1
|
Pesqué D, Borrego L, Zaragoza-Ninet V, Sanz-Sánchez T, Miquel-Miquel FJ, González-Pérez R, Silvestre JF, Córdoba-Guijarro S, Carrascosa JM, Gatica-Ortega ME, Ruiz-González I, Mercader-García P, Tous-Romero F, Ortiz de Frutos FJ, Serra-Baldrich E, Pastor-Nieto MA, Rodríguez-Serna M, Sánchez-Pérez J, Sánchez-Gilo A, Melé-Ninot G, Sánchez-Pedreño Guillén P, Pujol RM, Giménez-Arnau AM. Polysensitization in the Spanish Contact Dermatitis Registry (REIDAC): A 2019-2022 prospective study with cluster and network analysis. J Eur Acad Dermatol Venereol 2024. [PMID: 38411353 DOI: 10.1111/jdv.19934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/23/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND There is still limited clinical-practice data on specific clinical and patch test features, as well as on allergen clusters in polysensitization (PS). OBJECTIVES To determine the frequency, relevance, symptoms duration and risk factors in polysensitized patients and to assess possible allergen aggregation. METHODS Prospective multicentric study (January 2019-December 2022) conducted in setting of the Spanish Contact Dermatitis Register (REIDAC). Clinical and patch test data of polysensitized and oligosensitized patients were compared, and risk factors of PS were investigated with logistic multivariate regression. Unsupervised hierarchical clustering and network analysis were used to study allergen aggregation in PS. RESULTS A total of 10,176 patients were analysed. PS was found in 844 (8.3%). Current relevance was significantly higher in polysensitized patients (p < 0.01). Risk factors for PS were atopic dermatitis (OR: 1.58, 95% CI: 1.24-2.02), age (≥60 years vs. ≤24 years, OR: 1.75, 95% CI: 1.25-2.44) and some special locations (legs vs. face OR: 1.54, 95% CI: 1.05-2.25, hands vs. face OR: 1.46, 95% CI:1.15-1.85, arms vs. face OR: 1.49, 95% CI:1.01-2.20, trunk vs. face OR: 1.40, 95% CI:1.06-1.85). Cluster and network analyses revealed specific-allergen clusters and significant associations, including allergens belonging to metals group, fragrances and botanicals group, topical drugs group, rubber allergens and biocides. CONCLUSIONS This study confirms that PS is structured by discernible patterns of specific-allergen clusters and reinforces significant allergen associations in PS. Cross-reactivity and/or concomitant sensitization could explain the formation of allergen clusters in PS.
Collapse
Affiliation(s)
- David Pesqué
- Department of Dermatology, Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Leopoldo Borrego
- Department of Dermatology, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | | | | | | | - Ricardo González-Pérez
- Department of Dermatology, Hospital Universitario Araba, Universidad del País Vasco, Vitoria-Gasteiz, Spain
| | | | | | - José Manuel Carrascosa
- Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
| | | | | | - Pedro Mercader-García
- Department of Dermatology, Hospital General Universitario José María Morales Meseguer, Murcia, Spain
| | | | | | | | - María Antonia Pastor-Nieto
- Department of Dermatology, Hospital Universitario de Guadalajara, Guadalajara, Spain
- Department of Dermatology, Hospital Fundación Jiménez-Díaz, Madrid, Spain
| | | | | | - Araceli Sánchez-Gilo
- Department of Dermatology, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
| | - Gemma Melé-Ninot
- Department of Dermatology, Hospital Universitari Sagrat Cor, Grupo Quirónsalud, Barcelona, Spain
| | | | - Ramon Maria Pujol
- Department of Dermatology, Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Ana María Giménez-Arnau
- Department of Dermatology, Hospital del Mar Research Institute, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| |
Collapse
|
2
|
Kyritsi A, Tagka A, Stratigos A, Pesli M, Lagiokapa P, Karalis V. A Retrospective Analysis to Investigate Contact Sensitization in Greek Population Using Classic and Machine Learning Techniques. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1424:145-155. [PMID: 37486488 DOI: 10.1007/978-3-031-31982-2_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Allergic contact dermatitis (ACD) is an inflammatory reaction affecting all age groups and both sexes. ACD is characterized by a delayed-type hypersensitivity reaction IV caused by skin contact with haptens. Chronic exposure typically leads to a decrease in erythema accompanied by lichenification (thickening and hardening of the skin) and persistent itching. The current study aims to investigate the patterns of contact sensitization in the Greek population using patch test data analysis. Patch test data from 240 patients (120 Males/120 Females) with allergic contact dermatitis were collected at the Laboratory for Patch Testing, National Reference Center for Occupational Dermatoses "Andreas Syggros" Hospital in Athens Greece. The contact allergic reactions were caused by ethylenediamine dihydrochloride 1%, thimerosal 0.5%, and methyldibromo-glutaronitrile 0.1% from the European baseline series of allergens; information was also collected for ICDRG evaluation, an extended MOAHLFA index and patient-reported outcomes (daily routine questionnaire). The chi-square test for independence and Spearman's rank were used to evaluate the association and correlation, respectively, between patient characteristics and ACD-related factors. Multiple correspondence analysis (MCA), which is a data analysis approach, was used to find and depict underlying structures in the data collection for nominal categorical data. Statistically significant associations were found between the following pairs of characteristics: eczema triggers and gender and eczema triggers and hand dermatitis. The results from MCA showed that there is correlation between allergic contact dermatitis onset, allergens, and demographic variables.
Collapse
Affiliation(s)
- Aikaterini Kyritsi
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece.
| | - Anna Tagka
- First Department of Dermatology and Venereology, "Andreas Syggros" Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Alexandros Stratigos
- First Department of Dermatology and Venereology, "Andreas Syggros" Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Maria Pesli
- First Department of Dermatology and Venereology, "Andreas Syggros" Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Polyxeni Lagiokapa
- First Department of Dermatology and Venereology, "Andreas Syggros" Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Vangelis Karalis
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece.
| |
Collapse
|
3
|
Decision making in next generation risk assessment for skin allergy: Using historical clinical experience to benchmark risk. Regul Toxicol Pharmacol 2022; 134:105219. [PMID: 35835397 DOI: 10.1016/j.yrtph.2022.105219] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 05/24/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022]
Abstract
Our aim is to develop and apply next generation approaches to skin allergy risk assessment that do not require new animal test data and better quantify uncertainties. Quantitative risk assessment for skin sensitisation uses safety assessment factors to extrapolate from the point-of-departure to an acceptable human exposure level. It is currently unclear whether these safety assessment factors are appropriate when using non-animal test data to derive a point-of departure. Our skin allergy risk assessment model Defined Approach uses Bayesian statistics to infer a human-relevant metric of sensitiser potency with explicit quantification of uncertainty, using any combination of human repeat insult patch test, local lymph node assay, direct peptide reactivity assay, KeratinoSens™, h-CLAT or U-SENS™ data. Here we describe the incorporation of benchmark exposures pertaining to use of consumer products with clinical data supporting a high/low risk categorisation for skin sensitisation. Margins-of-exposure (potency estimate to consumer exposure level ratio) are regressed against the benchmark risk classifications, enabling derivation of a risk metric defined as the probability that an exposure is low risk. This approach circumvents the use of safety assessment factors and provides a simple and transparent mechanism whereby clinical experience can directly feed-back into risk assessment decisions.
Collapse
|
4
|
Mercader-García P, Pastor-Nieto MA, Gonzalez-Perez R, Cordoba-Guijarro S, Gimenez-Arnau AM, Ruiz-Gonzalez I, Mora-Fernández V, Miquel J, Silvestre-Salvador JF, Ortiz-Frutos FJ, Sanz-Sanchez T, Rodriguez-Serna M, Perez-Feal P, Sánchez-Pérez J, Heras-Mendaza F, Serra-Baldrich E, Zaragoza-Ninet V, Hervella-Garces M, Gatica-Ortega ME, García-Doval I, Descalzo MÁ, Borrego L. Should methyldibromo glutaronitrile continue to be used in the European baseline Series? A REIDAC national cross-sectional study. Contact Dermatitis 2021; 85:572-577. [PMID: 33745152 DOI: 10.1111/cod.13837] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/06/2021] [Accepted: 03/15/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Methyldibromo glutaronitrile (MDBGN) was one of the most frequent and relevant allergens found in patch testing at the beginning of this century. In 2008, this preservative was banned from cosmetics in Europe and ever since the prevalence of contact allergy to MDBGN has progressively decreased. Despite that gradual decline, MDBGN is still patch-tested in most baseline series. This study assessed the frequency of MDBGN sensitization, epidemiological characteristics of allergic patients, and the relevance of positive patch tests in a nationwide Spanish registry (REIDAC). PATIENTS AND METHODS We evaluated consecutively patch-tested patients in all participating centres. Using these data, we calculated the proportion of patients with positive patch tests to MDBGN from June 2018 to June 2020 and evaluated the relevance of the positive patch tests. RESULTS One hundred and fourteen out of 5072 (2.24 %) tested patients were sensitized to MDBGN. Clinical current relevance was confirmed in only one case. CONCLUSION Although the frequency of contact allergy to MDBGN remains high, no clinical significance was found in most of these patients (5072 tests needed to obtain one relevant positive result). The clinical usefulness of this allergen seems weak and its continued inclusion in the European baseline series is questionable. HIGHLIGHTS In 2008 methyldibromo glutaronitrile (MDBGN) was banned from cosmetics in Europe and since then, the prevalence of allergy to it has progressively decreased. Nevertheless, it is still being tested in European baseline series. This study assessed the frequency of MDBGN sensitization, epidemiological characteristics of allergic patients as well as the relevance of positive patch tests in a nationwide registry (REIDAC). The frequency of allergy to MDBGN remains high, but no clinical significance was found. Most of these patients are aged >40 years and probably represent historical sensitizations.
Collapse
Affiliation(s)
- Pedro Mercader-García
- Deparment of Dermatology, Hospital General Universitario Jose Mª Morales Meseguer, Murcia, Spain
| | | | | | | | | | | | - Verónica Mora-Fernández
- Department of Dermatology, Hospital General Universitari German Trias i Pujol, Barcelona, Spain
| | - Javier Miquel
- Department of Dermatology, Hospital Arnau de Vilanova, Valencia, Spain
| | | | | | - Tatiana Sanz-Sanchez
- Department of Dermatology, Hospital General Universitario Infanta Sofia, Madrid, Spain
| | | | - Patricia Perez-Feal
- Department of Dermatology, Complejo Hospitalario Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | - Ester Serra-Baldrich
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Violeta Zaragoza-Ninet
- Department of Dermatology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | | | | | - Ignacio García-Doval
- Research Unit, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, Spain
| | - Miguel Ángel Descalzo
- Research Unit, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, Spain
| | - Leopoldo Borrego
- Department of Dermatology, Complejo Hospitalario Universitario Insular Materno Infantil. Universidad de las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | | |
Collapse
|
5
|
Isaksson M, Rustemeyer T, Antelmi A. Contact Allergy to Dental Materials and Implants. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
6
|
|
7
|
Latheef F, Wilkinson M. Adverse Skin Reactions to Cosmetics and Skin Care Products. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
8
|
|
9
|
Uter W, Bauer A, Belloni Fortina A, Bircher AJ, Brans R, Buhl T, Cooper SM, Czarnecka-Operacz M, Dickel H, Dugonik A, Geier J, Giménez-Arnau AM, Gonçalo M, Johansen JD, Johnston GA, Mahler V, Rustemeyer T, Sanchez-Perez J, Schuttelaar MLA, Simon D, Spiewak R, Valiukevičienė S, Weisshaar E, White IR, Wilkinson M. Patch test results with the European baseline series and additions thereof in the ESSCA network, 2015-2018. Contact Dermatitis 2020; 84:109-120. [PMID: 32945543 DOI: 10.1111/cod.13704] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/12/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Clinical surveillance of the prevalence of contact allergy in consecutively patch tested patients is a proven instrument to continually assess the importance of contact allergens (haptens) assembled in a baseline series. OBJECTIVES To present current results from the European Surveillance System on Contact Allergies, including 13 countries represented by 1 to 11 departments. METHODS Anonymized or pseudonymized patch test and clinical data from various data capture systems used locally or nationally as transferred to the Erlangen data centre were pooled and descriptively analysed after quality control. RESULTS In the 4 years (2015-2018), data from 51 914 patients patch tested with the European baseline series (EBS) of contact allergens were analysed. Contact allergy to nickel was most frequent (17.6% positive), followed by contact allergy to fragrance mix I (6.9%), methylisothiazolinone (MI; 6.2%), and Myroxylon pereirae resin (balsam of Peru; 5.8%). CONCLUSIONS While the prevalence of MI contact allergy decreased substantially following regulatory intervention, the persistently high levels of allergy to metals, fragrances, other preservatives, and rubber chemicals point to problems needing further research and, potentially, preventive efforts. Results with national additions to the baseline series provide important information on substances possibly to be considered for inclusion in the EBS.
Collapse
Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Andrea Bauer
- Department of Dermatology, University Allergy Centre, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Anna Belloni Fortina
- Dermatology Unit, Department of Paediatrics, University of Padova, Padova, Italy
| | - Andreas J Bircher
- Allergy Unit, Department of Dermatology, University Hospital Basel, Basel, Switzerland.,Faculty of Biomedicine, Università della Svizzera Italiana, Lugano, Switzerland
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - 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
| | - Aleksandra Dugonik
- Department of Dermatology, University Medical Centre Maribor, Maribor, Slovenia
| | - Johannes Geier
- Information Network of Department of Dermatology, University Medical Center, Göttingen, Germany
| | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar. Universitat Autònoma and Pompeu Fabra, Barcelona, Spain
| | - Margarida Gonçalo
- Department of Dermatology, Coimbra University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Skin and Allergy, Gentofte Hospital, Hellerup, Denmark
| | | | - Vera Mahler
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany, Paul-Ehrlich-Institut, Langen, Germany
| | - Thomas Rustemeyer
- Department of Dermatology, Free University of Amsterdam, Amsterdam, The Netherlands
| | - Javier Sanchez-Perez
- Dermatology Department, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain
| | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Elke Weisshaar
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ian R White
- Cutaneous Allergy Team, St. John's Institute of Dermatology, Guy's Hospital, London, UK
| | - Mark Wilkinson
- Dermatology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | |
Collapse
|
10
|
|
11
|
Latheef F, Wilkinson M. Adverse Skin Reactions to Cosmetics and Skin Care Products. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_83-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
12
|
Dental Materials and Implants. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_39-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
13
|
Isaksson M, Rustemeyer T, Antelmi A. Contact Allergy to Dental Materials and Implants. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_39-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
14
|
Latheef F, Wilkinson M. Cosmetics and Skin Care Products. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_83-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
15
|
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]
|
16
|
Patch Testing: Technical Details and Interpretation. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_62-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
17
|
|
18
|
Aerts O, De Fré C, van Hoof T, Ghys K, Ortopelea RA, Lambert J. “Slime”: A new fashion among children causing severe hand dermatitis. Contact Dermatitis 2018; 79:385-387. [DOI: 10.1111/cod.13090] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Olivier Aerts
- Department of Dermatology; University Hospital Antwerp (UZA) and University of Antwerp (UA); Antwerp Belgium
| | - Charlotte De Fré
- Department of Dermatology; University Hospital Antwerp (UZA) and University of Antwerp (UA); Antwerp Belgium
| | - Tom van Hoof
- Department of Dermatology; University Hospital Antwerp (UZA) and University of Antwerp (UA); Antwerp Belgium
| | | | | | - Julien Lambert
- Department of Dermatology; University Hospital Antwerp (UZA) and University of Antwerp (UA); Antwerp Belgium
| |
Collapse
|
19
|
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.
Collapse
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.
| |
Collapse
|