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Fan G, Jiang C, Wu P, Zou Y, Tan Y. Evaluation and detection of early nail damage caused by nail enamel. J Cosmet Dermatol 2021; 21:3464-3468. [PMID: 34783156 DOI: 10.1111/jocd.14601] [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: 06/07/2021] [Revised: 10/22/2021] [Accepted: 11/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Many nail cosmetics have components that are considered irritants or allergens. Due to the current clinical assessment limitations, it is often too late to identify nail enamel hazards until they cause disease. Thus, it is essential to investigate effective methods of detecting minor changes and early lesions in nails before they worsen. OBJECTIVES To provide a reliable method to investigate and evaluate nail enamel hazards on nails earlier using ultrasonic equipment. METHODS Eighty-three volunteers with smooth, lustrous nails were enrolled after being clinically examined. The thumbnails and middle nails were evaluated before and after using nail enamel for 2 weeks. Nail health was then assessed using three methods: clinical evaluation, nail surface image analysis, and an ultrasonic device. RESULTS Using clinical diagnostic and imaging methods for analyzing the nail surface showed no visible differences before and after using nail enamel for 2 weeks. However, there was a significant difference in the nails' depth and density (p < 0.001). The depth had increased 10% for thumbnails (about 20 μm), and the density had decreased by 3.0%. As for middle nails, the depth had increased by 9.4% (about 19 μm), and the density had decreased by 3.0%. CONCLUSION The present study provided evidence that nail enamel can significantly irritate hyperplasia and decrease the density of the nails, but detecting that slow process of pathological changes cannot currently be assessed by conventional clinical evaluation and image analysis. Thus, our study provided a practical novel approach for evaluating these visually imperceptible nail changes.
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Affiliation(s)
- Guobiao Fan
- Skin & Cosmetic Research Department, Skin Disease Hospital of Tongji University, Shanghai, China
| | - Changing Jiang
- Skin & Cosmetic Research Department, Skin Disease Hospital of Tongji University, Shanghai, China
| | - Peilan Wu
- Skin & Cosmetic Research Department, Skin Disease Hospital of Tongji University, Shanghai, China
| | - Ying Zou
- Skin & Cosmetic Research Department, Skin Disease Hospital of Tongji University, Shanghai, China
| | - Yimei Tan
- Skin & Cosmetic Research Department, Skin Disease Hospital of Tongji University, Shanghai, China
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Clinical Features of Contact Dermatitis. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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3
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Contact Dermatitis Associated With Nail Care Products: Retrospective Analysis of North American Contact Dermatitis Group Data, 2001–2016. Dermatitis 2020; 31:191-201. [DOI: 10.1097/der.0000000000000583] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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4
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Veien NK. Clinical Features of Contact Dermatitis. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_15-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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5
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Lee S, Maor D, Palmer A, Nixon RL. Declining prevalence of allergic contact dermatitis caused by toslyamide/formaldehyde in nail polish. Contact Dermatitis 2018; 79:184-185. [PMID: 29726606 DOI: 10.1111/cod.13020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 03/27/2018] [Accepted: 03/30/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Senhong Lee
- Skin and Cancer Foundation Inc, Carlton, Victoria, Australia
| | - Danit Maor
- Skin and Cancer Foundation Inc, Carlton, Victoria, Australia
| | - Amanda Palmer
- Skin and Cancer Foundation Inc, Carlton, Victoria, Australia
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Abstract
Over the past several decades, the commercialization of nail cosmetics has increased. From nail polishes to artificial nails, different methods of nail beautification have become popularized. However, the impact of these products remains largely unknown. Governments have passed legislation in attempts to regulate nail cosmetics, but these regulations may not be adequate and are difficult to enforce. Knowledge of the safety and efficacy of nail products remains limited due to the relative dearth of literature published on the topic. This review serves to summarize and interpret the data available regarding common nail products and their safety and efficacy. Nail products such as nail polish, nail polish removers, and artificial nails have shown to have some adverse effects through case reports and studies. Harmful substances such as toluenesulfonamide-formaldehyde resin and methacrylates have been identified in commercial nail products, leading to several adverse effects, but in particular, allergic contact dermatitis. Exposure to substances such as acetonitrile found in removers may have more toxic and caustic effects, especially if ingested. In addition, for nail technicians there are negative effects linked with occupational exposure. Compounds used in nail products may become aerosolized and lead to asthma, eye and throat irritation, and even neurocognitive changes.
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Pongpairoj K, Morar N, McFadden JP. ‘Seborrhoeic dermatitis’ of the head and neck without scalp involvement - remember nail varnish allergy. Contact Dermatitis 2016; 74:306-7. [DOI: 10.1111/cod.12527] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 11/23/2015] [Accepted: 11/24/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Korbkarn Pongpairoj
- Department of Cutaneous Allergy; St John's Institute of Dermatology, St Thomas' Hospital; London SE1 7EH UK
| | - Nilesh Morar
- Department of Dermatology; Chelsea and Westminster Hospital; London SW109NH UK
| | - John P. McFadden
- Department of Cutaneous Allergy; St John's Institute of Dermatology, St Thomas' Hospital; London SE1 7EH UK
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9
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Clinical Features. Contact Dermatitis 2011. [DOI: 10.1007/978-3-642-03827-3_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Özkaya E, Ekinci A. Metal contact sites: a hidden localization for nail varnish allergy? Clin Exp Dermatol 2010; 35:e137-40. [DOI: 10.1111/j.1365-2230.2009.03773.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Abstract
The face is exposed to many foreign substances and may thus be a site of allergic contact dermatitis. Our aim is to elucidate the spectrum of factors associated with facial dermatitis by analyzing data of patients patch tested in the Information Network of Departments of Dermatology (IVDK) between 1995 and 2007. In 18,572 patients the main anatomical site of dermatitis was the face. Among these, the proportion of females and of patients with past or present atopic eczema was increased, while probable occupational causation was less common than in the overall group. Cosmetic allergens, as well as nickel, were significantly more common in women than men, including fragrance mix (10.8% vs. 8.3%), p-phenylenediamine (4.0% vs. 2.8%), lanolin alcohols (3.0% vs. 2.2%), Lyral(TM) (3.1% vs. 2.0%) and bufexamac (1.8% vs. 1.1%). In comparison, only epoxy resin contact allergy was diagnosed significantly more often in men than women: In patients with airborne contact dermatitis, over-represented allergens included sesquiterpene lactone mix, compositae mix, epoxy resin, (chloro-) methylisothiazolinone and oil of turpentine. In the clinical approach to patients with facial dermatitis, occupational airborne causation should be considered in addition to non-occupational (e.g., cosmetic) allergen exposure.
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13
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Özkaya E, Mirzoyeva L. Tosylamide/formaldehyde resin allergy in a young boy: exposure from bitter nail varnish used against nail biting. Contact Dermatitis 2009; 60:171-2. [DOI: 10.1111/j.1600-0536.2008.01433.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Temesvári E, Pónyai G, Németh I, Hidvégi B, Sas A, Kárpáti S. Periocular dermatitis: a report of 401 patients. J Eur Acad Dermatol Venereol 2009; 23:124-8. [DOI: 10.1111/j.1468-3083.2008.02949.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Allergic patch test reactions associated with cosmetics: retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001-2004. J Am Acad Dermatol 2008; 60:23-38. [PMID: 18992965 DOI: 10.1016/j.jaad.2008.07.056] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Revised: 07/28/2008] [Accepted: 07/29/2008] [Indexed: 12/13/2022]
Abstract
BACKGROUND Allergy to cosmetics is common. OBJECTIVES We sought to characterize patients with positive patch test reactions associated with a cosmetic source, to identify common allergens; and to explore gender and occupational associations. METHODS We performed a retrospective, cross-sectional analysis. RESULTS Of 6621 female and 3440 male patients, 1582 female (23.8%) and 611 of male (17.8%) patients had at least one allergic patch test reaction associated with a cosmetic source. Of "allergic" patients (>1 allergic reaction, n = 6815), females were 1.21 times more likely to have an allergic reaction associated with a cosmetic source than were male patients (p < .0001, 95% confidence interval [CI] 1.12-1.31). Within the "cosmetic allergic" group (n = 2243), head and neck involvement was significantly higher in female than in male patients (49.3% vs 23.7%, p < .0001). One hundred twenty-five patients had occupationally related allergic reactions associated with a cosmetic. LIMITATIONS This study is limited by its cross-sectional, retrospective design. CONCLUSION Of all patients studied, 21.8% had an allergic reaction associated with a cosmetic. Site of dermatitis, cosmetic categories, and specific allergens differed somewhat by gender.
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Lazzarini R, Duarte I, de Farias DC, Santos CA, Tsai AI. Frequency and Main Sites of Allergic Contact Dermatitis Caused by Nail Varnish. Dermatitis 2008. [DOI: 10.2310/6620.2008.08009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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18
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Chan HP, Maibach HI. Moustache p-phenylenediamine dye allergic contact dermatitis with distant site involvement – an atypical presentation. Contact Dermatitis 2008; 58:179-80. [DOI: 10.1111/j.1600-0536.2007.01234.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Scheman A, Jacob S, Zirwas M, Warshaw E, Nedorost S, Katta R, Cook J, Castanedo-Tardan MP. Contact Allergy: Alternatives for the 2007 North American Contact Dermatitis Group (NACDG) Standard Screening Tray. Dis Mon 2008; 54:7-156. [DOI: 10.1016/j.disamonth.2007.10.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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20
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Yokota M, Thong HY, Hoffman CA, Maibach HI. Allergic contact dermatitis caused by tosylamide formaldehyde resin in nail varnish: an old allergen that has not disappeared. Contact Dermatitis 2007; 57:277. [PMID: 17868224 DOI: 10.1111/j.1600-0536.2007.01113.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Miki Yokota
- Department of Dermatology, University of California, School of Medicine, San Francisco, CA 94143-0989, USA.
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21
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Costa IMC, Nogueira LSC, Garcia PS. Síndrome das unhas frágeis. An Bras Dermatol 2007. [DOI: 10.1590/s0365-05962007000300009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A síndrome das unhas frágeis é queixa comum, caracterizada por aumento da fragilidade das lâminas ungueais. Afeta quase 20% da população geral, sendo mais comum em mulheres. Clinicamente se manifesta com onicosquizia e onicorrexe - distúrbios nos fatores de adesão intercelular das unhas se manifestam como a primeira, ao passo que alterações da matriz apresentamse com onicorrexe. Mesmo sendo tão usual e afetando os pacientes de maneira importante em seu cotidiano, o tratamento das unhas frágeis avançou pouco nas últimas décadas e ainda se baseia principalmente no uso da biotina.
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Abstract
The clinical features of nail dystrophies depend on the part of the nail that has been damaged. Due to the important functions of fingernails and toenails, any abnormality of the nail causes impaired function of the hand or foot. Moreover, the aesthetic aspect of the nail may affect employability, self-esteem, and interaction with other people. Because the nails are often difficult to treat, cosmetology may be an effective support to medical treatment. Nail cosmetics may help the patient to cope with his or her nail dystrophy while waiting for treatment to show its efficacy. It may also be the only choice to hide nail dystrophy where the nail is irreversibly damaged. Nail cosmetics may also function at treatment for onychtillomania, nail biting, and nail ingrowing.
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Affiliation(s)
- Matilde Iorizzo
- Department of Dermatology, University of Bologna, Bologna, Italy
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23
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Abstract
Contact dermatitis of the nail unit is not rare. The most common allergens are found in nail cosmetics such as enamel, sculptured nails, and preformed plastic tips. Toluene sulfonamide formaldehyde resin, acrylates, and ethylcyanoacrylate are the most common allergens. Along with a proper clinical history focusing on nail practices, a thorough understanding of the common allergens and patch testing are necessary to diagnose contact dermatitis. A discussion of the common allergens and irritants relevant to the nail unit will be presented.
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Affiliation(s)
- Giuseppe Militello
- Department of Dermatology, Columbia University, New York, New York 10032, USA.
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24
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Abstract
With almost 65 million women in the workforce, their representation in various occupational sectors is crucial, as is their health and safety. Female-dominated occupations in health care and cosmetology along with their potential cutaneous exposures are reviewed. Proper evaluation and management are necessary to minimize the disability that can result from these illnesses.
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Affiliation(s)
- Antoine Amado
- Department of Dermatology, Desk A-61, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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26
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Abstract
Cosmetics applied on the nail encompass three types: (1) coatings that harden upon evaporation; (2) coatings that polymerize; and (3) stick-on nail dressings (synthetic covers). The adverse reactions induced by the two first types present with both local reactions and distant contact dermatitis. Whereas nail enamel applications result especially in ectopic contact dermatitis, polymerizing coatings and synthetic covers represent the main culprit for sometimes severe, local reactions. Whatever the nature of the nail cosmetics, they may produce some adverse reactions. They include: (1) local reactions to cosmetics applied on the nail; (2) distant reactions resulting from the use of nail cosmetics; (3) systemic side effects of nail cosmetics; and (4) infection risks from nail cosmetics.
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Abstract
A recent epidemiologic survey in the UK revealed that 23% of women and 13.8% of men experience some sort of adverse reaction to a personal care product over the course of a year. Although most of these reactions may be due to subjective sensory irritation, various studies reveal that up to 10% of dermatologic patients who are patch tested are allergic to cosmetic products or their constituent ingredients. Causative products include deodorants and perfumes, skin care products, hair care products, and nail cosmetics. Allergic contact dermatitis mainly results from fragrance chemicals and preservatives. Recent work has suggested that additional fragrance chemicals may need to be tested in order to identify those patients 'missed' by the current fragrance mix; in particular, hydroxy-isohexyl-3-cyclohexene carboxaldehyde (HMPPC Lyral) has been singled out as an important sensitizing agent. The increased usage of natural fragrances and botanic extracts can also cause problems in their own right or through co-reactivity. The preservative methyldibromo glutaronitrile has also been recognized as an increasingly important sensitizer in Europe, which has led to the recent recommendation that it should be prohibited from 'leave-on' products until information on 'safe' consumer levels becomes available. Other emerging allergens include UV filters, tosylamide/formaldehyde resin, and nail acrylates. The diagnosis of cosmetic allergy should be confirmed with patch testing, including testing of 'whole' products, when necessary, and repeat open application tests can be used to confirm the relevance of reactions in cases of doubt.
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Affiliation(s)
- David I Orton
- Environmental and Contact Dermatitis Unit, Department of Dermatology, Amersham Hospital, Amersham, Buckinghamshire, UK
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Abstract
Recent precise figures are not available for the number of adverse reactions related to the use of nail care products. Reactions to nail cosmetic procedures may be divided into reactions at the site of application to the nail itself and ectopic reactions, when the hand transfers a small amount of nail cosmetic to other areas of the skin. Fingernail coatings encompass two types: coatings that harden upon evaporation (nail enamel, base coat, top coat); and coatings that polymerize (sculptured nails, light-curing gels, preformed artificial nails, nail mending and nail wrapping). The test battery enables us to distinguish allergic reactions from irritant reactions. Interestingly, some reactions, such as distant allergic contact dermatitis, are more frequent with nail enamel than with coatings that polymerize. On the other hand, the latter are greater offenders in the nail area. Nail hardeners may just be modified nail enamels containing nylon fibers, acrylate resin and hydrolyzed proteins. Others may contain up to 5% formaldehyde tissue fixative (which can have adverse effects on the nail), but are designed in the US to be applied only to the free edge of the nail while the skin is shielded. Caution is necessary in interpreting formaldehyde patch testing reactions.
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Affiliation(s)
- Robert Baran
- Nail Disease Center, 42 rue des Serbes, Cannes 04600, France.
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Affiliation(s)
- M Moossavi
- Department of Dermatology, Wayne State University School of Medicine, Detroit, Michigan, USA
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30
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Staines KS, Felix DH, Forsyth A. Desquamative gingivitis, sole manifestation of tosylamide/formaldehyde resin allergy. Contact Dermatitis 1998; 39:90. [PMID: 9746196 DOI: 10.1111/j.1600-0536.1998.tb05846.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- K S Staines
- Department of Oral Medicine, Glasgow Dental Hospital and School NHS Trust, UK
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31
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Affiliation(s)
- A C De Groot
- Department of Dermatology, Carolus-Liduina Hospital, 's-Hertogenbosch, The Netherlands
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Abstract
It has been known since the 1940s that nail polishes contain allergenic ingredients. The aim of this study was to clarify whether the nail polishes on the market today contain significant amounts of allergens, and what the solvents are. The following ingredients were determined: toluene, toluene sulfonamide formaldehyde resins, free formaldehyde, acrylates, methacrylates and certain organic solvents. The study comprised 20 brands and 42 samples. All the nail polishes analysed contained allergenic toluene sulfonamide formaldehyde resins (TSFR), in concentrations from 0.08 to 11.0%. The concentration of total formaldehyde varied from 0.02% to 0.5%. The more TSFR a nail polish contained, the higher was its formaldehyde content. Probably not only TSFR-allergic but also formaldehyde-allergic persons may get dermatitis from many of the nail polishes studied. The concentrations of acrylates and methacrylates were so small that they are of practical significance only to those previously sensitized to acrylates. Of the organic solvents, toluene was still widely used, whereas xylene was found in only 1 product. The nail polishes on the market today are not safe for all consumers. However, according to the regulations of the European Union, the packaging labeling of all cosmetic products must be supplied with a list of ingredients from the beginning of 1998. This will help the consumer to avoid allergenic products. A better alternative could, however, be to substitute the most allergenic ingredients with substances possessing minor allergy potency.
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Affiliation(s)
- E L Sainio
- National Consumer Administration/Product Safety, Helsinki, Finland
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Affiliation(s)
- A C De Groot
- Department of Dermatology, Carolus-Liduina Hospital, 's-Hertogenbosch, Netherlands
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34
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Jolanki R, Kanerva L, Estlander T. Allergic patch test reaction to diglycidyl ether of bisphenol A in hardened nail base and top coat. Contact Dermatitis 1996; 35:246-7. [PMID: 8957647 DOI: 10.1111/j.1600-0536.1996.tb02367.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- R Jolanki
- Section of Dermatology, Department of Occupational Medicine, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
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35
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Rietschel RL. Human and economic impact of allergic contact dermatitis and the role of patch testing. J Am Acad Dermatol 1995; 33:812-5. [PMID: 7593782 DOI: 10.1016/0190-9622(95)91837-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- R L Rietschel
- Department of Dermatology, Ochsner Clinic, New Orleans, LA 70121, USA
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36
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Hausen BM, Milbrodt M, Koenig WA. The allergens of nail polish. (I). Allergenic constituents of common nail polish and toluenesulfonamide-formaldehyde resin (TS-F-R). Contact Dermatitis 1995; 33:157-64. [PMID: 8565455 DOI: 10.1111/j.1600-0536.1995.tb00537.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Nail polish that has completely dried on the fingernails contains water-soluble components that attain the skin during extensive but transient contact. This was proven by water extraction of thin layers of nail polish that had been painted onto glass plates and allowed to dry for 3 days. Comparing the isolated fractions and compounds with known nail polish ingredients revealed that the water-soluble substances are para- and ortho-toluenesulfonamide, dibutyl phthalate and 3 constituents of toluenesulfonamide-formaldehyde resin (TS-F-R), which is the basic material of almost all nail polishes sold worldwide. 12 female patients with proven nail polish allergy were patch tested with 21 nail polish components, including those isolated. Only 2 fractions were positive. These contained a monomer and a dimer created during condensation of TS-F-R. Their structures were elucidated. The 3rd compound, a trimer, remained negative, except in 1 case.
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Affiliation(s)
- B M Hausen
- Department of Dermatology, University Hospital, Hamburg, Germany
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Kanerva L, Lauerma A, Jolanki R, Estlander T. Methyl acrylate: a new sensitizer in nail lacquer. Contact Dermatitis 1995; 33:203-4. [PMID: 8565470 DOI: 10.1111/j.1600-0536.1995.tb00552.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- L Kanerva
- Section of Dermatology, Finnish Institute of Occupational Health, Helsinki
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Affiliation(s)
- B M Hausen
- Department of Dermatology, University Hospital, Hamburg, Germany
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