skin conditions, particularly atopic dermatitis and irritant contact dermatitis. Comprehensive history taking, guided by patient presentation, age group, and location of dermatitis, helps build clinical suspicion. Such clinical suspicion is one of the major reasons behind patch testing, with additional indications being recalcitrant dermatitis and dermatitis with atypical distribution. US pediatric data have shown the top allergens to be metals, fragrances, topical antibiotics, preservatives, and emollients. These trends are important to recognize to guide management and accurate diagnosis, because ACD tends to persist if the allergen is not identified and can affect patients' quality of life.
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Affiliation(s)
- Holly Neale
- University of Massachusetts School of Medicine, Worcester, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Anna Cristina Garza-Mayers
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Idy Tam
- Tufts University School of Medicine, Boston, Massachusetts
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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8
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Phadungsaksawasdi P, Sirithanabadeekul P. Ultraviolet filters in sunscreen products labeled for use in children and for sensitive skin. Pediatr Dermatol 2020; 37:632-636. [PMID: 32323359 DOI: 10.1111/pde.14170] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 03/08/2020] [Accepted: 03/19/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The active ingredients in sunscreen products are ultraviolet (UV) filters, many of which are known potential allergens. The use of sunscreen in younger children and individuals with sensitive skin requires special attention, since absorption and allergen sensitization are of concern. OBJECTIVE This study aims to evaluate the ultraviolet filters in sunscreen products labeled specifically for "kids" or as "sensitive/hypoallergenic" and compare these to general sunscreen products. METHODS From December 2017 to March 2018, the ingredient labels on commercially available sunscreen products in Bangkok, Thailand, were analyzed. RESULTS Two hundred and forty-six sunscreen products were examined. Of these, twenty products (8.1%) were marketed for "kids." Forty-one products (16.6%) were labeled as "sensitive" or "hypoallergenic." Ethylhexyl methoxycinnamate (EHMC) and benzophenone-3 (BP3) were less prevalent in products for children [(P = .004) and (P = .029), respectively]. Eighty-five percent of sunscreen products labeled for kids contained at least one chemical UV filter. There was no significant difference between BP3, butyl methoxydibenzoylmethane (BMDM), and octocrylene (OCR) in products labeled for sensitive skin compared to products with no specific labels. Moreover, methylene bis-benzotriazolyl tetramethylbutylphenol (MBBT) was more commonly found in products for sensitive skin than in nonsensitive products (P = .001). CONCLUSIONS Common allergenic UV filters were found in sunscreens labeled as sensitive and for children. Regulations for displaying these specific labels should be established for improved benefits and safety to allergy-prone skin.
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Affiliation(s)
- Pawit Phadungsaksawasdi
- Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Punyaphat Sirithanabadeekul
- Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
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9
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Weinhammer AP, Scheman A, Reeder MJ. Prevalence of Surfactant in the Contact Allergen Management Program. Dermatitis 2019; 30:358-362. [PMID: 31724989 DOI: 10.1097/der.0000000000000511] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Surfactants are common ingredients in topical products, which can cause both irritant and allergic contact dermatitis. OBJECTIVE The aim of this study was to determine the prevalence of 12 common groups of surfactants and 12 common individual surfactants among products in each category in the American Contact Dermatitis Society Contact Allergen Management Program (CAMP). METHODS The American Contact Dermatitis Society CAMP was queried for the 12 surfactant groups and the 12 individual surfactants. RESULTS The laureth/pareth sulfate group was the most prevalent surfactant group in CAMP products (17.9%). Laureth/pareth sulfates were the most common surfactant group in all product categories, except household and eye care products. The betaine/sultaine group (13.5%) and glucosides (10.0%) were also found in a significant proportion of CAMP products. Oleamidopropyl dimethylamine has the highest positive reaction rate (3.5%) but was tied for the lowest prevalence (0.20%) of the 12 individual surfactants studied. In contrast, cocamidopropyl betaine has a lower positive reaction rate (1.6%) with a higher prevalence (10.4%). CONCLUSIONS Surfactants were commonly found across all product types in CAMP. This study provides important information on allergen and irritant exposures in care products.
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10
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Clinically relevant contact allergens in the modern era. Ann Allergy Asthma Immunol 2019; 123:539-541. [PMID: 31276806 DOI: 10.1016/j.anai.2019.06.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 06/18/2019] [Accepted: 06/25/2019] [Indexed: 11/24/2022]
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12
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13
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Wilkinson M, Gonçalo M, Aerts O, Badulici S, Bennike NH, Bruynzeel D, Dickel H, Garcia-Abujeta JL, Giménez-Arnau AM, Hamman C, Isaksson M, Johansen JD, Mahler V, Niklasson B, Orton D, Pigatto P, Ponyai G, Rustemeyer T, Schuttelaar MLA, Spiewak R, Thyssen JP, Uter W. The European baseline series and recommended additions: 2019. Contact Dermatitis 2018; 80:1-4. [PMID: 30421432 DOI: 10.1111/cod.13155] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 09/30/2018] [Accepted: 10/01/2018] [Indexed: 02/06/2023]
Affiliation(s)
| | - Margarida Gonçalo
- Clinic of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Olivier Aerts
- University Hospital Antwerp (UZA) and University of Antwerp (UA), Antwerp, Belgium
| | | | - Niels H Bennike
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | | | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Bochum, Germany
| | | | | | - Curt Hamman
- Contact Dermatitis Institute, Phoenix, Arizona
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | | | | | | | - Paolo Pigatto
- IRCCS Galeazzi Orthopaedic Institute, Milan Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Gyorgyi Ponyai
- Department of Dermatology, Venerology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | | | - Marie L A Schuttelaar
- University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - Jacob P Thyssen
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen-Nürnberg, Erlangen, Germany
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14
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Are Injection Site Reactions in Monoclonal Antibody Therapies Caused by Polysorbate Excipient Degradants? J Pharm Sci 2018; 107:2735-2741. [PMID: 30055223 DOI: 10.1016/j.xphs.2018.07.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/11/2018] [Accepted: 07/17/2018] [Indexed: 12/22/2022]
Abstract
Injection site reactions (ISRs) and other adverse side effects are commonly observed during therapy with biologics. These hypersensitivity-related side effects can vary from simple rash to life-threatening anaphylactic reaction and may be linked to the immunogenicity of the drug including formation of antidrug antibodies. Reactions can also occur as a consequence of excipients in the product. We report the case of a patient who developed erythematous ISRs to both commercial PCSK9i formulations and had to go off therapy even though efficacy was not impacted. Skin testing showed that the patient was reacting to the polysorbates. Polysorbates are added to stabilize the biotherapeutic. Polysorbates can also activate complement and lead to a range of acute hypersensitivity and systemic immunostimulation reactions. Oxidative degradation products can function as haptens by reacting with proteins at the injection site. Reactive degradation products may even form adducts with the biologic itself, creating a potential neoantigen. Further research is needed to understand the fundamental causes of ISRs. It is critical that only the highest quality raw material is used, and proper storage conditions are employed to minimize degradation of polysorbates in the product. Although complete elimination of ISRs is unlikely, all efforts must be made to minimize them.
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15
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Boucneau F, Goossens A, Huygens S, Gilissen L. Arachidyl glucoside: Another cosmetic allergen. Contact Dermatitis 2018; 79:321-323. [DOI: 10.1111/cod.13077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 06/17/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Friedel Boucneau
- Department of Dermatology; University Hospital, Katholieke Universiteit Leuven; Leuven Belgium
| | - An Goossens
- Department of Dermatology; University Hospital, Katholieke Universiteit Leuven; Leuven Belgium
| | - Sara Huygens
- Department of Dermatology; University Hospital, Katholieke Universiteit Leuven; Leuven Belgium
| | - Liesbeth Gilissen
- Department of Dermatology; University Hospital, Katholieke Universiteit Leuven; Leuven Belgium
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16
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Kerre S, Strobbe T, Naessens T, Theunis M, Foubert K, Aerts O. Alkyl glucosides: Newly identified allergens in foam wound dressings. Contact Dermatitis 2018; 79:191-193. [DOI: 10.1111/cod.13026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 04/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - Tine Strobbe
- Imelda ziekenhuis, Department Dermatology; Bonheiden Belgium
| | - Tania Naessens
- Research Group Natural Products and Food-Research and Analysis (NatuRA), Department of Pharmaceutical Sciences; University of Antwerp (UA); Antwerp Belgium
| | - Mart Theunis
- Research Group Natural Products and Food-Research and Analysis (NatuRA), Department of Pharmaceutical Sciences; University of Antwerp (UA); Antwerp Belgium
| | - Kenn Foubert
- Research Group Natural Products and Food-Research and Analysis (NatuRA), Department of Pharmaceutical Sciences; University of Antwerp (UA); Antwerp Belgium
| | - Olivier Aerts
- Department of Dermatology; University Hospital Antwerp (UZA) and University of Antwerp (UA); Antwerp Belgium
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17
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Contact Dermatitis Associated With Skin Cleansers: Retrospective Analysis of North American Contact Dermatitis Group Data 2000–2014. Dermatitis 2018; 29:32-42. [DOI: 10.1097/der.0000000000000330] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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