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Navarro-Triviño FJ, Borrego L, Silvestre-Salvador JF, Mercader-García P, Giménez-Arnau AM, Ortiz-de Frutos FJ, Sanz-Sánchez T, Melé-Ninot G, Sánchez-Gilo A, Zaragoza-Ninet V, Serra-Baldrich E, Miquel-Miquel J, Córdoba-Guijarro S, Rodríguez-Serna M, Ruíz-González I, Carrascosa-Carrillo JM, Gómez-de la Fuente E, Pastor-Nieto MA, Heras-Mendaza F, González-Pérez R, Sánchez-Pedreño Guillén P, Sánchez-Pérez J, Gatica-Ortega ME, Fernández-Redondo V, Hervella-Garcés M, Manrique-Martínez P, Guimaraens-Juanena D, García-Gavín J, Giménez-Arnau E, Figueras-Nart I, Curto-Barredo L, Armario-Hita JC. Standard and Expanded Series Patch Testing Update by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC). ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:712-721. [PMID: 38556197 DOI: 10.1016/j.ad.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 04/02/2024] Open
Abstract
After the meeting held by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) back in October 2021, changes were suggested to the Spanish standard series patch testing. Hydroxyethyl methacrylate (2% pet.), textile dye mixt (6.6% pet.), linalool hydroperoxide (1% pet.), and limonene hydroperoxide (0.3% pet.) were, then, added to the series that agreed upon in 2016. Ethyldiamine and phenoxyethanol were excluded. Methyldibromoglutaronitrile, the mixture of sesquiterpene lactones, and hydroxyisohexyl 3-cyclohexene (Lyral) were alo added to the extended Spanish series of 2022.
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Affiliation(s)
- F J Navarro-Triviño
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - L Borrego
- Servicio de Dermatología, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
| | | | - P Mercader-García
- Servicio de Dermatología, Hospital Universitario José María Morales Meseguer, Murcia, España
| | - A M Giménez-Arnau
- Servicio de Dermatología, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, España
| | - F J Ortiz-de Frutos
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - T Sanz-Sánchez
- Servicio de Dermatología, Hospital Universitario Infanta Sofía, Madrid, España
| | - G Melé-Ninot
- Servicio de Dermatología, Hospital Universitari Sagrar Cor, Grupo Quironsalud, Barcelona, España
| | - A Sánchez-Gilo
- Servicio de Dermatología, Hospital Universitario Rey Juan Carlos, Madrid, España
| | - V Zaragoza-Ninet
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - E Serra-Baldrich
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - J Miquel-Miquel
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Valencia, España
| | - S Córdoba-Guijarro
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, España
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - I Ruíz-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - J M Carrascosa-Carrillo
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | | | - M A Pastor-Nieto
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - F Heras-Mendaza
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - R González-Pérez
- Servicio de Dermatología, Hospital Universitario Áraba, Universidad del País Vasco, Vitoria, Álava, España
| | | | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España
| | - M E Gatica-Ortega
- Servicio de Dermatología, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - V Fernández-Redondo
- Servicio de Dermatología, Complejo Hospitalario Universitario de Santiago, Universidad de Santiago, Santiago de Compostela, La Coruña, España
| | - M Hervella-Garcés
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - P Manrique-Martínez
- Servicio de Dermatología, Hospital Universitario Galdakao-Usansolo, Galdakao, Vizcaya, España
| | | | | | - E Giménez-Arnau
- Institut de Chimie CNRS UMR 7177, University of Strasbourg, Estrasburgo, Francia
| | - I Figueras-Nart
- Servicio de Dermatología, Hospital Universitario de Bellvitge, L' Hospitalet de Llobregat, Barcelona, España
| | - L Curto-Barredo
- Servicio de Dermatología, Hospital del Mar, Barcelona, España
| | - J C Armario-Hita
- Servicio de Dermatología, Hospital Universitario Puerto Real, Universidad de Cádiz, Cádiz, España
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Sukakul T, Uter W, Gonçalo M, Huggard J, Ljubojević Hadžavdić S, Schuttelaar MLA, Svedman C, Vey M, Isaksson M, Niklasson B, Rustemeyer T, Bruze M. Results of patch testing with five fragrance materials hitherto not tested: A dose-finding study in the clinical population. Contact Dermatitis 2024; 90:566-573. [PMID: 38387040 DOI: 10.1111/cod.14525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/18/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Quantitative risk assessment (QRA) for skin sensitization is used to derive safe use levels of sensitising fragrance ingredients in products. Post-marketing surveillance of the prevalence of contact allergy to these ingredients provides relevant data to help evaluate the performance of these measures. OBJECTIVES To determine a suitable patch test concentration for five fragrance materials that had hitherto not been tested on a regular basis. These concentrations are then to be used in a surveillance study with patch testing consecutive patients over an extended monitoring period. MATERIALS AND METHODS Furaneol, CAS.3658-77-3; trans-2-hexenal, CAS.6728-26-3; 4,8-dimethyl-4,9-decadienal, CAS.71077-31-1; longifolene, CAS.475-20-7; benzaldehyde, CAS.10052-7, were patch tested with other fragrance allergens in four clinics. Patch testing was conducted in three rounds, starting with the lowest concentrations of the five ingredients. The doses were increased in the subsequent rounds if no late-appearing positive reactions and virtually no irritant reactions were reported. RESULTS Overall, 373 patients were tested. No positive allergic reaction was reported to the five ingredients. Patch test results of other fragrance allergens are reported. CONCLUSIONS The highest test concentrations are each considered safe for patch testing consecutive patients. Further surveillance based on these preparations will evaluate the hypothesis that QRA-driven consumer product levels of these fragrances can prevent sensitization.
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Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Margarida Gonçalo
- Department of Dermatology, Coimbra University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Joseph Huggard
- The Huggard Consulting Group, S.A.R.L., Itzig, Luxembourg
- IFRA VP Scientific Affairs and IDEA Management Team, Brussels, Belgium
| | - Suzana Ljubojević Hadžavdić
- Department of Dermatology and Venereology, School of Medicine University of Zagreb, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marie L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, Groningen, The Netherlands
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Matthias Vey
- The Huggard Consulting Group, S.A.R.L., Itzig, Luxembourg
- IFRA VP Scientific Affairs and IDEA Management Team, Brussels, Belgium
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | | | - Thomas Rustemeyer
- Department of Dermatology-Allergology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
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Slodownik D, Bar J, Daniely D. Trends in contact sensitization, results, and implications from a contact dermatitis clinic in Israel. Contact Dermatitis 2024; 90:556-565. [PMID: 38368629 DOI: 10.1111/cod.14524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/18/2023] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND The baseline series includes common allergens, evolves over time, and differs by location. Our study aims to characterize allergen sensitization trends among the Israeli population during the last two decades, compare our results to American and European registries, as well as to highlight significant allergens in additional series outside the European baseline series (OEBS). METHODS We analysed patch test results of 2086 patients from a designated contact dermatitis clinic in Tel Aviv between 2019 and 2022, compared them to European and North American registries and to 2156 patch test results conducted in Israel two decades ago. RESULTS 38.6% of patients had at least one positive reaction to an allergen in the European baseline series (EBS), nickel sulphate (14.6%), fragrance mix I (4.6%), and Methylchloroisothiazolinone methylisothiazolinone (MCI/MI; 3.7%) were the most common among them. N-Isopropyl N-Phenyl-4-Phenylenediamine (NIPPD; 0%), Propolis (0.1%), Sesquiterpene lactone mix (0.1%), and Budesonide (0.1%) elicited a sensitization frequency significantly lower than the proposed threshold for baseline inclusion. Chi-square test revealed a statistically significant decrease (p < 0.05) in the sensitization frequency of fragrance mix I, Formaldehyde, Potassium dichromate, Neomycin sulphate, Myroxylon pereirae, Sesquiterpene lactone, and NIPPD during the last two decades. The overall sensitization frequency to the majority of allergens was lower in our cohort in comparison to the North American and European registries. CONCLUSIONS MCI/MI and 2-hydroxyethyl methacrylate-2 (HEMA) are common, relevant allergens, with high SPIN (significance and prevalence index number) and should be better regulated by the authorities. While among the EBS, NIPPD, Propolis, Sesquiterpene lactone, and Budesonide usually do not elicit a positive reaction and therefore should be reconsidered in baseline series, among the OEBS, Chloramphenicol, Quaternium 15, Propyl gallate, and Amerchol L101 have elicited high SPIN values and should be vigilantly examined in the suitable clinical scenario. Significantly lower sensitization frequency to propolis raises the possibility of a protective effect due to early oral exposure among the Israeli population.
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Affiliation(s)
- Dan Slodownik
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan Bar
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
| | - Danny Daniely
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
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Navarro-Triviño FJ, Borrego L, Silvestre-Salvador JF, Mercader-García P, Giménez-Arnau AM, Ortiz-de Frutos FJ, Sanz-Sánchez T, Melé-Ninot G, Sánchez-Gilo A, Zaragoza-Ninet V, Serra-Baldrich E, Miquel-Miquel J, Córdoba-Guijarro S, Rodríguez-Serna M, Ruíz-González I, Carrascosa-Carrillo JM, Gómez-de la Fuente E, Pastor-Nieto MA, Heras-Mendaza F, González-Pérez R, Sánchez-Pedreño Guillén P, Sánchez-Pérez J, Gatica-Ortega ME, Fernández-Redondo V, Hervella-Garcés M, Manrique-Martínez P, Guimaraens-Juanena D, García-Gavín J, Giménez-Arnau E, Figueras-Nart I, Curto-Barredo L, Armario-Hita JC. [Translated article] Standard and Expanded Series Patch Testing Update by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC). ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00439-3. [PMID: 38823769 DOI: 10.1016/j.ad.2024.05.018] [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: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 06/03/2024] Open
Abstract
After the meeting held by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) back in October 2021, changes were suggested to the Spanish Standard Series patch testing. Hydroxyethyl methacrylate (2% pet.), textile dye mixt (6.6% pet.), linalool hydroperoxide (1% pet.), and limonene hydroperoxide (0.3% pet.) were, then, added to the series that agreed upon in 2016. Ethyldiamine and phenoxyethanol were excluded. Methyldibromoglutaronitrile, the mixture of sesquiterpene lactones, and hydroxyisohexyl 3-cyclohexene (Lyral) were also added to the extended Spanish series of 2022.
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Affiliation(s)
- F J Navarro-Triviño
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
| | - L Borrego
- Servicio de Dermatología, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
| | | | - P Mercader-García
- Servicio de Dermatología, Hospital Universitario José María Morales Meseguer, Murcia, Spain
| | - A M Giménez-Arnau
- Servicio de Dermatología, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, Spain
| | - F J Ortiz-de Frutos
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - T Sanz-Sánchez
- Servicio de Dermatología, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - G Melé-Ninot
- Servicio de Dermatología, Hospital Universitari Sagrar Cor, Grupo Quironsalud, Barcelona, Spain
| | - A Sánchez-Gilo
- Servicio de Dermatología, Hospital Universitario Rey Juan Carlos, Madrid, Spain
| | - V Zaragoza-Ninet
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, Spain
| | - E Serra-Baldrich
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J Miquel-Miquel
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Valencia, Spain
| | - S Córdoba-Guijarro
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - I Ruíz-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, Spain
| | - J M Carrascosa-Carrillo
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | | | - M A Pastor-Nieto
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - F Heras-Mendaza
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - R González-Pérez
- Servicio de Dermatología, Hospital Universitario Áraba, Universidad del País Vasco, Vitoria, Álava, Spain
| | | | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, Spain
| | - M E Gatica-Ortega
- Servicio de Dermatología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - V Fernández-Redondo
- Servicio de Dermatología, Complejo Hospitalario Universitario de Santiago, Universidad de Santiago, Santiago de Compostela, La Coruña, Spain
| | - M Hervella-Garcés
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - P Manrique-Martínez
- Servicio de Dermatología, Hospital Universitario Galdakao-Usansolo, Galdakao, Vizcaya, Spain
| | | | | | - E Giménez-Arnau
- Institut de Chimie CNRS UMR 7177, University of Strasbourg, Strasbourg, France
| | - I Figueras-Nart
- Servicio de Dermatología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - L Curto-Barredo
- Servicio de Dermatología, Hospital del Mar, Barcelona, Spain
| | - J C Armario-Hita
- Servicio de Dermatología, Hospital Universitario Puerto Real, Universidad de Cádiz, Cádiz, Spain
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5
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Hopkins K, Antelmi A, Dahlin J, Olsson K, Svedman C, Åstrand J, Bruze M. Increased Rates of Gold and Acrylate Allergy in Individuals with Fibromyalgia Tested with an Extended Dental Patch Test Series. Acta Derm Venereol 2023; 103:adv22336. [PMID: 38078690 PMCID: PMC10726376 DOI: 10.2340/actadv.v103.22336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Fibromyalgia is a common chronic pain condition. Rates of contact allergy in individuals with fibromyalgia have not been widely studied. Systemic contact allergy can present with muscle and joint pain and general malaise. The aim of this study is to investigate contact allergy rates in individuals with fibromyalgia to the sensitizers in an extended dental series and compare with control groups. Contact allergy to gold was significantly more common in the fibromyalgia group than the dermatitis control group. When corrected for patch test system, contact allergy to gold was significantly more common in the fibromyalgia group than the dental control group. Contact allergy to hydroxyethyl methacrylate and grouped acrylates and methacrylates was significantly more common in the fibromyalgia group than the dental control group. In conclusion, individuals with fibromyalgia may have a propensity to sensitization to gold, either via an increased exposure or an alteration in the oral environment. Gold is also implicated in systemic contact dermatitis and may be a factor in elicitation of symptoms in individuals with fibromyalgia. Acrylate allergy is also common in the fibromyalgia population and may be a consequence of occupational exposure or dental treatment.
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Affiliation(s)
- Katharine Hopkins
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Karin Olsson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jacqueline Åstrand
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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6
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Paulsen E. The sesquiterpene lactone mix: A review of past, present and future aspects. Contact Dermatitis 2023; 89:434-441. [PMID: 37820718 DOI: 10.1111/cod.14419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/15/2023] [Accepted: 09/06/2023] [Indexed: 10/13/2023]
Abstract
The sesquiterpene lactones (SLs) are secondary plant metabolites, which are widespread in the Compositae/Asteraceae plant family. The first SLs were detected more than 100 years ago, and allergic contact dermatitis from Compositae has been reported since the beginning of the 1900s, but it was not until the late 1960s and early 1970s that a collaboration between dermatologists, chemists and botanists led to the detection of SLs as the main allergens of Compositae plants. In the 1980s, the SL mix, consisting of equimolar amounts of alantolactone, costunolide and dehydrocostus lactone, was developed as a screening agent for Compositae sensitisation. Today, after inclusion of SL mix in the baseline series, the mean prevalence of reactions in Europe is around 1%, and in North America 0.8%. In countries outside Europe and North America, the prevalence ranges between 0% and 10.7%. The detection rate of SL mix is lower than that of some plant extracts, and ideally, SL mix should be supplemented with a mix of SLs from locally prevalent allergenic plants. The prevalence of positive reactions to SL mix suggests continued baseline testing in most European countries, North America, New Zealand, Australia and probably some Chinese centres.
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Affiliation(s)
- Evy Paulsen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense C, Denmark
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7
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Kalicińska J, Wiśniowska B, Polak S, Spiewak R. Artificial Intelligence That Predicts Sensitizing Potential of Cosmetic Ingredients with Accuracy Comparable to Animal and In Vitro Tests-How Does the Infotechnomics Compare to Other "Omics" in the Cosmetics Safety Assessment? Int J Mol Sci 2023; 24:ijms24076801. [PMID: 37047774 PMCID: PMC10094956 DOI: 10.3390/ijms24076801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/25/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
The aim of the current study was to develop an in silico model to predict the sensitizing potential of cosmetic ingredients based on their physicochemical characteristics and to compare the predictions with historical animal data and results from "omics"-based in vitro studies. An in silico model was developed with the use of WEKA machine learning software fed with physicochemical and structural descriptors of haptens and trained with data from published epidemiological studies compiled into estimated odds ratio (eOR) and estimated attributable risk (eAR) indices. The outcome classification was compared to the results of animal studies and in vitro tests. Of all the models tested, the best results were obtained for the Naive Bayes classifier trained with 24 physicochemical descriptors and eAR, which yielded an accuracy of 86%, sensitivity of 80%, and specificity of 90%. This model was subsequently used to predict the sensitizing potential of 15 emerging and less-studied haptens, of which 7 were classified as sensitizers: cyclamen aldehyde, N,N-dimethylacrylamide, dimethylthiocarbamyl benzothiazole sulphide, geraniol hydroperoxide, isobornyl acrylate, neral, and prenyl caffeate. The best-performing model (NaiveBayes eAR, 24 parameters), along with an alternative model based on eOR (Random Comittee eOR, 17 parameters), are available for further tests by interested readers. In conclusion, the proposed infotechnomics approach allows for a prediction of the sensitizing potential of cosmetic ingredients (and possibly also other haptens) with accuracy comparable to historical animal tests and in vitro tests used nowadays. In silico models consume little resources, are free of ethical concerns, and can provide results for multiple chemicals almost instantly; therefore, the proposed approach seems useful in the safety assessment of cosmetics.
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Affiliation(s)
- Jadwiga Kalicińska
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, ul. Medyczna 9, 30-688 Krakow, Poland
| | - Barbara Wiśniowska
- Department of Social Pharmacy, Jagiellonian University Medical College, ul. Medyczna 9, 30-688 Krakow, Poland
| | - Sebastian Polak
- Department of Social Pharmacy, Jagiellonian University Medical College, ul. Medyczna 9, 30-688 Krakow, Poland
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, ul. Medyczna 9, 30-688 Krakow, Poland
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8
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Antelmi A, Dahlin J, Hopkins K, Svedman C, Bruze M. Contact allergy to gold simultaneously patch tested in two different chambers. Contact Dermatitis 2023. [PMID: 36942432 DOI: 10.1111/cod.14310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/23/2023]
Affiliation(s)
- Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Katharine Hopkins
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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9
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Sukakul T, Bruze M, Mowitz M, Svedman C. Use of sorbitan sesquioleate in patch test preparations and patch testing with the substance-What do our results mean? Contact Dermatitis 2023; 88:134-138. [PMID: 36305668 PMCID: PMC10092872 DOI: 10.1111/cod.14239] [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: 09/01/2022] [Revised: 10/12/2022] [Accepted: 10/23/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Sorbitan sesquioleate (SSO) is a sorbitan fatty acid ester, an emulsifier used in topical products and certain patch test preparations. SSO may affect the patch test results. It has been debated whether to include the substance in the baseline series to avoid misinterpretation of the results. OBJECTIVES To report the prevalence and simultaneous reactions of SSO with other patch test preparations containing SSO as an emulsifier. MATERIALS AND METHODS A retrospective analysis of 3539 dermatitis patients who underwent patch testing from 2016 to 2020 was performed. RESULTS The 5-year SSO contact allergy prevalence was 0.48%, and 1.3% had a doubtful reaction. Patients with a stronger positive reaction (2+, 3+) were more likely to react simultaneously to other allergen preparations containing SSO (p value = 0.018). One patient with a strong reaction to SSO reacted positively to all SSO-containing patch test preparations. Definite fragrance allergens could not be identified in the patients who had simultaneous reactions to SSO and fragrance mix (FM) I. CONCLUSIONS Patch testing with allergen preparations containing SSO affected the patch test interpretation. Fragrance contact allergy could not be ruled out when a patient simultaneously reacted to SSO and FM I. Changing emulsifiers in patch test preparations would be advantageous.
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Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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10
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Bizjak M, Adamič K, Bajrovič N, Eržen R, Jošt M, Kopač P, Košnik M, Lalek N, Zidarn M, Dinevski D. Patch testing with the European baseline series and 10 added allergens: Single-centre study of 748 patients. Contact Dermatitis 2022; 87:439-446. [PMID: 35736503 PMCID: PMC9796124 DOI: 10.1111/cod.14178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The European baseline series (EBS) of contact allergens is subject to change. An allergen is considered for inclusion when routine patch testing of patients with suspected contact dermatitis results in ≥0.5% prevalence rate. OBJECTIVES We aimed to determine the frequency of sensitizations to 30 EBS allergens and 10 locally added allergens. Additionally, we assessed the strength and evolution of reactions to all tested allergens and co-reactivity of additional allergens. METHODS Patch testing with our baseline series of 40 allergens was done in 748 consecutive adults. Tests were applied to the upper back and removed by patients after 48 h. Readings were done on Day 3 (D3) and D6 or D7 (D6/7). Positive reactions fulfilled the criteria of at least one plus (+) reaction. A retrospective analysis was done. RESULTS Eight allergens not listed in the EBS had ≥0.5% prevalence rate (i.e., cocamidopropyl betaine, thiomersal, disperse blue mix 106/124, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, propylene glycol, Compositae mix II and dexamethasone-21-phosphate), and 16.6% of positive reactions would have been missed without D6/7 readings. CONCLUSION We propose further studies to evaluate whether cocamidopropyl betaine, disperse blue mix 106/124, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea and Compositae mix II need to be added to the EBS.
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Affiliation(s)
- Mojca Bizjak
- University Clinic of Respiratory and Allergic Diseases GolnikGolnikSlovenia
| | - Katja Adamič
- University Clinic of Respiratory and Allergic Diseases GolnikGolnikSlovenia
| | - Nissera Bajrovič
- University Clinic of Respiratory and Allergic Diseases GolnikGolnikSlovenia
| | - Renato Eržen
- University Clinic of Respiratory and Allergic Diseases GolnikGolnikSlovenia,Topolšica HospitalTopolšicaSlovenia
| | - Maja Jošt
- University Clinic of Respiratory and Allergic Diseases GolnikGolnikSlovenia
| | - Peter Kopač
- University Clinic of Respiratory and Allergic Diseases GolnikGolnikSlovenia,Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Mitja Košnik
- University Clinic of Respiratory and Allergic Diseases GolnikGolnikSlovenia,Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Nika Lalek
- University Clinic of Respiratory and Allergic Diseases GolnikGolnikSlovenia
| | - Mihaela Zidarn
- University Clinic of Respiratory and Allergic Diseases GolnikGolnikSlovenia,Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
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11
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Patch Testing With Nickel Sulfate 5.0% Traces Significantly More Contact Allergy Than 2.5%: A Prospective Study Within the International Contact Dermatitis Research Group. Dermatitis 2022; 33:417-420. [PMID: 36125779 DOI: 10.1097/der.0000000000000935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Nickel allergy is the most common contact allergy, and a nickel salt is, therefore, included in most baseline patch test series. In the baseline series of the International Contact Dermatitis Research Group and the American Contact Dermatitis Society, nickel sulfate hexahydrate (NSH) in petrolatum at 2.5% is included, whereas NSH at 5.0% is included in many other baseline series, such as the European and Swedish ones. OBJECTIVE The aim of the study is to investigate whether NSH at 5.0% detects significantly more contact allergy than NSH 2.5% when both preparations are tested simultaneously in consecutive dermatitis patients. PATIENTS AND METHODS Two thousand two hundred eighty-seven consecutive dermatitis patients were patch tested simultaneously with NSH in petrolatum at 2.5% and 5.0%. The allergy rates were compared for all clinics individually and combined using McNemar test, 2-sided. RESULTS Contact allergy to NSH 5.0% and 2.5% was found in 20.3% and 16.8%, respectively (P < 0.0001). In 6 of 11 clinics, significantly more patients tested positive to the higher NSH concentration. For the 2 clinics in North America combined, significantly more patients tested positive to NSH 5.0%. CONCLUSIONS The NSH preparation in the International Contact Dermatitis Research Group baseline patch test series should be considered to be changed from NSH 2.5% (1 mg NSH/cm2) to 5.0% (2 mg NSH/cm2).
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12
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Uter W, Wilkinson SM, Aerts O, Bauer A, Borrego L, Brans R, Buhl T, Dickel H, Dugonik A, Filon FL, Garcìa PM, Giménez-Arnau A, Patruno C, Pesonen M, Pónyai G, Rustemeyer T, Schubert S, Schuttelaar MLA, Simon D, Stingeni L, Valiukevičienė S, Weisshaar E, Werfel T, Gonçalo M. Patch test results with the European baseline series, 2019/20-Joint European results of the ESSCA and the EBS working groups of the ESCD, and the GEIDAC. Contact Dermatitis 2022; 87:343-355. [PMID: 35678309 DOI: 10.1111/cod.14170] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 05/06/2022] [Accepted: 06/06/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Continual analyses of patch test results with the European baseline series (EBS) serve both contact allergy surveillance and auditing the value of included allergens. OBJECTIVES To present results of current EBS patch testing, obtained in 53 departments in 13 European countries during 2019 and 2020. METHODS Anonymised or pseudonymised individual data and partly aggregated data on demographic/clinical characteristics and patch test rest results with the EBS were prospectively collected and centrally pooled and analysed. RESULTS In 2019 and 2020, 22 581 patients were patch tested with the EBS. Sensitization to nickel remained most common (19.8 [19.2-20.4]% positivity [95% confidence interval]). Fragrance mix I and Myroxylon pereirae yielded very similar results with 6.80 (6.43-7.19)% and 6.62 (6.25-7.00)% positivity, respectively. Formaldehyde at 2% aq. yielded almost one percentage point more positive reactions than 1% concentration (2.49 [2.16-2.85]% vs. 1.59 [1.33-1.88]); methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI alone up to around 5% positives. Among the new additions, propolis was most commonly positive (3.48 [3.16-3.82]%), followed by 2-hydroxyethyl methacrylate (2.32 [2.0-2.68]%). CONCLUSION Ongoing surveillance on the prevalence of contact sensitization contributes to an up-to-date baseline series containing the most frequent and/or relevant contact sensitizers for routine patch testing in Europe.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Mark Wilkinson
- Dermatology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and Research group Immunology, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - Leopoldo Borrego
- Complejo Hospitalario Universitario Insular Materno Infantil, Universidad de las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Göttingen, Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center, Ruhr University Bochum, Bochum, Germany
| | - Aleksandra Dugonik
- Department of Dermatology, University Medical Centre Maribor, Maribor, Slovenia
| | - Francesca Larese Filon
- Department of Public Health, Occupational Medicine, University of Trieste, Trieste, Italy
| | | | - Ana Giménez-Arnau
- Department of Dermatology, Hospital del Mar, Institut Mar d´Investigacions Mèdiques, Universitat Pompeu Fabra de Barcelona, Barcelona, Spain
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Maria Pesonen
- Division Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Györgyi Pónyai
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - Thomas Rustemeyer
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Marie-L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Margarida Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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13
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Roque Quintana B, Falcón Hernández A, Sagrera Guedes A, Borrego L. Dermatitis de contacto a alérgenos de la Batería Estándar Española en población del sur de Gran Canaria. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:555-562. [DOI: 10.1016/j.ad.2022.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/24/2022] [Accepted: 02/27/2022] [Indexed: 11/29/2022] Open
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14
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Roque Quintana B, Falcón Hernández A, Sagrera Guedes A, Borrego L. [Translated article] Contact Dermatitis to Allergens in the Spanish Standard Series: Patch Test Findings in the South of Gran Canaria. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:T555-T562. [DOI: 10.1016/j.ad.2022.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/27/2022] [Indexed: 10/18/2022] Open
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15
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Updated Criteria to Include Contact Allergens in the European Baseline Series With Suggested Additions. CURRENT TREATMENT OPTIONS IN ALLERGY 2022. [DOI: 10.1007/s40521-022-00302-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Özkaya E, Pehlivan G, Babuna Kobaner G. Sorbitan sesquioleate: A rare contact allergen per se but an important indicator for allergic contact dermatitis from cross-reacting compounds as well as for false-positive fragrance allergy. Clin Exp Dermatol 2022; 47:1291-1297. [PMID: 35245949 DOI: 10.1111/ced.15158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 02/12/2022] [Accepted: 03/01/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Esen Özkaya
- İstanbul University, İstanbul Faculty of Medicine, Department of Dermatology and Venereology, Istanbul, Turkey
| | - Gizem Pehlivan
- İstanbul University, İstanbul Faculty of Medicine, Department of Dermatology and Venereology, Istanbul, Turkey
| | - Goncagul Babuna Kobaner
- İstanbul University, İstanbul Faculty of Medicine, Department of Dermatology and Venereology, Istanbul, Turkey
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17
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Sukakul T, Bruze M, Mowitz M, Antelmi A, Boonchai W, Dahlin J, Hamnerius N, Hauksson I, Lejding T, Svedman C. Simultaneous patch testing with fragrance markers in the baseline series and the ingredients of fragrance mixes ‐ an update from southern Sweden. Contact Dermatitis 2022; 86:514-523. [PMID: 35152428 PMCID: PMC9314710 DOI: 10.1111/cod.14072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 11/28/2022]
Abstract
Background Regularly updating the prevalence of fragrance contact allergy (CA) is important. Patch testing with fragrance markers in the baseline series and the ingredients of fragrance mixes (FMs) is still debated. Objectives To update the prevalence and clinical characteristics of patients with fragrance CA. To establish the results of patch testing with individual allergens of FMs. Methods A retrospective analysis of 3539 patients with dermatitis who were patch tested with the baseline series and FMs ingredients during 2016 to 2020 was performed. Results The prevalence of fragrance CA was 13%. About 10% of these patients with fragrance CA would be missed if the individual ingredients were not tested. Unlike hydroxyisohexyl 3‐cyclohexene carboxaldehyde, there was no decreasing trend of CA to Evernia prunastri (oakmoss) extract after the EU regulation came into force. Patients with CA from only one ingredient of the mixes or having a weak positive reaction to the ingredients were significantly missed when tested with only the fragrance markers in the baseline series. Conclusions Patch testing with individual fragrance allergens is crucial for experts to expand knowledge in the fragrance CA field. The concentrations of the allergens in FMs may need to be adjusted to detect patients with fragrance CA, since some were significantly overlooked.
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Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Waranya Boonchai
- Department of Dermatology Faculty of Medicine Siriraj Hospital, Mahidol University Bangkok Thailand
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Nils Hamnerius
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Inese Hauksson
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Tina Lejding
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
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18
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Hosseinpour S, Gaudin A, Peters OA. A critical analysis of research methods and experimental models to study biocompatibility of endodontic materials. Int Endod J 2022; 55 Suppl 2:346-369. [PMID: 35124840 PMCID: PMC9315036 DOI: 10.1111/iej.13701] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/04/2022] [Indexed: 12/03/2022]
Abstract
Materials used for endodontics and with direct contact to tissues have a wide range of indications, from vital pulpal treatments to root filling materials and those used in endodontic surgery. In principle, interaction with dental materials may result in damage to tissues locally or systemically. Thus, a great variety of test methods are applied to evaluate a materials' potential risk of adverse biological effects to ensure their biocompatibility before commercialization. However, the results of biocompatibility evaluations are dependent on not only the tested materials but also the test methods due to the diversity of these effects and numerous variables involved. In addition, diverse biological effects require equally diverse assessments on a structured and planned approach. Such a structured assessment of the materials consists of four phases: general toxicity, local tissue irritation, pre‐clinical tests and clinical evaluations. Various types of screening assays are available; it is imperative to understand their advantages and limitations to recognize their appropriateness and for an accurate interpretation of their results. Recent scientific advances are rapidly introducing new materials to endodontics including nanomaterials, gene therapy and tissue engineering biomaterials. These new modalities open a new era to restore and regenerate dental tissues; however, all these new technologies can also present new hazards to patients. Before any clinical usage, new materials must be proven to be safe and not hazardous to health. Certain international standards exist for safety evaluation of dental materials (ISO 10993 series, ISO 7405 and ISO 14155‐1), but researchers often fail to follow these standards due to lack of access to standards, limitation of the guidelines and complexity of new experimental methods, which may cause technical errors. Moreover, many laboratories have developed their testing strategy for biocompatibility, which makes any comparison between findings more difficult. The purpose of this review was to discuss the concept of biocompatibility, structured test programmes and international standards for testing the biocompatibility of endodontic material biocompatibility. The text will further detail current test methods for evaluating the biocompatibility of endodontic materials, and their advantages and limitations.
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Affiliation(s)
- S Hosseinpour
- School of Dentistry The University of Queensland Herston QLD Australia
| | - A Gaudin
- Inserm UMR 1229 RMeS, Regenerative Medicine and Skeleton Université de Nantes ONIRIS Nantes France
- Université de Nantes UFR Odontologie Nantes France
| | - O A Peters
- School of Dentistry The University of Queensland Herston QLD Australia
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19
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Uter W, Wilkinson SM, Aerts O, Bauer A, Borrego L, Buhl T, Cooper SM, Dickel H, Gallo R, Giménez-Arnau AM, John SM, Navarini AA, Pesonen M, Pónyai G, Rustemeyer T, Schliemann S, Schubert S, Schuttelaar MLA, Valiukevičienė S, Wagner N, Weisshaar E, Gonçalo M. European patch test results with audit allergens as candidates for inclusion in the European Baseline Series, 2019/20 - Joint results of the ESSCA A and the EBS B working groups of the ESCD, and the GEIDAC C. Contact Dermatitis 2022; 86:379-389. [PMID: 35099073 DOI: 10.1111/cod.14059] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND In 2019, a number of allergens (haptens), henceforth, 'the audit allergens,' were considered as potential additions to the European baseline series (EBS), namely, sodium metabisulfite, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, imidazolidinyl urea, Compositae mix II (2.5 or 5% pet), linalool hydroperoxides (lin-OOH), limonene hydroperoxides (lim-OOH), benzisothiazolinone (BIT), octylisothiazolinone (OIT), decyl glucoside, lauryl glucoside; Evernia furfuracea (tree moss), was additionally tested by some departments, too. OBJECTIVES To collect further data on patch test reactivity and clinical relevance of the audit allergens in consecutive patients across Europe. METHODS Patch test data covering the audit allergens in 2019 and 2020 were collected by those departments of the ESSCA testing these, as well as further collaborators from the EBS working group of the ESCD, and the Spanish GEIDAC. As patch test outcome, reactions between day (D) 3 and D5 were considered. RESULTS Altogether n=12403 patients were tested with any of the audit allergen. Positive reactions were most common to lin-OOH 1% pet. (8.74 (8.14-9.37)), followed by lin-OOH 0.5% pet., and lim-OOH 0.3% pet (5.41 (4.95-5.89)). Beyond these terpene hydroperoxides, BIT 0.1% pet. was the second most common allergen with 4.72 (4.2-5.28), followed by sodium metabisulfite 1% pet. (3.75 (3.32-4.23)) and Compositae mix 5% pet. (2.31 (1.84-2.87). For some allergens, clinical relevance was frequently difficult to ascertain. CONCLUSIONS Despite many positive patch test reactions, it remains controversial whether lin- and lim-OOH should be tested routinely, while at least the two preservatives BIT and sodium metabisulfite appear suitable. The present results are a basis for further discussion among the ESCD members and ultimately decision on their implementation into routine testing. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - S Mark Wilkinson
- Dermatology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and Research group Immunology, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Andrea Bauer
- Department of Dermatology, University Allergy Centre, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Leopoldo Borrego
- Complejo Hospitalario Universitario Insular Materno Infantil. Universidad de las Palmas de Gran Canaria, Spain
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Susan M Cooper
- Department of Dermatology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Rosella Gallo
- Clinica Dermatologica, Department of Health Sciences, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Swen M John
- Department of Dermatology and Environmental Medicine, Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute for Occupational Dermatology (NIB), Osnabrück, Germany
| | | | - Maria Pesonen
- Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Györgyi Pónyai
- Semmelweis University, Department of Dermatology, Venerology and Dermatooncology, Budapest, Hungary
| | - Thomas Rustemeyer
- Department of Dermatology-Allergology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Steffen Schubert
- Information Network of Departments of Dermatology, Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Marie-Louise A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nicola Wagner
- Department of Dermatology, University Hospital of Erlangen, University of Erlangen-, Nuremberg, (FAU), Erlangen, Germany
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Margarida Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Abstract
ABSTRACT Exposure to elemental aluminum and its salts is unavoidable. Aluminum as a metal is present in transport, construction, packaging, and electronic equipment. Aluminum salts are present in consumer products, food items and drinking water, vaccines, drugs, and antiperspirants. Aluminum in vaccines and preparations for allergen-specific immunotherapy are the major sensitization sources. The predominent clinical manifestations of aluminum allergy are pruritic subcutaneous nodules and eczematous dermatitis. Patch testing shall be performed with aluminum chloride hexahydrate (ACH) in petrolatum. The preparation with ACH 10% detects substantially more aluminum allergy than ACH 2%. A patch test with elemental aluminum, for example, an empty Finn Chamber, is only positive when there is a strong aluminum allergy. A patch test reading should be performed 1 week after the application so as not to miss 15% to 20% of aluminum allergy. Aluminum should be included in any baseline patch test series for children and investigated for a possible inclusion in baseline series for adults. Aluminum test chambers can interfere with the testing resulting in both false-negative and false-positive patch test reactions to nonaluminum contact sensitizers.
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21
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Mahler V, Uter W. Epicutaneous Patch Testing in Type IV Allergy Diagnostics: State of the Art and Best Practice Recommendations. Handb Exp Pharmacol 2022; 268:405-433. [PMID: 34312717 DOI: 10.1007/164_2021_508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This chapter summarises all relevant aspects of patch testing, closely following recommendations outlined in a recent European, and a German S3 guideline on diagnostic patch testing with contact allergens and medicinal products (drugs). Patch testing is indicated in patients suspected of suffering, or having been suffering, from delayed-type hypersensitivity leading to allergic contact dermatitis or other skin and mucosal diseases. Sections of this chapter include detailed indications, reasons for possibly postponing the test, considerations on choosing haptens (contact allergens) to test, various aspects of the application of patch test allergen preparations (storage, dosing) and of testing with individual materials provided by the patients. Special aspects of patch testing in cutaneous adverse drug reactions, children, or occupational contact dermatitis are outlined. Supplemental test methods, notably the repeated open application test, are briefly described. Finally, the final evaluation in terms of assessment of clinical relevance of reactions and patient counselling are outlined.
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Affiliation(s)
- Vera Mahler
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany.
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
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22
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Cheng HS, Konya J, Lobel E, Fernandez-Penas P. Australian baseline series allergens in assessment of allergic contact dermatitis in New South Wales. Australas J Dermatol 2021; 63:e78-e80. [PMID: 34751435 DOI: 10.1111/ajd.13745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/23/2021] [Accepted: 10/10/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Harriet Sara Cheng
- The Skin Hospital, Sydney, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia
| | - Joseph Konya
- The Skin Hospital, Sydney, New South Wales, Australia
| | - Edmund Lobel
- The Skin Hospital, Sydney, New South Wales, Australia
| | - Pablo Fernandez-Penas
- The Skin Hospital, Sydney, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia
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Andernord D, Bruze M, Bryngelsson IL, Bråred Christensson J, Glas B, Hagvall L, Isaksson M, Matura M, Nyman G, Stenberg B, Svedman C, Lindberg M. Contact allergy to haptens in the Swedish baseline series: Results from the Swedish Patch Test Register (2010 to 2017). Contact Dermatitis 2021; 86:175-188. [PMID: 34704261 DOI: 10.1111/cod.13996] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Allergic contact dermatitis has considerable public health impact and causative haptens vary over time. OBJECTIVES To report the prevalence of contact allergy to allergens in the Swedish baseline series 2010 to 2017, as registered in the Swedish Patch Test Register. METHODS Results and demographic information for patients tested with the Swedish baseline series in 2010 to 2017 were analysed. RESULTS Data for 21 663 individuals (females 69%) were included. Females had significantly more positive patch tests (54% vs 40%). The reaction prevalence rates were highest for nickel sulfate (20.7%), fragrance mix I (7.1%), Myroxylon pereirae (6.9%), potassium dichromate (6.9%), cobalt chloride (6.8%), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI; 6.4%), MI (3.7%), colophonium (3.5%), fragrance mix II (3.2%), and formaldehyde (3.2%). Myroxylon pereirae reaction prevalence increased from 5% in 2010 to 9% in 2017 and that for methyldibromo glutaronitrile from 3.1% to 4.6%. MCI/MI and MI reactions decreased in prevalence after 2014. Nickel reaction prevalence decreased among females aged 10 to 19 years. CONCLUSIONS Nickel remains the most common sensitizing agent, with reaction prevalence decreasing among females younger than 20 years. The changes in MCI/MI and MI reaction prevalence mirrored those in Europe. The register can reveal changes in contact allergy prevalence over time among patients patch tested in Sweden.
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Affiliation(s)
- Daniel Andernord
- Department of Dermatology, Central Hospital, Karlstad, Sweden.,Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ing-Liss Bryngelsson
- Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Johanna Bråred Christensson
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Bo Glas
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Lina Hagvall
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Mihály Matura
- Department of Dermatology, Skaraborg Hospital Skövde, Skövde, Sweden
| | - Gunnar Nyman
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Berndt Stenberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Magnus Lindberg
- Department of Dermatology, Örebro University Hospital and Department of Dermatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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24
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Active Sensitization to Textile Dyes Disperse Blue 106 and Disperse Blue 124. Dermatitis 2021; 32:e119-e121. [PMID: 34657084 DOI: 10.1097/der.0000000000000791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Recently, aluminum chloride hexahydrate (ACH) 10.0% petrolatum (pet) was recommended for patch testing to detect aluminum contact allergy. Aluminum lactate (AL) may be as reliable a test substance as ACH. OBJECTIVE We aimed to investigate the frequencies of aluminum allergy when ACH and AL were used in patch testing consecutive patients. METHODS Petrolatum preparations of ACH 10.0% and AL 12.0% were added to the baseline series in 2010-2017. Aluminum chloride hexahydrate 10.0% pet was added to the children baseline series from July 1, 2012, to December 31, 2017. RESULTS A total of 5448 patients were patch tested with the extended baseline series and 196 children with the extended children baseline series. Forty-eight of the 5448 adults (0.9%) and 10 of the 196 children (5.1%) were diagnosed with aluminum contact allergy. A significant difference was found between the aluminum allergy frequencies in children and adults patch tested with ACH in 2013-2017 (P < 0.001). The difference between the frequencies of contact allergies for the 2 aluminum salts is not statistically significant. CONCLUSIONS Patch testing with ACH and AL demonstrated similar contact allergy frequencies. To detect aluminum allergy, patch testing with ACH 10.0% pet is recommended. Aluminum chloride hexahydrate 10.0% pet should be considered for inclusion in baseline series for patch testing adults and children.
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Sukakul T, Bruze M, Mowitz M, Antelmi A, Bergendorff O, Björk J, Dahlin J, Hamnerius N, Hauksson I, Isaksson M, Lejding T, Pontén A, Svedman C. Contact allergy to oxidized linalool and oxidized limonene: Patch testing in consecutive patients with dermatitis. Contact Dermatitis 2021; 86:15-24. [PMID: 34561893 DOI: 10.1111/cod.13980] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/26/2021] [Accepted: 09/19/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Contact allergy to oxidized (ox.) linalool and ox. limonene has been reported to have a high prevalence, raising the question of inclusion into the baseline series. However, several important issues should be clarified and further investigated before inclusion can be warranted. OBJECTIVES To report the trends of ox. terpenes allergy in patients with dermatitis, features of the patch test reactions, and clinical characteristics of the patients. METHODS A retrospective analysis of 5773 patients was performed. All patients were patch tested with baseline series, individual ingredients of fragrance mix I and II, ox. linalool, and ox. limonene from 2013 to 2020. RESULTS The prevalence rates of contact allergy to ox. linalool and ox. limonene were 7.0% and 5.1%, respectively. Significantly increasing trends of contact allergy were observed. More than 95% of contact allergy cases were identified on Day 3/4. Patients with contact allergy to ox. linalool and ox. limonene were significantly younger than those with contact allergy to other fragrances and were predominantly female. Strong reactions were associated with older age and multiple fragrance allergies. CONCLUSIONS Contact allergy to ox. linalool and ox. limonene is becoming increasingly important, and findings show intriguing features. More studies concerning the clinical relevance before recommending these substances for screening are required.
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Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.,Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Inese Hauksson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Tina Lejding
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ann Pontén
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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Further Evidence of Allergic Contact Dermatitis Caused by 2,2'-Methylenebis(6-tert-Butyl-4-Methylphenol) Monoacrylate, a New Sensitizer in the Dexcom G6 Glucose Sensor. Dermatitis 2021; 33:287-292. [PMID: 34115662 DOI: 10.1097/der.0000000000000767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Since the spring of 2020, we have seen several patients experiencing severe allergic contact dermatitis (ACD) from the Dexcom G6 glucose sensor after the composition of the sensor's adhesive patch had been changed. We have previously reported the finding of a new sensitizer, 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate, in the Dexcom G6 adhesive patch. Three patients with ACD from Dexcom G6 tested positive to this sensitizer. They were also allergic to isobornyl acrylate, a sensitizer present both in Dexcom G6 and in other medical devices previously used by these patients. OBJECTIVE The aim of the study was to report the first 4 cases sensitized to 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate without a simultaneous allergy to isobornyl acrylate. METHODS The cases were patch tested their own materials, a medical device series, and 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate in several concentrations. RESULTS All 4 cases tested positive to 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate at either 1.0% or 1.5% in petrolatum, whereas 20 controls tested negative to both concentrations. CONCLUSIONS The cases reported here provide further evidence of 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate as a relevant culprit sensitizer in patients with ACD from Dexcom G6. However, the initially used patch test concentration (0.3%) did not suffice to elicit positive reactions in these cases, which is why patch testing at 1.5% is recommended.
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Hernández-Fernández CP, Mercader-García P, Silvestre Salvador JF, Sánchez Pérez J, Fernández Redondo V, Miquel Miquel FJ, Ortiz de Frutos FJ, Gatica Ortega ME, Mora Fernández V, Giménez Arnau AM, Zaragoza Ninet V, González Pérez R, Sanz Sánchez T, Pastor Nieto MA, Serra Baldrich E, Córdoba Guijarro S, Heras Mendaza F, Ruiz González I, Rodríguez Serna M, Hervella Garcés M, Gallego Descalzo MÁ, García Doval I, Borrego Hernando L. Candidate Allergens for Inclusion in the Spanish Standard Series Based on Data from the Spanish Contact Dermatitis Registry. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:S0001-7310(21)00192-7. [PMID: 34029518 DOI: 10.1016/j.ad.2021.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/03/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Standard patch test series must be updated using objective data on allergen sensitization. The Spanish standard series was last updated in 2016 and the European series in 2019, and the inclusion of several emerging allergens needs to be evaluated. MATERIAL AND METHODS We conducted a prospective, observational, multicenter study of consecutive patients from the registry of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) who were patch tested in 2019 and 2020 with linalool hydroperoxide, limonene hydroperoxide, 2-hydroxyethyl-methacrylate, benzisothiazolinone, octylisothiazolinone, textile dye mix (TDM), sodium metabisulfite, propolis, bronopol, Compositae mix II, diazolidinyl urea, imidazolidinyl urea, decyl glucoside, and lauryl glucoside. RESULTS We analyzed data for 4654 patients tested with diazolidinyl urea, imidazolidinyl urea, and bronopol, and 1890 tested with the other allergens. The values for the MOAHLFA index components were 30% for male, 18% for occupational dermatitis, 15% for atopic dermatitis, 29% for hand, 6.5% for leg, 23% for face, and 68% for age > 40 years. Sensitization rates above 1% were observed for 7 allergens: linalool hydroperoxide, 2-hydroxyethyl-methacrylate, benzisothiazolinone, limonene hydroperoxide, TDM, sodium metabisulfite, and propolis. Three allergens had a current relevance rate of over 1%: linalool hydroperoxide, 2-hydroxyethyl-methacrylat, and limonene hydroperoxide. Benzisothiazolinone and TDM had a relevance rate of between 0.9% and 1%. CONCLUSIONS Our results indicate that 7 new allergens should be considered when extending the Spanish standard patch test series. The data from our series could be helpful for guiding the next extension of the European baseline series.
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Affiliation(s)
- Carlos Pelayo Hernández-Fernández
- Servicio de Dermatología. Hospital Universitario de Gran Canaria Doctor Negrín. Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
| | - Pedro Mercader-García
- Servicio de Dermatología. Hospital General Universitario Jose Mª Morales Meseguer, Murcia, España
| | | | | | - Virginia Fernández Redondo
- Servicio de Dermatología. Complejo Hospitalario Universitario de Santiago. Universidad de Santiago de Compostela, Santiago de Compostela, España
| | | | | | | | | | - Ana María Giménez Arnau
- Servicio de Dermatología. Hospital del Mar. Instituto Municipal de Asistencia Sanitaria, Barcelona, España
| | | | - Ricardo González Pérez
- Servicio de Dermatología. Hospital Universitario Araba. Universidad del País Vasco, Vitoria, España
| | | | | | | | | | - Felipe Heras Mendaza
- Servicio de Dermatología. Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | | | | | | | | | | | - Leopoldo Borrego Hernando
- Servicio de Dermatología. Hospital Universitario Insular de Gran Canaria. Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
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29
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Wilkinson SM, Badulici S, Giménez-Arnau A, Dickel H, Gonçalo M, Hervella M, Isaksson M, Johansen JD, Mahler V, Thyssen JP, Uter W. The European baseline series: Criteria for allergen inclusion (with reference to formaldehyde releasers). Contact Dermatitis 2021; 85:125-128. [PMID: 33745196 DOI: 10.1111/cod.13836] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 12/12/2022]
Abstract
Existing criteria for inclusion in the European baseline series are summarized. Additional criteria are developed to aid decision making where the current criteria do not yield an unequivocal result. These include a consideration of whether an allergen (hapten) is better placed in a special series and the frequency with which an allergen cross-reacts with existing markers in the baseline series.
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Affiliation(s)
- S Mark Wilkinson
- Department of Dermatology, Chapel Allerton CSU, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Ana Giménez-Arnau
- Department of Dermatology, Hospital del Mar, Institut Mar d'Investigacions Mediques, Universitat Autónoma, Barcelona, Spain
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Bochum, Germany
| | - Margarida Gonçalo
- Clinic of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Marcos Hervella
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jeanne D Johansen
- 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
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
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30
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Dugonik A, Dugonik B, Podgorelec V, Brezočnik L. Associated positive patch test reactions to standard contact allergens: 10-year data from the Slovenian E-Surveillance System. Contact Dermatitis 2021; 85:17-25. [PMID: 33368304 DOI: 10.1111/cod.13767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/11/2020] [Accepted: 12/21/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND A considerable share of patients tested with a baseline patch test series respond with a positive reaction to more than one allergen, and some associations between synchronous positive reactions to distinct baseline patch allergens have been described in the literature. OBJECTIVES To evaluate the prevalence of sensitization to haptens of the European baseline series as well as the prevalence of oligosensitization and polysensitization and the most significant associated positive patch test reactions in Slovenia. METHODS Patch testing data collected by the Slovenian E-Surveillance System from January 2008 to December 2017 were retrospectively analysed. RESULTS Of a total of 15 171 patients analysed, 39.29% showed at least one positive reaction. The highest prevalences were noted for metals (nickel[II]sulfate hexahydrate: 16.33%) and fragrances (fragrance mix I: 6.70%). The correlation analysis showed the strongest correlation between mercapto mix and 2-mercaptobenzothiazole (61.2%), fragrance Mix II and hydroxyisohexyl 3-cyclohexene carboxaldehyde (50.5%), and potassium dichromate and cobalt(II) chloride hexahydrate (33.3%). CONCLUSIONS Sensitization prevalences to the most common haptens were described, and their strongest correlations on a national level quantified. A comparison with other European results confirms already known associations between allergens in terms of cross-reactivity.
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Affiliation(s)
| | - Bogdan Dugonik
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
| | - Vili Podgorelec
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
| | - Lucija Brezočnik
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
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31
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Murphy VL, Patel DC, Lamb SR, Cheng HS. Topical corticosteroid allergy: Results of sequential testing to a corticosteroid series in New Zealand. Contact Dermatitis 2021; 85:32-38. [PMID: 33400819 DOI: 10.1111/cod.13776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/26/2020] [Accepted: 12/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Our institution tests the European Baseline Series (EBS) and a steroid series sequentially in all patients presenting for patch testing. The rate of steroid sensitization in New Zealand has not previously been documented. OBJECTIVES To investigate the rate of corticosteroid sensitization and assess additional benefit of testing the full steroid series over the steroid allergy markers in the EBS. METHODS/PATIENTS Retrospective analysis of all patient demographics and patch test results over a 5-year period (2014 to 2019) was performed at a tertiary patch test clinic in Auckland, New Zealand. RESULTS A total of 319 patients completed patch testing, and 4.4% were sensitized to one or more corticosteroids. As much as 79% of positive reactions were of current relevance; 11/14 reactions were to tixocortol pivalate or budesonide. The "number needed to test" to detect one additional case of corticosteroid sensitization by using the full corticosteroid series over the EBS alone was 107. CONCLUSIONS Although corticosteroid sensitization was not uncommon in our population, the results suggest that sequential testing with the corticosteroid markers (budesonide and tixocortol) in the standard series alone is adequate. The additional corticosteroid series should be added if the markers are positive or where there is a clinical suspicion of corticosteroid allergy.
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Affiliation(s)
- Victoria L Murphy
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Denesh C Patel
- Department of Medicine, University of Auckland, Auckland, New Zealand.,Department of Dermatology, Auckland City Hospital, Auckland, New Zealand
| | - Steven R Lamb
- Department of Medicine, University of Auckland, Auckland, New Zealand.,Department of Dermatology, Auckland City Hospital, Auckland, New Zealand
| | - Harriet S Cheng
- Department of Medicine, University of Auckland, Auckland, New Zealand.,Department of Dermatology, Auckland City Hospital, Auckland, New Zealand
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Patch Testing With a New Composition of the Mercapto Mix-A Multicenter Study from the International Contact Dermatitis Research Group. Dermatitis 2021; 32:160-163. [PMID: 33405485 DOI: 10.1097/der.0000000000000669] [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 Mercaptobenzothiazole compounds are associated with allergic contact dermatitis caused by rubber products. Several screening substances have been used for patch testing. OBJECTIVE To compare the frequency of positive test reactions to a mercapto mix containing a higher concentration of 2-mercaptobenzothiazole with reactions to the combination of 2-mercaptobenzothiazole 2.0% and mercapto mix 2.0%. METHODS There were 7103 dermatitis patients in 12 International Contact Dermatitis Research Group dermatology departments who were patch tested with 2-mercaptobenzothiazole 2.0% petrolatum (pet.), mercapto mix 2.0% pet., and mercapto mix 3.5% pet. RESULTS Contact allergy to the 3 test preparations varied among the 12 centers: 2-mercaptobenzothiazole 2.0% pet. (0-2.4%), mercapto mix 2.0% pet. (0-4.9%), and mercapto mix 3.5% pet. (0-1.4%). 2-Mercaptobenzothiazole 2.0% and mercapto mix 2.0% detected a few more positive patients compared with mercapto mix 3.5%, but the difference was statistically insignificant (mercapto mix 2.0% pet., P = 1.0; 2-mercapto-benzothiazole 2.0% pet., P = 0.66). CONCLUSIONS Mercapto mix 3.5% pet. is not better than 2-mercaptobenzothiazole 2.0% and mercapto mix 2.0% by a difference that is significant. By using only 1 test preparation (mercapto mix 3.5%), an additional hapten could be tested. No cases of suspected/proven patch test sensitization were registered.
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33
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Aerts O, Rustemeyer T, Wilkinson M. Comments on Various Baseline Series for Patch Testing. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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34
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Uter W, Johansen JD. Prevention of Allergic Contact Dermatitis: Safe Exposure Levels of Sensitizers. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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35
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36
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Mizutani H, Nixon RL. The Australian Baseline Series. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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37
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The European Baseline Series. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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38
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The German Baseline Series: Evolution and History of a National BLS. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Blom T, de Boer EM, Rustemeyer T. A patient allergic to multiple chemically unrelated dyes. Contact Dermatitis 2020; 84:198-199. [PMID: 32954515 PMCID: PMC7984442 DOI: 10.1111/cod.13705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/14/2020] [Accepted: 09/17/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Tirza Blom
- Department of Dermatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Edith M de Boer
- Department of Dermatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
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40
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Horton E, Uter W, Geier J, Ballmer-Weber B, Bauer A, Bircher A, Dickel H, Giménez-Arnau A, Gonçalo M, John SM, Mahler V, Schuttelaar MLA, Simon D, Sanchez-Perez J, Rustemeyer T, Weisshaar E, Wilkinson M. Developing a cosmetic series: Results from the ESSCA network, 2009-2018. Contact Dermatitis 2020; 84:82-94. [PMID: 32845019 DOI: 10.1111/cod.13690] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/24/2020] [Accepted: 08/18/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND There is considerable variability across European patch test centres as to which allergens are included in local and national cosmetics series. OBJECTIVES To propose a standardized, evidence-based cosmetic series for Europe based on up-to-date analysis of relevant contact allergens. METHODS We collated data from the European Surveillance System on Contact Allergies (ESSCA) from 2009 to 2018 to determine which cosmetic allergens produce a high yield of contact allergy. Contact allergens with a prevalence of >0.3% that were considered relevant were included. Rare contact allergens were excluded if deemed no longer relevant or added to a supplemental cosmetic series for further analysis. RESULTS Sensitization prevalences of 39 cosmetic contact allergens were tabulated. Thirty of these allergens yielded >0.3% positive reactions and are therefore included in our proposed European cosmetic series. Six were considered no longer relevant and therefore excluded. Three were included in a supplementary European cosmetic series. An additional nine allergens were included in either the core or supplemental European cosmetic series following literature review. CONCLUSION We have derived a potential European cosmetic series based upon the above methods. This will require ongoing investigation based upon the changing exposure profiles of cosmetic allergens as well as new and evolving substances.
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Affiliation(s)
- Emma Horton
- Department of Dermatology, Chapel Allerton Hospital, Leeds, UK
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Barbara Ballmer-Weber
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Department of Dermatology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Andreas Bircher
- Department of Dermatology, Allergy Unit, University Hospital Basel, Basel, Switzerland
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Ana Giménez-Arnau
- Department of Dermatology, Hospital del Mar, Institut Mar d'Investigacions Mediques, Universitat Autónoma, Barcelona, Spain
| | - Margarida Gonçalo
- Department of Dermatology, Clinic of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Swen Malte John
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabruck, Lower Saxony Institute for Occupational Dermatology (NIB), Osnabruck, Germany
| | - Vera Mahler
- Department of Dermatology, University Hospital Erlangen, University of Erlangen-Nurnberg, Erlangen, Germany.,Department of Dermatology, Paul-Ehrlich-Institut, Langen, Germany
| | - Marie L A Schuttelaar
- Department of Dermatology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Thomas Rustemeyer
- Department of Dermatology, VU University, Amsterdam, The Netherlands
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Mark Wilkinson
- Department of Dermatology, Chapel Allerton Hospital, Leeds, UK
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Bruze M, Mowitz M, Netterlid E, Siemund I, Svedman C. Patch testing with aluminum chloride hexahydrate in petrolatum. Contact Dermatitis 2020; 83:176-177. [DOI: 10.1111/cod.13571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/22/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Magnus Bruze
- Department of Occupational and Environmental DermatologyLund University, Skåne University Hospital Mamö Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental DermatologyLund University, Skåne University Hospital Mamö Sweden
| | - Eva Netterlid
- Department of Occupational and Environmental DermatologyLund University, Skåne University Hospital Mamö Sweden
| | - Ingrid Siemund
- Department of Occupational and Environmental DermatologyLund University, Skåne University Hospital Mamö Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental DermatologyLund University, Skåne University Hospital Mamö Sweden
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Bruze M, Ale I, Andersen KE, Cannavó A, Diepgen T, Elsner P, Goh CL, Gonçalo M, Goossens A, McFadden J, Nixon R, Puangpet P, Sasseville D. Contact Allergy to Fragrance Mix II and Hydroxyisohexyl 3-Cyclohexene Carboxaldehyde: A Retrospective Study by International Contact Dermatitis Research Group. Dermatitis 2020; 31:268-271. [DOI: 10.1097/der.0000000000000545] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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García‐Gavín J, Mercader P, Descalzo M, Garcia‐Doval I, Silvestre J, Sánchez‐Pérez J, Fernández‐Redondo V, Armario‐Hita J, Ruiz‐González I, Giménez Arnau A. Efficiency in patch testing: the number needed to test to get one relevant result as a new approach in the evaluation of baseline series. Br J Dermatol 2020; 183:391-393. [DOI: 10.1111/bjd.18975] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
| | - P. Mercader
- Servicio de Dermatología Hospital Morales Meseguer Spain
| | - M.A. Descalzo
- Unidad de Investigación Fundación Piel Sana AEDV Madrid Spain
| | - I. Garcia‐Doval
- Unidad de Investigación Fundación Piel Sana AEDV Madrid Spain
| | - J.F. Silvestre
- Servicio de Dermatología Hospital General Universitario de Alicante Alicante Spain
| | - J. Sánchez‐Pérez
- Servicio de Dermatología Hospital Universitario de la Princesa Madrid Spain
| | - V. Fernández‐Redondo
- Servicio de Dermatología Complexo Hospitalario Universitario de Santiago Santiago de Compostela Spain
| | - J.C. Armario‐Hita
- Servicio de Dermatología Hospital Universitario Puerto Real Cadiz Spain
| | - I. Ruiz‐González
- Servicio de Dermatología Complejo Asistencial Universitario de León León Spain
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Uter W, Gefeller O, Mahler V, Geier J. Trends and current spectrum of contact allergy in Central Europe: results of the Information Network of Departments of Dermatology (IVDK) 2007–2018*. Br J Dermatol 2020; 183:857-865. [DOI: 10.1111/bjd.18946] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2020] [Indexed: 12/30/2022]
Affiliation(s)
- W. Uter
- Department of Medical Informatics, Biometry and Epidemiology University of Erlangen/Nürnberg Erlangen Germany
| | - O. Gefeller
- Department of Medical Informatics, Biometry and Epidemiology University of Erlangen/Nürnberg Erlangen Germany
| | - V. Mahler
- Paul Ehrlich Institut Langen Germany
| | - J. Geier
- Information Network of Departments of Dermatology University Medical Center Göttingen Germany
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46
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Horton E, Wilkinson M, Aalto‐Korte K, Pesonen M, Bauer A, Chowdhury MM, Cooper S, Cousen P, Crépy M, Larese Filon F F, Gallo R, Geier J, Giménez‐Arnau A, Gonçalo M, Goossens A, Green C, Guarneri F, Ljubojević Hadžavdić S, Johansen JD, Johnston GA, Rustemeyer T, Sánchez‐Pérez J, Thyssen JP, Schuttelaar MA, Stone N, Uter W. A survey of members of the European Surveillance System on Contact Allergy and the EU project “StanDerm” to identify allergens tested in cosmetic series across Europe. Contact Dermatitis 2020; 82:195-200. [DOI: 10.1111/cod.13437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/15/2019] [Accepted: 11/15/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Emma Horton
- Department of DermatologyChapel Allerton Hospital Leeds UK
| | - Mark Wilkinson
- Department of DermatologyChapel Allerton Hospital Leeds UK
| | - Kristiina Aalto‐Korte
- Occupational MedicineFinnish Institute of Occupational Health (FIOH) Helsinki Finland
| | - Maria Pesonen
- Occupational MedicineFinnish Institute of Occupational Health (FIOH) Helsinki Finland
| | - Andrea Bauer
- Department of DermatologyUniversity Hospital Carl Gustav Carus, Technical University of Dresden Dresden Germany
| | | | - Susan Cooper
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust Oxford UK
| | - Philippa Cousen
- Department of Dermatology, The James Cook University Hospital Middlesbrough UK
| | - Marie‐Noëlle Crépy
- Department of Occupational MedicineUniversity Hospital of Centre of Paris COCHIN Paris France
| | - Francesca Larese Filon F
- Department of Dermatology, Dipartimento di Scienze Mediche, Chirurgiche e della SaluteUnità Operativa di Medicina del Lavoro, Università di Trieste Trieste Italy
| | - Rosella Gallo
- Department of Dermatology, Section of Dermatology, DISSALUniversity of Genoa Genoa Italy
| | - Johannes Geier
- Department of Dermatology, Information Network of Department of Dermatology (IVDK)Institute at the University Medical Center Goettingen Goettingen Germany
| | - Ana Giménez‐Arnau
- Department of Dermatology, Hospital del MarInstitut Mar d'Investigacions Mediques, Universitat Autónoma Barcelona Spain
| | - Margarida Gonçalo
- Department of Dermatology, Clinic of DermatologyUniversity Hospital and Faculty of Medicine, University of Coimbra Coimbra Portugal
| | - An Goossens
- Department of Dermatology, Universitair Ziekenhuis Leuven Belgium
| | - Cathy Green
- Department of Dermatology, Ninewells Hospital Dundee UK
| | | | - Suzana Ljubojević Hadžavdić
- Department of Dermatology, University Department of Dermatology and VenerologyZagreb University Hospital Center Zagreb Croatia
| | - Jeanne D. Johansen
- Department of Dermatology & Allergy and National Allergy Research CentreHerlev‐Gentofte Hospital Hellerup Denmark
| | | | - Thomas Rustemeyer
- Department of Dermatology and AllergologyAmsterdam University Medical Centres Amsterdam The Netherlands
| | | | - Jacob P. Thyssen
- Dermatology Department of the Hospital de la Princesa Madrid Spain
| | - Marie‐Louise A. Schuttelaar
- Department of DermatologyUniversity Medical Centre Groningen, University of Groningen Groningen The Netherlands
| | - Natalie Stone
- Department of Dermatology, Royal Gwent Hospital Newport UK
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and EpidemiologyUniversity of Erlangen/Nürnberg Erlangen Germany
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Prevention of Allergic Contact Dermatitis: Safe Exposure Levels of Sensitizers. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_70-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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48
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Mahler V, Becker D. The German Baseline Series: Evolution and History of a National BLS. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_65-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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49
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The European Baseline Series. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_64-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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50
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The Australian Baseline Series. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_68-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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