1
|
Kursawe Larsen C, Jensen MB, Schwensen JFB. Contact allergy to neomycin in consecutively patch tested Danish eczema patients from 2000 to 2023: A cross-sectional study. Contact Dermatitis 2024. [PMID: 39041641 DOI: 10.1111/cod.14653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Neomycin is an aminoglycoside antibiotic that may cause contact allergy. It was withdrawn as a medicine for human use in Denmark in October 2009 but is still found in some vaccines. OBJECTIVES To identify time trends in contact allergy to neomycin in the period from 2000 to 2023. METHODS A cross-section study of patients ≥18 years consecutively patch-tested with neomycin sulfate (20% in pet.) at Gentofte Hospital, Denmark, during the period 2000-2023 was conducted. RESULTS The overall prevalence of contact allergy to neomycin was 1.4%. The prevalence was significantly lower in the period '2010-2023' (1.2%) than in '2000-2009' (1.8%) (p < 0.005). Contact allergy to neomycin was significantly positively associated with facial dermatitis and age >40 years, and significantly negatively associated with occupational dermatitis and hand dermatitis. No changes in sex, occupational dermatitis, atopic dermatitis, hand dermatitis, leg dermatitis, facial dermatitis, or age > 40/≤40 (the MOAHLFA-index) were identified when comparing neomycin contact allergic-patients in the two periods '2010-2023' and '2001-2009'. CONCLUSION Neomycin is a rare cause of contact allergy in Denmark with a significantly lower prevalence following its withdrawal as a medicinal product for human use in Denmark in 2009.
Collapse
Affiliation(s)
- Christoffer Kursawe Larsen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Faculty of Health Science, Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - Mikkel Bak Jensen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Faculty of Health Science, Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - Jakob F B Schwensen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Faculty of Health Science, Institute of Clinical Medicine, University of Copenhagen, Denmark
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| |
Collapse
|
2
|
Schwensen JFB, Uter W, Aerts O, Agner T, Brans R, Bruze M, Foti C, Am GA, Gonçalo M, Svedman C, Stingeni L, Wilkinson M, Johansen JD. Current frequency of contact allergy to isothiazolinones (methyl-, benz- and octylisothiazolinone) across Europe. Contact Dermatitis 2024. [PMID: 39021255 DOI: 10.1111/cod.14641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 06/24/2024] [Accepted: 07/01/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND The use of methylisothiazolinone (MI) as a preservative in cosmetic products caused an alarming increase in MI contact allergy across Europe in the 2010s. This was followed by regulations of use with a total ban on leave-on (implemented in 2017) and reduced use concentrations in rinse-off cosmetics (2018). OBJECTIVE To follow-up on the prevalence of contact allergy to MI and the related benzisothiazolinone (BIT) and octylisothiazolinone (OIT) in consecutively patch-tested patients in Europe. METHODS A cross-sectional audit following the design of two previous audits on MI contact allergy from 1 May 2022 to 31 October 2022 included all patients patch tested with the European baseline series, including or supplemented with MI, BIT and OIT across 10 departments in eight European countries. RESULTS A total of 2554 patients were consecutively patch tested with the three isothiazolinones during the study period. The prevalence of MI and BIT contact allergy was 2.9% (95% confidence interval [CI]: 2.3%-3.7%; range 1.1%-5.8%) and 3.1% (95% CI: 2.4%-3.9%; range 0.0%-6.6%), respectively; that of OIT was 0.7% (95% CI: 0.4%-1.1%; range 0%-3.2%). Rinse-off cosmetic (73.3%) and leave-on cosmetic products (13.3%) were still associated with eliciting allergic contact dermatitis to MI. CONCLUSION We confirmed a positive impact of regulatory measures on the prevalence of MI contact allergy in Europe, which halved compared to 2015. However, our data suggest that consumers may still be exposed to older cosmetic products containing MI. BIT has superseded MI in causing contact allergy, despite not being allowed for use in cosmetic products.
Collapse
Affiliation(s)
- Jakob F B Schwensen
- Department of Dermato-Allergology, National Allergy Research Centre, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and Research Group Immunology, University of Antwerp, Antwerp, Belgium
| | - Tove Agner
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark
| | - Richard Brans
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Caterina Foti
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Giménez-Arnau Am
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Margarida Gonçalo
- Department of Dermatology, University Hospital, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Mark Wilkinson
- Department of Dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Jeanne Duus Johansen
- Department of Dermato-Allergology, National Allergy Research Centre, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| |
Collapse
|
3
|
Kursawe Larsen C, Jensen MB, Schwensen JFB. Contact allergy to textile dye mix in consecutively patch tested Danish eczema patients: An observational study with historical data from 2015 to 2023. Contact Dermatitis 2024. [PMID: 38979649 DOI: 10.1111/cod.14640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/10/2024]
Affiliation(s)
- Christoffer Kursawe Larsen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Institute of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Denmark
| | - Mikkel Bak Jensen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Institute of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Denmark
| | - Jakob F B Schwensen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Institute of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Denmark
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| |
Collapse
|
4
|
Mercader-García P, Silvestre JF, Navarro-Triviño FJ, Giménez-Arnau AM, Pastor-Nieto MA, Cordoba-Guijarro S, Melé-Ninot G, Tous-Romero F, González-Pérez R, Ruiz-González I, Sánchez-Pérez J, Gática-Ortega ME, Sánchez-Pedreño P, Miquel-Miquel J, Ortiz-Frutos J, Carrascosa JM, Serra-Baldrich E, Sanz-Sánchez T, Soria-Aledo V, Carrillo A, Borrego L. A re-assessment of the value of markers of corticosteroid contact allergy in the Spanish baseline series: Clobetasol propionate in the spotlight. Contact Dermatitis 2024. [PMID: 38965446 DOI: 10.1111/cod.14639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/22/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Budesonide and tixocortol pivalate as markers of contact allergy to corticosteroids have been questioned, as they are not able to detect a significant percentage of allergic patients. OBJECTIVES To investigate the potential role of clobetasol propionate in enhancing corticosteroid sensitisation detection. METHODS Between January 2022 and December 2023, patients who attended centres involved in the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy were tested with an extended baseline series that included budesonide, tixocortol pivalate, clobetasol propionate 0.1% in ethanol and 1% in petrolatum. RESULTS A total of 4338 patients were tested. Twenty-four patients were allergic to budesonide (0.55%, 95% CI: 0.37-0.82); nine patients were allergic to tixocortol pivalate (0.21%, 95% CI: 0.11-0.39); and 23 patients were allergic to clobetasol (0.53%, 95% CI: 0.35-0.79). Only four of those patients allergic to clobetasol were detected by budesonide and one by tixocortol pivalate. No significant differences in the number of positive tests were found between clobetasol in petrolatum or ethanol. CONCLUSIONS In Spain budesonide remains the main corticosteroid allergy marker whereas the role of tixocortol pivalate is questionable. The addition of clobetasol propionate to the Spanish baseline series would improve the ability to detect patients allergic to corticosteroids.
Collapse
Affiliation(s)
- Pedro Mercader-García
- Hospital General Universitario Morales Meseguer, Universidad de Murcia, Murcia, Spain
| | | | | | | | | | | | - Gemma Melé-Ninot
- Dermatology Department, Hospital Universitari Sagrat Cor, Barcelona, Spain
| | - Fátima Tous-Romero
- Dermatology Department, Hospital General Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | | | | | | | - Javier Ortiz-Frutos
- Dermatology Department, Hospital General Universitario 12 de Octubre, Madrid, Spain
| | | | - Esther Serra-Baldrich
- Dermatology Department, Hospital Universitari Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Andrés Carrillo
- Hospital General Universitario Morales Meseguer, Universidad de Murcia, Murcia, Spain
| | - Leopoldo Borrego
- Complejo Hospitalario Universitario Insular Materno Infantil, Universidad de las Palmas de Gran Canaria, Las Palmas, Spain
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Botvid S, Bennike NH, Simonsen AB, Johansen JD, Uter W. Contact sensitization to fragrance mix I and fragrance mix II among European dermatitis patients: A systematic review. Contact Dermatitis 2024. [PMID: 38945918 DOI: 10.1111/cod.14618] [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: 01/30/2024] [Revised: 05/21/2024] [Accepted: 05/25/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Fragrance substances are a frequent cause of contact allergy worldwide. Fragrance exposure varies by sex, age and possibly country, influenced by cosmetic availability, environmental conditions and cultural practices. OBJECTIVES To systematically review and gather prevalence of sensitization to fragrance mix I (FM I) and fragrance mix II (FM II) in consecutively patch-tested European dermatitis patients. METHOD A total of 4134 publications on patch test results of European dermatitis patients, published from 1981 to 2022, were systematically reviewed according to a previously registered and published PROSPERO protocol. RESULTS Eighty-four eligible original articles were analysed. Overall prevalence of sensitization to fragrance mix I (FM I) was 6.81% (95% CI: 6.37-7.28), and FM II was 3.64% (95% CI: 3.3-4.01). Sensitization to FM I was most prevalent in Central and Eastern Europe and to FM II in Western Europe. No clear time trends were observed. Among paediatric dermatitis patients, sensitization prevalence for FM I and FM II was 4.09% (95% CI: 3.37-4.96) and 2.17% (95% CI: 1.53-3.07). CONCLUSION The frequency of positive patch test results for both FMI and FMII remains high. Sensitization is also prevalent among children. Enhanced regulation and labelling of cosmetic products play a vital role in averting exposure and sensitization to fragrance allergens.
Collapse
Affiliation(s)
- Sofia Botvid
- The National Allergy Research Centre (Videncenter for Allergi), Department of Allergy, Dermatology and Venerology, Copenhagen University Hospital Herlev-Gentofte, Gentofte Hospital, Hellerup, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels H Bennike
- The National Allergy Research Centre (Videncenter for Allergi), Department of Allergy, Dermatology and Venerology, Copenhagen University Hospital Herlev-Gentofte, Gentofte Hospital, Hellerup, Denmark
| | - Anne Birgitte Simonsen
- The National Allergy Research Centre (Videncenter for Allergi), Department of Allergy, Dermatology and Venerology, Copenhagen University Hospital Herlev-Gentofte, Gentofte Hospital, Hellerup, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jeanne Duus Johansen
- The National Allergy Research Centre (Videncenter for Allergi), Department of Allergy, Dermatology and Venerology, Copenhagen University Hospital Herlev-Gentofte, Gentofte Hospital, Hellerup, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| |
Collapse
|
7
|
Kursawe Larsen C, Jensen MB, Schwensen JFB. Contact allergy to N-isopropyl-N'-phenyl paraphenylenediamine in consecutively patch tested Danish eczema patients: An observational study with historical data from 2013 to 2023. Contact Dermatitis 2024. [PMID: 38922961 DOI: 10.1111/cod.14629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Christoffer Kursawe Larsen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Institute of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Bak Jensen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Jakob F B Schwensen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Institute of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| |
Collapse
|
8
|
Kyritsi A, Tagka A, Stratigos A, Karalis V. Preservative contact allergy in occupational dermatitis: a machine learning analysis. Arch Dermatol Res 2024; 316:372. [PMID: 38850385 DOI: 10.1007/s00403-024-03101-1] [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: 01/26/2024] [Revised: 01/26/2024] [Accepted: 04/26/2024] [Indexed: 06/10/2024]
Abstract
Occupational dermatoses impose a significant socioeconomic burden. Allergic contact dermatitis related to occupation is prevalent among healthcare workers, cleaning service personnel, individuals in the beauty industry and industrial workers. Among risk factors, the exposure to preservatives is frequent, since they are extensively added in products for occupational use. The goal of this study is to investigate the contact allergy patterns in order to understand the linkage among hypersensitivity to preservatives, occupational profiles, patients' clinical and demographic characteristics. Patch test results were collected from monosensitized patients to Formaldehyde 2%, KATHON 0.02%, thimerosal 0.1%, and MDBGN 0.5%; information was also collected for an extended MOAHLFA (Male-Occupational-Atopic-Hand-Leg-Face-Age) index. To assess the relationship between allergen group and occupational-related ACD, the chi-square test for independence was utilized. To uncover underlying relationships in the data, multiple correspondence analysis (MCA) and categorical principal components analysis (CATPCA), which are machine learning approaches, were applied. Significant relationships were found between allergen group and: occupation class, atopy, hand, leg, facial, trunk, neck, head dermatitis, clinical characteristics, ICDRG 48 h and ICDRG 72 h clinical evaluation. MCA and CATPCA findings revealed a link among allergen group, occupation class, patients' demographic and clinical characteristics, the MOAHLFA index, and the ICDRG scores. Significant relationships were identified between the allergen group and various manifestations of dermatitis. The utilization of machine learning techniques facilitated the discernment of meaningful patterns in the data.
Collapse
Affiliation(s)
- Aikaterini Kyritsi
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimioupolis, Zografou, 15784, Athens, Greece
| | - Anna Tagka
- First Department of Dermatology and Venereology, "Andreas Syggros" Hospital, Medical School, National and Kapodistrian University of Athens, Ionos Dragoumi 5, 11621, Athens, Greece
| | - Alexandros Stratigos
- First Department of Dermatology and Venereology, "Andreas Syggros" Hospital, Medical School, National and Kapodistrian University of Athens, Ionos Dragoumi 5, 11621, Athens, Greece
| | - Vangelis Karalis
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimioupolis, Zografou, 15784, Athens, Greece.
| |
Collapse
|
9
|
Sukakul T, Uter W, Gonçalo M, Huggard J, Ljubojević Hadžavdić S, Schuttelaar MLA, Svedman C, Vey M, Isaksson M, Niklasson B, Rustemeyer T, Bruze M. Results of patch testing with five fragrance materials hitherto not tested: A dose-finding study in the clinical population. Contact Dermatitis 2024; 90:566-573. [PMID: 38387040 DOI: 10.1111/cod.14525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/18/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Quantitative risk assessment (QRA) for skin sensitization is used to derive safe use levels of sensitising fragrance ingredients in products. Post-marketing surveillance of the prevalence of contact allergy to these ingredients provides relevant data to help evaluate the performance of these measures. OBJECTIVES To determine a suitable patch test concentration for five fragrance materials that had hitherto not been tested on a regular basis. These concentrations are then to be used in a surveillance study with patch testing consecutive patients over an extended monitoring period. MATERIALS AND METHODS Furaneol, CAS.3658-77-3; trans-2-hexenal, CAS.6728-26-3; 4,8-dimethyl-4,9-decadienal, CAS.71077-31-1; longifolene, CAS.475-20-7; benzaldehyde, CAS.10052-7, were patch tested with other fragrance allergens in four clinics. Patch testing was conducted in three rounds, starting with the lowest concentrations of the five ingredients. The doses were increased in the subsequent rounds if no late-appearing positive reactions and virtually no irritant reactions were reported. RESULTS Overall, 373 patients were tested. No positive allergic reaction was reported to the five ingredients. Patch test results of other fragrance allergens are reported. CONCLUSIONS The highest test concentrations are each considered safe for patch testing consecutive patients. Further surveillance based on these preparations will evaluate the hypothesis that QRA-driven consumer product levels of these fragrances can prevent sensitization.
Collapse
Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Margarida Gonçalo
- Department of Dermatology, Coimbra University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Joseph Huggard
- The Huggard Consulting Group, S.A.R.L., Itzig, Luxembourg
- IFRA VP Scientific Affairs and IDEA Management Team, Brussels, Belgium
| | - Suzana Ljubojević Hadžavdić
- Department of Dermatology and Venereology, School of Medicine University of Zagreb, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marie L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, Groningen, The Netherlands
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Matthias Vey
- The Huggard Consulting Group, S.A.R.L., Itzig, Luxembourg
- IFRA VP Scientific Affairs and IDEA Management Team, Brussels, Belgium
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | | | - Thomas Rustemeyer
- Department of Dermatology-Allergology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| |
Collapse
|
10
|
Slodownik D, Bar J, Daniely D. Trends in contact sensitization, results, and implications from a contact dermatitis clinic in Israel. Contact Dermatitis 2024; 90:556-565. [PMID: 38368629 DOI: 10.1111/cod.14524] [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: 08/23/2023] [Revised: 12/18/2023] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND The baseline series includes common allergens, evolves over time, and differs by location. Our study aims to characterize allergen sensitization trends among the Israeli population during the last two decades, compare our results to American and European registries, as well as to highlight significant allergens in additional series outside the European baseline series (OEBS). METHODS We analysed patch test results of 2086 patients from a designated contact dermatitis clinic in Tel Aviv between 2019 and 2022, compared them to European and North American registries and to 2156 patch test results conducted in Israel two decades ago. RESULTS 38.6% of patients had at least one positive reaction to an allergen in the European baseline series (EBS), nickel sulphate (14.6%), fragrance mix I (4.6%), and Methylchloroisothiazolinone methylisothiazolinone (MCI/MI; 3.7%) were the most common among them. N-Isopropyl N-Phenyl-4-Phenylenediamine (NIPPD; 0%), Propolis (0.1%), Sesquiterpene lactone mix (0.1%), and Budesonide (0.1%) elicited a sensitization frequency significantly lower than the proposed threshold for baseline inclusion. Chi-square test revealed a statistically significant decrease (p < 0.05) in the sensitization frequency of fragrance mix I, Formaldehyde, Potassium dichromate, Neomycin sulphate, Myroxylon pereirae, Sesquiterpene lactone, and NIPPD during the last two decades. The overall sensitization frequency to the majority of allergens was lower in our cohort in comparison to the North American and European registries. CONCLUSIONS MCI/MI and 2-hydroxyethyl methacrylate-2 (HEMA) are common, relevant allergens, with high SPIN (significance and prevalence index number) and should be better regulated by the authorities. While among the EBS, NIPPD, Propolis, Sesquiterpene lactone, and Budesonide usually do not elicit a positive reaction and therefore should be reconsidered in baseline series, among the OEBS, Chloramphenicol, Quaternium 15, Propyl gallate, and Amerchol L101 have elicited high SPIN values and should be vigilantly examined in the suitable clinical scenario. Significantly lower sensitization frequency to propolis raises the possibility of a protective effect due to early oral exposure among the Israeli population.
Collapse
Affiliation(s)
- Dan Slodownik
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan Bar
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
| | - Danny Daniely
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
Lidén C, White IR. Increasing non-cosmetic exposure and sensitization to isothiazolinones require action for prevention: Review. Contact Dermatitis 2024; 90:445-457. [PMID: 38382085 DOI: 10.1111/cod.14523] [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: 11/27/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
Frequent use of methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI in cosmetic products has been the main cause of widespread sensitization and allergic contact dermatitis to these preservatives (biocides). Their use in non-cosmetic products is also an important source of sensitization. Less is known about sensitization rates and use of benzisothiazolinone (BIT), octylisothiazolinone (OIT), and dichlorooctylisothiazolinone (DCOIT), which have never been permitted in cosmetic products in Europe. BIT and OIT have occasionally been routinely patch-tested. These preservatives are often used together in chemical products and articles. In this study, we review the occurrence of contact allergy to MI, BIT, OIT, and DCOIT over time, based on concomitant patch testing in large studies, and case reports. We review EU legislations, and we discuss the role of industry, regulators, and dermatology in prevention of sensitization and protection of health. The frequency of contact allergy to MI, BIT, and OIT has increased. The frequency of contact allergy to DCOIT is not known because it has seldom been patch-tested. Label information on isothiazolinones in chemical products and articles, irrespective of concentration, is required for assessment of relevance, information to patients, and avoidance of exposure and allergic contact dermatitis.
Collapse
Affiliation(s)
- Carola Lidén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ian R White
- Cutaneous Allergy, St. John's Institute of Dermatology, Guy's Hospital, London, UK
| |
Collapse
|
13
|
Geier J, Schubert S, Rieker-Schwienbacher J, Brans R, Weisshaar E, Kränke B, Brockow K, Ruёff F, Recke A, Uter W. Declining frequency of sensitization to fragrance mixes I and II: IVDK-data of the years 2012-2021. Contact Dermatitis 2024; 90:470-478. [PMID: 38146081 DOI: 10.1111/cod.14493] [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: 08/18/2023] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND EU Commission Regulation 2017/1410 prohibits using atranol and chloroatranol, the main allergens in Evernia prunastri (oakmoss), and hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) in cosmetic products. Oakmoss absolute is contained in fragrance mix (FM) I and HICC in FM II which are patch tested as screening mixtures in the baseline series. OBJECTIVE To describe the time trends of reaction frequencies to both FMs as well as to their components in FM-positive patients. METHODS Retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK), 2012-2021. RESULTS Positive reactions to FM I (FM II) declined from 9.1% (4.7%) in 2012 to 4.6% (3.0%) in 2021. Full breakdown tests were performed in 24% (FM I) and 31% (FM II), respectively, of the mix-positive patients. From this data, frequencies of sensitization to the 14 single fragrances of FM I and FM II were calculated. For the majority, a decline was noted from 2012/2013 to 2020/2021, for oakmoss absolute 1.9%-0.8% and for HICC 1.8%-0.9%. CONCLUSION EU Commission Regulation 2017/1410 was an effective measure. However, our data have some limitations, possibly causing underestimation of sensitization frequencies to fragrances.
Collapse
Affiliation(s)
- Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | | | - Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
| | - Elke Weisshaar
- Unit for Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Birger Kränke
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Knut Brockow
- Department of Dermatology and Allergology, Technical University Munich, Munich, Germany
| | - Franziska Ruёff
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Andreas Recke
- Department of Dermatology, Allergology and Venereology, University of Luebeck, Luebeck, Germany
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| |
Collapse
|
14
|
Gatica-Ortega ME, Pastor-Nieto MA, Giménez-Arnau AM, Mercader-García P, Sanz-Sánchez T, Carrascosa-Carrillo JM, Córdoba-Guijarro S, Sánchez-Pérez J, Silvestre JF, Frutos FJOD, Tous-Romero F, Fernández-Redondo V, Serra-Baldrich E, Ruíz-González I, González Pérez R, Miquel-Miquel J, Guillén PSP, Hervella-García M, Heras-Mendaza F, Gómez-de-la-Fuente E, Zaragoza-Ninet V, Gilo AS, Rodríguez-Serna M, Melé-Ninot G, Descalzo MÁ, de-Vega M, García-Doval I, Borrego L. 2-Hydroxyethyl methacrylate (2-HEMA) sensitization, a global epidemic at its peak in Spain? Contact Dermatitis 2024; 90:507-513. [PMID: 38351475 DOI: 10.1111/cod.14520] [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: 10/22/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND A global epidemic of allergic contact dermatitis to (meth)acrylates has been described in relation to the widespread use of manicure products. OBJECTIVES To evaluate the frequency of sensitization to 2-hydroxyethyl methacrylate (2-HEMA) among consecutively patch tested patients with eczema in Spain; the percentage of current relevance; the MOAHLFA index; and, the potential sources of exposure to (meth)acrylates. METHODS From January 2019 to December 2022, 2-HEMA 2% pet. was prospectively patch tested in 24 REIDAC (Spanish Allergic Contact Dermatitis Registry) centres. RESULTS Six thousand one hundred thirty-four patients were consecutively patch tested with 2-HEMA 2% pet. 265/6134 (4.3%) were positive. Positive reactions of current relevance were identified to involve 184/265 (69%). The efficiency (number of patch tests needed to detect relevant positive patch test reactions) was 34 (6134/184). The variable 'occupational' was found to be significantly associated with a higher risk for relevant positive reactions to 2-HEMA (OR: 10.9; 95% CI: 8.1-14.9). CONCLUSION (Meth)acrylate sensitization is a prevalent health issue in Spain. 2-HEMA 2% pet. has been identified to be a highly effective (meth)acrylate allergy marker in the GEIDAC baseline series. The responsible authorities should implement policies guaranteeing accurate labelling of industrial, medical, and consumer materials while ensuring the enforcement of said labelling through appropriate legal means.
Collapse
Affiliation(s)
- Maria Elena Gatica-Ortega
- Dermatology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
- Escuela Internacional de Doctorado, Universidad de Castilla-La-Mancha, Toledo, Spain
| | - Maria Antonia Pastor-Nieto
- Escuela Internacional de Doctorado, Universidad de Castilla-La-Mancha, Toledo, Spain
- Dermatology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
- Dermatology Department, Hospital Universitario Fundacion Jiménez Díaz, Madrid, Spain
- Faculty of Medicine and Health Sciences, Medicine and Medical Specialties Department, Universidad de Alcalá, Alcalá de Henares, Spain
| | - Ana María Giménez-Arnau
- Dermatology Department, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, Spain
| | - Pedro Mercader-García
- Dermatology Department, Hospital General Universitario José Mª Morales Meseguer, Murcia, Spain
| | | | | | | | | | | | | | - Fátima Tous-Romero
- Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | | | | | | | | | - Felipe Heras-Mendaza
- Dermatology Department, Hospital Universitario Fundacion Jiménez Díaz, Madrid, Spain
| | | | | | | | | | - Gemma Melé-Ninot
- Dermatology Department, Hospital Universitari Sagrat Cor - Grupo Quirónsalud, Barcelona, Spain
| | - Miguel Ángel Descalzo
- Unidad de Investigación of the Fundación Piel Sana AEDV of the Spanish Academy of Dermatology, Madrid, Spain
| | - Marina de-Vega
- Unidad de Investigación of the Fundación Piel Sana AEDV of the Spanish Academy of Dermatology, Madrid, Spain
| | - Ignacio García-Doval
- Unidad de Investigación of the Fundación Piel Sana AEDV of the Spanish Academy of Dermatology, Madrid, Spain
| | - Leopoldo Borrego
- Dermatology Department, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| |
Collapse
|
15
|
Kocabas G, Steunebrink IM, de Groot A, Rustemeyer T. Results of patch testing 2-hydroxyethyl methacrylate (HEMA) in the European baseline series: A 4-year retrospective study. Contact Dermatitis 2024; 90:466-469. [PMID: 38146793 DOI: 10.1111/cod.14488] [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: 11/08/2023] [Accepted: 12/09/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND 2-Hydroxyethyl methacrylate (HEMA) was added to the European baseline series (EBS) in 2019. Few recent data are available on the frequency and relevance of positive reactions to this hapten. OBJECTIVES To investigate the frequency and relevance of positive patch tests to HEMA in the EBS in a university hospital in Amsterdam, The Netherlands. PATIENTS AND METHODS Retrospective study in patients with positive patch tests to HEMA investigated between June 2019 and August 2023. RESULTS Of 2927 consecutive patients, 88 (79 women and 9 men; 3.0%) had a positive reaction to HEMA. The prevalence in women was 3.9%, in men 1.0%. Forty-three (49%) reactions were judged to be of current clinical relevance and 21 (24%) of past relevance. In this group of 64 patients with relevant reactions, 18 (28%) had occupational contact with (meth)acrylate-containing products, of who 11 (61%) were nail stylists. In 46 patients with non-occupational allergic contact dermatitis, 31 (67%) had allergic reactions to nail cosmetics. Glues and glue-containing products accounted for 22% of the materials causing allergic contact dermatitis and dental products for 8%. CONCLUSIONS Allergic reactions to HEMA are very frequent in women investigated in Amsterdam. Nearly two thirds of cases were caused by nail cosmetics.
Collapse
Affiliation(s)
- Gizem Kocabas
- Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Anton de Groot
- Dermato-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Dermato-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| |
Collapse
|
16
|
Stingeni L, Bianchi L, Caroppo ES, Belloni Fortina A, Caroppo F, Corazza M, Borghi A, Gallo R, Trave I, Ferrucci SM, Beretta A, Guarneri F, Martina E, Napolitano M, DE Lucia M, Patruno C, Bennardo L, Romita P, Foti C, Tramontana M, Marietti R, Argenziano G, Hansel K. The new Italian SIDAPA Baseline Series for patch testing (2023): an update according to the new regulatory pathway for contact allergens. Ital J Dermatol Venerol 2024; 159:83-104. [PMID: 38650492 DOI: 10.23736/s2784-8671.24.07733-8] [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: 04/25/2024]
Abstract
Allergic contact dermatitis (ACD) is a common inflammatory skin disease caused by delayed hypersensitivity to chemical and biotic contact allergens. ACD significantly affects the patients' quality of life negatively impacting both occupational and non-occupational settings. Patch testing is the gold standard diagnostic in vivo test to precise the ACD etiology and to correctly perform prevention. According to the Italian Medicines Agency (AIFA) legislative decree no. 178 of 29th May 1991, allergens are defined as medicines and therefore they are subject to strict regulation. In 2017, AIFA (decree no. 2130/2017) started a procedure to regulate contact allergens on the Italian market and actually the contact allergens temporarily authorized are reported in AIFA decree no. 98/2022, valid until November 2023. The availability on the market of contact allergens to diagnose ACD and continuous updating on the basis of new epidemiological trends are mandatory, jointly with the continuous update of the baseline and integrative series for patch testing. For this reason, the scientific community represented in Italy by the Skin Allergies Study Group of SIDeMaST (Italian Society of Dermatology and Venereology) and SIDAPA (Italian Society of Allergological, Occupational and Environmental Dermatology) are constantly working, in close relationship with the European scientific communities with large expertise in this important sector of the modern Dermatology. Herein, we report the setting up of regulatory legislation by AIFA and the new Italian Adult Baseline Series for patch testing.
Collapse
Affiliation(s)
- Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy -
| | - Leonardo Bianchi
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elena S Caroppo
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | | | - Monica Corazza
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Borghi
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Rosella Gallo
- Division of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Ilaria Trave
- Division of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Silvia M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Beretta
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabrizio Guarneri
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Emanuela Martina
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mario DE Lucia
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Cataldo Patruno
- Section of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Luigi Bennardo
- Section of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Marta Tramontana
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Rossella Marietti
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, "Luigi Vanvitelli" University of Campania, Naples, Italy
| | - Katharina Hansel
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| |
Collapse
|
17
|
Tous-Romero F, Borrego-Hernando L, García-Doval I, Mercader-García P, Silvester-Salvador JF, Sánchez-Gilo A, Sanz-Sánchez T, Giménez-Arnau AM, Zaragoza-Ninet V, Miquel-Miquel J, González Pérez R, Córdoba-Guijarro S, Carrascosa-Carrillo JM, Gática-Ortega ME, Ruíz-González I, Serra-Baldrich E, Pastor-Nieto A, Rodríguez-Serna M, Sánchez-Pérez J, Melé I Ninot G, Sánchez-Pedreño Guillén P, Ortiz-de Frutos J. Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:331-340. [PMID: 38061453 DOI: 10.1016/j.ad.2023.10.039] [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: 06/22/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. OBJECTIVES To describe the various temporary trends in allergen positivity in the GEIDAC standard series from 2018 through December 31, 2022. METHODS This was a multicenter, observational trial of consecutive patients analyzed via patch tests as part of the study of possible allergic contact dermatitises collected prospectively within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. The data was analyzed using 2 statistical tests: one homogeneity test (to describe the changes seen over time) and one trend test (to see whether the changes described followed a linear trend). RESULTS A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. A statistically significant decrease was found in the percentage of methylisothiazolinone positive tests across the study years with an orderly trend. CONCLUSIONS Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained. Only a significant downward trend was seen for methylisothiazolinone.
Collapse
Affiliation(s)
- F Tous-Romero
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - L Borrego-Hernando
- Servicio de Dermatología, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, Madrid, España
| | - P Mercader-García
- Servicio de Dermatología, Hospital General Universitario José M. Morales Meseguer, Murcia, España
| | | | - A Sánchez-Gilo
- Servicio de Dermatología, Hospital Rey Juan Carlos, Madrid, España
| | - T Sanz-Sánchez
- Servicio de Dermatología, Hospital Universitario Infanta Sofía, Madrid, España
| | | | - V Zaragoza-Ninet
- Servicio de Dermatología, Hospital Universitario de Valencia, Valencia, España
| | - J Miquel-Miquel
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Valencia, España
| | - R González Pérez
- Servicio de Dermatología, Hospital Universitario Araba, Vitoria, Álava, España
| | - S Córdoba-Guijarro
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - J M Carrascosa-Carrillo
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - M E Gática-Ortega
- Servicio de Dermatología, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - I Ruíz-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - E Serra-Baldrich
- Servicio de Dermatología, Hospital de la Santa Creu i San Pau, Barcelona, España
| | - A Pastor-Nieto
- Servicio de Dermatología, Hospital Fundación Jiménez Díaz, Madrid, España
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España
| | - G Melé I Ninot
- Servicio de Dermatología, Hospital Sagrat Cor, Barcelona, España
| | | | - J Ortiz-de Frutos
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| |
Collapse
|
18
|
Tous-Romero F, Borrego-Hernando L, García-Doval I, Mercader-García P, Silvester-Salvador JF, Sánchez-Gilo A, Sanz-Sánchez T, Giménez-Arnau AM, Zaragoza-Ninet V, Miquel-Miquel J, González Pérez R, Córdoba-Guijarro S, Carrascosa-Carrillo JM, Gática-Ortega ME, Ruíz-González I, Serra-Baldrich E, Pastor-Nieto A, Rodríguez-Serna M, Sánchez-Pérez J, Melé I Ninot G, Sánchez-Pedreño Guillén P, Ortiz-de Frutos J. [Translated article] Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T331-T340. [PMID: 38331170 DOI: 10.1016/j.ad.2024.02.006] [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: 06/22/2023] [Accepted: 10/31/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. OBJECTIVES To describe the various temporary trends in allergen positivity in the GEIDAC standard series from 2018 through December 31, 2022. METHODS This was a multicenter, observational trial of consecutive patients analyzed via patch tests as part of the study of possible allergic contact dermatitises collected prospectively within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. The data was analyzed using 2 statistical tests: one homogeneity test (to describe the changes seen over time) and one trend test (to see whether the changes described followed a linear trend). RESULTS A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. A statistically significant decrease was found in the percentage of methylisothiazolinone positive tests across the study years with an orderly trend. CONCLUSIONS Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained. Only a significant downward trend was seen for methylisothiazolinone.
Collapse
Affiliation(s)
- F Tous-Romero
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - L Borrego-Hernando
- Servicio de Dermatología, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, Madrid, Spain
| | - P Mercader-García
- Servicio de Dermatología, Hospital General Universitario José M. Morales Meseguer, Murcia, Spain
| | | | - A Sánchez-Gilo
- Servicio de Dermatología, Hospital Rey Juan Carlos, Madrid, Spain
| | - T Sanz-Sánchez
- Servicio de Dermatología, Hospital Universitario Infanta Sofía, Madrid, Spain
| | | | - V Zaragoza-Ninet
- Servicio de Dermatología, Hospital Universitario de Valencia, Valencia, Spain
| | - J Miquel-Miquel
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Valencia, Spain
| | - R González Pérez
- Servicio de Dermatología, Hospital Universitario Araba, Vitoria, Álava, Spain
| | - S Córdoba-Guijarro
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - J M Carrascosa-Carrillo
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - M E Gática-Ortega
- Servicio de Dermatología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - I Ruíz-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, Spain
| | - E Serra-Baldrich
- Servicio de Dermatología, Hospital de la Santa Creu i San Pau, Barcelona, Spain
| | - A Pastor-Nieto
- Servicio de Dermatología, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, Spain
| | - G Melé I Ninot
- Servicio de Dermatología, Hospital Sagrat Cor, Barcelona, Spain
| | | | - J Ortiz-de Frutos
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
| |
Collapse
|
19
|
Piapan L, Belloni Fortina A, Giulioni E, Larese Filon F. Sensitization to ethylenediamine dihydrochloride in patients with contact dermatitis in northeastern Italy from 1996 to 2021. Contact Dermatitis 2024; 90:253-261. [PMID: 38038148 DOI: 10.1111/cod.14454] [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: 09/14/2023] [Revised: 10/09/2023] [Accepted: 10/23/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Ethylenediamine dihydrochloride is a versatile aliphatic amine found in numerous medications and industrial compounds and is a known sensitiser. The sensitization prevalence is affected by geographical and socio-cultural factors. OBJECTIVES The objectives are to analyse the temporal trend of sensitization to ethylenediamine dihydrochloride in northeastern Italy and to investigate associations with occupations. METHODS Between 1996 and 2021, 30 629 patients with suspected allergic contact dermatitis were patch tested with the Triveneto baseline series. Individual characteristics were collected through a standardised questionnaire. RESULTS The overall prevalence of ethylenediamine dihydrochloride sensitization was 1.29% with percentages similar in both sexes. We observed a significant decreasing trend over time (p < 0.001), yielding a sensitization prevalence <1% in recent years. Among departments, residence in Pordenone area was protective for sensitization. No significant associations were observed with specific occupations. We found significant associations between ethylenediamine dihydrochloride sensitization and being 26-35 years old (odds ratio [OR], 1.47; 95% confidence interval [CI]: 1.05-2.08), and sensitization for many haptens, such as paraben mix (OR, 5.3; 95% CI: 3.3-8.5), epoxy resin (OR, 5.1; 95% CI: 3.0-8.7), neomycin sulphate and mercaptobenzothiazole. CONCLUSIONS Our study showed a downward time trend of ethylenediamine dihydrochloride sensitization in northeastern Italian population and pointed to an update of the Triveneto baseline series.
Collapse
Affiliation(s)
- Linda Piapan
- Department of Medical Sciences, Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | | | - Erika Giulioni
- Dermatology Unit, Ospedale Santa Maria degli Angeli, Azienda Sanitaria Friuli Orientale, Pordenone, Italy
| | - Francesca Larese Filon
- Department of Medical Sciences, Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| |
Collapse
|
20
|
de Groot AC, Rustemeyer T. 2-Hydroxyethyl methacrylate (HEMA): A clinical review of contact allergy and allergic contact dermatitis. Part 2. Cross- and co-sensitization, other skin reactions to HEMA, position of HEMA among (meth)acrylates, sensitivity as screening agent, presence of HEMA in commercial products and practical information on patch test procedures. Contact Dermatitis 2024; 90:1-16. [PMID: 37778325 DOI: 10.1111/cod.14430] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023]
Abstract
This is the second part of a literature review of the clinical aspects of contact allergy to and allergic contact dermatitis from 2-hydroxyethyl methacrylate (HEMA). Topics include cross- and co-sensitization, atypical manifestations of contact allergy, frequency of positive patch tests to HEMA compared with other (meth)acrylates, sensitivity of HEMA as a screening agent, the presence of HEMA in commercial products, and practical information on patch testing procedures. Primary sensitization to methacrylates including HEMA may result in methacrylate and acrylate cross-sensitization. There is a strong cross-allergy between HEMA, ethylene glycol dimethacrylate (EGDMA), and hydroxypropyl methacrylate; many reactions to EGDMA are cross-reactions to primary HEMA sensitization. Rare atypical manifestations of HEMA-allergy include lichen planus, lymphomatoid papulosis, systemic contact dermatitis, leukoderma after positive patch tests, and systemic side effects such as nausea, diarrhoea, malaise, and palpitations. The occurrence of respiratory disease caused by methacrylates such as asthma is not infrequent. HEMA is the most frequently patch test-positive methacrylate. It is a good screening agent for allergy to other (meth)acrylates. Patch test sensitization to HEMA 2% pet. is extremely rare. There are (some) indications that HEMA is frequently used in dental products and nail cosmetics.
Collapse
Affiliation(s)
| | - Thomas Rustemeyer
- Dermato-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| |
Collapse
|
21
|
Kingston P, Khan S, Chan J, Pourali SP, Armstrong AW, DeLeo V, Adler BL. Trends in Patch-Test Positivity to Methylchloroisothiazolinone and Methylisothiazolinone Based on Regulatory Status: A Systematic Review. Dermatitis 2023. [PMID: 38052035 DOI: 10.1089/derm.2023.0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Affiliation(s)
- Paige Kingston
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Samiya Khan
- Long School of Medicine, San Antonio, TX, USA
- Los Angeles General Hospital (Current affiliation), University of Southern California, Los Angeles, CA, USA
| | - Justin Chan
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sarah P Pourali
- Department of Dermatology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - April W Armstrong
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Vincent DeLeo
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brandon L Adler
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA,
| |
Collapse
|
22
|
Samaran Q, Allichon S, Pernet C, Dereure O, Raison-Peyron N. Occupational allergic contact dermatitis to several metals, including rhodium. Contact Dermatitis 2023; 89:513-515. [PMID: 37731330 DOI: 10.1111/cod.14423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Affiliation(s)
- Quentin Samaran
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, France
| | - Salomé Allichon
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, France
| | | | - Olivier Dereure
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, France
| | - Nadia Raison-Peyron
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, France
| |
Collapse
|
23
|
Paulsen E. The sesquiterpene lactone mix: A review of past, present and future aspects. Contact Dermatitis 2023; 89:434-441. [PMID: 37820718 DOI: 10.1111/cod.14419] [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: 07/05/2023] [Revised: 08/15/2023] [Accepted: 09/06/2023] [Indexed: 10/13/2023]
Abstract
The sesquiterpene lactones (SLs) are secondary plant metabolites, which are widespread in the Compositae/Asteraceae plant family. The first SLs were detected more than 100 years ago, and allergic contact dermatitis from Compositae has been reported since the beginning of the 1900s, but it was not until the late 1960s and early 1970s that a collaboration between dermatologists, chemists and botanists led to the detection of SLs as the main allergens of Compositae plants. In the 1980s, the SL mix, consisting of equimolar amounts of alantolactone, costunolide and dehydrocostus lactone, was developed as a screening agent for Compositae sensitisation. Today, after inclusion of SL mix in the baseline series, the mean prevalence of reactions in Europe is around 1%, and in North America 0.8%. In countries outside Europe and North America, the prevalence ranges between 0% and 10.7%. The detection rate of SL mix is lower than that of some plant extracts, and ideally, SL mix should be supplemented with a mix of SLs from locally prevalent allergenic plants. The prevalence of positive reactions to SL mix suggests continued baseline testing in most European countries, North America, New Zealand, Australia and probably some Chinese centres.
Collapse
Affiliation(s)
- Evy Paulsen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense C, Denmark
| |
Collapse
|
24
|
de Groot AC, Rustemeyer T. 2-Hydroxyethyl methacrylate (HEMA): A clinical review of contact allergy and allergic contact dermatitis-Part 1. Introduction, epidemiology, case series and case reports. Contact Dermatitis 2023; 89:401-433. [PMID: 37752620 DOI: 10.1111/cod.14405] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 07/31/2023] [Accepted: 08/04/2023] [Indexed: 09/28/2023]
Abstract
2-Hydroxyethyl methacrylate (HEMA) has been increasingly recognised as a contact allergen and was added to the European baseline series in 2019. In this article (2 parts), the results of an extensive literature review of the clinical aspects of contact allergy/allergic contact dermatitis to HEMA are presented. In part 1, the epidemiology of HEMA contact allergy is discussed and detailed information on published case series and case reports presented. HEMA is an important cause of contact allergy/allergic contact dermatitis in North America and Europe with recent prevalences of >3% in the USA + Canada and 1.5%-3.7% in Europe. Currently, most cases are caused by nail cosmetics, both in consumers and professional nail stylists. In our literature review, we have found 24 studies presenting case series of patients with allergic contact dermatitis attributed to HEMA and 168 case reports. However, the presence of HEMA in the products causing ACD was established in only a minority. Part 2 will discuss cross- and co-sensitisation, and other skin reactions to HEMA, will assess whether HEMA is the most frequent (meth)acrylate allergen and how sensitive HEMA as a screening agent is, investigate the presence of HEMA in commercial products and provide practical information on patch testing procedures.
Collapse
Affiliation(s)
| | - Thomas Rustemeyer
- Dermato-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, AZ, The Netherlands
| |
Collapse
|
25
|
Warshaw EM, Peterson MY, Atwater AR, DeKoven JG, Pratt MD, Taylor JS, Belsito DV, Silverberg JI, Reeder MJ, DeLeo VA, Houle MC, Dunnick CA, Yu J, Adler B, Mowad C, Botto NC. Patch Testing to Paraphenylenediamine: The North American Contact Dermatitis Group Experience (1994-2018). Dermatitis 2023; 34:536-546. [PMID: 37523239 DOI: 10.1089/derm.2023.0140] [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: 08/02/2023]
Abstract
Background/Objectives: Paraphenylenediamine (PPD) is an aromatic amine dye that may cause allergic contact dermatitis. This study examines the epidemiology of allergic patch test reactions to PPD. Methods: This retrospective analysis characterizes individuals tested to PPD (1% petrolatum) by the North American Contact Dermatitis Group (1994-2018). Demographics and dermatitis site(s) were compared between PPD-allergic and PPD-negative patients. PPD reactions were analyzed by reaction strength, clinical relevance, occupational relatedness, and source as well as coreactivity with structurally related compounds. Results: Of 54,917 patients tested to PPD, 3095 (5.6%) had an allergic patch test reaction. Compared with PPD-negative patients, PPD-allergic patients had significantly greater odds of age >40 years (odds ratio [OR] 1.55 [95% confidence interval; CI 1.43-1.69]) and female gender (OR 1.52 [95% CI 1.41-1.66]), but lower odds of being White (OR 0.66 [95% CI 0.60-0.71]). The most common primary anatomic sites of dermatitis were face (25.5%), hands (21.9%), and scattered/generalized pattern (15.5%). Over half (55.3%) of PPD reactions were ++ or +++ at the final reading and 60.9% were currently relevant. Common exposure sources included hair dye (73.5%) and clothing/shoes/apparel (3.9%). Occupationally related reactions occurred in 8.3%, most commonly in hairdressers/cosmetologists (72.8%). The most common coreactions were benzocaine (11.3%), N-isopropyl-N'-phenyl-p-phenylenediamine (6.7%), disperse dye mix (6.5%), and black rubber mix (5.1%). Conclusions: The 24-year percentage of allergic reactions to PPD was 5.6%. PPD allergy was associated with female gender and age >40 years. PPD allergic patients were less likely to be White. Allergic reactions were usually clinically relevant and hair dye was the most frequently identified source.
Collapse
Affiliation(s)
- Erin M Warshaw
- From the Department of Dermatology, Park Nicollet/Health Partners Health Services, Minneapolis, Minnesota, USA
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
| | - Malina Yamashita Peterson
- From the Department of Dermatology, Park Nicollet/Health Partners Health Services, Minneapolis, Minnesota, USA
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ontario, Canada
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, 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
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Marie-Claude Houle
- Division of Dermatology, Centre Hospitalier Universitaire de Québec, Laval University, Québec, Canada
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jiade Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Brandon Adler
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Christen Mowad
- Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Nina C Botto
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
26
|
Pegalajar-García MD, Cebolla-Verdugo M, Prados-Carmona Á, Llamas-Segura C, Navarro-Triviño FJ. Systemic allergic dermatitis to cobalt present in cyanocobalamin supplementation. Contact Dermatitis 2023. [PMID: 37290457 DOI: 10.1111/cod.14362] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/10/2023]
Affiliation(s)
- María Dolores Pegalajar-García
- Department of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Granada, Spain
| | - Marta Cebolla-Verdugo
- Department of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Granada, Spain
| | - Álvaro Prados-Carmona
- Department of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Granada, Spain
| | - Carlos Llamas-Segura
- Department of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Granada, Spain
| | - Francisco J Navarro-Triviño
- Department of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Granada, Spain
| |
Collapse
|
27
|
Basketter DA. Risk management of skin sensitisers: A commentary. Regul Toxicol Pharmacol 2023; 140:105384. [PMID: 37028500 DOI: 10.1016/j.yrtph.2023.105384] [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: 01/16/2023] [Revised: 03/10/2023] [Accepted: 03/25/2023] [Indexed: 04/09/2023]
Abstract
Historically, allergic contact dermatitis (ACD) to chemicals encouraged hazard identification improvements, more sophisticated risk assessment and implementation of regulatory strategies, including banning of specific sensitising substances. The validation process applied to hazard identification methods demonstrates their accuracy; their use to characterise sensitiser potency facilitates quantitative and transparent risk assessment. Diagnostic patch testing at dermatology clinics worldwide delivers feedback showing where risk assessment/management has been insufficient or did not target the exposure of concern, thereby facilitating improvements. When urgent action to protect human health was required, regulations limited/banned, specific skin sensitisers. This can be seen in practice with the fragrance industry, a known source of ACD, thus requiring risk management, usually restrictions to limit allergy induction, and very rarely specific bans on ingredients. Experience and development of more sophisticated tools, e.g. to assess aggregate exposure from multitude of consumer product types, has led to repeated adaptation of risk assessment and promulgation of updated fragrance use limits. Although targeted control may not always lead to rapid change in the overall clinical picture, it is preferable to a blanket undifferentiated regulatory control of all sensitisers, resulting in unwarranted restrictions for many uses of no health concern, with consequent substantial socio-economic impacts.
Collapse
|
28
|
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.
Collapse
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
| |
Collapse
|