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Slodownik D, Bar J, Solomon M, Lavy Y, Baum S, Mordechai Galed O, Cnaan R, Solomon-Cohen E, Horev L, Daniely D. Pediatric Contact Dermatitis: A 10-Year Multicenter Retrospective Study. Dermatitis 2023; 34:399-404. [PMID: 37192492 DOI: 10.1089/derm.2023.0009] [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: 05/18/2023]
Abstract
Background: Although allergic contact dermatitis (ACD) is relatively common in the adult and pediatric populations alike, few studies describe the special features of contact sensitization among the Israeli pediatric populations, none of them is multicenter. Our study aims to describe and analyze patch test results and trends in 4 tertiary care centers between 2012 and 2022. Methods: We assessed the results of 357 patch tests performed on children 0-18 years old between 2012 and 2022 in designated clinics in 4 tertiary medical centers. All patients were tested using the European baseline series and additional series as clinically indicated. We assessed the demographic features, atopic features, and influence, as well as the main allergens to cause sensitization and allergic contact dermatitis among the pediatric population. Results: In total 69% of the study population were females, mainly 12-18 years old, 35% of the study population were previously diagnosed with atopic dermatitis, and 57% had an atopic diathesis. Females were more commonly sensitized (P < 0.05). Patients without atopic dermatitis were more commonly diagnosed with ACD and had more reactions on patch test (P < 0.05). The most common allergens to cause ACD are preservatives and metals, as previously described, however, acrylate sensitivity is an emerging group that has not been described among the Israeli pediatric population in previous studies. Fragrance mix 2 and Mroxylon pereirae are relatively rare allergens among the Israeli pediatric population, whereas linalool hyperoxide might be considered an emerging allergen. Methylisothiazolinone causes ACD more frequently among patients without atopic dermatitis (P < 0.05). Conclusions: Among the Israeli pediatric population, ACD is more common in females without atopic dermatitis. Acrylates become a common culprit and should be included in baseline series. Patients with atopic dermatitis are less frequently sensitized by methylisothiazolinone.
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Affiliation(s)
- Dan Slodownik
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan Bar
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Solomon
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Yaron Lavy
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Sharon Baum
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | - Roten Cnaan
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | - Liran Horev
- Department of Dermatology, Hadassah University Medical Center, Jerusalem, Israel; and
- Shamir Medical Center, Zerifin, Israel
| | - Danny Daniely
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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2
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The Added Value of Patch Testing Beyond the Baseline Tray. Dermatitis 2022; 33:227-231. [PMID: 35481846 DOI: 10.1097/der.0000000000000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The patch test is the standard for diagnosing allergic contact dermatitis. Standardized trays allow the examination of the most prevalent allergens, whereas customized trays are more appropriate for addressing specific allergens and require expertise. They are therefore usually performed in specialized clinics. METHODS We assessed the results of 4355 patch tests performed between 2012 and 2020 in a contact dermatitis clinic located in a large tertiary medical center. All patients were tested using the European baseline series and additional trays as clinically indicated. We assessed the frequency of relevant positive reactions outside the European baseline series. We then examined the added value and number of tests (NNTs) that need to be performed to elicit one relevant positive reaction per tray and common allergens. RESULTS Nine hundred fifty-four patients (21.9%) had 1 or more positive relevant reactions; 43.3% tested positive for an allergen outside the European baseline series (OEBS). The acrylate and fragrance trays were highly represented among the positive and relevant reactions OEBS with NNTs of 4.4 and 6.8, respectively. 2-Hydroxyethyl methacrylate is the most prevalent allergen OEBS and is considered a marker for acrylate sensitivity with a high rate of cross-reactions and concordance rate of 85%, justifying its addition to the EBS in 2018. Other highly represented allergens include chloramphenicol, 2-hydroxyethyl acrylate, and Amerchol L-101, a lanolin derivative. The cosmetics and textile trays, although often tested, have relatively low added values of 3.7% and 2.3%, respectively. Surprisingly, the cutaneous adverse drug reaction series tray (CAD-1000) yielded no positive reactions, whereas testing the patients' medication yielded positive results in 10.9% of the cases. CONCLUSIONS Expanded patch testing is crucial to accurately diagnose allergic contact dermatitis and almost doubles the number of patients with relevant positive reactions. Acrylate sensitivity is an emerging epidemic with a high positive reaction rate and low NNT, as is sensitivity to the allergens in the fragrance tray. 2-Hydroxyethyl methacrylate is a reliable marker for acrylate sensitivity with a concordance rate of 85%. Chloramphenicol is a common culprit and should be added to the standard tray in countries with a high usage rate. A low NNT was also observed when testing the patients' own cosmetics and medications; this should, therefore, be encouraged. The textile tray yielded a relatively high NNT; however, it should be performed when clinically indicated in the absence of a reliable marker in the EBS.
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3
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Kazim T, Tariq A, Usman M, Ayoob MF, Khan A. Chitosan hydrogel for topical delivery of ebastine loaded solid lipid nanoparticles for alleviation of allergic contact dermatitis. RSC Adv 2021; 11:37413-37425. [PMID: 35496417 PMCID: PMC9043795 DOI: 10.1039/d1ra06283b] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/17/2021] [Indexed: 02/05/2023] Open
Abstract
Ebastine, is an antihistamine drug that exerts its effect upon oral administration in humans for the treatment of allergic contact dermatitis (ACD), it also has some systemic side effects like gastric distress, headache, drowsiness, and epistaxis. Moreover, topical corticosteroids are used for treatment of ACD, which causes the human skin to lose its thickness and elasticity. Hence, ebastine-loaded solid lipid nanoparticles (E-SLNs) were prepared and their topical efficacy against allergic contact dermatitis was determined. Compritol 888 ATO and tween 80 were used to prepare E-SLNs by cold dilution of the hot micro-emulsion. E-SLNs were optimized statistically by employing a central composite design using Design-Expert® version 11.0. Optimized E-SLNs showed spherical surface morphology, zeta potential of −15.6 ± 2.4 mV, PDI of 0.256 ± 0.03, and particle sizes of 155.2 ± 1.5 nm and th eentrapment efficiency of ebastine was more than 78%. Nanoparticles were characterized using FT-IR, XRD, and TEM. An E-SLNs loaded hydrogel was prepared using chitosan as a gelling agent and glutaraldehyde as a crosslinker. In vitro drug release studies performed for 24 hours on the E-SLNs dispersion and E-SLNs loaded hydrogel showed a sustained release of maximum 82.9% and 73.7% respectively. In vivo studies were conducted on BALB/c mice to evaluate the topical efficacy of the E-SLNs loaded hydrogel for allergic contact dermatitis. ACD was induced on the ear using picryl chloride solution. After induction, ears were treated daily with the E-SLNs loaded hydrogel for 15 days. Swelling behavior, mast cell count, and histopathological studies of the ear confirmed that the hydrogel alleviated the symptoms of allergic contact dermatitis. Ebastine exerts its effect upon oral administration in humans for the treatment of allergic contact dermatitis (ACD), but it has some systemic side effects. Hence, ebastine-SLNs loaded hydrogel was prepared to increase topical efficacy of ebastine.![]()
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Affiliation(s)
- Tasbiha Kazim
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Abeer Tariq
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muhammad Usman
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | | | - Ahmad Khan
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
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4
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Silverberg NB, Pelletier JL, Jacob SE, Schneider LC. Nickel Allergic Contact Dermatitis: Identification, Treatment, and Prevention. Pediatrics 2020; 145:e20200628. [PMID: 32341178 DOI: 10.1542/peds.2020-0628] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Nickel is a ubiquitous metal added to jewelry and metallic substances for its hardening properties and because it is inexpensive. Estimates suggest that at least 1.1 million children in the United States are sensitized to nickel. Nickel allergic contact dermatitis (Ni-ACD) is the most common cutaneous delayed-type hypersensitivity reaction worldwide. The incidence among children tested has almost quadrupled over the past 3 decades. The associated morbidities include itch, discomfort, school absence, and reduced quality of life. In adulthood, individuals with Ni-ACD may have severe disabling hand eczema. The increasing rate of Ni-ACD in children has been postulated to result from early and frequent exposure to metals with high amounts of nickel release (eg, as occurs with ear piercing or with products used daily in childhood such as toys, belt buckles, and electronics).To reduce exposure to metal sources with high nickel release by prolonged and direct contact with human skin, Denmark and the European Union legislated a directive several decades ago with the goal of reducing high nickel release and the incidence of Ni-ACD. Since then, there has been a global reduction in incidence of Ni-ACD in population-based studies of adults and studies of children and young adults being tested for allergic contact dermatitis. These data point to nickel exposure as a trigger for elicitation of Ni-ACD and, further, provide evidence that legislation can have a favorable effect on the economic and medical health of a population.This policy statement reviews the epidemiology, history, and appearances of Ni-ACD. Examples of sources of high nickel release are discussed to highlight how difficult it is to avoid this metal in modern daily lives. Treatments are outlined, and avoidance strategies are presented. Long-term epidemiological interventions are addressed. Advocacy for smarter nickel use is reviewed. The American Academy of Pediatrics supports US legislation that advances safety standards (as modeled by the European Union) that protect children from early and prolonged skin exposure to high-nickel-releasing items. Our final aim for this article is to aid the pediatric community in developing nickel-avoidance strategies on both individual and global levels.
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Affiliation(s)
- Nanette B Silverberg
- Departments of Dermatology and Pediatrics, Mt Sinai Hospital and Icahn School of Medicine at Mt Sinai, New York, New York;
| | - Janice L Pelletier
- Northern Light Health, Bangor, Maine
- College of Medicine, University of New England, Biddeford, Maine
| | - Sharon E Jacob
- Department of Dermatology, Loma Linda University, Loma Linda, California
- Departments of Medicine and Pediatrics, University of California, Riverside, California; and
| | - Lynda C Schneider
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
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5
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Romita P, Foti C, Stingeni L, Hansel K, Magrone T, Belsito DV, Bonamonte D. Contact Allergy in Children with Atopic Dermatitis: A Retrospective Study. Endocr Metab Immune Disord Drug Targets 2019; 19:1083-1087. [DOI: 10.2174/1871530319666190211123342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/28/2019] [Accepted: 01/28/2019] [Indexed: 11/22/2022]
Abstract
Background:
The relationship between atopic dermatitis and allergic contact dermatitis is
frequently debated, particularly in children. The impaired skin barrier of atopic subjects can facilitate
the penetration of exogenous agents and its mutations in the filaggrin gene might be implicated in an
increased risk to develop contact dermatitis. Moreover, atopic children are protractedly exposed to
chemical substances contained in skin care products from an early age.
Patients And Methods:
The aim of this retrospective study is to determine if atopic children are more
prone to allergic contact dermatitis and which substances are more frequently related to this disease.
From 2014 to 2016, a total of 268 children under 14 years with a history of eczematous dermatitis, of
whom 141 (52.6%) were affected, and 127 (47.4%) were not affected by AD, underwent patch testing
with the baseline S.I.D.A.P.A standard series.
Results:
Based on the results of our study, the prevalence of contact allergy in atopic children is comparable
to that noted in non-atopic children. The most frequent causes of contact allergy in children are
fragrances, and their prevalence is significantly higher in atopic children (19.9%) than in non-atopic
ones, (11.8%; p < .05).
Conclusion:
Our study highlights the importance of patch testing in atopic children for continuously
monitoring the trends and changes of contact allergies that are a common disease and is even significantly
increasing for some allergens, as fragrances. We may speculate that the protracted use of skincare
products, associated with the impaired skin barrier of atopic children, enhances the risk of sensitization
to the ingredients of these products.
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Affiliation(s)
- Paolo Romita
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, IT-70124 Bari, Italy
| | - Caterina Foti
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, IT-70124 Bari, Italy
| | - Luca Stingeni
- Clinical, Allergological and Venereological Dermatology Section, Department of Medicine, University of Perugia, IT-06129 Perugia, Italy
| | - Katharina Hansel
- Clinical, Allergological and Venereological Dermatology Section, Department of Medicine, University of Perugia, IT-06129 Perugia, Italy
| | - Thea Magrone
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, School of Medicine, Bari, Italy
| | - Donald V. Belsito
- Department of Dermatology, Columbia University Medical Center, New York, NY, United States
| | - Domenico Bonamonte
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, IT-70124 Bari, Italy
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6
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Mortz CG, Brockow K, Bindslev‐Jensen C, Broesby‐Olsen S. It looks like childhood eczema but is it? Clin Exp Allergy 2019; 49:744-753. [DOI: 10.1111/cea.13381] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/28/2019] [Accepted: 03/03/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Charlotte G. Mortz
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital University of Southern Denmark Odense C Denmark
| | - Knut Brockow
- Division Environmental Dermatology and Allergology, Department of Dermatology und Allergology Biederstein, Helmholtz Zentrum München/TUM Technical University Munich Munich Germany
| | - Carsten Bindslev‐Jensen
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital University of Southern Denmark Odense C Denmark
| | - Sigurd Broesby‐Olsen
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital University of Southern Denmark Odense C Denmark
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7
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Alinaghi F, Bennike NH, Egeberg A, Thyssen JP, Johansen JD. Prevalence of contact allergy in the general population: A systematic review and meta-analysis. Contact Dermatitis 2018; 80:77-85. [DOI: 10.1111/cod.13119] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/06/2018] [Accepted: 08/10/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Farzad Alinaghi
- National Allergy Research Centre, Department of Dermatology and Allergy; Copenhagen University Hospital Herlev-Gentofte; Hellerup Denmark
| | - Niels H. Bennike
- National Allergy Research Centre, Department of Dermatology and Allergy; Copenhagen University Hospital Herlev-Gentofte; Hellerup Denmark
| | - Alexander Egeberg
- National Allergy Research Centre, Department of Dermatology and Allergy; Copenhagen University Hospital Herlev-Gentofte; Hellerup Denmark
| | - Jacob P. Thyssen
- National Allergy Research Centre, Department of Dermatology and Allergy; Copenhagen University Hospital Herlev-Gentofte; Hellerup Denmark
| | - Jeanne D. Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy; Copenhagen University Hospital Herlev-Gentofte; Hellerup Denmark
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8
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Simonsen AB, Foss-Skiftesvik MH, Thyssen JP, Deleuran M, Mortz CG, Zachariae C, Skov L, Osterballe M, Funding A, Avnstorp C, Andersen BL, Vissing S, Danielsen A, Dufour N, Nielsen NH, Thormann H, Sommerlund M, Johansen JD. Contact allergy in Danish children: Current trends. Contact Dermatitis 2018; 79:295-302. [DOI: 10.1111/cod.13079] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/15/2018] [Accepted: 06/17/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Anne B. Simonsen
- National Allergy Research Centre, Department of Dermatology and Allergy; University of Copenhagen, Herlev and Gentofte Hospital; Gentofte, Denmark
- Department of Dermatology and Allergy; University of Copenhagen; Herlev and Gentofte Hospital Gentofte, Denmark
| | - Majken H. Foss-Skiftesvik
- Department of Dermatology and Allergy; University of Copenhagen; Herlev and Gentofte Hospital Gentofte, Denmark
| | - Jacob P. Thyssen
- Department of Dermatology and Allergy; University of Copenhagen; Herlev and Gentofte Hospital Gentofte, Denmark
| | - Mette Deleuran
- Department of Dermatology and Venereology; Aarhus University Hospital; Aarhus Denmark
| | - Charlotte G. Mortz
- Department of Dermatology and Allergy Centre; Odense University Hospital; Odense Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy; University of Copenhagen; Herlev and Gentofte Hospital Gentofte, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy; University of Copenhagen; Herlev and Gentofte Hospital Gentofte, Denmark
| | | | | | | | | | | | | | | | | | | | - Mette Sommerlund
- Department of Dermatology and Venereology; Aarhus University Hospital; Aarhus Denmark
| | - Jeanne D. Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy; University of Copenhagen, Herlev and Gentofte Hospital; Gentofte, Denmark
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9
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Choi DW, Kwon DA, Jung SK, See HJ, Jung SY, Shon DH, Shin HS. Silkworm dropping extract ameliorate trimellitic anhydride-induced allergic contact dermatitis by regulating Th1/Th2 immune response. Biosci Biotechnol Biochem 2018; 82:1531-1538. [PMID: 29806566 DOI: 10.1080/09168451.2018.1475210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Allergic contact dermatitis (ACD) is an inflammatory skin disease caused by hapten-specific immune response. Silkworm droppings are known to exert beneficial effects during the treatment of inflammatory diseases. Here, we studied whether topical treatment and oral administration of silkworm dropping extract (SDE) ameliorate trimellitic anhydride (TMA)-induced ACD. In ACD mice model, SDE treatment significantly suppressed the increase in both ear thickness and serum IgE levels. Furthermore, IL-1β and TNF-α levels were reduced by SDE. In allergic responses, SDE treatment significantly attenuated the production of the Th2-associated cytokine IL-4 in both ear tissue and draining lymph nodes. However, it increased the production of the Th1-mediated cytokine IL-12. Thus, these results showed that SDE attenuated TMA-induced ACD symptoms through regulation of Th1/Th2 immune response. Taken together, we suggest that SDE treatment might be a potential agent in the prevention or therapy of Th2-mediated inflammatory skin diseases such as ACD and atopic dermatitis. ABBREVIATIONS ACD: allergic contact dermatitis; AD: atopic dermatitis; APC: antigen presenting cells; CCL: chemokine (C-C motif) ligand; CCR: C-C chemokine receptor; Dex: dexamethasone; ELISA: enzyme-linked immunosorbent assay; IFN: interferon; Ig: immunoglobulin; IL: interleukin; OVA: ovalbumin; PS: prednisolone; SDE: silkworm dropping extract; Th: T helper; TMA: trimellitic anhydride; TNF: tumor necrosis factor.
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Affiliation(s)
- Dae Woon Choi
- a Food Biotechnology Program , Korea University of Science and Technology , Republic of Korea.,b Division of Nutrition and Metabolism Research , Korea Food Research Institute , Wanju-gun , Republic of Korea
| | - Da-Ae Kwon
- b Division of Nutrition and Metabolism Research , Korea Food Research Institute , Wanju-gun , Republic of Korea
| | - Sung Keun Jung
- a Food Biotechnology Program , Korea University of Science and Technology , Republic of Korea.,c Division of Functional Food Research , Korea Food Research Institute , Wanju-gun , Republic of Korea.,e School of Food Science and Biotechnology , Kyungpook National University , Daegu , Republic of Korea
| | - Hye-Jeong See
- b Division of Nutrition and Metabolism Research , Korea Food Research Institute , Wanju-gun , Republic of Korea
| | - Sun Young Jung
- a Food Biotechnology Program , Korea University of Science and Technology , Republic of Korea.,b Division of Nutrition and Metabolism Research , Korea Food Research Institute , Wanju-gun , Republic of Korea
| | - Dong-Hwa Shon
- b Division of Nutrition and Metabolism Research , Korea Food Research Institute , Wanju-gun , Republic of Korea.,d Department of Food Processing and Distribution , Gangneung-Wonju National University , Gangneung , Republic of Korea
| | - Hee Soon Shin
- a Food Biotechnology Program , Korea University of Science and Technology , Republic of Korea.,b Division of Nutrition and Metabolism Research , Korea Food Research Institute , Wanju-gun , Republic of Korea
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10
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Bjørklund G, Dadar M, Aaseth J. Delayed-type hypersensitivity to metals in connective tissue diseases and fibromyalgia. ENVIRONMENTAL RESEARCH 2018; 161:573-579. [PMID: 29245125 DOI: 10.1016/j.envres.2017.12.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 11/28/2017] [Accepted: 12/03/2017] [Indexed: 06/07/2023]
Abstract
Rheumatic diseases include a group of autoimmune disorders with environmental and genetic etiology that are characterized as a subgroup of connective tissue diseases (CTD). Rheumatoid arthritis (RA) often involves the small joints of the hands in a symmetrical fashion that can lead to loss of joint function, and RA, as well as Sjögren's syndrome (SS) and other rheumatic diseases, are often accompanied by sensitivity to metals. Numerous investigations on metal sensitivity were evaluated in this review. A detailed metal exposure history was collected by different evaluation of studies. In all subjects, the main source of metal exposure was nickel, mercury, gold, palladium, titanium, and chromium. All of SLE (systemic lupus erythematosus), RA and SS patients appeared to have an increased frequency of metal delayed-type hypersensitivity (DTH) (Type IV allergy). As dental restorative materials release minor amounts of their metals (including mercury, gold, and nickel), many adults are commonly exposed to these metal ions by vapor or corrosion into saliva. Metal-related DTH in these patients will induce an inflammatory response. Such inflammations are important factors in CTD progress. It is hypothesized that metal-specific T cell reactivity can act as an etiological agent in the propagation and chronification of rheumatic inflammation. The key responses of metal delayed-type hypersensitivity in autoimmunity are precipitating as an appealing challenge for further investigations.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Toften 24, 8610 Mo i Rana, Norway.
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Jan Aaseth
- Faculty of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
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11
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Zafrir Y, Trattner A, Hodak E, Eldar O, Lapidoth M, Ben Amitai D. Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review. Pediatr Dermatol 2018; 35:76-86. [PMID: 29143366 DOI: 10.1111/pde.13333] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND/OBJECTIVES Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature. METHODS The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files. RESULTS Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively). CONCLUSION Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background.
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Affiliation(s)
- Yaron Zafrir
- Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel
| | - Akiva Trattner
- Department of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Emmillia Hodak
- Department of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oren Eldar
- Department of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
| | - Moshe Lapidoth
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Laser Unit, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
| | - Dan Ben Amitai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
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12
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Lachapelle JM, Gimenez-Arnau A, Metz M, Peters J, Proksch E. Best practices, new perspectives and the perfect emollient: optimizing the management of contact dermatitis. J DERMATOL TREAT 2017; 29:241-251. [DOI: 10.1080/09546634.2017.1370074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Ana Gimenez-Arnau
- Department of Dermatology, Hospital del Mar, Universitat Autònoma, Barcelona, Spain
| | - Martin Metz
- Department of Dermatology and Allergy, Allergie-Centrum-Charité/ECARF, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jill Peters
- Integrated Dermatology Service, Ipswich Hospital NHS Trust, Ipswich, United Kingdom
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13
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Soto-Ramírez N, Kar S, Zhang H, Karmaus W. Infant feeding patterns and eczema in children in the first 6 years of life. Clin Exp Allergy 2017; 47:1285-1298. [PMID: 28815821 DOI: 10.1111/cea.12998] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/10/2017] [Accepted: 08/05/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Modes of infant feeding such as direct and indirect breastfeeding, and formula feeding, and their combinations may play a role in child health. OBJECTIVE The aim was to investigate which feeding patterns in the first 6 months pose risks of eczema/skin allergy in children up to 6 years compared to direct breastfeeding for at least 3 months. METHODS The Infant Feeding Practices Study II in the United States and its 6-year follow-up provided data on feeding modes in infancy and doctor's diagnosed eczema/skin allergy in the first 6 years of life (1387 infants), based on parental reports. Different feeding patterns were identified. Log-linear models were used to estimate prevalence ratios (PRs) of feeding patterns for doctor's diagnosed eczema/skin allergy in the first 6 years of life, adjusting for confounders. RESULTS Compared to "direct breastfeeding for at least 3 months" (DBF3m), the combination of "direct feeding at the breast (DBF), pumping and feeding breast milk (BM), and formula (FF) in the first months" (DBF/BM/FF) showed a statistically significant higher risk of eczema/skin allergy in the first 6 years of life (PR = 1.46), adjusting for confounders. DBF combined with BM for the first 3 months followed by mixed feeding also had an increased risk (PR = 1.26), although not statistically significant. Formula feeding introduced since birth had no effect on eczema. Among the confounders, paternal eczema and race/ethnicity (Hispanic vs White) were associated with a higher risk of eczema/skin allergy. CONCLUSIONS & CLINICAL RELEVANCE Mixed infant feeding may carry a higher risk of eczema/skin allergy compared to direct feeding at the breast. The recent epidemic of pumping and feeding in the United States and the use of mixed infant feeding modes requires additional studies to provide appropriate and renewed assessments of the risks of feeding modes for the future development of allergies.
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Affiliation(s)
- N Soto-Ramírez
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - S Kar
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - H Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - W Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
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14
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Ascha M, Irfan M, Bena J, Taylor JS, Sood A. Pediatric patch testing: A 10-year retrospective study. Ann Allergy Asthma Immunol 2017; 117:661-667. [PMID: 27979024 DOI: 10.1016/j.anai.2016.09.445] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patch testing is the gold standard for diagnosing allergic contact dermatitis in children. OBJECTIVE To present a 10-year retrospective review of pediatric patch testing at our institution. METHODS Data from patients 18 years or younger who presented for patch testing from February 1, 2005, to May 31, 2015, were entered into a database. Patch testing was performed according to North American Contact Dermatitis Group standards. A positive reaction was defined as any allergen for which the patient had a 1+ or greater reaction and provided avoidance information. RESULTS A total of 157 patients with a mean (SD) age of 12.3 (4.1) years were evaluated. The 2 most frequent allergens were nickel and cobalt. Most patients were referred by dermatologists for suspected allergic contact dermatitis (72.3%). Dermatitis was present for more than 2 years in most cases (n = 67 [46.2%]), from 6 months to 2 years (n = 49 [33.8%]), and for less than 6 months (n = 29 [20.0%]). Males were more likely to have a positive reaction to fragrance mix 1 compared with females (P = .02). No significant association was found between age and allergen sensitivity. Those with a history of atopy were more likely to have a positive reaction to cobalt (P = .008) and chromium (P = .03). Sixty patients (38.2%) returned for follow-up, and 37 (60.7%) reported improvement; most (n = 54 [88.5%]) were being treated with topical corticosteroids. CONCLUSION Our study of pediatric patch testing can provide information regarding common allergens in children, which can enhance patient care. Primary care practitioners may benefit from awareness of patch testing as an alternative to prescribing systemic immunosuppressants.
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Affiliation(s)
- Mona Ascha
- Case Western Reserve University School of Medicine, Cleveland, Ohio.
| | - Mahwish Irfan
- Department of Dermatology, Cleveland Clinic Foundation and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - James Bena
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic Foundation and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - Apra Sood
- Department of Dermatology, Cleveland Clinic Foundation and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
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15
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Jacob SE, Lipp MB, Suh E, Goldenberg A. Practice Patterns of Dermatologists in the Pediatric Contact Dermatitis Registry. Pediatr Dermatol 2017; 34:408-412. [PMID: 28543809 DOI: 10.1111/pde.13154] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND/OBJECTIVES U.S. adults and children are equally likely to have allergic contact dermatitis. Historically the narrow geographic location of data-reporting providers has quantitatively and qualitatively limited the pediatric contact dermatitis data. The Pediatric Contact Dermatitis Registry was used to evaluate self-identified pediatric patch test providers within the United States with regard to demographic characteristics, geographic location, and practice patterns. METHODS A wide range of U.S. providers were invited to join the registry by completing a secure online 11-question registration survey. RESULTS There were 252 respondents from 50 states and the District of Columbia; 28.6% were pediatric dermatologists and members of the Society for Pediatric Dermatology (SPD), and 38% were members of the American Contact Dermatitis Society. The cumulative range of pediatric patch-test evaluations performed each year was 1,726 to 4,613 children. SPD members had a significantly greater likelihood of performing a commercially available patch test (odds ratio 7.14 [95% confidence interval 5.11, 9.97], p < .001) than those who were not SPD members. SPD members also had significantly lower odds of performing North American Contact Dermatitis Group standard tests than nonmembers. CONCLUSIONS The frequency of patch test evaluations in children is significantly underreported. This study provides insight into the practice patterns of various providers who are patch testing children and makes recommendations for evidence-based modifications regarding these practices. Limitations of the study include survey responder selection bias and small sample size.
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Affiliation(s)
- Sharon E Jacob
- Department of Dermatology, Loma Linda University, Loma Linda, California
| | - Michael B Lipp
- Department of Dermatology, Larkin Community Hospital Palm Springs, Hialeah, Florida.,Dermatitis Academy, Redlands, California
| | - Eric Suh
- School of Public Health, Loma Linda University, Loma Linda, California
| | - Alina Goldenberg
- Department of Dermatology, University of California, San Diego, San Diego, California
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16
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Andersen HH, Elberling J, Arendt-Nielsen L. High-concentration topical capsaicin may abolish the clinical manifestations of allergic contact dermatitis by effects on induction and elicitation. Med Hypotheses 2016; 99:53-56. [PMID: 28110699 DOI: 10.1016/j.mehy.2016.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 12/17/2016] [Indexed: 01/19/2023]
Abstract
Allergic contact dermatitis (ACD) is a common skin condition caused by a type-IV hypersensitivity reaction. Even though ACD is considered as a T-cell mediated disease, indications exists that peptidergic nerve fibers at the site of allergen exposure and associated with the draining lymph node play a prominent role in both induction and elicitation of ACD. This neuro-immune cross talk seems rely on neuropeptides such as Substance P secreted by nerve fiber terminals. It is hypothesized that local complete or partial cutaneous denervation/defunctionalization of peptidergic fibers in humans could be a feasible approach towards treating allergic contact dermatitis. Recently, human experimental protocols for prominent, temporary defunctionalization of peptidergic fibers have been published relying on prolonged application of 8% topical capsaicin patches. Combined with human experimental ACD models the importance of peptidergic nerve fibers in the induction and elicitation phases of ACD could be accurately established. Understanding the role of cutaneous peptidergic fibers in the pathogenesis and potentially of ACD and how contact sensitization can be modulated by topical defunctionalization of these fibers could lead to new approaches to treatment for ACD. In patients with localized ACD occurring to an allergen that is difficult or unfeasible to evade this would have particular relevance.
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Affiliation(s)
- Hjalte H Andersen
- Laboratory of Experimental Cutaneous Pain Research, SMI®, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Jesper Elberling
- The Allergy Clinic, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark
| | - Lars Arendt-Nielsen
- Laboratory of Experimental Cutaneous Pain Research, SMI®, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark.
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Lubbes S, Rustemeyer T, Sillevis Smitt JH, Schuttelaar ML, Middelkamp-Hup MA. Contact sensitization in Dutch children and adolescents with and without atopic dermatitis - a retrospective analysis. Contact Dermatitis 2016; 76:151-159. [DOI: 10.1111/cod.12711] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 09/10/2016] [Accepted: 09/20/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Stefanie Lubbes
- Department of Dermatology; Academic Medical Centre, University of Amsterdam; 1100 DD Amsterdam The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology; VU University Medical Centre; 1081 HV Amsterdam The Netherlands
| | - Johannes H. Sillevis Smitt
- Department of Dermatology; Academic Medical Centre, University of Amsterdam; 1100 DD Amsterdam The Netherlands
| | - Marie Louise Schuttelaar
- Department of Dermatology; University Medical Centre Groningen; 9700 RB Groningen The Netherlands
| | - Maritza A. Middelkamp-Hup
- Department of Dermatology; Academic Medical Centre, University of Amsterdam; 1100 DD Amsterdam The Netherlands
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18
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Rodrigues DF, Goulart EMA. Patch-test results in children and adolescents: systematic review of a 15-year period. An Bras Dermatol 2016; 91:64-72. [PMID: 26982781 PMCID: PMC4782649 DOI: 10.1590/abd1806-4841.20163927] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 09/01/2014] [Indexed: 12/31/2022] Open
Abstract
The number of studies on patch-test results in children and adolescents has
gradually increased in recent years, thus stimulating reviews. This paper is a
systematic review of a 15-year period devoted to studying the issue. Variations
pertaining to the number and age groups of tested children and/or adolescents,
the number of subjects with atopy/atopic dermatitis history, the quantity, type
and concentrations of the tested substances, the test technique and type of data
regarding clinical relevance, must all be considered in evaluating these
studies, as they make it harder to formulate conclusions. The most common
allergens in children were nickel, thimerosal, cobalt, fragrance, lanolin and
neomycin. In adolescents, they were nickel, thimerosal, cobalt, fragrance,
potassium dichromate, and Myroxylon pereirae. Knowledge of this matter aids
health professionals in planning preventive programs aimed at improving
children's quality of life and ensuring that their future prospects are not
undermined.
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19
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Mortazavi H, Ehsani A, Sajjadi SS, Aghazadeh N, Arian E. Patch testing in Iranian children with allergic contact dermatitis. BMC DERMATOLOGY 2016; 16:10. [PMID: 27405224 PMCID: PMC4943022 DOI: 10.1186/s12895-016-0047-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 06/30/2016] [Indexed: 12/23/2022]
Abstract
Background Allergic contact dermatitis is a common disorder in adults and children alike and appears to be on the increase. The purpose of this study was to determine the sensitization trends in Iranian children with contact dermatitis. Methods The result of 109 patch tests performed using the 24 allergens of the European Standard Series in patients below 18 years old from September 2007 to March 2009 were recorded and analyzed. The tests were evaluated at 48 and 72 h after performing. Results The study population consisted of 72 (66.1 %) females and 37 (33.9 %) males. Hands were the most commonly affected anatomic site. In the final evaluation of the tests on day three, 51 (46.8 %) individuals showed a positive reaction to at least one allergen. Females were significantly more likely to show a positive response to at least one allergen (p-value = 0.031, odds ratio: 2.46). The most common allergens were nickel sulfate, cobalt, methylisothiazolinone, and colophony with 21 (19.3 %), 11 (10.1 %), 7 (6.4 %), and 6 (5.5 %) positive reactions, respectively. Contact allergy to nickel sulfate was more common in females than males (23.6 % vs. 10.8 %). There was no statistically significant relationship between personal or family history of atopy and a positive reaction to patch testing. The clinical and practical relevance were assessed for nickel and cobalt with a clinical current relevance in 11 (52.3 %) and 4 (36.4 %), respectively. Conclusions Nickel sulfate, cobalt, methylisothiazolinone, and colophony are the most common allergens responsible for induction of allergic contact dermatitis in Iranian children and adolescents. Females tended to show more positive reactions to allergens. Electronic supplementary material The online version of this article (doi:10.1186/s12895-016-0047-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hossein Mortazavi
- Autoimmune Bullous Diseases Research Center, Razi Dermatology Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Razi Dermtology Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhooshang Ehsani
- Autoimmune Bullous Diseases Research Center, Razi Dermatology Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Razi Dermtology Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Sajed Sajjadi
- Razi Dermtology Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nessa Aghazadeh
- Autoimmune Bullous Diseases Research Center, Razi Dermatology Hospital, Tehran University of Medical Sciences, Tehran, Iran. .,Razi Dermtology Hospital, Tehran University of Medical Sciences, Tehran, Iran. .,Children's Medical Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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20
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Andersen HH, Lundgaard AC, Petersen AS, Hauberg LE, Sharma N, Hansen SD, Elberling J, Arendt-Nielsen L. The Lancet Weight Determines Wheal Diameter in Response to Skin Prick Testing with Histamine. PLoS One 2016; 11:e0156211. [PMID: 27213613 PMCID: PMC4877047 DOI: 10.1371/journal.pone.0156211] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 05/03/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Skin prick test (SPT) is a common test for diagnosing immunoglobulin E-mediated allergies. In clinical routine, technicalities, human errors or patient-related biases, occasionally results in suboptimal diagnosis of sensitization. OBJECTIVE Although not previously assessed qualitatively, lancet weight is hypothesized to be important when performing SPT to minimize the frequency of false positives, false negatives, and unwanted discomfort. METHODS Accurate weight-controlled SPT was performed on the volar forearms and backs of 20 healthy subjects. Four predetermined lancet weights were applied (25 g, 85 g, 135 g and 265 g) using two positive control histamine solutions (1 mg/mL and 10 mg/mL) and one negative control (saline). A total of 400 SPTs were conducted. The outcome parameters were: wheal size, neurogenic inflammation (measured by superficial blood perfusion), frequency of bleeding, and the lancet provoked pain response. RESULTS The mean wheal diameter increased significantly as higher weights were applied to the SPT lancet, e.g. from 3.2 ± 0.28 mm at 25 g to 5.4 ± 1.7 mm at 265 g (p<0.01). Similarly, the frequency of bleeding, the provoked pain, and the neurogenic inflammatory response increased significantly. At 265 g saline evoked two wheal responses (/160 pricks) below 3 mm. CONCLUSION AND CLINICAL RELEVANCE The applied weight of the lancet during the SPT-procedure is an important factor. Higher lancet weights precipitate significantly larger wheal reactions with potential diagnostic implications. This warrants additional research of the optimal lancet weight in relation to SPT-guidelines to improve the specificity and sensitivity of the procedure.
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Affiliation(s)
- Hjalte H. Andersen
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Anna Charlotte Lundgaard
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Anne S. Petersen
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Lise E. Hauberg
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Neha Sharma
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Sofie D. Hansen
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Jesper Elberling
- The Allergy Clinic, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark
| | - Lars Arendt-Nielsen
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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21
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Potential Allergens in Disposable Diaper Wipes, Topical Diaper Preparations, and Disposable Diapers. Dermatitis 2016; 27:110-8. [DOI: 10.1097/der.0000000000000177] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Children are as likely as adults to be sensitized and reactive to contact allergens. However, the prevailing data on pediatric allergic contact dermatitis are quantitatively and qualitatively limited because of a narrow geographic localization of data-reporting providers. OBJECTIVE The aim of the study was to present the first quarter results from the Loma Linda Pediatric Contact Dermatitis Registry focused on registered providers who self-identified as providing care for pediatric allergic contact dermatitis (ACD) within the United States. METHODS The US providers were invited to join the registry via completion of an online, secure, 11-question registration survey addressing demographics and clinical practice essentials. The presented results reflect data gathered within the first quarter of registry recruitment; registration is ongoing. RESULTS Of 169 responders from 48 states, the majority of providers were female (60.4%), academic (55.6%), and dermatologists (76.3%). Based on individual provider averages, the minimum cumulative number of pediatric patch-test evaluations performed each year ranged between 1372 and 3468 children. CONCLUSIONS The Pediatric Contact Dermatitis Registry provides a description of the current leaders in the realm of pediatric ACD and gaps, which are in need of attention. The registry allows for a collaborative effort to exchange information, educate providers, and foster investigative research with the hope of legislation that can reduce the disease burden of ACD in US children.
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Hill H, Goldenberg A, Golkar L, Beck K, Williams J, Jacob SE. Pre-Emptive Avoidance Strategy (P.E.A.S.) – addressing allergic contact dermatitis in pediatric populations. Expert Rev Clin Immunol 2016; 12:551-61. [DOI: 10.1586/1744666x.2016.1142373] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Smith VM, Clark SM, Wilkinson M. Allergic contact dermatitis in children: trends in allergens, 10 years on. A retrospective study of 500 children tested between 2005 and 2014 in one UK centre. Contact Dermatitis 2015; 74:37-43. [DOI: 10.1111/cod.12489] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/07/2015] [Accepted: 09/21/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Vanessa M. Smith
- Dermatology Department; Chapel Allerton Hospital; Leeds LS7 4SA UK
| | - Sheila M. Clark
- Dermatology Department; Chapel Allerton Hospital; Leeds LS7 4SA UK
| | - Mark Wilkinson
- Dermatology Department; Chapel Allerton Hospital; Leeds LS7 4SA UK
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Lagrelius M, Wahlgren CF, Matura M, Kull I, Lidén C. High prevalence of contact allergy in adolescence: results from the population-based BAMSE birth cohort. Contact Dermatitis 2015; 74:44-51. [PMID: 26538115 DOI: 10.1111/cod.12492] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 09/02/2015] [Accepted: 09/21/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Contact allergy is common among adults. However, little is known about the prevalence in adolescents. OBJECTIVES To assess the prevalence of allergy to common contact allergens in Swedish adolescents in the general population. PARTICIPANTS AND METHODS The BAMSE cohort is a population-based birth cohort with the main aim of studying the risk factors for asthma, rhinitis, and atopic dermatitis. Patch testing was performed at the 16-year follow-up. The test (TRUE Test(®) ) was applied at home, and removed 2 days later by nurses, who recorded and photographed the results. Dermatologists made final assessments on the basis of photographs and protocols. RESULTS Two thousand two hundred and eighty-five participants (88% of all 16-year follow-up participants) were patch tested; 15.3% had at least one positive reaction. Contact allergy was more common in girls than in boys (17.0% versus 13.4%, p = 0.018). Sensitization to nickel was most common (7.5%), followed by sensitization to fragrance mix I (2.1%) and p-tert-butylphenol formaldehyde resin (1.9%). Nickel allergy was more frequent in girls (9.8% versus 4.9%, p < 0.001). Solitary sensitization to cobalt was more common than co-sensitization to nickel and cobalt. CONCLUSIONS The prevalence of contact allergy in adolescents is of almost the same high magnitude as in adults. The applied method was feasible in the population-based setting.
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Affiliation(s)
- Maria Lagrelius
- Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65, Stockholm, Sweden
| | - Carl-Fredrik Wahlgren
- Dermatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, SE-171 76, Stockholm, Sweden
| | - Mihály Matura
- Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65, Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Science and Education, Stockholm South General Hospital, Karolinska Institutet, SE-118 83, Stockholm, Sweden.,Sachs' Children's Hospital, SE-118 83, Stockholm, Sweden
| | - Carola Lidén
- Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden
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27
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de Waard-van der Spek FB, Darsow U, Mortz CG, Orton D, Worm M, Muraro A, Schmid-Grendelmeier P, Grimalt R, Spiewak R, Rudzeviciene O, Flohr C, Halken S, Fiocchi A, Borrego LM, Oranje AP. EAACI position paper for practical patch testing in allergic contact dermatitis in children. Pediatr Allergy Immunol 2015; 26:598-606. [PMID: 26287570 DOI: 10.1111/pai.12463] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Allergic contact dermatitis (ACD) in children appears to be on the increase, and contact sensitization may already begin in infancy. The diagnosis of contact dermatitis requires a careful evaluation of a patient's clinical history, physical examination, and skin testing. Patch testing is the gold standard diagnostic test. METHODS Based on consensus, the EAACI Task Force on Allergic Contact Dermatitis in Children produced this document to provide details on clinical aspects, the standardization of patch test methodology, and suggestions for future research in the field. RESULTS We provide a baseline list of test allergens to be tested in children with suspected ACD. Additional tests should be performed only on specific indications.
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Affiliation(s)
| | - Ulf Darsow
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, München, Germany
| | - Charlotte G Mortz
- Department of Dermatology & Allergy Center, Odense University Hospital, Odense, Denmark
| | - David Orton
- Department of Dermatology & Allergy, Hillingdon Hospitals NHS Foundation Trust, Uxbridge (London), UK
| | - Margitta Worm
- Department of Dermatology and Allergy, Allergy-Center Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Antonella Muraro
- Department of Pediatrics, Padua General University Hospital, Padua, Italy
| | | | - Ramon Grimalt
- Department of Dermatology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland
| | - Odilija Rudzeviciene
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Carsten Flohr
- Department of Paediatric Allergy & Dermatology, St John's Institute of Dermatology, St Thomas' Hospital & King's College London, London, UK
| | - Susanne Halken
- Department of Pediatrics, Odense University Hospital, Odense, Denmark
| | - Alessandro Fiocchi
- Department of Pediatrics - Chief Division of Allergy, Pediatric Hospital Bambino Gesu, Roma, Vatican City, Italy
| | - Luis Miguel Borrego
- Department of Allergology/Immunology, CUF Descobertas Hospital, Lisbon and NOVA Medical School, Lisbon, Portugal
| | - Arnold P Oranje
- Department of Dermatology, Dermicis Skin Hospital, Alkmaar, Foundation Pediatric Dermatology, Rotterdam, The Netherlands
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Pediatric Allergic Contact Dermatitis: Lessons for Better Care. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2015; 3:661-7; quiz 668. [DOI: 10.1016/j.jaip.2015.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 02/17/2015] [Accepted: 02/17/2015] [Indexed: 11/22/2022]
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29
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Nardelli A, Consigli C, Bercik P, Wismer J. Contact Allergy in Atopic Patients: What We Suspected and What We Know. CURRENT TREATMENT OPTIONS IN ALLERGY 2015. [DOI: 10.1007/s40521-015-0058-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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30
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Gölz L, Papageorgiou SN, Jäger A. Nickel hypersensitivity and orthodontic treatment: a systematic review and meta-analysis. Contact Dermatitis 2015; 73:1-14. [DOI: 10.1111/cod.12392] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 02/14/2015] [Accepted: 02/24/2015] [Indexed: 02/06/2023]
Affiliation(s)
- Lina Gölz
- Department of Orthodontics; School of Dentistry, University of Bonn; 53111 Bonn Germany
| | - Spyridon N. Papageorgiou
- Department of Orthodontics; School of Dentistry, University of Bonn; 53111 Bonn Germany
- Department of Oral Technology; School of Dentistry, University of Bonn; 53111 Bonn Germany
| | - Andreas Jäger
- Department of Orthodontics; School of Dentistry, University of Bonn; 53111 Bonn Germany
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Young individuals with atopic disease and asthma or rhinoconjunctivitis may have clinically relevant contact allergies. Dermatitis 2015; 25:115-9. [PMID: 24819284 DOI: 10.1097/der.0000000000000037] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children and adolescents with atopic disease who have allergic asthma and/or rhinitis with and without atopic dermatitis may have hidden, clinically relevant contact allergies. OBJECTIVE The objective of this study was to survey contact allergies in children and adolescents who had been offered allergen-specific immunotherapy and accepted (exposed)/not accepted (unexposed) such treatment. METHODS Thirty-seven exposed and 24 unexposed individuals with atopic disease were patch tested with a standard series supplemented with aluminum chloride hexahydrate, an empty Finn Chamber, and 8 antigen preparations. RESULTS In the exposed group, 18 allergies were detected in 13 individuals with atopic disease when excluding reactions to aluminum and antigen preparations, whereas the corresponding figures for the unexposed group were 9 and 6, respectively (non-significant difference). Independent of the allergen-specific immunotherapy, significantly more (P = 0.013) individuals with atopic dermatitis had at least 1 contact allergy. Clinically relevant allergies were represented by sesquiterpene lactone mix, para-tertiary butylphenol-formaldehyde resin, tixocortol pivalate, and colophony. CONCLUSIONS Clinically relevant contact allergies are not uncommon in children and adolescents with atopic disease, which is why patch testing always should be considered in the management of dermatitis in individuals with atopic disease.
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Lee J, Sun HJ, Lee HY. Biohazard surveillance of allergic contact dermatitis in genetically-modified Zoysiagrasses using patch testing. ALLERGY ASTHMA & RESPIRATORY DISEASE 2015. [DOI: 10.4168/aard.2015.3.2.134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jaechun Lee
- Jeju National University School of Medicine, Jeju, Korea
| | - Hyeon-Jin Sun
- Faculty of Biotechnology and Subtropical Horticulture Research Institute, Jeju National University, Jeju, Korea
| | - Hyo-Yeon Lee
- Faculty of Biotechnology and Subtropical Horticulture Research Institute, Jeju National University, Jeju, Korea
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de Waard-van der Spek FB, Andersen KE, Darsow U, Mortz CG, Orton D, Worm M, Muraro A, Schmid-Grendelmeier P, Grimalt R, Spiewak R, Rudzeviciene O, Flohr C, Halken S, Fiocchi A, Borrego LM, Oranje AP. Allergic contact dermatitis in children: which factors are relevant? (review of the literature). Pediatr Allergy Immunol 2013; 24:321-9. [PMID: 23373713 DOI: 10.1111/pai.12043] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2013] [Indexed: 11/30/2022]
Abstract
Allergic contact dermatitis (ACD) in children is increasing. Sensitization to contact allergens can start in early infancy. The epidermal barrier is crucial for the development of sensitization and elicitation of ACD. Factors that may influence the onset of sensitization in children are atopic dermatitis, skin barrier defects and intense or repetitive contact with allergens. Topical treatment of ACD is associated with cutaneous sensitization, although the prevalence is not high. ACD because of haptens in shoes or shin guards should be considered in cases of persistent foot eruptions or sharply defined dermatitis on the lower legs. Clinical polymorphism of contact dermatitis to clothing may cause difficulties in diagnosing textile dermatitis. Toys are another potentially source of hapten exposure in children, especially from toy-cosmetic products such as perfumes, lipstick and eye shadow. The most frequent contact allergens in children are metals, fragrances, preservatives, neomycin, rubber chemicals and more recently also colourings. It is very important to remember that ACD in young children is not rare, and should always be considered when children with recalcitrant eczema are encountered. Children should be patch-tested with a selection of allergens having the highest proportion of positive, relevant patch test reactions. The allergen exposure pattern differs between age groups and adolescents may also be exposed to occupational allergens. The purpose of this review is to alert the paediatrician and dermatologist of the frequency of ACD in young children and of the importance of performing patch tests in every case of chronic recurrent or therapy-resistant eczema in children.
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Affiliation(s)
- Flora B de Waard-van der Spek
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam and KinderHaven Havenziekenhuis, Rotterdam, The Netherlands.
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Abstract
Difficult to control atopic dermatitis (AD) presents a therapeutic challenge and often requires combinations of topical and systemic treatment. Anti-inflammatory treatment of severe AD most commonly includes topical glucocorticosteroids and topical calcineurin antagonists used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, the topical calcineurin inhibitors tacrolimus and pimecrolimus are preferred in certain locations. Systemic anti-inflammatory treatment is an option for severe refractory cases. Microbial colonization and superinfection contribute to disease exacerbation and thus justify additional antimicrobial / antiseptic treatment. Systemic antihistamines (H1) may relieve pruritus but do not have sufficient effect on eczema. Adjuvant therapy includes UV irradiation preferably of UVA1 wavelength. “Eczema school” educational programs have been proven to be helpful.
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Bernard S, Baeck M, Tennstedt D, Haufroid V, Dekeuleneer V. Chromate or titanium allergy - the role of impurities? Contact Dermatitis 2013; 68:191-2. [DOI: 10.1111/cod.12024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Duarte I, Silva MDF, Malvestiti AA, Machado BDAR, Lazzarini R. Evaluation of the permanence of skin sensitization to allergens in patients with allergic contact dermatitis. An Bras Dermatol 2012; 87:833-7. [PMID: 23197200 PMCID: PMC3699917 DOI: 10.1590/s0365-05962012000600002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 01/23/2012] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Background: Patch tests are an efficient method to confirm the etiological diagnosis of allergic contact dermatitis. OBJECTIVES 1) To determine the permanence of results between two tests performed with an interval of at least one year, in patients with allergic contact dermatitis; 2) To compare the positive results according to rates of intensity; 3) To evaluate the permanence of sensitization according to each substance that was tested. METHODS Patients with previous diagnosis of allergic contact dermatitis, confirmed by patch tests carried out between the years 2005 and 2008, underwent new testing, using the same methodology, and data was compared. RESULTS A total of 1470 results of both tests on 49 patients were analyzed. The negative results remained in the second test in a rate of 96%, and 4% became positive (+) without relevance to the clinical history. Moreover, moderately (++) and strongly (+++) positive results were also maintained in, respectively, 86% and 100%. Nevertheless, weakly (+) positive results became negative in 65%. By ignoring all weakly (+) positive tests, the calculation of Kappa Index of Agreement Statistics between the two tests showed a value of 0.88. CONCLUSION Patch tests showed to be reliable for negative, moderately (++) positive and strongly (+++) positive results, by reproducing the same standard of individual response to allergens. However, for weakly (+) positive results, tests were not reliable.
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Affiliation(s)
- Ida Duarte
- Faculdade de Ciências Médicas da Santa Casa SP - São Paulo (SP), Brazil.
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Sabolić Pipinić I, Varnai VM, Turk R, Breljak D, Kezić S, Macan J. Low frequency of filaggrin null mutations in Croatia and their relation with allergic diseases. Int J Immunogenet 2012; 40:192-8. [PMID: 23078034 DOI: 10.1111/iji.12006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 07/16/2012] [Accepted: 09/20/2012] [Indexed: 12/12/2022]
Abstract
Filaggrin gene (FLG) null mutations are considered associated with atopic dermatitis. This study was conducted to determine the prevalence of FLG null mutations R501X, 2282del4, R2447X and S3247X in the Croatian population and their role in the occurrence of allergic diseases including atopic dermatitis, allergic rhinitis, asthma and allergic contact dermatitis (ACD). Study enrolled 440 freshmen with defined allergic diseases by means of both present symptoms in International Study of Asthma and Allergies in Childhood questionnaire (relevant respiratory and/or skin symptoms) and markers of allergic sensitization (positive skin prick and/or patch test). FLG null mutations were successfully genotyped in 423 students of which 11 (2.6%) were carriers of FLG null mutation: 1/423 (0.2%) was heterozygous for R501X and 10/423 (2.4%) were heterozygous for 2282del4. No carriers of R2447X and S3247X mutations were identified. In wild-type FLG carriers (412 subjects), atopic dermatitis was present in 45 (11%), allergic rhinitis in 70 (17%) and allergic asthma in 29 (7%) students. Twenty-five of 393 (7%) patch-tested wild-type FLG carriers had ACD. Among 11 FLG null mutation carriers, four had one or more allergic diseases, and five had reported skin symptoms without defined allergic sensitization (positive skin prick test and/or patch test). FLG null mutations were not confirmed as a predictor of analysed allergic diseases, but were confirmed as an independent predictor of skin symptoms (OR 17.19, 95% CI 3.41-86.6, P < 0.001). Our results in general indicate a low frequency of FLG null mutations in the studied Croatian population supporting a theory of a latitude-dependent distribution of FGL null mutations in Europe, with a decreasing north-south gradient of R501X and 2282del4 mutation frequency. The relation between FLG null mutations and skin disorders was confirmed.
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Affiliation(s)
- I Sabolić Pipinić
- Occupational Health and Environmental Medicine Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia.
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Affiliation(s)
- Julia M Kwan
- Department of Dermatology, Naval Medical Center San Diego, CA, USA
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Gittler JK, Krueger JG, Guttman-Yassky E. Atopic dermatitis results in intrinsic barrier and immune abnormalities: implications for contact dermatitis. J Allergy Clin Immunol 2012; 131:300-13. [PMID: 22939651 DOI: 10.1016/j.jaci.2012.06.048] [Citation(s) in RCA: 152] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 06/29/2012] [Indexed: 01/14/2023]
Abstract
Atopic dermatitis (AD), as well as irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD), are common skin diseases. These diseases are characterized by skin inflammation mediated by activated innate immunity or acquired immune mechanisms. Although AD, ICD, and ACD can be encountered in pure forms by allergists and dermatologists, patients with AD often present with increased frequency of ICD and ACD. Although a disturbed barrier alone could potentiate immune reactivity in patients with AD through increased antigen penetration, additional immune mechanisms might explain the increased susceptibility of atopic patients to ICD and ACD. This review discusses cellular pathways associated with increased skin inflammation in all 3 conditions and presents mechanisms that might contribute to the increased rate of ICD and ACD in patients with AD.
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Brandão MHT, Gontijo B. Contact sensitivity to metals (chromium, cobalt and nickel) in childhood. An Bras Dermatol 2012; 87:269-76. [DOI: 10.1590/s0365-05962012000200012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 03/20/2011] [Indexed: 11/22/2022] Open
Abstract
Metals, especially nickel, are the most common contact allergens in children. Recent data has shown increased incidence of allergy in industrialized countries. Sensitization can occur at any age, even in neonates. Costume jewelry, particularly earrings, is linked to increased sensitization to nickel. Sensitization to cobalt often occurs by the use of costume jewelry. The most common source of sensitization to chromium is leather. Due to the absence of a specific therapy, the main treatment is to identify and avoid the responsible allergens. This article presents an updated view on the epidemiological and clinical aspects of contact allergy to metals, focusing on prevention strategies and risk factors, and warns about possible and new sources of contact.
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Krecisz B, Chomiczewska D, Palczynski C, Kiec-Swierczynska M. Contact allergy to metals in adolescents. Nickel release from metal accessories 7 years after the implementation of the EU Nickel Directive in Poland. Contact Dermatitis 2012; 67:270-6. [DOI: 10.1111/j.1600-0536.2012.02059.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Allergische Kontaktekzeme bei Kindern. Monatsschr Kinderheilkd 2011. [DOI: 10.1007/s00112-011-2427-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Simonsen AB, Deleuran M, Johansen JD, Sommerlund M. Contact allergy and allergic contact dermatitis in children - a review of current data. Contact Dermatitis 2011; 65:254-65. [DOI: 10.1111/j.1600-0536.2011.01963.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Spornraft-Ragaller P, Kämmerer E, Gillitzer C, Schmitt J. Severe allergic reactions to para-phenylenediamine in children and adolescents: should the patch test concentration of PPD be changed? J Dtsch Dermatol Ges 2011; 10:258-64. [PMID: 21812929 DOI: 10.1111/j.1610-0387.2011.07756.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Semipermanent henna tattoos containing para-phenylenediamine (PPD) are a well-known cause of severe contact dermatitis, mainly in children. Another relevant exposure source to PPD are hair dyes, which are increasingly used by children and have also been reported to cause intense facial and scalp dermatitis. German patch test guidelines for children recommend that PPD should only be tested in patients who have had a henna tattoo, and then at a reduced concentration of PPD 0.5 % for 24 hours. PATIENTS AND METHODS We report on patch test results in four patients, three children and one adolescent, with a history of contact dermatitis to henna tattoos or hair dye. We used the recommended or even lower patch test concentrations of PPD with 24-hours exposure in all patients. RESULTS AND CONCLUSION All patients showed very strong patch test reactions to PPD and cross-reactions to related compounds even after dilution of PPD to as low as 0.05 %. Therefore, we suggest that in children with a history of allergic reactions to this compound, a titration test should be performed beginning at a concentration of maximal 0.05 %. This procedure has also been proposed previously based on a larger cases series in adults.
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Affiliation(s)
- Petra Spornraft-Ragaller
- Clinic and Polyclinic for Dermatology, Carl Gustav Carus University Hospital, Technical University Dresden, Fetscherstrasse 74, Dresden, Germany.
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Castanedo-Tardan MP, Matiz C, Jacob SE. [Contact dermatitis in children - a review of current opinions]. ACTAS DERMO-SIFILIOGRAFICAS 2011; 102:8-18. [PMID: 21296311 DOI: 10.1016/j.ad.2009.12.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 12/17/2009] [Accepted: 12/21/2009] [Indexed: 11/15/2022] Open
Abstract
In the not so distant past, in the United States contact dermatitis was considered to be a condition that affected mainly adults. The diagnosis was certainly less often rendered in pediatrics, mainly because it was believed that a child's immune system was immature and that children were generally exposed to fewer allergens. With this in mind, we can attribute the low prevalence formerly reported for this disease partly to the fact that most affected children were not (and are still not) evaluated using appropriate skin tests. Patch testing in children requires certain modifications, but the international literature of the last decade and US data published in the past year indicate that contact dermatitis is a common condition in the pediatric population and that the prevalence is similar in children and adults.
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Castanedo-Tardan M, Matiz C, Jacob S. Contact Dermatitis in Children − A Review of Current Opinions. ACTAS DERMO-SIFILIOGRAFICAS 2011. [DOI: 10.1016/s1578-2190(11)70747-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Darsow U, Wollenberg A, Simon D, Taïeb A, Werfel T, Oranje A, Gelmetti C, Svensson A, Deleuran M, Calza AM, Giusti F, Lübbe J, Seidenari S, Ring J. ETFAD/EADV eczema task force 2009 position paper on diagnosis and treatment of atopic dermatitis. J Eur Acad Dermatol Venereol 2010; 24:317-28. [DOI: 10.1111/j.1468-3083.2009.03415.x] [Citation(s) in RCA: 207] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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