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Karagounis TK, Cohen DE. Occupational Hand Dermatitis. Curr Allergy Asthma Rep 2023; 23:201-212. [PMID: 36749448 PMCID: PMC9903276 DOI: 10.1007/s11882-023-01070-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Occupational hand dermatitis is a common work-related disorder of the skin. Prevention and management of this disease is critical to improving workers' quality of life and for occupation-specific retention. RECENT FINDINGS This is a critical review of the current literature on occupational hand dermatitis. Occupational dermatitis continues to have a high prevalence among workers although the overall incidence may be slowly decreasing. Irritant contact dermatitis due to wet work exposure is the most common cause of occupational hand dermatitis. Healthcare workers, hairdressers, and metal workers are at particularly high risk for this disease. While some prevention programs have been ineffective in mitigating occupational hand dermatitis, other more resource-intensive initiatives may have benefit. Continued research is needed on ways to manage wet work exposures and on scalable, effective prevention programs for occupational hand dermatitis. The spectrum of culprit contact allergens continues to evolve, and vigilance for potential occupation-specific allergens remains important.
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Affiliation(s)
- Theodora K. Karagounis
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY USA
| | - David E. Cohen
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY USA
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2
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The 2-Methoxymethyl Modification of p-Phenylenediamine Reduces the Sensitization Risk for Hairdressers to Hair Dyes-An Occupational Hand Exposure-Based Risk Assessment. Dermatitis 2022; 33:293-301. [PMID: 35777963 PMCID: PMC9301993 DOI: 10.1097/der.0000000000000915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Allergic contact dermatitis involving the hands is a common occupational skin disease for hairdressers and the potent sensitizers p-phenylenediamine (PPD) and toluene-2,5-diamine (PTD) are associated with the development of occupational allergic contact dermatitis. OBJECTIVE The aim of the study was to analyze whether the use of the moderate sensitizer 2-methoxymethyl-PPD (ME-PPD) in professional hair dyes is a suitable tool to reduce the occupational contact allergy risk for hairdressers. METHODS Hand exposure of hairdressers (N = 11) to ME-PPD was analyzed under routine hair coloring conditions in commercial salons. By accounting for wet work and uneven hand exposure, the daily hand exposure was derived and compared with the occupational acceptable exposure level (AEL), that is, the sensitization induction threshold of ME-PPD adjusted for interindividual variability among workers. RESULTS The daily hand exposure to ME-PPD was 1.6 μg/cm2, and the occupational AEL was 215 μg/cm2. The ratio of hand exposure to AEL was calculated as the margin of safety (MOS) against occupational sensitization. For ME-PPD, the MOS of 134 indicates a low likelihood of sensitization versus PPD and PTD with MOS values of 2.7 and 5.9, respectively. CONCLUSIONS Our data predict that the use of ME-PPD in professional hair color products improves the protection of hairdressers against hair dye-related contact allergy versus the use of PPD and PTD.
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Scheman A, Fournier E, Kerchinsky L, Wei J. Identifying Safe Alternatives for Contact Allergy Patients. Immunol Allergy Clin North Am 2021; 41:455-466. [PMID: 34225900 DOI: 10.1016/j.iac.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Allergen avoidance is the most effective treatment of contact allergy. Patient improvement ultimately relies on identification of safe alternative products, which can be used by the patient. Safe personal care product options typically can be found using ingredient database programs. Avoidance of allergens in other products (eg, shoes, clothing, and dental care) often is challenging. This article discusses specific safe alternatives for the 80 allergens on the 2017 American Contact Dermatitis Society core allergen series.
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Affiliation(s)
- Andrew Scheman
- Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL 60611, USA.
| | - Elise Fournier
- Michigan State University, 426 Auditorium Rd, East Lansing, MI 48824, USA
| | - Lilly Kerchinsky
- Michigan State University, 426 Auditorium Rd, East Lansing, MI 48824, USA
| | - Jason Wei
- University of Illinois Urbana-Champaign, 1304 W Pennsylvania Ave, Urbana, IL 61801, USA
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Barbaud A, Lafforgue C. Risks associated with cosmetic ingredients. Ann Dermatol Venereol 2021; 148:77-93. [PMID: 33642039 DOI: 10.1016/j.annder.2020.04.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/29/2019] [Accepted: 04/22/2020] [Indexed: 12/13/2022]
Abstract
The media and social networks often echo fears about the potential toxicity of cosmetics and the dangers they pose to the environment. Dermatologists may be asked about these topics, but despite regulatory labelling constraints and the proliferation of specialized sites and applications, they do not always have access to reliable information. It is for this reason that we are providing the present overview of current knowledge on the subject.
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Affiliation(s)
- A Barbaud
- Sorbonne université, INSERM, institut Pierre-Louis d'Epidemiologie et de santé publique, AP-HP, Sorbonne université, hopital Tenon, service de dermatologie et allergologie, 4 rue de la Chine, 75020 Paris, France.
| | - C Lafforgue
- Unité de dermopharmacologie et cosmétologie, faculté de pharmacie, université Paris sud - Paris Saclay, 5, rue J.B. Clément, 92296 Chatenay-Malabry cedex, France
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Gregoriou S, Mastraftsi S, Hatzidimitriou E, Tsimpidakis A, Nicolaidou E, Stratigos A, Katsarou A, Rigopoulos D. Occupational and non‐occupational allergic contact dermatitis to hair dyes in Greece. A 10‐year retrospective study. Contact Dermatitis 2020; 83:277-285. [DOI: 10.1111/cod.13598] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Stamatis Gregoriou
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Faculty of Medicine National and Kapodistrian University of Athens Athens Greece
| | - Styliani Mastraftsi
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Faculty of Medicine National and Kapodistrian University of Athens Athens Greece
| | - Eleni Hatzidimitriou
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Faculty of Medicine National and Kapodistrian University of Athens Athens Greece
| | - Antonis Tsimpidakis
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Faculty of Medicine National and Kapodistrian University of Athens Athens Greece
| | - Electra Nicolaidou
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Faculty of Medicine National and Kapodistrian University of Athens Athens Greece
| | - Alexander Stratigos
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Faculty of Medicine National and Kapodistrian University of Athens Athens Greece
| | - Alexandra Katsarou
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Faculty of Medicine National and Kapodistrian University of Athens Athens Greece
| | - Dimitrios Rigopoulos
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Faculty of Medicine National and Kapodistrian University of Athens Athens Greece
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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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Meisser SS, Altunbulakli C, Bandier J, Opstrup MS, Castro-Giner F, Akdis M, Bonefeld CM, Johansen JD, Akdis CA. Skin barrier damage after exposure to paraphenylenediamine. J Allergy Clin Immunol 2019; 145:619-631.e2. [PMID: 31783056 DOI: 10.1016/j.jaci.2019.11.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND p-Phenylenediamine (PPD) is a strong contact allergen used in hair dye that is known to cause allergic contact dermatitis (ACD). Both private and occupational exposure to PPD is frequent, but the effect of PPD exposure in nonallergic occupationally exposed subjects is unknown. OBJECTIVE We sought to investigate the effects of PPD exposure on the skin of occupationally exposed subjects with and without clinical symptoms. METHODS Skin biopsy specimens were collected from 4 patients with mild and 5 patients with severe PPD-related ACD and 7 hairdressers without contact dermatitis on day 4 after patch testing with 1% PPD in petrolatum. RNA sequencing and transcriptomics analyses were performed and confirmed by using quantitative RT-PCR. Protein expression was analyzed in skin from 4 hairdressers and 1 patient with ACD by using immunofluorescence staining. Reconstructed human epidermis was used to test the effects of PPD in vitro. RESULTS RNA sequencing demonstrated downregulation of tight junction and stratum corneum proteins in the skin of patients with severe ACD after PPD exposure. Claudin-1 (CLDN-1), CLDN8, CLDN11, CXADR-like membrane protein (CLMP), occludin (OCLN), membrane-associated guanylate kinase inverted 1 (MAGI1), and MAGI2 mRNA expression was downregulated in patients with severe ACD. CLDN1 and CLMP expression were downregulated in nonresponding hairdressers and patients with mild ACD. Filaggrin 1 (FLG1), FLG2, and loricrin (LOR) expression were downregulated in patients with ACD. Confocal microscopic images showed downregulation of CLDN-1, FLG-1, and FLG-2 expression. In contrast, 3-dimensional skin cultures showed upregulation of FLG-1 in response to PPD but downregulation of FLG-2. CONCLUSION PPD-exposed skin is associated with extensive transcriptomic changes, including downregulation of tight junction and stratum corneum proteins, even in the absence of clinical symptoms.
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Affiliation(s)
- Sanne S Meisser
- Research Centre for Hairdressers and Beauticians and the National Allergy Research Centre, Department of Dermatology and Allergy, University Hospital Gentofte, Hellerup, Switzerland; LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Switzerland; Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Can Altunbulakli
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Josefine Bandier
- Research Centre for Hairdressers and Beauticians and the National Allergy Research Centre, Department of Dermatology and Allergy, University Hospital Gentofte, Hellerup, Switzerland
| | - Morten S Opstrup
- Research Centre for Hairdressers and Beauticians and the National Allergy Research Centre, Department of Dermatology and Allergy, University Hospital Gentofte, Hellerup, Switzerland
| | - Francesc Castro-Giner
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Charlotte M Bonefeld
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Switzerland
| | - Jeanne D Johansen
- Research Centre for Hairdressers and Beauticians and the National Allergy Research Centre, Department of Dermatology and Allergy, University Hospital Gentofte, Hellerup, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.
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Schuttelaar MLA, van Amerongen CCA, Lichter J, Blömeke B. Evaluation of risk modification for p-phenylenediamine sensitization by N-acetyltransferase 1 and 2 for two highly sensitive cases. Contact Dermatitis 2019; 81:138-140. [PMID: 30843224 PMCID: PMC6619056 DOI: 10.1111/cod.13260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/27/2019] [Accepted: 03/03/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Cynthia C A van Amerongen
- Department of Dermatology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Jutta Lichter
- Department of Environmental Toxicology, Trier University, Trier, Germany
| | - Brunhilde Blömeke
- Department of Environmental Toxicology, Trier University, Trier, Germany
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Schuttelaar ML, Dittmar D, Burgerhof JGM, Blömeke B, Goebel C. Cross-elicitation responses to 2-methoxymethyl-p-phenylenediamine in p-phenylenediamine-allergic individuals: Results from open use testing and diagnostic patch testing. Contact Dermatitis 2018; 79:288-294. [PMID: 30084179 PMCID: PMC6175459 DOI: 10.1111/cod.13078] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/14/2018] [Accepted: 06/18/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Allergic contact dermatitis caused by p-phenylenediamine (PPD) is a health concern for hair dye users. Because of its lower sensitization potency, the PPD derivative 2-methoxymethyl-p-phenylenediamine (ME-PPD) has been developed as an alternative hair dye for primary prevention. However, cross-elicitation responses can occur in PPD-allergic subjects. OBJECTIVES To compare cross-elicitation responses to ME-PPD in open use and diagnostic patch testing of PPD-allergic subjects with hair dye-related allergic contact dermatitis. METHODS Reactions to ME-PPD were investigated in 25 PPD-allergic subjects by performing (1) 45-minute open use testing with a hair dye containing 2.0% of either ME-PPD or PPD, and (2) patch testing with increasing ME-PPD concentrations (0.1%-2.0% pet.). RESULTS Of the 25 PPD-allergic subjects, 21 (84%) reacted to open use testing with a hair dye containing 2.0% PPD, and testing with 2.0% ME-PPD led to cross-elicitation in 12 (48%). When patch tested with increasing ME-PPD concentrations, 13 (52%) cross-reacted at 0.1% (lowest dose) and 21 (84%) at 2.0% (highest dose), indicating decreased reactivity as compared with published PPD dose-response data. CONCLUSION In line with the decreased cross-reactivity of ME-PPD in hair dye open use testing, PPD-allergic subjects show an attenuated cross-elicitation dose response to ME-PPD in patch testing.
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Affiliation(s)
- Marie L Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Daan Dittmar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johannes G M Burgerhof
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Brunhilde Blömeke
- Department of Environmental Toxicology, Trier University, Trier, Germany
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