Causal agents of photoallergic contact dermatitis diagnosed in the national institute of dermatology of Colombia

Allergic contact dermatitis to lip care cosmetic products - a systematic review

Aim: Lip care cosmetics products are any external preparation used by people to prevent drying, chapping, dullness, and beautification of lips. This study aimed to review the literature on allergic reactions induced by different types of lip care cosmetic products. Methods: A literature search was performed in PubMed from inception to June 2022. The study included articles published in English and available in full text. References of illegible articles were searched. Studies describing any patient who developed allergic contact dermatitis after the application of lip care cosmetic products were included. Results: A total of 47 reports consisting of 58 individuals experienced allergic reactions to lip care products. Several lip care cosmetics products, such as lipsticks, lip balms, lip salve, lip gloss, lip liner, and lip plumper, were found to be associated with allergic reactions. The most common ingredients that caused the allergic contact dermatitis were castor oil, benzophenone-3, gallate, wax, and colophony. Conclusions: Lip care cosmetics products contain several components that have been associated with allergic reactions. Awareness needs to be created among the general public and dermatologists regarding the presence of possible allergens in lip care cosmetic products.

Non-animal approaches for photoallergenicity safety assessment: Needs and perspectives for the toxicology for the 21st century

Certain chemicals and/or their byproducts are photoactivated by UV/VIS and trigger a dermal allergenic response, clinically recognized as photoallergic contact dermatitis (PACD). It is important to identify the chemicals which are potentially photoallergenic, not only for establishing the correct differential diagnosis between PACD and other photodermatoses, but also as causative agents which should be avoided as a preventative measure. Moreover, materials with photoallergenic properties need to be correctly identified to allow thorough safety assessments for their use in finished products (e.g. cosmetics). Development of methods for predicting photoallergenicity potential of chemicals has advanced at slow pace in recent years. To date, there are no validated methods for photosensitisation potential of chemicals for regulatory purposes, although it remains a required endpoint in some regions. The purpose of this review is to explore the mechanisms potentially involved in the photosensitisation process and discuss the methods available in the literature for identification of photosensitisers. The review also explores the possibilities of further research investment required to develop human-relevant new approach methodologies (NAMs) and next generation risk assessment (NGRA) approaches, considering the current perspectives and needs of the Toxicology for the 21st Century.

Frequency of Allergenic Ingredients in Antifungal Creams

BACKGROUND

Allergic contact dermatitis (ACD) may occur secondary to topical antifungals containing potential allergens in their vehicles. Variation of allergenic ingredients among commonly used antifungal creams (AFCs) has not been well characterized.

OBJECTIVE

The study goal was to assess the frequency of allergenic ingredients in 4 commonly used topical AFCs.

METHODS

Topical AFCs (clotrimazole, ketoconazole, miconazole, and terbinafine) were selected, and the ingredient lists for these products were obtained from the US Food and Drug Administration's Online Label Repository via a proprietary name search. A systematic literature review was performed using the ingredient name on MEDLINE (PubMed) database to identify reports of ACD confirmed by patch testing.

RESULTS

Of the 20 ingredients analyzed, 6 had frequent allergenic potential. Propylene glycol was the most common cause of ACD identified in the literature and is an ingredient in ketoconazole 2% and miconazole nitrate 2%. Ketoconazole 2% and miconazole nitrate 2% creams contained the highest number of potential allergens (n = 3) among the 4 creams analyzed.

CONCLUSIONS

Of the 4 creams, terbinafine hydrochloride 1% and clotrimazole 1% contained the least number of potential allergenic ingredients. Awareness of the allergenic potential of commonly used AFCs may help health care providers when evaluating patients with ACD.

Exploring Mycosporine-Like Amino Acids (MAAs) as Safe and Natural Protective Agents against UV-Induced Skin Damage

Prolonged exposure to harmful ultraviolet radiation (UVR) can induce many chronic or acute skin disorders in humans. To protect themselves, many people have started to apply cosmetic products containing UV-screening chemicals alone or together with physical sunblocks, mainly based on titanium–dioxide (TiO₂) or zinc-oxide (ZnO₂). However, it has now been shown that the use of chemical and physical sunblocks is not safe for long-term application, so searches for the novel, natural UV-screening compounds derived from plants or bacteria are gaining attention. Certain photosynthetic organisms such as algae and cyanobacteria have evolved to cope with exposure to UVR by producing mycosporine-like amino acids (MAAs). These are promising substitutes for chemical sunscreens containing commercially available sunblock filters. The use of biopolymers such as chitosan for joining MAAs together or with MAA-Np (nanoparticles) conjugates will provide stability to MAAs similar to the mixing of chemical and physical sunscreens. This review critically describes UV-induced skin damage, problems associated with the use of chemical and physical sunscreens, cyanobacteria as a source of MAAs, the abundance of MAAs and their biotechnological applications. We also narrate the effectiveness and application of MAAs and MAA conjugates on skin cell lines.

Sunscreens and their usefulness: have we made any progress in the last two decades?

Sunscreens have now been around for decades to mitigate the Sun's damaging ultraviolet (UV) radiation which, although essential for the existence of life, is a recognized prime carcinogen. Accordingly, have suncreams achieved their intended purposes towards protection against sunburns, skin photo-ageing and the like? Most importantly, however, have they provided the expected protection against skin cancers that current sunscreen products claim to do? In the last two decades, there have been tens, if not hundreds of studies on sunscreens with respect to skin protection against UVB (280‒320 nm)-traditionally sunscreens with rather low sun protection factors (SPF) were intended to protect against this type of radiation-and UVA (320‒400 nm) radiation; a distinction between SPF and UVA protection factor (UVA-PF) is made. Many of the studies of the last two decades have focused on protection against the more skin-penetrating UVA radiation. This non-exhaustive article reviews some of the important facets of what is currently known about sunscreens with regard (i) to the physical UV filters titanium dioxide (TiO₂) and zinc oxide (ZnO) and the mostly photo-unstable chemical UVB/UVA filters (e.g., octinoxate (OMC) and avobenzone (AVO), among others), (ii) to novel chemical sunscreen agents, (iii) to means that minimize the breakdown of chemical filters and improve their stability when exposed to UV sunlight, (iv) to SPF factors, and (v) to a short discussion on non-melanoma skin cancers and melanoma. Importantly, throughout the article we allude to the safety aspects of sunscreens and at the end ask the question: do active ingredients in sunscreen products pose a risk to human health, and what else can be done to enhance protection? Significant loss of skin protection from two well-known commercial suncreams when exposed to simulated UV sunlight. Cream I: titanium dioxide, ethylhexyl triazone, avobenzone, and octinoxate; Cream II: octyl salicylate, oxybenzone, avobenzone, and octinoxate.

Feeling the Burn: Phototoxicity and Photoallergy

An interaction between light's radiation and certain exogenous and endogenous substances can lead to the development of photoallergic and/or phototoxic dermatoses. Clinically, reactions may range from acute and self-limited to chronic and recurrent. Delays in diagnosis are not uncommon due to complex clinical presentations, broad differentials, and limited number of specialists who perform phototesting. Therefore, a critical understanding of these dermatoses is essential for accurate diagnosis and appropriate management. The epidemiology, light sources, mechanisms, clinical presentations, evaluation protocols, common culprits, treatments, key challenges, and future directions related to photoallergy and phototoxicity are reviewed herein.

Allergic Contact Dermatitis Secondary to Moisturizers

Background: Moisturizers are cosmetic products used routinely to manage various skin conditions. Even though moisturizers are often thought to have minimal or no adverse reactions, allergic contact dermatitis (ACD) to these products can develop in some cases. Methods: We studied ingredients included in 3 of the most commonly used moisturizer brands, identified their presence in standard patch testing series, and evaluated their allergenic potential, categorizing the allergens as frequent or infrequent. The standard patch testing series used as reference were the Thin-layer Rapid Use Epicutaneous patch test (T.R.U.E. test), the North American Contact Dermatitis Group (NACDG) screening standard series, and the American Contact Dermatitis Society (ACDS) core allergen series. Results: Aveeno, Cetaphil, and Cerave products had a total of 12, 14, and 9 potential allergens, respectively, the majority of which were infrequent and not included in standard patch testing series. Conclusion: Being aware of the allergenic potential of commonly used moisturizers may help healthcare providers when evaluating patients with ACD. Further testing is recommended in a targeted manner when suspecting ACD with negative standard patch testing series or when ACD is refractory to treatment.

Prospective of Monascus Pigments as an Additive to Commercial Sunscreens

Red and yellow pigments from Monascus purpureus (NMCC-PF01) were evaluated to enhance sun protection factor (SPF) of commercial sunscreens and Aloe vera extract. The extracted Monascus pigments contain rubropunctamine (red pigment) and the mixture of monascin and ankaflavin (yellow pigment) as major components. Antioxidant activity and in-vitro safety of the pigments were assessed by ferric reduction potential and DPPH radical scavenging assays, human keratinocytes (HaCaT), and erythrocytes (RBCs) cytotoxicity assay, respectively. In results, SPF of commercial sunscreens showed an increase of 36.5% with red pigment compared to the 13% increase by yellow pigment. The in-vitro studies showed 67.6% ferric reducing potential and 27% DPPH radical scavenging activity, neither cytotoxic effect against human keratinocytes nor haemolytic activity. These results confirmed the safe nature of the Monascus pigments; however, in-vivo studies merit further research. In conclusion, screened pigments from Monascus purpureus may act as potential candidates to increase SPF of commercial sunscreen naturally.

Sunscreen Application, Safety, and Sun Protection: The Evidence

Recently in Canada, there has been an effort to create consistent messaging about sun safety as there is a lack of up-to-date evidence-based guidelines regarding sun-protection measures. This review aimed to provide updated, evidence-based recommendations on sunscreen application, safety, and sun protection regarding the following topics for which there is clinical uncertainty: physical barriers, sunscreen properties, sunscreen application, and risk-benefit analysis.

Gas chromatographic-mass spectrometric analysis of sunscreens and their effects on mice liver and kidney enzyme function

Background

Sunscreens are one of the most widely used products among cosmetics and personal care products. Recent studies have shown that some of sunscreen formulations may contain toxic, carcinogenic, or even nonallowed chemicals that may affect skin, cells, and hormones.

Materials and methods

This study aimed to develop and validate a method that allows the determination of sunscreen ingredients by gas chromatography-mass spectrometry (GC-MS). Analysis of original sunscreen products (n=5) from a licensed pharmacy and counterfeit sunscreen products (n=5) from local markets in Jordan was performed using GC-MS. pH stability of the sunscreen samples were also monitored under different storage temperatures. Topical application of sunscreens on mice skin was conducted to study their effects on liver and kidney enzymes' function.

Results

In terms of pH stability, there is a significant change in pH at different degrees of temperature between the products. Diethyl phthalate (DEP) was detected in two counterfeit products and was not mentioned on the ingredients' label. DEP was reported for its percutaneous absorption and systemic uptake in the literature. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were significantly increased with a P<0.005 in some groups treated with original sunscreens under sun radiation. Creatinine showed a significant decrease in some groups treated with original and counterfeit sunscreens, while blood urea nitrogen (BUN) showed no differences.

Conclusion

This study presents a method that allows the scanning and profiling of sunscreen ingredients as well as investigates their stability, permeation, and toxicity. Profiling of sunscreen product, changing in pH stability, and analyzing kidney and liver enzymes' level would be of a great impact on products' safety and consumers' health.

Photopatch testing in Bogota (Colombia): 2011-2013

BACKGROUND

Photopatch tests are used to diagnose photoallergic contact dermatitis and identify the causal agents. The frequencies of positive results and associated allergens vary by country; therefore, it is necessary to know the information specific to each country.

OBJECTIVE

To establish the frequency of positive photopatch test results, and their relevance, in patients with suspected photoallergic contact dermatitis in a national dermatology centre located in Bogota, Colombia.

MATERIALS AND METHODS

One hundred patients investigated for possible photoallergic contact dermatitis were enrolled in the study. They were photopatch tested with a selected group of allergens, and occluded for 48 hours; the duplicate right-hand panel was irradiated with 5 J/cm(2) ultraviolet (UV)A. The readings were performed on day (D)2, D4, and D6, in accordance with the guidelines of the ICDRG, and the relevance was evaluated with the COADEX system.

RESULTS

There were a total of 20 photopatch reactions in 15 patients, 95% of which were caused by UV filters, most frequently benzophenone-3 (55%). Eight of the positive reactions (53.3%) appeared on D6.

CONCLUSIONS

UV filters continue to be the most common causes of photoallergic contact dermatitis in our patients. Readings up to D6 (96 h after irradiation) are important to identify delayed positive reactions.

Safety assessment of propylene glycol, tripropylene glycol, and PPGs as used in cosmetics

Propylene glycol is an aliphatic alcohol that functions as a skin conditioning agent, viscosity decreasing agent, solvent, and fragrance ingredient in cosmetics. Tripropylene glycol functions as a humectant, antioxidant, and emulsion stabilizer. Polypropylene glycols (PPGs), including PPG-3, PPG-7, PPG-9, PPG-12, PPG-13, PPG-15, PPG-16, PPG-17, PPG-20, PPG-26, PPG-30, PPG-33, PPG-34, PPG-51, PPG-52, and PPG-69, function primarily as skin conditioning agents, with some solvent use. The majority of the safety and toxicity information presented is for propylene glycol (PG). Propylene glycol is generally nontoxic and is noncarcinogenic. Clinical studies demonstrated an absence of dermal sensitization at use concentrations, although concerns about irritation remained. The CIR Expert Panel determined that the available information support the safety of tripropylene glycol as well as all the PPGs. The Expert Panel concluded that PG, tripropylene glycol, and PPGs ≥3 are safe as used in cosmetic formulations when formulated to be nonirritating.

Sunscreen use: controversies, challenges and regulatory aspects

Mismatches between skin pigmentation and modern lifestyle continue to challenge our naked skin. One of our responses to these challenges is the development and use of sunscreens. The management of sunscreens has to balance their protective effect against erythema, photocarcinogenesis and photoageing owing to the potential toxicity of the ultraviolet (UV) filters for humans and the environment. The protection against UV radiation offered by sunscreens was recently standardized in the European Union (EU) based on international harmonization of measurement techniques. Four different categories of sun protection have been implemented along with recommendations on how to use sunscreen products in order to obtain the labelled protection. The UV filters in sunscreens have long been authorized for use by the EU authority on the basis of data from studies on acute toxicity, subchronic and chronic toxicity, reproductive toxicity, genotoxicity, photogenotoxicity, carcinogenicity, irritation, sensitization, phototoxicity and photosensitization as well as on environmental aspects. New challenges with respect to the safety of UV filters have arisen from the banning of animal experiments for the development of cosmetics. Future debates on sunscreens are likely to focus on nanoparticles and environmental issues, along with motivation campaigns to persuade consumers to protect their skin. However, more efficient sunscreen use will also continue to raise questions on the benefit in preventing vitamin D synthesis in the skin induced by sunlight.

A reversed-phase ion-interaction chromatographic method for in-vitro estimation of the percutaneous absorption of water-soluble UV filters

An analytical method based on ion-interaction chromatography with UV detection for simultaneous in-vitro estimation of the percutaneous absorption of the most used water-soluble UV filters in sunscreen cosmetics is proposed. These UV filters were phenylbenzimidazole sulfonic acid, disodium phenyl dibenzimidazole tetrasulfonate, benzophenone-4, and terephthalylidene dicamphor sulfonic acid. The methodology is based on applying the sunscreen containing the target UV filters to human epidermis in a diffusion cell. Analytes are determined in the receptor solution. To ensure skin integrity, screening of the cells was carried out by analytical determination of a marker. Analytical variables such as percentage ethanol, concentration of ion-pairing agent, pH of the mobile phase, and temperature were studied in order to achieve high resolution of the chromatographic peaks in the lowest possible time of analysis. The conditions selected consisted of a mobile phase composed of 35:65 (v/v) ethanol-ammonium acetate buffer solution (pH 4, containing 50 mmol L(-1) tetra-n-butylammonium bromide). The chromatographic determination was carried out with the analytical column at 50 degrees C. UV detection was carried out at the maximum absorption wavelength for each analyte. The limit of detection (3s(y/x)/b) ranged from 16 to 65 ng mL(-1), depending on the analyte.

Sensitive determination of free benzophenone-3 in human urine samples based on an ionic liquid as extractant phase in single-drop microextraction prior to liquid chromatography analysis

Benzophenone-3 (BZ3), one of the compounds most commonly used as UV filter in cosmetic products, can be absorbed through the skin into the human body, since it can be found at trace levels in urine from users of cosmetic products that contain BZ3. Moreover, different undesirable effects have been attributed to this compound. Thus, sensitive analytical methods to monitor urinary excretion of this compound should be developed. This paper presents a selective and sensitive methodology for BZ3 determination at ultratrace levels in human urine samples. The methodology is based on a novel microextraction technique, known as single-drop microextraction (SDME). An ionic liquid (IL) has been used as extractant phase instead of an organic solvent. After the microextraction process, the extractant phase was injected into a liquid chromatography system. The variables of interest in the SDME process were optimized using a multivariate optimization approach. A Plackett-Burman design for screening and a circumscribed central composite design for optimizing the significant variables were applied. Ionic strength, extraction time, stirring speed, pH, ionic liquid type, drop volume and sample volume were the variables studied. The optimum experimental conditions found were: sodium chloride concentration, 13% (w/v); extraction time, 25 min; stirring speed, 900 rpm; pH, 2; ionic liquid type, 1-hexyl-3-methylimidazolium hexafluorophosphate ([C(6)MIM][PF(6)]); drop volume, 5 microL; and sample volume, 10 mL. The proposed method requires a standard addition calibration approach, and it has been successfully employed to determine free BZ3 in urine samples coming from human volunteers who applied a sunscreen cosmetic containing this UV filter. The limit of detection was in the order of 1.3 ng mL(-1) and repeatability of the method, expressed as relative standard deviation, was 6% (n=8).