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Sürgün E, Boyvat A. Increased rates of contact allergy to selected preservatives in patients with allergic contact dermatitis in Turkey. Contact Dermatitis 2024; 90:110-115. [PMID: 37840032 DOI: 10.1111/cod.14435] [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: 04/12/2023] [Revised: 08/28/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Preservatives are a frequent cause of allergic contact dermatitis (ACD) and have caused numerous epidemics. OBJECTIVES The objective of this study is to determine the prevalence of preservative sensitivity, assess the change in the frequency of sensitivity, identify new preservatives with increased sensitivity rates, and evaluate the situation in Turkey by comparing our findings with current literature. METHODS A total of 201 patients diagnosed with ACD between 2018 and 2020, were patch tested with the European baseline series and additional seven preservative haptens. The change in the prevalence of sensitivity to each preservative hapten was investigated by comparing the data from the study conducted in our department between 2000 and 2004. RESULTS Results showed that 17.4% (n = 35) of the patients were positive to preservatives. Comparison with previous data from 2000 to 2004 revealed an increase in the frequency of sensitization. The most prevalent allergen was methyldibromo glutaronitrile (9.5%), followed by methylchloroisothiazolinone/methylisothiazolinone (6.5%), and methylisothiazolinone (5%). CONCLUSION The increase in preservative sensitivity in Turkey is the most remarkable finding. Although MDBGN was prohibited in cosmetic products, MCI/MI and MI are still widely used. Our findings suggest that awareness of preservative sensitivity should be increased and additional precautions should be taken, also in Turkey, regarding the use of preservatives.
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Affiliation(s)
- Ece Sürgün
- Faculty of Medicine, Department of Dermatology, Ankara University, Ankara, Turkey
| | - Ayşe Boyvat
- Faculty of Medicine, Department of Dermatology, Ankara University, Ankara, Turkey
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Burnett C, Bergfeld WF, Belsito DV, Klaassen CD, Liebler DC, Marks JG, Shank RC, Slaga TJ, Snyder PW, Fiume M, Heldreth B. Imidazolidinyl Urea. Int J Toxicol 2023; 42:53S-55S. [PMID: 37776363 DOI: 10.1177/10915818231204614] [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] [Indexed: 10/02/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 1980, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Imidazolidinyl Urea is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
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Affiliation(s)
- Christina Burnett
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer, Washington, DC, USA
| | | | | | | | | | - James G Marks
- Expert Panel for Cosmetic Ingredient Safety Former Member
| | - Ronald C Shank
- Expert Panel for Cosmetic Ingredient Safety Former Member
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Ünal A. Analysis of patch testing results in patients with contact dermatitis in Istanbul, Turkey, from 2012 to 2022. J Cosmet Dermatol 2023; 22:2831-2838. [PMID: 37103790 DOI: 10.1111/jocd.15791] [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: 12/09/2022] [Revised: 04/04/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Allergens responsible for allergic contact dermatitis (ACD) differ between populations. They can even change over the years with the effect of environmental factors. AIMS To evaluate the results of patch testing performed in our center. METHODS In this study, the thin-layer rapid-use epicutaneous (T.R.U.E.) test results of patients with a diagnosis of ACD between 2012 and 2022 were retrospectively evaluated. RESULTS In 431 (42.5%) of the total 1012 patients, a positive reaction to at least one allergen was detected in the patch test. Allergen positivity was most detected for nickel sulphate (16.8%), gold sodium thiosulfate (GST) (6.9%), thimerosal (4.2%), fragrance mix (3.4%), carba mix (3.2%), and cobalt dichloride (2.9%). Nickel sulfate and GST sensitivity was found to be significantly higher in women, fragrance mix sensitivity in men, thimerosal sensitivity in individuals aged under 40 years, colophony and balsam of Peru sensitivity in head and neck dermatitis, and carba mix and thiuram mix sensitivity in atopic individuals. CONCLUSIONS This study presents comprehensive data from Turkey concerning the sensitivity frequencies for allergens included in the T.R.U.E. test.
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Affiliation(s)
- Alkım Ünal
- Department of Dermatology, Medical Faculty, Istanbul Medipol University, Istanbul, Turkey
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Kalicińska J, Wiśniowska B, Polak S, Spiewak R. Artificial Intelligence That Predicts Sensitizing Potential of Cosmetic Ingredients with Accuracy Comparable to Animal and In Vitro Tests-How Does the Infotechnomics Compare to Other "Omics" in the Cosmetics Safety Assessment? Int J Mol Sci 2023; 24:ijms24076801. [PMID: 37047774 PMCID: PMC10094956 DOI: 10.3390/ijms24076801] [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: 02/28/2023] [Revised: 03/25/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
The aim of the current study was to develop an in silico model to predict the sensitizing potential of cosmetic ingredients based on their physicochemical characteristics and to compare the predictions with historical animal data and results from "omics"-based in vitro studies. An in silico model was developed with the use of WEKA machine learning software fed with physicochemical and structural descriptors of haptens and trained with data from published epidemiological studies compiled into estimated odds ratio (eOR) and estimated attributable risk (eAR) indices. The outcome classification was compared to the results of animal studies and in vitro tests. Of all the models tested, the best results were obtained for the Naive Bayes classifier trained with 24 physicochemical descriptors and eAR, which yielded an accuracy of 86%, sensitivity of 80%, and specificity of 90%. This model was subsequently used to predict the sensitizing potential of 15 emerging and less-studied haptens, of which 7 were classified as sensitizers: cyclamen aldehyde, N,N-dimethylacrylamide, dimethylthiocarbamyl benzothiazole sulphide, geraniol hydroperoxide, isobornyl acrylate, neral, and prenyl caffeate. The best-performing model (NaiveBayes eAR, 24 parameters), along with an alternative model based on eOR (Random Comittee eOR, 17 parameters), are available for further tests by interested readers. In conclusion, the proposed infotechnomics approach allows for a prediction of the sensitizing potential of cosmetic ingredients (and possibly also other haptens) with accuracy comparable to historical animal tests and in vitro tests used nowadays. In silico models consume little resources, are free of ethical concerns, and can provide results for multiple chemicals almost instantly; therefore, the proposed approach seems useful in the safety assessment of cosmetics.
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Affiliation(s)
- Jadwiga Kalicińska
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, ul. Medyczna 9, 30-688 Krakow, Poland
| | - Barbara Wiśniowska
- Department of Social Pharmacy, Jagiellonian University Medical College, ul. Medyczna 9, 30-688 Krakow, Poland
| | - Sebastian Polak
- Department of Social Pharmacy, Jagiellonian University Medical College, ul. Medyczna 9, 30-688 Krakow, Poland
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, ul. Medyczna 9, 30-688 Krakow, Poland
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De Marco A, Romita P, Ambrogio F, De Prezzo S, Schinzari L, Foti C. Allergic contact dermatitis due to excipients in topical drugs. Contact Dermatitis 2023; 88:158-160. [PMID: 36331181 DOI: 10.1111/cod.14241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Aurora De Marco
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Francesca Ambrogio
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Serena De Prezzo
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Luca Schinzari
- 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
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Patch Test Results to European Baseline Series in Turkey: A Prospective and Multicenter Study. Dermatitis 2021; 32:397-405. [PMID: 33731647 DOI: 10.1097/der.0000000000000631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Patch testing with the European Baseline Series (EBS) is an essential diagnostic tool for the assessment of allergic contact dermatitis. OBJECTIVE The aims of the study were to describe the most common contact allergens identified with patch testing in Turkey and to establish the distribution of contact allergens among different regions in Turkey. PATIENTS AND METHODS Twelve centers consisting of tertiary health care institutions were included in the study. A total of 1169 patients were patch tested with the EBS from 2015 to 2017. RESULTS A total of 596 patients (51.0%) had 1 or more positive patch test reactions to the EBS. A total of 30.2% (n = 353) of those tested had clinical relevance. Contact sensitivity was more common in young patients. The most common 10 allergens were nickel sulfate (20.4%), followed by textile dye mix (8.6%), cobalt chloride (8.3%), potassium dichromate (8.0%), p-phenylenediamine base (4.5%), balsam of Peru (4.3%), methylchloroisothiazolinone/methylisothiazolinone (3.8%), thiuram mix (3.6%), fragrance mix I (3.0%), and methylisothiazolinone (2.9%). CONCLUSIONS This study provides a comprehensive profile of patch test results with the EBS in Turkey. An ongoing decrease in contact allergy to methylchloroisothiazolinone/methylisothiazolinone and methylisothiazolinone was observed. Textile dye mix and p-phenylenediamine are beginning to pose a new risk in Turkey.
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Dear K, Palmer A, Nixon R. Contact allergy and allergic contact dermatitis from benzalkonium chloride in a tertiary dermatology center in Melbourne, Australia. Contact Dermatitis 2021; 85:146-153. [PMID: 33656745 DOI: 10.1111/cod.13826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/30/2021] [Accepted: 02/03/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Benzalkonium chloride (BAK) is a quaternary ammonium compound that is used widely as an antiseptic and preservative. It is a strong irritant and considered a weak sensitizer. OBJECTIVE To analyze the temporal trend of BAK sensitization and the demographics of sensitized patients. METHODS We conducted a single-center retrospective study of 7390 patients who were patch tested with BAK between January 1, 2003 and December 31, 2019. RESULTS Of the 7390 patients who were patch tested to BAK, 108 (1.5%) had a positive reaction, with 21 reactions deemed clinically relevant (0.3% of total patch tested) and a further 5 doubtful reactions deemed clinically relevant, resulting in a total of 26 relevant reactions (0.4% of total patch tested). Common sources of exposure were ophthalmic drops (30.8%), topical antiseptic preparations (26.9%), cosmetics (15.4%), disinfectant solutions (11.5%), hand sanitizers (11.5%), and hand washes (7.7%). One fifth of patients with relevant reactions were health care workers. There has been a dramatic increase in the number of positive reactions since 2017, for reasons not totally clear. CONCLUSION Contact allergy (CA) and allergic contact dermatitis (ACD) in response to BAK are now increasing at our center. Awareness of this trend is important, given that the coronavirus disease 2019 (COVID-19) pandemic is likely to further expose people to BAK.
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Affiliation(s)
- Kate Dear
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - Amanda Palmer
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
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Fiume MM, Bergfeld WF, Belsito DV, Hill RA, Klaassen CD, Liebler D, Marks JG, Shank RC, Slaga TJ, Snyder PW, Andersen FA. Safety assessment of propylene glycol, tripropylene glycol, and PPGs as used in cosmetics. Int J Toxicol 2013; 31:245S-60S. [PMID: 23064775 DOI: 10.1177/1091581812461381] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Propylene glycol is an aliphatic alcohol that functions as a skin conditioning agent, viscosity decreasing agent, solvent, and fragrance ingredient in cosmetics. Tripropylene glycol functions as a humectant, antioxidant, and emulsion stabilizer. Polypropylene glycols (PPGs), including PPG-3, PPG-7, PPG-9, PPG-12, PPG-13, PPG-15, PPG-16, PPG-17, PPG-20, PPG-26, PPG-30, PPG-33, PPG-34, PPG-51, PPG-52, and PPG-69, function primarily as skin conditioning agents, with some solvent use. The majority of the safety and toxicity information presented is for propylene glycol (PG). Propylene glycol is generally nontoxic and is noncarcinogenic. Clinical studies demonstrated an absence of dermal sensitization at use concentrations, although concerns about irritation remained. The CIR Expert Panel determined that the available information support the safety of tripropylene glycol as well as all the PPGs. The Expert Panel concluded that PG, tripropylene glycol, and PPGs ≥3 are safe as used in cosmetic formulations when formulated to be nonirritating.
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Affiliation(s)
- Monice M Fiume
- Cosmetic Ingredient Review, 1101 17th Street NW, Washington, DC 20036, USA.
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Svedman C, Andersen KE, Brandão FM, Bruynzeel DP, Diepgen TL, Frosch PJ, Rustemeyer T, Giménez-Arnau A, Gonçalo M, Goossens A, Johansen JD, Lahti A, Menné T, Seidenari S, Tosti A, Wahlberg JE, White IR, Wilkinson JD, Mowitz M, Bruze M. Follow-up of the monitored levels of preservative sensitivity in Europe. Overview of the years 2001-2008. Contact Dermatitis 2012; 67:312-4. [DOI: 10.1111/j.1600-0536.2012.02140.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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LEE SS, HONG DK, JEONG NJ, LEE JH, CHOI YS, LEE AY, LEE CH, KIM KJ, PARK HY, YANG JM, LEE GY, LEE J, EUN HC, MOON KC, SEO SJ, HONG CK, LEE SW, CHOI HY, LEE JY. Multicenter study of preservative sensitivity in patients with suspected cosmetic contact dermatitis in Korea. J Dermatol 2012; 39:677-81. [DOI: 10.1111/j.1346-8138.2012.01551.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Andersen FA. Annual Review of Cosmetic Ingredient Safety Assessments: 2007-2010. Int J Toxicol 2011; 30:73S-127S. [DOI: 10.1177/1091581811412618] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Aakhus AE, Warshaw EM. Allergy to Methyldibromoglutaronitrile/Phenoxyethanol (Euxyl K 400): Regulatory Issues, Epidemiology, Clinical Characteristics, and Management. Dermatitis 2011. [DOI: 10.2310/6620.2011.10081] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Lee SL, Yu LX, Cai B, Johnsons GR, Rosenberg AS, Cherney BW, Guo W, Raw AS. Scientific considerations for generic synthetic salmon calcitonin nasal spray products. AAPS J 2011; 13:14-9. [PMID: 21052882 PMCID: PMC3032093 DOI: 10.1208/s12248-010-9242-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Accepted: 10/19/2010] [Indexed: 11/30/2022] Open
Abstract
Under the Abbreviated New Drug Application pathway, a proposed generic salmon calcitonin nasal spray is required to demonstrate pharmaceutical equivalence and bioequivalence to the brand-name counterpart or the reference listed drug. This review discusses two important aspects of pharmaceutical equivalence for this synthetic peptide nasal spray product. The first aspect is drug substance sameness, in which a proposed generic salmon calcitonin product is required to demonstrate that it contains the same active ingredient as that in the brand-name counterpart. The second aspect is comparability in product- and process-related factors that may influence immunogenicity (i.e., peptide-related impurities, aggregates, formulation, and leachates from the container/closure system). The comparability of these factors helps to ensure the product safety, particularly with respect to immunogenicity. This review also highlights the key features of in vitro and/or in vivo studies for establishing bioequivalence for a solution nasal spray containing a systemically acting salmon calcitonin.
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Affiliation(s)
- Sau L. Lee
- />Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, 7519 Standish Place, Rockville, Maryland 20855 USA
| | - Lawrence X. Yu
- />Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, 7519 Standish Place, Rockville, Maryland 20855 USA
| | - Bing Cai
- />Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, 7519 Standish Place, Rockville, Maryland 20855 USA
| | - Gibbes R. Johnsons
- />Office of Biotechnology Products, Center for Drug Evaluation and Research, US Food and Drug Administration, 9000 Rockville Pike, Bethesda, Maryland 20892 USA
| | - Amy S. Rosenberg
- />Office of Biotechnology Products, Center for Drug Evaluation and Research, US Food and Drug Administration, 9000 Rockville Pike, Bethesda, Maryland 20892 USA
| | - Barry W. Cherney
- />Office of Biotechnology Products, Center for Drug Evaluation and Research, US Food and Drug Administration, 9000 Rockville Pike, Bethesda, Maryland 20892 USA
| | - Wei Guo
- />Office of Biotechnology Products, Center for Drug Evaluation and Research, US Food and Drug Administration, 9000 Rockville Pike, Bethesda, Maryland 20892 USA
| | - Andre S. Raw
- />Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, 7519 Standish Place, Rockville, Maryland 20855 USA
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Amaral LFB, Camilo NS, Pereda MDCV, Levy CE, Moriel P, Mazzola PG. Evaluation of antimicrobial effectiveness of C-8 xylitol monoester as an alternative preservative for cosmetic products. Int J Cosmet Sci 2011; 33:391-7. [PMID: 21338375 DOI: 10.1111/j.1468-2494.2010.00633.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Xylitol is a natural sugar derived from plants, fruits and vegetables, whose antimicrobial properties are described in the literature. This study aimed to evaluate the antimicrobial effectiveness of C-8 xylitol monoester, for its use as a preservative in cosmetic formulations. The minimum inhibitory concentration (MIC) was determined by the broth macrodilution method, and the antimicrobial effectiveness of C-8 xylitol monoester was determined by using challenge test method. The results obtained in the determination of minimum inhibitory concentration are between 1.0% and 1.25% for Staphylococcus aureus, Escherichia coli and Candida albicans and between 1.0% and 1.5% for Pseudomonas aeruginosa and Aspergillus niger. The amount of 1% of C-8 xylitol monoester was added to the lotion used in the challenge test, observing a rapid decline in the number of CFU g(-1) in stages of evaluation after contamination of the product by all bacteria. The same occurs in relation to C. albicans, which shows a 90% reduction in the number of CFU g(-1). Regarding A. niger, similar reduction is observed when pH value of the lotion is adjusted from 5.5 to 7.0. The results indicate that under the tests conditions, C-8 xylitol monoester has antimicrobial activity and could be considered as an alternative preservative for cosmetic formulations.
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Affiliation(s)
- L F B Amaral
- Department of Clinical Pathology, Faculty of Medical Sciences - University of Campinas, Rua Tessália Vieira de Camargo, 126 - Campinas, SP, Brazil.
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ÖZKAYA E, POLAT EKINCI A. Low sensitization rate but good clinical relevance of preservatives in Turkey: Evaluation of 1256 patients over 10 years (1996-2006). J Dermatol 2010; 38:194-6. [DOI: 10.1111/j.1346-8138.2010.00955.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ada S, Seçkin D. Patch testing in allergic contact dermatitis: is it useful to perform the cosmetic series in addition to the European standard series? J Eur Acad Dermatol Venereol 2010; 24:1192-6. [DOI: 10.1111/j.1468-3083.2010.03619.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Thyssen JP, Engkilde K, Lundov MD, Carlsen BC, Menné T, Johansen JD. Temporal trends of preservative allergy in Denmark (1985-2008). Contact Dermatitis 2010; 62:102-8. [DOI: 10.1111/j.1600-0536.2009.01668.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Doi T, Kajimura K, Taguchi S. Survey of Formaldehyde (FA) Concentration in Cosmetics Containing FA-donor Preservatives. ACTA ACUST UNITED AC 2010. [DOI: 10.1248/jhs.56.116] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
Positive patch tests to sodium metabisulfite (SMB) are frequent. Standard series patch testing to SMB in 1751 patients showed 71 reactions interpreted as positive and allergic. 33 (46.5%) reactions were originally reported as relevant and 38 (53.5%) were of unexplained relevance depending on the presence or absence of identifiable sources responsible for the presenting dermatitis. A breakdown of these findings is presented. An additional detailed study of the sources of SMB in the environment and a retrospective analysis of these results have been undertaken to identify further, possibly overlooked sources of SMB exposure based on the occupational and recreational history. Most of the positive reactions in the relevant group were attributed to the use of Trimovate cream (63%). 5 patients (13%) with positive reactions in the unexplained relevance group were potentially exposed to SMB in local anaesthetic solutions while at work. 3 patients in the unexplained relevance group (7.8%) and 4 (12.1%) in the relevant group had potential for occupational exposure to SMB as bakers or caterers. Overall, occupational exposure was considered as a possible source of sensitization in 10 (26.3%) patients in the unexplained relevance group. We propose that sensitization to SMB from parenteral solutions and occupational exposure from food handling may account for some of the otherwise unexplained positive patch test reactions. A detailed occupational history should be therefore be sought in otherwise unexplained positive reactions to SMB. We also propose that it is worthwhile including SMB in our standard series in the UK.
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Affiliation(s)
- Vishal Madan
- Contact Dermatitis Investigation Unit, University of Manchester, School of Medicine, Hope Hospital, Manchester, UK.
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Zoller L, Bergman R, Weltfriend S. Preservatives sensitivity in Israel: a 10-year overview (1995?2004). Contact Dermatitis 2006; 55:227-9. [PMID: 16958921 DOI: 10.1111/j.1600-0536.2006.00902.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study presents a 10-year survey of 2285 patients tested to common preservatives in northern Israel. The demographic and clinical data were analysed using a revised MOAHLFA index. Patch testing was based on the International Contact Dermatitis Research Group (ICDRG) guidelines. 411 (18%) patients were found to have positive reactions to 1 or more preservatives. The most frequent allergens tested positively were thimerosal, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), and formaldehyde. The reactions to MCI/MI remained stable around 1.7% throughout the years 1995-1998, with a significant increase to 3.7%-4% (P = 0.029) during 1999-2004. The reactions to formaldehyde remained low around 0.3% until 1999; however, a considerable increase throughout the years 2000-2004 was noted, with rates of 1.5%-1.9% (P = 0.028). The sensitivity rates for parabens, quaternium-15, imidazolidinylurea, and diazolidinylurea were low and unchanged, mostly under 0.5%. As for methyldibromoglutaronitrile (MDBGN), sensitivity rates around 2% were detected for the years 1996 and throughout 2000-2004. Overall, this extensive survey showed a concerning increase in the sensitivity rates for MCI/MI, formaldehyde, and MDBGN.
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Affiliation(s)
- Lilach Zoller
- Department of Dermatology, Rambam Medical Center, Haifa 31096, Israel.
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