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Hilewitz D, Trattner A, Reiter O, Uvaidov V, Noyman Y, Solomon Cohen E, Hackett A, Mimouni D, Snast I. Pandemic of sensitivity to acrylate containing nail cosmetic among young Israeli women? Result of patch testing 2-hydroxyethyl methacrylate in the European baseline series. Contact Dermatitis 2024. [PMID: 39180387 DOI: 10.1111/cod.14683] [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: 05/27/2024] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND 2-Hydroxyethyl methacrylate (HEMA) was added into the European baseline series (EBS) in 2019. There is limited data regarding the frequency, relevance, and sources of exposure to HEMA. OBJECTIVES To investigate the frequency and clinical relevance of positive reactions to HEMA in the EBS in Israel, and explore sources of exposure. METHODS Retrospective cohort study that included all patients who underwent patch testing with the EBS in a tertiary center in Israel between 2020 and 2023. Positive reactions to HEMA were stratified by sex, six age groups, and year of study. Sources of exposure to HEMA as well as occupational data were recorded. RESULTS A total of 1671 consecutive patients underwent HEMA patch testing, with 135 (8.1%) showing positive reactions to HEMA (130 females, 5 males). The prevalence in women (11.0%) was significantly higher compared to men (1.0%) (p < 0.001). Stratification by age and sex revealed the highest frequency of HEMA sensitivity of 16.7% among women younger than 30 years of age, with odds ratio of 2.3 (95%CI: 1.6-3.3, p < 0.001) compared to older women. There was an increase in frequency among women between the years 2022 and 2023 when compared to 2020-2021 (OR 1.7, 95%CI: 1.5-2.1, p < 0.01) attributable to COVID-19 pandemic and social restrictions. Among men the frequency fluctuations over the study period and age categories were nonsignificant. 111 (84%) were judged to be of clinical relevance and nail cosmetics was responsible for 95% of them. Of 111 patients with relevant reaction (110 females, 1 males), 20 (18%) had occupational contact dermatitis (18 nails stylists, 2 dentists). Other culprit products included sanitary pads (n = 4), medical adhesives (n = 3), and paints (n = 2). CONCLUSION We report the highest frequency of HEMA sensitivity to date of 8.1%, that was most common among young women and in vast majority of cases was attributable to nail cosmetics. Our findings reflect the popularity of nail cosmetics in Israel as well as the global trend of increasing sensitivity to (meth)acrylates.
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Affiliation(s)
- D Hilewitz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - A Trattner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - O Reiter
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - V Uvaidov
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - Y Noyman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - E Solomon Cohen
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - A Hackett
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - D Mimouni
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - I Snast
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
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Keskinkaya Z, Işık Mermutlu S, Kaya Ö, Çakır H. Artificial nail modelling systems in healthcare workers: An emerging risk of contact sensitization to a well-known occupational allergen in an alternative way. Contact Dermatitis 2024; 91:38-44. [PMID: 38561321 DOI: 10.1111/cod.14548] [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: 01/16/2024] [Revised: 02/26/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Artificial nail modelling systems (ANMS) pose a significant risk for nail stylists and their clients regarding acrylate sensitization, which might jeopardize the use of acrylate-containing medical devices. OBJECTIVES To evaluate the frequency of artificial nail practices among female healthcare workers (HCWs) compared with controls and assess ANMS-related side effects. METHODS In this comparative, cross-sectional, single-centre study, a face-to-face interview with 200 female HCWs and 200 age-matched female dermatology patients (controls) was conducted regarding the use of ANMS between March and November 2023. RESULTS Among 400 participants (median age: 25), 85 (21.3%) have applied ANMS at least once. The prevalence of ANMS application was significantly higher in HCWs (n = 54/200, 27%) compared with controls (n = 31/200, 15.5%) (p < 0.05). Long-lasting nail polish was the most commonly preferred technique (n = 82/85, 96.5%). ANMS were mainly performed in nail studios by nail stylists (n = 79/85, 92.9%), while three participants were using home kits. Nail brittleness was the most frequently reported side effect (n = 19/85, 22.4%). No case of allergic contact dermatitis (ACD) was detected. CONCLUSIONS The popularity of ANMS among young female HCWs is growing. This striking trend might further put these individuals not only at risk of medical device-related adverse events but also occupational ACD.
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Affiliation(s)
- Zeynep Keskinkaya
- Department of Dermatology and Venereology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Selda Işık Mermutlu
- Department of Dermatology and Venereology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Özge Kaya
- Department of Dermatology and Venereology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Haile Çakır
- Department of Dermatology and Venereology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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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.
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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
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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.
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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
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Steunebrink IM, de Groot A, Rustemeyer T. Contact allergy to acrylate-containing nail cosmetics: A retrospective 8-year study. Contact Dermatitis 2024; 90:262-265. [PMID: 38093676 DOI: 10.1111/cod.14475] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/03/2023] [Accepted: 11/28/2023] [Indexed: 02/13/2024]
Abstract
BACKGROUND Over the last 10 years, allergic contact dermatitis (ACD) from acrylate-containing nail cosmetics (acrylic nails, gel nails, gel nail polish) has been reported repeatedly. OBJECTIVES To investigate the frequency and clinical features of ACD in nail cosmetics in a university hospital in Amsterdam, The Netherlands. PATIENTS AND METHODS A retrospective study in patients diagnosed with ACD from acrylate-containing nail cosmetics at the Amsterdam University Medical Centers between January 2015 and August 2023. RESULTS Sixty-seven patients, all women, were diagnosed with ACD from nail cosmetics, representing 1.6% of all individuals and 2.3% of all women patch tested in this period. Sixty-five of sixty-seven (97%) subjects had a positive patch test to 2-hydroxyethyl methacrylate (HEMA). Forty-nine patients (73%) were consumers and 18 (27%) were professional nail stylists. The sites most frequently affected with dermatitis were the fingers (79%), hands (40%) and the head and/or neck. Avoidance of contact with acrylate-containing products resulted in complete clearing of dermatitis in 80% of patients. CONCLUSIONS ACD from acrylate-containing nail cosmetics is frequent in women patch tested in Amsterdam. Nearly all were identified by a positive patch test to 2-hydroxyethyl methacrylate in the (meth)acrylate series or the European baseline series.
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Affiliation(s)
| | - 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
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