Ring-shaped positive allergic patch test reactions to allergens in liquid vehicles

An update of the risk assessment for methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) with focus on rinse-off products

Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) has been widely used during the last 20 years for the preservation of aqueous systems in cosmetics, toiletries and in various industrial applications. MCI/MI has a broad spectrum of activity against fungi and bacteria at very low concentrations. The allergic contact potential of MCI/MI has been known for many years. This paper provides a review of pre-clinical and clinical experimental studies as well as experience from dermatology clinics worldwide. This forms the basis for an update of the risk assessment for the use of MCI/MI in rinse-off products. The scientific data indicate that the actual sensitization rate observed with a contact allergen is extremely dependent on dose and type of exposure. This review of the data leads to the conclusion that, under normal use conditions, within the current permitted/ recommended use concentrations for MCI/MI of up to 15ppm, the risk of primary sensitization from the use of rinse-off products is negligible, and elicitation of allergic contact dermatitis in MCI/MI-sensitized individuals rare, after exposure to MCI/MI-preserved rinse-off products.

Patch testing with budesonide in serial dilutions: the significance of dose, occlusion time and reading time

Budesonide is advocated as a marker molecule for corticosteroid contact allergy. When patch testing corticosteroids, one must consider their sensitizing potential but also their anti-inflammatory properties, as well as the possibility of different time courses for such properties. The dose-response relationship for budesonide was therefore investigated with regard to dose, occlusion time, and reading time. 10 patients were patch tested with budesonide in ethanol in serial dilutions from 2.0% down to 0.0002% with occlusion times of 48, 24, and 5 h. Readings were on D2, D4, and D7. The 48-h occlusion picked up most positive reactors, 8/10. The D4 reading (48-h occlusion) detected most positive reactors, 8/10, and here 0.002% picked up most contact allergies. Late readings favoured high concentrations. The "edge effect" was noted for several concentrations at early readings. Due to the individual corticosteroid reactivity, the dose-response relationship and the time courses of the elicitation and the anti-inflammatory capacity, several features may be explained, i.e., that lower concentrations may detect budesonide allergy better at early readings, that patients with an "edge reaction" can have positive reactions to lower concentrations.