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Navarro-Triviño FJ, Borrego L, Silvestre-Salvador JF, Mercader-García P, Giménez-Arnau AM, Ortiz-de Frutos FJ, Sanz-Sánchez T, Melé-Ninot G, Sánchez-Gilo A, Zaragoza-Ninet V, Serra-Baldrich E, Miquel-Miquel J, Córdoba-Guijarro S, Rodríguez-Serna M, Ruíz-González I, Carrascosa-Carrillo JM, Gómez-de la Fuente E, Pastor-Nieto MA, Heras-Mendaza F, González-Pérez R, Sánchez-Pedreño Guillén P, Sánchez-Pérez J, Gatica-Ortega ME, Fernández-Redondo V, Hervella-Garcés M, Manrique-Martínez P, Guimaraens-Juanena D, García-Gavín J, Giménez-Arnau E, Figueras-Nart I, Curto-Barredo L, Armario-Hita JC. Standard and Expanded Series Patch Testing Update by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC). ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:712-721. [PMID: 38556197 DOI: 10.1016/j.ad.2024.03.024] [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: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 04/02/2024] Open
Abstract
After the meeting held by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) back in October 2021, changes were suggested to the Spanish standard series patch testing. Hydroxyethyl methacrylate (2% pet.), textile dye mixt (6.6% pet.), linalool hydroperoxide (1% pet.), and limonene hydroperoxide (0.3% pet.) were, then, added to the series that agreed upon in 2016. Ethyldiamine and phenoxyethanol were excluded. Methyldibromoglutaronitrile, the mixture of sesquiterpene lactones, and hydroxyisohexyl 3-cyclohexene (Lyral) were alo added to the extended Spanish series of 2022.
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Affiliation(s)
- F J Navarro-Triviño
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - L Borrego
- Servicio de Dermatología, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
| | | | - P Mercader-García
- Servicio de Dermatología, Hospital Universitario José María Morales Meseguer, Murcia, España
| | - A M Giménez-Arnau
- Servicio de Dermatología, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, España
| | - F J Ortiz-de Frutos
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - T Sanz-Sánchez
- Servicio de Dermatología, Hospital Universitario Infanta Sofía, Madrid, España
| | - G Melé-Ninot
- Servicio de Dermatología, Hospital Universitari Sagrar Cor, Grupo Quironsalud, Barcelona, España
| | - A Sánchez-Gilo
- Servicio de Dermatología, Hospital Universitario Rey Juan Carlos, Madrid, España
| | - V Zaragoza-Ninet
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - E Serra-Baldrich
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - J Miquel-Miquel
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Valencia, España
| | - S Córdoba-Guijarro
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, España
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - I Ruíz-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - J M Carrascosa-Carrillo
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | | | - M A Pastor-Nieto
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - F Heras-Mendaza
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - R González-Pérez
- Servicio de Dermatología, Hospital Universitario Áraba, Universidad del País Vasco, Vitoria, Álava, España
| | | | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España
| | - M E Gatica-Ortega
- Servicio de Dermatología, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - V Fernández-Redondo
- Servicio de Dermatología, Complejo Hospitalario Universitario de Santiago, Universidad de Santiago, Santiago de Compostela, La Coruña, España
| | - M Hervella-Garcés
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - P Manrique-Martínez
- Servicio de Dermatología, Hospital Universitario Galdakao-Usansolo, Galdakao, Vizcaya, España
| | | | | | - E Giménez-Arnau
- Institut de Chimie CNRS UMR 7177, University of Strasbourg, Estrasburgo, Francia
| | - I Figueras-Nart
- Servicio de Dermatología, Hospital Universitario de Bellvitge, L' Hospitalet de Llobregat, Barcelona, España
| | - L Curto-Barredo
- Servicio de Dermatología, Hospital del Mar, Barcelona, España
| | - J C Armario-Hita
- Servicio de Dermatología, Hospital Universitario Puerto Real, Universidad de Cádiz, Cádiz, España
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2
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Navarro-Triviño FJ, Borrego L, Silvestre-Salvador JF, Mercader-García P, Giménez-Arnau AM, Ortiz-de Frutos FJ, Sanz-Sánchez T, Melé-Ninot G, Sánchez-Gilo A, Zaragoza-Ninet V, Serra-Baldrich E, Miquel-Miquel J, Córdoba-Guijarro S, Rodríguez-Serna M, Ruíz-González I, Carrascosa-Carrillo JM, Gómez-de la Fuente E, Pastor-Nieto MA, Heras-Mendaza F, González-Pérez R, Sánchez-Pedreño Guillén P, Sánchez-Pérez J, Gatica-Ortega ME, Fernández-Redondo V, Hervella-Garcés M, Manrique-Martínez P, Guimaraens-Juanena D, García-Gavín J, Giménez-Arnau E, Figueras-Nart I, Curto-Barredo L, Armario-Hita JC. [Translated article] Standard and Expanded Series Patch Testing Update by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC). ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00439-3. [PMID: 38823769 DOI: 10.1016/j.ad.2024.05.018] [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: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 06/03/2024] Open
Abstract
After the meeting held by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) back in October 2021, changes were suggested to the Spanish Standard Series patch testing. Hydroxyethyl methacrylate (2% pet.), textile dye mixt (6.6% pet.), linalool hydroperoxide (1% pet.), and limonene hydroperoxide (0.3% pet.) were, then, added to the series that agreed upon in 2016. Ethyldiamine and phenoxyethanol were excluded. Methyldibromoglutaronitrile, the mixture of sesquiterpene lactones, and hydroxyisohexyl 3-cyclohexene (Lyral) were also added to the extended Spanish series of 2022.
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Affiliation(s)
- F J Navarro-Triviño
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
| | - L Borrego
- Servicio de Dermatología, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
| | | | - P Mercader-García
- Servicio de Dermatología, Hospital Universitario José María Morales Meseguer, Murcia, Spain
| | - A M Giménez-Arnau
- Servicio de Dermatología, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, Spain
| | - F J Ortiz-de Frutos
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - T Sanz-Sánchez
- Servicio de Dermatología, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - G Melé-Ninot
- Servicio de Dermatología, Hospital Universitari Sagrar Cor, Grupo Quironsalud, Barcelona, Spain
| | - A Sánchez-Gilo
- Servicio de Dermatología, Hospital Universitario Rey Juan Carlos, Madrid, Spain
| | - V Zaragoza-Ninet
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, Spain
| | - E Serra-Baldrich
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J Miquel-Miquel
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Valencia, Spain
| | - S Córdoba-Guijarro
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - I Ruíz-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, Spain
| | - J M Carrascosa-Carrillo
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | | | - M A Pastor-Nieto
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - F Heras-Mendaza
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - R González-Pérez
- Servicio de Dermatología, Hospital Universitario Áraba, Universidad del País Vasco, Vitoria, Álava, Spain
| | | | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, Spain
| | - M E Gatica-Ortega
- Servicio de Dermatología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - V Fernández-Redondo
- Servicio de Dermatología, Complejo Hospitalario Universitario de Santiago, Universidad de Santiago, Santiago de Compostela, La Coruña, Spain
| | - M Hervella-Garcés
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - P Manrique-Martínez
- Servicio de Dermatología, Hospital Universitario Galdakao-Usansolo, Galdakao, Vizcaya, Spain
| | | | | | - E Giménez-Arnau
- Institut de Chimie CNRS UMR 7177, University of Strasbourg, Strasbourg, France
| | - I Figueras-Nart
- Servicio de Dermatología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - L Curto-Barredo
- Servicio de Dermatología, Hospital del Mar, Barcelona, Spain
| | - J C Armario-Hita
- Servicio de Dermatología, Hospital Universitario Puerto Real, Universidad de Cádiz, Cádiz, Spain
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3
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Ekstein SF, Warshaw EM. Sulfites: Allergen of the Year 2024. Dermatitis 2024; 35:6-12. [PMID: 37590472 DOI: 10.1089/derm.2023.0154] [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: 08/19/2023]
Abstract
Sodium disulfite, also known as sodium metabisulfite or sodium pyrosulfite, is an inorganic compound, which may cause allergic contact dermatitis. Sulfites act as antioxidants and preservatives; common sources include food/beverages, pharmaceuticals, and personal care products. Importantly, sulfites are not included in most screening patch test series and thus may be missed as a relevant contact allergen. The American Contact Dermatitis Society chose sulfites as the Allergen of the Year for 2024 to raise awareness about this significant allergen.
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Affiliation(s)
- Samuel F Ekstein
- From the Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota, USA
| | - Erin M Warshaw
- From the Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
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4
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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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5
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Warshaw EM, Buonomo M, DeKoven JG, Atwater AR, Reeder MJ, Belsito DV, Silverberg JI, Taylor JS, Maibach HI, Zug KA, Sasseville D, Fowler JF, Pratt MD, DeLeo VA, Zirwas MJ. Patch testing with sodium disulfite: North American Contact Dermatitis Group experience, 2017 to 2018. Contact Dermatitis 2021; 85:285-296. [PMID: 33843061 DOI: 10.1111/cod.13860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/23/2021] [Accepted: 04/07/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sodium disulfite (SD), also known as sodium metabisulfite, is an increasingly recognized cause of allergic contact dermatitis. OBJECTIVES The objective of this work was to characterize individuals with positive patch test reactions to SD as well as analyse reaction strength, clinical relevance, and sources. METHODS This is a retrospective analysis of patients patch tested with SD (1% petrolatum) by the North American Contact Dermatitis Group (NACDG), 2017 to 2018. RESULTS Of 4885 patients patch tested with SD, 132 (2.7%) had a positive reaction. Common primary anatomic sites of dermatitis were face (28.8%), hands (20.5%), and a scattered/generalized distribution (13.6%). Compared with SD-negative patients, SD-positive patients were more likely male (odds ratio 2.81, 95% confidence interval 1.98-4.00) and/or over 40 years (odds ratio 1.95, 95% confidence interval 1.30-2.94). Reactions were most commonly + (50.4%) or ++ (34.1%); 65.2% were considered currently relevant. About 15.2% were definitively confirmed in sources, commonly personal care products (18.9%, especially hair dye), and drugs/medications/alcoholic beverages (9.1%). Only 2.3% of positive reactions were linked to occupation. CONCLUSIONS Positive reactions to SD occurred in 2.7% of tested patients. Reactions were often clinically relevant and linked to personal care products and drugs/medications/alcoholic beverages.
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Affiliation(s)
- Erin M Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA.,Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
| | - Michele Buonomo
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA.,Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.,University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical School, New York, New York, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Denis Sasseville
- Division of Dermatology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Joseph F Fowler
- Division of Dermatology, University of Louisville, Louisville, Kentucky, USA
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California, USA
| | - Matt J Zirwas
- Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, USA
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7
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Sodium Disulfite/Bisulfite Allergy Manifesting From Dish Soap: Not Limited to Hairdressing or Food Industries. Dermatitis 2020; 31:e51-e52. [DOI: 10.1097/der.0000000000000576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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9
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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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10
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Uter W, Werfel T, White IR, Johansen JD. Contact Allergy: A Review of Current Problems from a Clinical Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061108. [PMID: 29844295 PMCID: PMC6025382 DOI: 10.3390/ijerph15061108] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/20/2018] [Accepted: 05/26/2018] [Indexed: 12/17/2022]
Abstract
Contact allergy is common, affecting 27% of the general population in Europe. Original publications, including case reports, published since 2016 (inclusive) were identified with the aim of collating a full review of current problems in the field. To this end, a literature search employing methods of systematic reviewing was performed in the Medline® and Web of Science™ databases on 28 January 2018, using the search terms (“contact sensitization” or “contact allergy”). Of 446 non-duplicate publications identified by above search, 147 were excluded based on scrutiny of title, abstract and key words. Of the remaining 299 examined in full text, 291 were deemed appropriate for inclusion, and main findings were summarised in topic sections. In conclusion, diverse sources of exposures to chemicals of widely-differing types and structures, continue to induce sensitisation in man and may result in allergic contact dermatitis. Many of the chemicals are “evergreen” but others are “newcomers”. Vigilance and proper investigation (patch testing) are required to detect and inform of the presence of these haptens to which our populations remain exposed.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, 91054 Erlangen, Germany.
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, 30625 Hannover, Germany.
| | - Ian R White
- St John's Institute of Dermatology, Guy's Hospital, London SE1 9RT, UK.
| | - Jeanne D Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Herlev and Gentofte, 2900 Hellerup, Denmark.
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11
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Borges AS, Valejo Coelho MM, Fernandes C, Brasileiro A, Gonçalo M. Systemic allergic dermatitis caused by sodium metabisulfite in rectal enemas. Contact Dermatitis 2018; 78:429-430. [DOI: 10.1111/cod.12971] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 12/27/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Ana S. Borges
- Dermatology and Venereology Department, Hospital Santo António dos CapuchosCentro Hospitalar de Lisboa Central 1169‐050 Lisbon Portugal
| | - Margarida M. Valejo Coelho
- Dermatology and Venereology Department, Hospital Santo António dos CapuchosCentro Hospitalar de Lisboa Central 1169‐050 Lisbon Portugal
| | - Cândida Fernandes
- Dermatology and Venereology Department, Hospital Santo António dos CapuchosCentro Hospitalar de Lisboa Central 1169‐050 Lisbon Portugal
| | - Ana Brasileiro
- Dermatology and Venereology Department, Hospital Santo António dos CapuchosCentro Hospitalar de Lisboa Central 1169‐050 Lisbon Portugal
| | - Margarida Gonçalo
- Clinic of Dermatology, University Hospital and Faculty of MedicineUniversity of Coimbra 3000‐075 Coimbra Portugal
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