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Rodas-Areiza JS, Crespo-Vergara NM, Calle-Álvarez AM, Díez-Zuluaga LS, Santamaría-Salazar LC. Patch Test Results with the Latin American Baseline Series in a Colombian Population. 2016-2021. Dermatitis 2024. [PMID: 38842461 DOI: 10.1089/derm.2023.0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Background: Contact dermatitis (CD) is one of the most prevalent skin diseases. It is commonly divided into irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD). Patch testing is a procedure used to support the diagnosis of ACD. This test should be interpreted along with the clinical history and morphology of the skin lesions to determine clinical relevance. Objective: To describe the sensitization patterns of patients undergoing patch testing with the Latin American baseline series. Methods: A single-center retrospective study was performed. For the study, patients older than 18 years with a clinical diagnosis of contact dermatitis, who underwent patch testing using the Latin American baseline series were considered. These tests took place at the Alma Mater Hospital of Antioquia between January 1, 2016, and December 31, 2021. Results: A total of 648 patients were included. Patch tests were positive in 63% of cases, with a mean age of 51.5 years. Around 36.6% had atopy-related diseases. The main occupation was housework (30.7%). The hands were the most affected area in the body (31%). The main allergens were nickel sulfate (34%), sodium tetrachloropalladate (24.2%), and thimerosal (8.0%). Fifteen allergens had a percentage below 1%. Hydrocortisone and budesonide did not yield positive results. Conclusion: Nickel sulfate was the most frequent allergen, and women were the most affected. The information gathered could be useful for adjusting the allergens that should be included in the regional baseline series, taking into account the frequency found.
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Affiliation(s)
- Juan Sebastián Rodas-Areiza
- From the Clinical and Experimental Allergology Group (GACE), Alma Mater Hospital of Antioquia, University of Antioquia, Medellin, Colombia
| | - Nardey María Crespo-Vergara
- From the Clinical and Experimental Allergology Group (GACE), Alma Mater Hospital of Antioquia, University of Antioquia, Medellin, Colombia
| | - Ana María Calle-Álvarez
- Clinical and Experimental Allergology Group (GACE), Alma Mater Hospital of Antioquia, University of Antioquia, San Vicente Foundation Hospital, Medellin, Colombia
| | - Libia Susana Díez-Zuluaga
- Clinical and Experimental Allergology Group (GACE), Alma Mater Hospital of Antioquia, Medellín, Colombia
| | - Luis Carlos Santamaría-Salazar
- Clinical and Experimental Allergology Group (GACE), Alma Mater Hospital of Antioquia, University of Antioquia, San Vicente Foundation Hospital, Medellin, Colombia
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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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Tramontana M, Bianchi L, Hansel K, Agostinelli D, Stingeni L. Nickel Allergy: Epidemiology, Pathomechanism, Clinical Patterns, Treatment and Prevention Programs. Endocr Metab Immune Disord Drug Targets 2021; 20:992-1002. [PMID: 31994473 DOI: 10.2174/1871530320666200128141900] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/10/2019] [Accepted: 04/04/2019] [Indexed: 01/19/2023]
Abstract
Nickel is the most common cause of contact allergy in the general population and the most frequently detected allergen in patients patch tested for suspected allergic contact dermatitis (ACD). ACD from nickel is a typical type IV hypersensitivity. Nickel allergy is mostly caused by nonoccupational exposure, such as jewelry and clothing decorations, metal tools, medical devices (mainly orthopedic and orthodontic implants, cardiovascular prosthesis), eyeglasses, utensils, keys, pigment for paint, cosmetics, and food (mainly legumes, chocolate, salmon, peanuts). Occupational exposure can involve several workers (mechanics, metalworkers, platers, hairdressers, jewelers, workers in the constructions and electronic industries), classically involving hands and forearms. The classic clinical pattern of ACD caused by nickel is characterized by eczematous dermatitis involving the sites of direct contact with the metal. Non-eczematous-patterns are reported, including lichenoid dermatitis, granuloma annulare, vitiligo-like lesions, dyshidrosiform dermatitis, and vasculitis. In the case of systemic exposure to nickel, sensitized patients could develop systemic contact dermatitis. Patch testing represents the gold standard for the diagnosis of ACD from nickel. Treatment includes avoidance of contact with products containing nickel and the patient's education about the possible use of alternative products. A recent EU nickel directive, regulating the content and release of nickel from products, has caused a decrease of nickel contact allergy in some European countries. Nickel allergy is a relevant issue of public health with significant personal, social, and economic impact. This review summarizes epidemiology, pathomechanism, clinical patterns, treatment, and prevention programs.
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Affiliation(s)
- Marta Tramontana
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Leonardo Bianchi
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Katharina Hansel
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Daniela Agostinelli
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Luca Stingeni
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
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Scheinman PL, Vocanson M, Thyssen JP, Johansen JD, Nixon RL, Dear K, Botto NC, Morot J, Goldminz AM. Contact dermatitis. Nat Rev Dis Primers 2021; 7:38. [PMID: 34045488 DOI: 10.1038/s41572-021-00271-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 02/04/2023]
Abstract
Contact dermatitis (CD) is among the most common inflammatory dermatological conditions and includes allergic CD, photoallergic CD, irritant CD, photoirritant CD (also called phototoxic CD) and protein CD. Occupational CD can be of any type and is the most prevalent occupational skin disease. Each CD type is characterized by different immunological mechanisms and/or requisite exposures. Clinical manifestations of CD vary widely and multiple subtypes may occur simultaneously. The diagnosis relies on clinical presentation, thorough exposure assessment and evaluation with techniques such as patch testing and skin-prick testing. Management is based on patient education, avoidance strategies of specific substances, and topical treatments; in severe or recalcitrant cases, which can negatively affect the quality of life of patients, systemic medications may be needed.
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Affiliation(s)
- Pamela L Scheinman
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Marc Vocanson
- CIRI - Centre International de Recherche en Infectiologie, INSERM, U1111; Univ Lyon; Université Claude Bernard Lyon 1; Ecole Normale Supérieure de Lyon; CNRS, UMR, 5308, Lyon, France
| | - Jacob P Thyssen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jeanne Duus Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Rosemary L Nixon
- Skin Health Institute - Occupational Dermatology Research and Education Centre, Carlton, VIC, Australia
| | - Kate Dear
- Skin Health Institute - Occupational Dermatology Research and Education Centre, Carlton, VIC, Australia
| | - Nina C Botto
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Johanna Morot
- CIRI - Centre International de Recherche en Infectiologie, INSERM, U1111; Univ Lyon; Université Claude Bernard Lyon 1; Ecole Normale Supérieure de Lyon; CNRS, UMR, 5308, Lyon, France
| | - Ari M Goldminz
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.
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Comparison of Different Metal Salts: Nickel Sulfate 2.5% Versus 5% and Palladium Chloride Versus Sodium Tetrachloropalladate. Dermatitis 2020; 32:e44-e45. [PMID: 33273221 DOI: 10.1097/der.0000000000000662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Resor CD, Goldminz AM, Shekar P, Padera R, O'Gara PT, Shah PB. Systemic Allergic Contact Dermatitis Due to a GORE CARDIOFORM Septal Occluder Device: A Case Report and Literature Review. JACC Case Rep 2020; 2:1867-1871. [PMID: 34317069 PMCID: PMC8299130 DOI: 10.1016/j.jaccas.2020.05.091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/14/2020] [Accepted: 05/27/2020] [Indexed: 11/29/2022]
Abstract
Nickel hypersensitivity is a rarely reported complication of percutaneous patent foramen ovale/atrial septal defect closure. Herein, we report a case of systemic allergic contact dermatitis to nickel present in a GORE CARDIOFORM (W.L. Gore, Flagstaff, Arizona) septal occluder that resolved following explanation. To our knowledge this is the first published case of nickel hypersensitivity associated with this device. (Level of Difficulty: Beginner.)
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Affiliation(s)
- Charles D Resor
- The CardioVascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Ari M Goldminz
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Prem Shekar
- Department of Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Robert Padera
- Department of Pathology, Brigham and Women's Hosptial, Boston, Massachusetts
| | - Patrick T O'Gara
- Department of Cardiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Pinak B Shah
- Department of Cardiology, Brigham and Women's Hospital, Boston, Massachusetts
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Contact Allergy-Emerging Allergens and Public Health Impact. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072404. [PMID: 32244763 PMCID: PMC7177224 DOI: 10.3390/ijerph17072404] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 02/07/2023]
Abstract
Contact allergy (sensitisation) and allergic contact dermatitis (ACD) resulting from it have a considerable public health impact. For the present review, all pertinent articles were systematically searched via Medline and Web of Science™; additionally, all available issues of the journals "Contact Dermatitis" and "Dermatitis" were manually searched, covering the years 2018-2019, thereby extending and re-focusing a previous similar review. New allergens, or previously described allergens found in a new exposure context or of other current importance, are described in sections according to substance classes, e.g., metals, preservatives, fragrances. As a common finding in many investigations, a lack of information on product composition has been noted, for instance, regarding a newly described allergen in canvas shoes (dimethylthiocarbamylbenzothiazole sulfide) and, most notably, absence of co-operation from manufacturers of glucose-monitoring devices and insulin pumps, respectively. These latter devices have been shown to cause severe ACD in a considerable number of diabetic patients caused by the liberation of isobornyl acrylate and N,N'-dimethylacrylamide, respectively, as demonstrated by an international collaboration between dermatologists and chemists. Improved and complete ingredient labelling for all types of products, and not just cosmetics, must be put on the legislative agenda.
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Patch Test Results of Contact Sensitization in Children Without Atopic Dermatitis: A Single Tertiary Center Experience. Dermatitis 2019; 31:153-156. [DOI: 10.1097/der.0000000000000530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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