1
|
Wikström V, Sinikumpu SP, Jokelainen J, Huilaja L. Incidence of allergic contact dermatitis in Finland 1998-2021: A nationwide registry-based study. Contact Dermatitis 2024. [PMID: 39253805 DOI: 10.1111/cod.14688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 08/16/2024] [Accepted: 08/27/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) may be chronic and can cause distress, disability, and absence from work. Nationwide epidemiological studies of ACD are sparse. OBJECTIVES To use national registry data to study the incidence and aetiology of ACD in the working age population of Finland. METHODS Patient records from the years 1998-2021 were obtained from the Finnish Care Register for Health Care. Study subjects aged 18-65 years were selected on the basis of a diagnosis of ACD. RESULTS Total number of study subjects was 26 701. The incidence of ACD increased until 2016 after which it started to decrease. The increase was more marked in females and ACD was particularly common in women reporting reactions to cosmetics and other chemical products and in people of both sexes reacting to adhesives. The incidence 'ACD of unspecific cause' has decreased since 2016. The most commonly reported allergens were metals, followed by cosmetics. One fourth of subjects had ≥2 ACD diagnoses. CONCLUSIONS The incidence of ACD in working age subjects rose from 1998 to 2016, especially in females. However, the incidence has been decreasing since 2016. Our findings highlight the ongoing and even increasing burden of ACD among the working age population.
Collapse
Affiliation(s)
- Ville Wikström
- Medical Research Center, Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
| | - Suvi-Päivikki Sinikumpu
- Medical Research Center, Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Dermatology, University Hospital of Oulu, Oulu, Finland
| | - Jari Jokelainen
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Laura Huilaja
- Medical Research Center, Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Dermatology, University Hospital of Oulu, Oulu, Finland
| |
Collapse
|
2
|
Roellke E, Fonacier L, Banta E. Methylisothiazolinone-containing paint contributing to mucocutaneous and cutaneous symptoms: A case of aerosolized allergic contact dermatitis. Ann Allergy Asthma Immunol 2024; 133:217-218. [PMID: 38705271 DOI: 10.1016/j.anai.2024.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/22/2024] [Accepted: 04/29/2024] [Indexed: 05/07/2024]
Affiliation(s)
- Emma Roellke
- Department of Internal Medicine, New York University Grossman Long Island School of Medicine, Mineola, New York
| | - Luz Fonacier
- Division of Rheumatology, Allergy, and Immunology, New York University Grossman Long Island School of Medicine, Garden City, New York
| | - Erin Banta
- Division of Rheumatology, Allergy, and Immunology, New York University Grossman Long Island School of Medicine, Garden City, New York.
| |
Collapse
|
3
|
Schwensen JFB, Uter W, Aerts O, Agner T, Brans R, Bruze M, Foti C, Am GA, Gonçalo M, Svedman C, Stingeni L, Wilkinson M, Johansen JD. Current frequency of contact allergy to isothiazolinones (methyl-, benz- and octylisothiazolinone) across Europe. Contact Dermatitis 2024. [PMID: 39021255 DOI: 10.1111/cod.14641] [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: 03/01/2024] [Revised: 06/24/2024] [Accepted: 07/01/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND The use of methylisothiazolinone (MI) as a preservative in cosmetic products caused an alarming increase in MI contact allergy across Europe in the 2010s. This was followed by regulations of use with a total ban on leave-on (implemented in 2017) and reduced use concentrations in rinse-off cosmetics (2018). OBJECTIVE To follow-up on the prevalence of contact allergy to MI and the related benzisothiazolinone (BIT) and octylisothiazolinone (OIT) in consecutively patch-tested patients in Europe. METHODS A cross-sectional audit following the design of two previous audits on MI contact allergy from 1 May 2022 to 31 October 2022 included all patients patch tested with the European baseline series, including or supplemented with MI, BIT and OIT across 10 departments in eight European countries. RESULTS A total of 2554 patients were consecutively patch tested with the three isothiazolinones during the study period. The prevalence of MI and BIT contact allergy was 2.9% (95% confidence interval [CI]: 2.3%-3.7%; range 1.1%-5.8%) and 3.1% (95% CI: 2.4%-3.9%; range 0.0%-6.6%), respectively; that of OIT was 0.7% (95% CI: 0.4%-1.1%; range 0%-3.2%). Rinse-off cosmetic (73.3%) and leave-on cosmetic products (13.3%) were still associated with eliciting allergic contact dermatitis to MI. CONCLUSION We confirmed a positive impact of regulatory measures on the prevalence of MI contact allergy in Europe, which halved compared to 2015. However, our data suggest that consumers may still be exposed to older cosmetic products containing MI. BIT has superseded MI in causing contact allergy, despite not being allowed for use in cosmetic products.
Collapse
Affiliation(s)
- Jakob F B Schwensen
- Department of Dermato-Allergology, National Allergy Research Centre, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and Research Group Immunology, University of Antwerp, Antwerp, Belgium
| | - Tove Agner
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark
| | - Richard Brans
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Caterina Foti
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Giménez-Arnau Am
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Margarida Gonçalo
- Department of Dermatology, University Hospital, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Mark Wilkinson
- Department of Dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Jeanne Duus Johansen
- Department of Dermato-Allergology, National Allergy Research Centre, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| |
Collapse
|
4
|
Tous-Romero F, Borrego-Hernando L, García-Doval I, Mercader-García P, Silvester-Salvador JF, Sánchez-Gilo A, Sanz-Sánchez T, Giménez-Arnau AM, Zaragoza-Ninet V, Miquel-Miquel J, González Pérez R, Córdoba-Guijarro S, Carrascosa-Carrillo JM, Gática-Ortega ME, Ruíz-González I, Serra-Baldrich E, Pastor-Nieto A, Rodríguez-Serna M, Sánchez-Pérez J, Melé I Ninot G, Sánchez-Pedreño Guillén P, Ortiz-de Frutos J. Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:331-340. [PMID: 38061453 DOI: 10.1016/j.ad.2023.10.039] [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: 06/22/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. OBJECTIVES To describe the various temporary trends in allergen positivity in the GEIDAC standard series from 2018 through December 31, 2022. METHODS This was a multicenter, observational trial of consecutive patients analyzed via patch tests as part of the study of possible allergic contact dermatitises collected prospectively within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. The data was analyzed using 2 statistical tests: one homogeneity test (to describe the changes seen over time) and one trend test (to see whether the changes described followed a linear trend). RESULTS A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. A statistically significant decrease was found in the percentage of methylisothiazolinone positive tests across the study years with an orderly trend. CONCLUSIONS Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained. Only a significant downward trend was seen for methylisothiazolinone.
Collapse
Affiliation(s)
- F Tous-Romero
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - L Borrego-Hernando
- Servicio de Dermatología, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, Madrid, España
| | - P Mercader-García
- Servicio de Dermatología, Hospital General Universitario José M. Morales Meseguer, Murcia, España
| | | | - A Sánchez-Gilo
- Servicio de Dermatología, Hospital Rey Juan Carlos, Madrid, España
| | - T Sanz-Sánchez
- Servicio de Dermatología, Hospital Universitario Infanta Sofía, Madrid, España
| | | | - V Zaragoza-Ninet
- Servicio de Dermatología, Hospital Universitario de Valencia, Valencia, España
| | - J Miquel-Miquel
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Valencia, España
| | - R González Pérez
- Servicio de Dermatología, Hospital Universitario Araba, Vitoria, Álava, España
| | - S Córdoba-Guijarro
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - J M Carrascosa-Carrillo
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - M E Gática-Ortega
- Servicio de Dermatología, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - I Ruíz-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - E Serra-Baldrich
- Servicio de Dermatología, Hospital de la Santa Creu i San Pau, Barcelona, España
| | - A Pastor-Nieto
- Servicio de Dermatología, Hospital Fundación Jiménez Díaz, Madrid, España
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España
| | - G Melé I Ninot
- Servicio de Dermatología, Hospital Sagrat Cor, Barcelona, España
| | | | - J Ortiz-de Frutos
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| |
Collapse
|
5
|
Tous-Romero F, Borrego-Hernando L, García-Doval I, Mercader-García P, Silvester-Salvador JF, Sánchez-Gilo A, Sanz-Sánchez T, Giménez-Arnau AM, Zaragoza-Ninet V, Miquel-Miquel J, González Pérez R, Córdoba-Guijarro S, Carrascosa-Carrillo JM, Gática-Ortega ME, Ruíz-González I, Serra-Baldrich E, Pastor-Nieto A, Rodríguez-Serna M, Sánchez-Pérez J, Melé I Ninot G, Sánchez-Pedreño Guillén P, Ortiz-de Frutos J. [Translated article] Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T331-T340. [PMID: 38331170 DOI: 10.1016/j.ad.2024.02.006] [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: 06/22/2023] [Accepted: 10/31/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. OBJECTIVES To describe the various temporary trends in allergen positivity in the GEIDAC standard series from 2018 through December 31, 2022. METHODS This was a multicenter, observational trial of consecutive patients analyzed via patch tests as part of the study of possible allergic contact dermatitises collected prospectively within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. The data was analyzed using 2 statistical tests: one homogeneity test (to describe the changes seen over time) and one trend test (to see whether the changes described followed a linear trend). RESULTS A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. A statistically significant decrease was found in the percentage of methylisothiazolinone positive tests across the study years with an orderly trend. CONCLUSIONS Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained. Only a significant downward trend was seen for methylisothiazolinone.
Collapse
Affiliation(s)
- F Tous-Romero
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - L Borrego-Hernando
- Servicio de Dermatología, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, Madrid, Spain
| | - P Mercader-García
- Servicio de Dermatología, Hospital General Universitario José M. Morales Meseguer, Murcia, Spain
| | | | - A Sánchez-Gilo
- Servicio de Dermatología, Hospital Rey Juan Carlos, Madrid, Spain
| | - T Sanz-Sánchez
- Servicio de Dermatología, Hospital Universitario Infanta Sofía, Madrid, Spain
| | | | - V Zaragoza-Ninet
- Servicio de Dermatología, Hospital Universitario de Valencia, Valencia, Spain
| | - J Miquel-Miquel
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Valencia, Spain
| | - R González Pérez
- Servicio de Dermatología, Hospital Universitario Araba, Vitoria, Álava, Spain
| | - S Córdoba-Guijarro
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - J M Carrascosa-Carrillo
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - M E Gática-Ortega
- Servicio de Dermatología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - I Ruíz-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, Spain
| | - E Serra-Baldrich
- Servicio de Dermatología, Hospital de la Santa Creu i San Pau, Barcelona, Spain
| | - A Pastor-Nieto
- Servicio de Dermatología, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, Spain
| | - G Melé I Ninot
- Servicio de Dermatología, Hospital Sagrat Cor, Barcelona, Spain
| | | | - J Ortiz-de Frutos
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
| |
Collapse
|
6
|
Sürgün E, Boyvat A. Increased rates of contact allergy to selected preservatives in patients with allergic contact dermatitis in Turkey. Contact Dermatitis 2024; 90:110-115. [PMID: 37840032 DOI: 10.1111/cod.14435] [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: 04/12/2023] [Revised: 08/28/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Preservatives are a frequent cause of allergic contact dermatitis (ACD) and have caused numerous epidemics. OBJECTIVES The objective of this study is to determine the prevalence of preservative sensitivity, assess the change in the frequency of sensitivity, identify new preservatives with increased sensitivity rates, and evaluate the situation in Turkey by comparing our findings with current literature. METHODS A total of 201 patients diagnosed with ACD between 2018 and 2020, were patch tested with the European baseline series and additional seven preservative haptens. The change in the prevalence of sensitivity to each preservative hapten was investigated by comparing the data from the study conducted in our department between 2000 and 2004. RESULTS Results showed that 17.4% (n = 35) of the patients were positive to preservatives. Comparison with previous data from 2000 to 2004 revealed an increase in the frequency of sensitization. The most prevalent allergen was methyldibromo glutaronitrile (9.5%), followed by methylchloroisothiazolinone/methylisothiazolinone (6.5%), and methylisothiazolinone (5%). CONCLUSION The increase in preservative sensitivity in Turkey is the most remarkable finding. Although MDBGN was prohibited in cosmetic products, MCI/MI and MI are still widely used. Our findings suggest that awareness of preservative sensitivity should be increased and additional precautions should be taken, also in Turkey, regarding the use of preservatives.
Collapse
Affiliation(s)
- Ece Sürgün
- Faculty of Medicine, Department of Dermatology, Ankara University, Ankara, Turkey
| | - Ayşe Boyvat
- Faculty of Medicine, Department of Dermatology, Ankara University, Ankara, Turkey
| |
Collapse
|
7
|
Johnson H, Yu J. Patch Testing Results From the Massachusetts General Hospital Occupational and Contact Dermatitis Clinic, 2017-2022. Dermatitis 2023; 34:525-531. [PMID: 37222747 DOI: 10.1089/derm.2023.0085] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Background: Patch testing is gold standard for identifying the source of allergic contact dermatitis (ACD). Objective: To report patch testing results from the Massachusetts General Hospital (MGH) Occupational and Contact Dermatitis Clinic from 2017 to 2022. Methods: Retrospective analysis of patients referred to MGH for patch testing, 2017-2022. Results: In total, 1438 patients were included. At least 1 positive patch test (PPT) reaction was observed in 1168 (81.2%) patients and at least 1 relevant PPT reaction was observed in 1087 (75.6%) patients. The most common allergen with a PPT was nickel (21.5%), followed by hydroperoxides of linalool (20.4%) and balsam of Peru (11.5%). Sensitization rates statistically increased over time for propylene glycol and decreased for 12 other allergens (all P values <0.0004). Limitations: Retrospective design, single institution tertiary referral population, and variations in allergens and suppliers across the study period. Conclusion: The field of ACD is constantly evolving. Regular analysis of patch test data is crucial to identify emerging and diminishing contact allergen trends.
Collapse
Affiliation(s)
- Hadley Johnson
- From the University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
8
|
Bauer A, Brans R, Brehler R, Büttner M, Dickel H, Elsner P, Fartasch M, Herzog C, John SM, Köllner A, Maul JT, Merk H, Molin S, Nast A, Nikolakis GD, Schliemann S, Skudlik C, Weisshaar E, Werfel T, Zidane M, Worm M. S2k-Leitlinie Diagnostik, Prävention und Therapie des Handekzems: S2k guideline diagnosis, prevention and therapy of hand eczema. J Dtsch Dermatol Ges 2023; 21:1054-1076. [PMID: 37700403 DOI: 10.1111/ddg.15179_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/14/2023] [Indexed: 09/14/2023]
Abstract
ZusammenfassungDie S2k‐Leitlinie „Diagnostik, Prävention und Therapie des Handekzems (HE)“ gibt auf der Grundlage eines evidenz‐ und konsensbasierten Ansatzes konkrete Handlungsanweisungen und Empfehlungen für die Diagnostik, Prävention und Therapie des HE. Die Leitlinie wurde auf der Grundlage der deutschen Leitlinie „Management von Handekzemen“ aus dem Jahr 2009 und der aktuellen Leitlinie der European Society of Contact Dermatitis (ESCD) „Guidelines for diagnosis, prevention and treatment of hand eczema“ aus dem Jahr 2022 erstellt. Allgemeines Ziel der Leitlinie ist es, Dermatologen und Allergologen in der Praxis und Klinik eine akzeptierte, evidenzbasierte Entscheidungshilfe für die Auswahl sowie Durchführung einer geeigneten und suffizienten Therapie für Patienten mit Handekzemen zur Verfügung zu stellen. Die Leitlinie basiert auf zwei Cochrane‐Reviews zu therapeutischen und präventiven Interventionen beim HE. Die übrigen Kapitel wurden überwiegend basierend auf nicht systematischen Literaturrecherchen durch die Expertengruppe erarbeitet und konsentiert. Die Expertenkommission bestand aus Mitgliedern von allergologischen und berufsdermatologischen Fachgesellschaften und Arbeitsgruppen, einer Patientenvertretung und Methodikern. Im Rahmen einer Konsensuskonferenz am 15.09.2022 wurden die Vorschläge für die Empfehlungen und Kernaussagen unter Verwendung eines nominalen Gruppenprozesses konsentiert. Der strukturierte Konsensfindungsprozess wurde professionell moderiert. Die vorliegende Leitlinie hat eine Gültigkeit bis zum 22.02.2028.
Collapse
Affiliation(s)
- Andrea Bauer
- Klinik für Dermatologie und Poliklinik, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Deutschland
| | - Richard Brans
- Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Osnabrück, Deutschland und Institut für Interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück, Osnabrück, Deutschland
| | - Randolf Brehler
- Allergologie, Berufsdermatologie und Umweltmedizin an der Hautklinik, Universitätsklinikum Münster, Münster, Deutschland
| | | | - Heinrich Dickel
- Bochum Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital, Universitätsklinikum, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Peter Elsner
- Privatpraxis für Dermatologie und Allergologie, SRH Krankenhaus Gera, Gera, Deutschland
| | - Manigé Fartasch
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung (IPA), Institut der Ruhr-Universität Bochum, Bochum, Deutschland
| | - Claudia Herzog
- Universitätskrebszentrum, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Deutschland
| | - Swen-Malte John
- Fachbereich Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Osnabrück, Deutschland und Institut für interdisziplinäre dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück, Osnabrück, Deutschland
| | - Arno Köllner
- Dermatologische Gemeinschaftspraxis, Duisburg, Deutschland
| | | | - Hans Merk
- Professor für Dermatologie und Allergologie, ehemaliger Direktor der Hautklinik, RWTH Aachen, Deutschland
| | - Sonja Molin
- Abteilung für Dermatologie, Fachbereich Medizin, Queen's University, Kingston, Kanada
| | - Alexander Nast
- Klinik für Dermatologie, Venerologie und Allergologie, Abteilung für Evidenzbasierte Medizin (dEBM), Charité - Universitätsmedizin Berlin, gemeinsames Mitglied der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Georgios D Nikolakis
- Klinik für Dermatologie, Venerologie, Allergologie und Immunologie, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane und Fakultät für Gesundheitswissenschaften Brandenburg, Dessau, Deutschland
| | | | - Christoph Skudlik
- Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Osnabrück, Deutschland und Institut für Interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück, Osnabrück, Deutschland
| | - Elke Weisshaar
- Berufsdermatologie, Abteilung Dermatologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Thomas Werfel
- Klinik für Dermatologie und Allergologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Miriam Zidane
- Klinik für Dermatologie, Venerologie und Allergologie, Abteilung für Evidenzbasierte Medizin (dEBM), Charité - Universitätsmedizin Berlin, gemeinsames Mitglied der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Berlin, Deutschland
| |
Collapse
|
9
|
Bauer A, Brans R, Brehler R, Büttner M, Dickel H, Elsner P, Fartasch M, Herzog C, John SM, Köllner A, Maul JT, Merk H, Molin S, Nast A, Nikolakis GD, Schliemann S, Skudlik C, Weisshaar E, Werfel T, Zidane M, Worm M. S2k guideline diagnosis, prevention, and therapy of hand eczema. J Dtsch Dermatol Ges 2023; 21:1054-1074. [PMID: 37700424 DOI: 10.1111/ddg.15179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/14/2023] [Indexed: 09/14/2023]
Abstract
The consensus-based guideline "Diagnosis, prevention, and treatment of hand eczema (HE)" provides concrete instructions and recommendations for diagnosis, prevention, and therapy of HE based on an evidence- and consensus-based approach. The guideline was created based on the German guideline "Management von Handekzemen" from 2009 and the current guideline of the European Society of Contact Dermatitis (ESCD) "Guidelines for diagnosis, prevention, and treatment of hand eczema" from 2022. The general goal of the guideline is to provide dermatologists and allergologists in practice and clinics with an accepted, evidence-based decision-making tool for selecting and conducting suitable and sufficient therapy for patients with hand eczema. The guideline is based on two Cochrane reviews of therapeutic and preventive interventions for HE. The remaining chapters were mainly developed and consented based on non-systematic literature research by the expert group. The expert group consisted of members of allergological and occupational dermatological professional associations and working groups, a patient representative, and methodologists. The proposals for recommendations and key statements were consented by using a nominal group process during a consensus conference on September 15, 2022. The structured consensus-building process was professionally moderated. This guideline is valid until February 22, 2028.
Collapse
Affiliation(s)
- Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany and Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Randolf Brehler
- Department of Allergy, Occupational Dermatology and Environmental Medicine, University Hospital Münster, Münster, Germany
| | | | - Heinrich Dickel
- Bochum Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center, Ruhr University Bochum, Bochum, Germany
| | - Peter Elsner
- Privat practice for dermatology and allergology, SRH Hospital Gera, Germany
| | - Manigé Fartasch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr University Bochum, Bochum, Germany
| | - Claudia Herzog
- University Cancer Center, University Hospital Carl Gustav Carus, Technical University Dresden, Germany
| | - Swen-Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany and Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | | | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Hans Merk
- Professor of Dermatology and Allergology, Former Chairman of the Department of Dermatology, RWTH University, Aachen, Germany
| | - Sonja Molin
- Division of Dermatology, Department of Medicine, Queen's University, Kingston, Canada
| | - Alexander Nast
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Georgios D Nikolakis
- Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | | | - Christoph Skudlik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany and Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Miriam Zidane
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Margitta Worm
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| |
Collapse
|
10
|
Kazan D, Odyakmaz-Demirsoy E, Kiran R, Şikar-Aktürk A, Sayman N, Bayramgürler D. Methyl(chloro)isothiazolinone contact allergy: a monocentric experience from Turkey. Cutan Ocul Toxicol 2023; 42:97-102. [PMID: 37235630 DOI: 10.1080/15569527.2023.2217244] [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: 04/12/2023] [Revised: 05/08/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Due to their ubiquitous use, isothiazolinones caused allergic contact dermatitis epidemics and their use was restricted by legal regulations. OBJECTIVES We aimed to evaluate demographic data, clinical findings, and patch test features of patients with methylisothiazolinone (MI) and/or methylchloroisothiazolinone(MCI) sensitivity in our study. METHODS This study is a bidirectional and cross-sectional study, between July 2020 and September 2021. A total of 616 patients, including prospective and retrospective populations, demographic data, clinical findings, and patch test results were reviewed. Patients' demographics, patch test results, allergen sources, presence of occupational contact, and the characteristics of dermatitis attacks were recorded. RESULTS A total of 50 patients with MI and MCI/MI sensitivity, 36 male (72%) and 14 female (28%), were included in our study. The overall prevalence of MI and MCI/MI between 2014 and 2021 was 8.4% (52/616) with two peak levels in 2015(21%) and 2021 (20%). A statistically significant relationship was found between shampoo use and facial involvement (p = 0.031), shower gel use and arm involvement (p = 0.027), wet wipe use and hand involvement (p = 0.049), detergent use and the pulps (p = 0.026) and the lateral aspects of fingers involvement (p = 0.048), water-based dye use and periungual involvement (p = 0.047). CONCLUSION Although legal regulations related to MI and MCI/MI cause a decrease in the frequency of their sensitivities were still common causes of allergic contact dermatitis.
Collapse
Affiliation(s)
- Didem Kazan
- Department of Dermatology, Kocaeli University, Kocaeli, Turkey
| | | | - Rebiay Kiran
- Department of Dermatology, Kocaeli University, Kocaeli, Turkey
| | | | - Nilgün Sayman
- Department of Dermatology, Kocaeli University, Kocaeli, Turkey
| | | |
Collapse
|
11
|
Hernández Fernández CP, Borrego L, Mercader García P, Giménez Arnau AM, Sánchez Pérez J, Silvestre Salvador JF, González Pérez R, Sanz Sánchez T, Sánchez Gilo A, Melé Ninot G, Zaragoza Ninet V, Miquel Miquel FJ, Carrascosa Carrillo JM, Córdoba Guijarro S, Gatica Ortega ME, Ruiz González I, Serra Baldrich E, Tous Romero F, Rodríguez Serna M, Pastor Nieto MA, Pérez Feal P, Hervella Garcés M, de Vega Martínez M, García Doval I. Sensitization to isothiazolinones in the Spanish Contact Dermatitis Registry (REIDAC): 2019-2021 epidemiological situation. Contact Dermatitis 2023; 88:212-219. [PMID: 36403138 DOI: 10.1111/cod.14251] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 11/07/2022] [Accepted: 11/16/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Current frequency and risk factors for sensitization to methylisothiazolinone (MI), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), benzisothiazolinone (BIT) and octylisothiazolinone (OIT) in Spain are not well known. OBJECTIVES To study the frequency of sensitization, risk factors and simultaneous sensitization between the four isothiazolinones. MATERIALS AND METHODS We analysed all 2019-2021 consecutive patients patch-tested with MI (0.2% aq.), MCI/MI (0.02% aq.), BIT (0.1% pet.) and OIT (0.1% pet) within the Spanish Contact Dermatitis Registry (REIDAC). RESULTS A total of 2511 patients were analysed. Frequencies of sensitization were: any isothiazolinone 15.7%, MI 6.8%, MCI/MI 4.8%, BIT 3.5% and OIT 0.5%. MI and MCI/MI sensitization was associated with being occupationally active, hand dermatitis, detergents and age over 40. BIT sensitization was associated with leg dermatitis and age over 40. About one in nine MI-positive patients were positive to BIT, whereas one in five BIT-positive patients were positive to MI. CONCLUSIONS Sensitization to MI, MCI/MI and BIT is still common in Spain, while sensitization to OIT is rare. Currently, sensitization to MI and MCI/MI seems to be occupationally related. Although its origin is unknown, sensitization to BIT is more frequent in patients aged over 40 years. Simultaneous sensitization between MI and BIT is uncommon.
Collapse
Affiliation(s)
- Carlos Pelayo Hernández Fernández
- Department of Dermatology, Hospital Universitario de Gran Canaria Doctor Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Leopoldo Borrego
- Department of Dermatology, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Pedro Mercader García
- Department of Dermatology, Hospital General Universitario José María Morales Meseguer, Murcia, Spain
| | - Ana María Giménez Arnau
- Department of Dermatology, Hospital del Mar, Instituto Municipal de Investigación Médica, Barcelona, Spain
| | | | | | - Ricardo González Pérez
- Department of Dermatology, Hospital Universitario Araba, Universidad del País Vasco, Vitoria, Spain
| | | | - Araceli Sánchez Gilo
- Department of Dermatology, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
| | - Gemma Melé Ninot
- Department of Dermatology, Hospital Universitario Sagrat Cor, Barcelona, Spain
| | | | | | | | | | | | | | | | - Fátima Tous Romero
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - Patricia Pérez Feal
- Department of Dermatology, Complejo Hospitalario Universitario de Santiago, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | |
Collapse
|
12
|
DeKoven JG, Warshaw EM, Reeder MJ, Atwater AR, Silverberg JI, Belsito DV, Sasseville D, Zug KA, Taylor JS, Pratt MD, Maibach HI, Fowler JF, Adler BL, Houle MC, Mowad CM, Botto N, Yu J, Dunnick CA. North American Contact Dermatitis Group Patch Test Results: 2019-2020. Dermatitis 2023; 34:90-104. [PMID: 36917520 DOI: 10.1089/derm.2022.29017.jdk] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: Patch testing is an important diagnostic tool for assessment of allergic contact dermatitis (ACD). Objective: This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2019, to December 31, 2020. Methods: At 13 centers in North America, patients were tested in a standardized manner with a screening series of 80 allergens, and, as indicated, supplemental allergens. Results: Overall, 4121 patients were tested; 2871 (69.7%) had at least 1 positive/allergic patch test reaction and 2095 patients (51.2%) had a primary diagnosis of ACD. The most commonly positive allergens were nickel (18.2%), methylisothiazolinone (MI) (13.8%), fragrance mix (FM) I (12.8%), hydroperoxides of linalool (HPL) (11.1%), and benzisothiazolinone (BIT) (10.4%). Compared with that of 2017-2018, prevalence of top 20 allergens statistically increased for FM I, HPL, BIT, propolis, and hydroperoxides of limonene (3.5%). For the first time, MI positivity did not increase between reporting periods. Approximately one-fifth of patients (20.3%) had ≥1 clinically relevant reaction(s) to allergens/substances not on the NACDG series. Conclusions: The epidemic of MI contact allergy in North America may have reached a plateau. Patch testing using a robust screening series, and supplemental allergens as indicated, is necessary for comprehensive evaluation of ACD.
Collapse
Affiliation(s)
- Joel G DeKoven
- From the *Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
- Division of Occupational Health, Unity Health Toronto, St. Michael's Hospital, Toronto, Canada
| | - Erin M Warshaw
- Department of Dermatology, Park Nicollet/Health Partners Health Services, Minneapolis, Minnesota, USA
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical College, New York, New York, USA
| | - Denis Sasseville
- Division of Dermatology, McGill University Health Centre, Montréal, Canada
| | - Kathryn A Zug
- Department of Dermatology, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, Nebraska, USA
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Canada
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Joseph F Fowler
- Division of Dermatology, University of Louisville, Louisville, Kentucky, USA
| | - Brandon L Adler
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Marie-Claude Houle
- Division of Dermatology, Centre Hospitalier Universitaire de Québec, Laval University, Québec, Canada
| | - Christen M Mowad
- Division of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Nina Botto
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado, Aurora, Colorado, USA
| |
Collapse
|
13
|
Barwari L, Rustemeyer T, Franken SM, Ipenburg NA. Patch test results in a Dutch paediatric population with suspected contact allergy: A retrospective cohort study. Contact Dermatitis 2023; 88:120-128. [PMID: 36183152 PMCID: PMC10091938 DOI: 10.1111/cod.14231] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) in paediatric patients is on the rise. Continuous identification of emerging allergens is of great importance to ensure accurate patch testing. OBJECTIVES To assess the frequency and relevance of contact sensitivity in children and adolescents and evaluate changes in sensitization rates in the last decade. METHODS All patients with suspected ACD who underwent patch testing at the Amsterdam University Medical Centers between 2015 and 2021 were included. RESULTS Of 439 patients tested with the European Baseline Series (EBS) and additional series, 334 (76%) patients had at least 1 positive reaction and 172 patients (39%) had 1 or more relevant positive reactions. If additional series would have been omitted, 20% of patients would have been underdiagnosed. Compared to patients tested between 1996 and 2013, reactions to metal allergens, isothiazolinones, methyldibromo glutaronitrile, carba mix, amerchol L-101, and benzophenone-4 were more frequently observed. CONCLUSIONS This study confirms the need for patch testing in paediatric patients suspected of having ACD. For accurate patch testing, it is advised to include additional series.
Collapse
Affiliation(s)
- Lizan Barwari
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Sylvie M Franken
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Norbertus A Ipenburg
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| |
Collapse
|
14
|
Wilkinson SM, Gonçalo M, Aerts O, Badulici S, Dickel H, Gallo R, Garcia-Abujeta JL, Giménez-Arnau AM, Hamman C, Hervella M, Isaksson M, Johansen JD, Mahler V, Niklasson B, Pigatto P, Ponyai G, Rustemeyer T, Schuttelaar MLA, Spiewak R, Stingeni L, Thyssen JP, Uter W. The European baseline series and recommended additions: 2023. Contact Dermatitis 2023; 88:87-92. [PMID: 36443008 DOI: 10.1111/cod.14255] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/09/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
The European baseline series was last updated in 2019. This article discusses the reasoning behind a further iteration of the series for 2023.
Collapse
Affiliation(s)
| | - Margarida Gonçalo
- Clinic of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Olivier Aerts
- University Hospital Antwerp (UZA) and University of Antwerp (UA), Antwerp, Belgium
| | - Sonia Badulici
- Alfa Medical Services, Bucharest, Romania.,Dermato-Aesthetic Institute Dr. Irinel Nedelcu, Bucharest, Romania
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Centre, Ruhr University Bochum, Bochum, Germany
| | - Rosella Gallo
- Clinica Dermatologica-DISSAL-Università di Genova Ospedale Policlinico San Martino, Genova, Italy
| | | | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Pompeu Fabra, Barcelona, Spain
| | - Curt Hamman
- Contact Dermatitis Institute, Phoenix, Arizona, USA
| | - Marcos Hervella
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | | | | | - Paolo Pigatto
- IRCCS Galeazzi Orthopaedic Institute, Milan Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Gyorgyi Ponyai
- Department of Dermatology-Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | | | - Marie L A Schuttelaar
- University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | | | - Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Jacob P Thyssen
- Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
15
|
Decision making in next generation risk assessment for skin allergy: Using historical clinical experience to benchmark risk. Regul Toxicol Pharmacol 2022; 134:105219. [PMID: 35835397 DOI: 10.1016/j.yrtph.2022.105219] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 05/24/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022]
Abstract
Our aim is to develop and apply next generation approaches to skin allergy risk assessment that do not require new animal test data and better quantify uncertainties. Quantitative risk assessment for skin sensitisation uses safety assessment factors to extrapolate from the point-of-departure to an acceptable human exposure level. It is currently unclear whether these safety assessment factors are appropriate when using non-animal test data to derive a point-of departure. Our skin allergy risk assessment model Defined Approach uses Bayesian statistics to infer a human-relevant metric of sensitiser potency with explicit quantification of uncertainty, using any combination of human repeat insult patch test, local lymph node assay, direct peptide reactivity assay, KeratinoSens™, h-CLAT or U-SENS™ data. Here we describe the incorporation of benchmark exposures pertaining to use of consumer products with clinical data supporting a high/low risk categorisation for skin sensitisation. Margins-of-exposure (potency estimate to consumer exposure level ratio) are regressed against the benchmark risk classifications, enabling derivation of a risk metric defined as the probability that an exposure is low risk. This approach circumvents the use of safety assessment factors and provides a simple and transparent mechanism whereby clinical experience can directly feed-back into risk assessment decisions.
Collapse
|
16
|
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]
|
17
|
Johansen JD, Bonefeld CM, Schwensen JFB, Thyssen JP, Uter W. Novel insights into contact dermatitis. J Allergy Clin Immunol 2022; 149:1162-1171. [PMID: 35183605 DOI: 10.1016/j.jaci.2022.02.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/04/2022] [Accepted: 02/11/2022] [Indexed: 11/30/2022]
Abstract
Contact dermatitis is a common disease, caused by repeated skin contact to contact allergens or irritants, resulting in allergic contact dermatitis (ACD) and/or irritant contact dermatitis. Attempts have been made to identify biomarkers to distinguish irritant and allergic patch test reactions, which could aid diagnosis. Some promising candidates have recently been identified, but verification and validation in clinical cases still need to be done. New causes of ACD are constantly recognized. In this review, 10 new contact allergens from recent years, were identified, several relating to anti-age products. Frequent allergens causing considerable morbidity in the population such as the preservative methylisothiazolinone (MI) have been regulated in EU. A significant drop in cases has been seen, while high rates are still occurring in other areas such as North America. Other frequent causes are fragrance allergens especially widely used terpenes and acrylates used in medical devises for control of diabetes. These represent unsolved problems. Recent advances in immunology have opened for a better understanding of the complexity of contact dermatitis, especially ACD. The disease may be more heterogenous that previous understood with several subtypes. With the rapidly evolving molecular understanding of the disease, the potential for development of new drugs for personalized treatment of contact dermatitis is considerable.
Collapse
Affiliation(s)
- J D Johansen
- National Allergy Research Centre, Department of Skin and Allergy. Gentofte Hospital University of Copenhagen, 2900 Hellerup, Denmark.
| | - C M Bonefeld
- The LEO Foundation Skin Immunology Research Center, Department of Immunology & Microbiology, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
| | - J F B Schwensen
- National Allergy Research Centre, Department of Skin and Allergy. Gentofte Hospital University of Copenhagen, 2900 Hellerup, Denmark
| | - J P Thyssen
- National Allergy Research Centre, Department of Skin and Allergy. Gentofte Hospital University of Copenhagen, 2900 Hellerup, Denmark
| | - W Uter
- Dept. of Medical Informatics, Biometry and Epidemiology, Univ. Erlangen / Nürnberg; Waldstr. 6 91054 Erlangen, GERMANY
| |
Collapse
|
18
|
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: 24] [Impact Index Per Article: 12.0] [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.
Collapse
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
| | | |
Collapse
|
19
|
Photoaggravated Contact Dermatitis to Methylisothiazolinone and Associated Photosensitivity: A Case Series. Dermatitis 2022; 33:e60-e63. [PMID: 35089901 DOI: 10.1097/der.0000000000000833] [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]
|
20
|
Bilgic A, Bozca B, Subası G, Dicle Ö, Uzun S, Yılmaz E, Alpsoy E, Akman-Karakas A. Standard patch test results and clinical relevance: A cross-sectional study of 10-year retrospective experience. Indian J Dermatol 2022; 67:258-264. [PMID: 36386088 PMCID: PMC9644757 DOI: 10.4103/ijd.ijd_965_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Allergic contact dermatitis (ACD) is a type IV hypersensitivity reaction, and The European Standard Series (ESS) Patch Test (PT) is widely used in determining the possible responsible allergens causing ACD. The dynamic nature of the industrial products, socioeconomic and environmental factors cause the frequency of common allergens to change over the years and among different regions. Aims and Objectives: This study aimed to retrospectively evaluate the results of ESS PT of our centre in the last decade, and determine the current spectrum of allergens and their clinical relevance. Materials and Methods: The data of patients who underwent ESS PT in our clinic between January 2010 and March 2020 were included in the study. The patient files were examined retrospectively. The clinical relevance was evaluated according to the COADEX system. Statistical analysis used: SPSS for Windows version 23.0 software program. Results: The data of 1037 patients [623 (60.1%) female, 414 (39.9%) male] were analysed. The mean age was 38.34 ± 14.55 years. The five most common allergens were nickel sulphate (23.1%), cobalt chloride (12%), potassium dichromate (9.5%), Fragrance mix II (7.3%) and balsam of Peru (5.7%). According to the COADEX coding system, current relevance was detected in 319 (49.3%) of 646 patients who had a positive reaction to any substance in the patch test. Conclusion: Our study showed that with increasing awareness in society, the tendency to avoid some well-known allergenic substances and consumer products causes changes in common allergens. These results prove the value of long-term surveillance of contact allergy.
Collapse
|
21
|
Thyssen JP, Schuttelaar MLA, Alfonso JH, Andersen KE, Angelova-Fischer I, Arents BWM, Bauer A, Brans R, Cannavo A, Christoffers WA, Crépy MN, Elsner P, Fartasch M, Larese Filon F, Giménez-Arnau AM, Gonçalo M, Guzmán-Perera MG, Hamann CR, Hoetzenecker W, Johansen JD, John SM, Kunkeler ACM, Ljubojevic Hadzavdic S, Molin S, Nixon R, Oosterhaven JAF, Rustemeyer T, Serra-Baldrich E, Shah M, Simon D, Skudlik C, Spiewak R, Valiukevičienė S, Voorberg AN, Weisshaar E, Agner T. Guidelines for diagnosis, prevention and treatment of hand eczema. Contact Dermatitis 2021; 86:357-378. [PMID: 34971008 DOI: 10.1111/cod.14035] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/22/2021] [Accepted: 12/27/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Jacob P Thyssen
- Dep. Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jose H Alfonso
- Dep. of Dermatology, Oslo University Hospital, Oslo, Norway.,Dep. of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Klaus E Andersen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Irena Angelova-Fischer
- Department of Dermatology, Comprehensive Allergy Center, Kepler University Hospital, Linz, Austria
| | - Bernd W M Arents
- Dutch Association for People with Atopic Dermatitis, Nijkerk, the Netherlands
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Alicia Cannavo
- Contact Dermatitis and Occupational Dermatoses, Hospital de Clínicas "José de San Martín", Buenos Aires University, Argentina
| | | | - Marie-Noelle Crépy
- Department of Occupational and Environmental Diseases, University Hospital of Centre of Paris, Hotel-Dieu Hospital, AP-HP, Paris, France.,Department of Dermatology, University Hospital of Centre of Paris, Cochin Hospital, AP-HP, Paris, France
| | - Peter Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - Manigé Fartasch
- Institute for Prevention and Occupational Medicine (IPA) of the German Social Accident Insurance, Department of Clinical and Experimental Occupational Dermatology, Ruhr University Bochum, Bochum, Germany
| | | | - Ana M Giménez-Arnau
- Department of Dermatology, Hopsital del Mar, IMIM , Universitat Autònoma de Barcelona
| | - Margarida Gonçalo
- Clinic of Dermatology - University Hospital and Faculty of Medicine, University of Coimbra, Portugal
| | | | - Carsten R Hamann
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Wolfram Hoetzenecker
- Department of Dermatology, Kepler University Hospital and Kepler University Linz, Linz, Austria
| | - Jeanne Duus Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Herlev-Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Swen M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Amalia C M Kunkeler
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Sonja Molin
- Division of Dermatology, Queen's University, Kingston, Canada
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Melbourne, Australia
| | - Jart A F Oosterhaven
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Mili Shah
- Liverpool University Hospitals NHS Trust, Liverpool, UK
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Skudlik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Angelique N Voorberg
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elke Weisshaar
- Division of Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Tove Agner
- Dep. Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
22
|
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.
Collapse
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
| |
Collapse
|
23
|
King N, Latheef F, Wilkinson M. Trends in preservative allergy: Benzisothiazolinone emerges from the pack. Contact Dermatitis 2021; 85:637-642. [PMID: 34482552 DOI: 10.1111/cod.13968] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Preservatives are used widely in cosmetic, household, and industrial products to prevent microbial growth and spoiling of the products. There has been a recent epidemic of contact allergy to methylisothiazolinone (MI). OBJECTIVES To establish emerging trends in preservative contact allergy as MI is replaced. METHODS We performed a retrospective study on consecutively patch-tested patients at our center from January 2011 to December 2019. RESULTS A total of 7846 consecutively patch-tested patients were included who were patch tested between January 2011 and December 2019. The prevalence of allergy to MI fell from a peak of 9.39% in 2013 to 1.98% in 2019. MI/methylchloroisothiazolinone (MCI) followed a similar trend, with a peak prevalence of 7.85% in 2014 and falling to 1.39% in 2018. The prevalence of contact allergy to benzisothiazolinone (BIT) has increased steadily increased in 2014 from 0.26% (confidence interval [CI] 0.03-0.93) to 3.42% (CI 2.43-4.66) in 2019. CONCLUSIONS Our data show a significant increase in the prevalence of contact allergy to BIT over the last 6 years, probably as a consequence of increased use in household products. It is essential to continue to look for emerging trends in contact allergy to enable prompt preventative measures to be taken.
Collapse
Affiliation(s)
- Natalie King
- Department of Dermatology, Chapel Allerton Hospital, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Faheem Latheef
- Department of Dermatology, Chapel Allerton Hospital, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Mark Wilkinson
- Department of Dermatology, Chapel Allerton Hospital, Leeds Teaching Hospitals Trust, Leeds, UK
| |
Collapse
|
24
|
Herman A, Aerts O, Jacobs MC, Scheers C, Gilissen L, Goossens A, Baeck M. Evolution of methylisothiazolinone sensitization: a Belgian multicentric study from 2014 to 2019. Contact Dermatitis 2021; 85:643-649. [PMID: 34387868 DOI: 10.1111/cod.13956] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/29/2021] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND In the 2010s an epidemic of allergic contact dermatitis to methylisothiazolinone occurred in Europe. European authorities banned the use of methylisothiazolinone in leave-on cosmetics in 2017 and limited its use in rinse-off products in 2018. OBJECTIVES To investigate the sensitization rate to methylisothiazolinone in Belgium between January 2014 and December 2019, and to assess co-sensitizations to octylisothiazolinone and benzisothiazolinone in methylisothiazolinone -sensitized patients. METHODS A retrospective study of patch test results with methylisothiazolinone, octylisothiazolinone and benzisothiazolinone observed in patients attending five Belgian hospitals. RESULTS Overall, 560 of 10.029 patients (5.58%) had a positive patch test reaction to methylisothiazolinone, and its sensitization rate decreased from 7.9% in 2014 to 3.1% in 2019. Rinse-off cosmetics, paints and detergents were the most prevalent sensitization sources in recent years. Simultaneous reactions readily occurred to octylisothiazolinone, and, surprisingly, and increasingly, also to benzisothiazolinone. CONCLUSIONS Contact allergy to methylisothiazolinone in Belgium has reached a pre-epidemic level, reflecting the impact of recent regulatory measures. Leave-on cosmetics, in contrast to rinse-off products, have almost disappeared as sensitization sources in Europe. Paints and detergents also remain problematic. The remarkably high number of patients (co-) sensitized to benzisothiazolinone should be a focus of future research. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Anne Herman
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), and Institute of Experimental and Clinical Research, Pneumology, ENT and Dermatology pole, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA), and Infla-Med Centre of Excellence, Research group Immunology, University of Antwerp, Antwerp, Belgium
| | - Marie Claude Jacobs
- Department of Dermatology, Cliniques Saint Jean, 1000 Brussels, and Private Dermatologist, Brussels, Belgium
| | - Christel Scheers
- Department of Dermatology, Cliniques Saint- Pierre, Brussels, Belgium
| | - Liesbeth Gilissen
- Department of Dermatology, University Hospitals Leuven, and Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, 3000 KU Leuven, 3000, Leuven, Belgium
| | - An Goossens
- Department of Dermatology, University Hospitals Leuven, and Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, 3000 KU Leuven, 3000, Leuven, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), and Institute of Experimental and Clinical Research, Pneumology, ENT and Dermatology pole, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| |
Collapse
|
25
|
Virgens AR, Goes HFO, de Carvalho GC, Pietrobon AJ, C C Branco AC, Ramos YAL, Pereira NV, Orfali RL, Aoki V, da Silva LFF, Sotto MN, Dos Reis VMS, Sato MN. Perivascular clusters of Th2 cells and M2 macrophages in allergic contact dermatitis to methylchloroisothiazolinone and methylisothiazolinone. Exp Dermatol 2021; 31:191-201. [PMID: 34358352 DOI: 10.1111/exd.14442] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Methylisothiazolinone (MI) and Methylchloroisothiazolinone (MCI) are among the most common skin sensitizers, yet the immunological events that occur during MCI/MI allergic contact dermatitis (ACD) are still poorly understood. OBJECTIVES To analyse dendrocytes, macrophage subtypes and T cells in skin during the elicitation phase of MCI/MI ACD. METHODS Thirteen patients with positive patch test reactions to MCI/MI (ACD group) and 11 individuals with negative patch test results were selected. Skin biopsies were only performed at 48 hours of patch testing. Immunohistochemistry was conducted to assess T cells, dendrocytes (Factor XIIIa), M1 (p-Stat1, CD68) and M2 (c-Maf, CD163) macrophages. Transcriptional analyses were performed for cytokines and related factors, and further compared to atopic dermatitis samples (n=4). Immunofluorescence assays addressed T cells location, along with IL-4 or IL-13, within the skin. RESULTS MCI/MI elicited dermal dendrocytes and macrophages, pronouncedly the M2 subtype. T cells, majorly CD4+ T cells, accumulated in the perivascular areas. Similarly, abundant IL-4 protein was detected in these areas. There was an upregulation of IL-4 and IL-13 mRNA expression, a mild increase in IFNG mRNA levels and a down-regulation of RORC in the ACD group. Immunofluorescence revealed dermal clusters of T cells co-localized with IL-4. CONCLUSIONS M2 macrophages and Th2 cells participate in the immunopathogenesis of MCI/MI ACD. Dermal dendrocytes and M2 macrophages may assist the formation of CD4+ T cells perivascular clusters. These findings render a mechanistic insight into the MCI/MI reaction. Further analysis at different timepoints of patch testing is required to fully comprehend this ACD kinetics.
Collapse
Affiliation(s)
- Anangélica R Virgens
- Laboratory of Investigation in Medicine, LIM-56, Department of Dermatology, Tropical Medicine Institute of São Paulo, University of São Paulo Medical School, São Paulo, SP, Brazil.,Department of Dermatology, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Heliana F O Goes
- Laboratory of Investigation in Medicine, LIM-56, Department of Dermatology, Tropical Medicine Institute of São Paulo, University of São Paulo Medical School, São Paulo, SP, Brazil.,Department of Dermatology, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Gabriel C de Carvalho
- Laboratory of Investigation in Medicine, LIM-56, Department of Dermatology, Tropical Medicine Institute of São Paulo, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Anna Julia Pietrobon
- Laboratory of Investigation in Medicine, LIM-56, Department of Dermatology, Tropical Medicine Institute of São Paulo, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Anna Cláudia C C Branco
- Laboratory of Investigation in Medicine, LIM-56, Department of Dermatology, Tropical Medicine Institute of São Paulo, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Yasmim A L Ramos
- Department of Pathology, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Naiura V Pereira
- Department of Dermatology, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Raquel L Orfali
- Department of Dermatology, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Valéria Aoki
- Department of Dermatology, University of São Paulo Medical School, São Paulo, SP, Brazil
| | | | - Mirian N Sotto
- Department of Pathology, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Vitor M S Dos Reis
- Department of Dermatology, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Maria N Sato
- Laboratory of Investigation in Medicine, LIM-56, Department of Dermatology, Tropical Medicine Institute of São Paulo, University of São Paulo Medical School, São Paulo, SP, Brazil
| |
Collapse
|
26
|
Burnett CL, Bergfeld WF, Belsito DV, Cohen D, Klaassen CD, Liebler DC, Marks JG, Peterson LA, Shank RC, Slaga TJ, Snyder PW, Heldreth B. Amended Safety Assessment of Methylisothiazolinone as Used in Cosmetics. Int J Toxicol 2021; 40:5S-19S. [PMID: 34259065 DOI: 10.1177/10915818211015795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Expert Panel for Cosmetic Ingredient Safety (Panel) reassessed the safety of Methylisothiazolinone, which functions as a preservative in cosmetics. The Panel reviewed relevant animal and human data provided in this safety assessment, and data from the previously published safety assessments of Methylisothiazolinone, and concluded that Methylisothiazolinone is safe for use in rinse-off cosmetic products at concentrations up to 100 ppm (ie, 0.01%) and safe in leave-on cosmetic products when they are formulated to be nonsensitizing, which may be determined based on a quantitative risk assessment or similar methodology.
Collapse
Affiliation(s)
| | | | | | - David Cohen
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - James G Marks
- Expert Panel for Cosmetic Ingredient Safety Former Member
| | | | | | | | | | | |
Collapse
|
27
|
Scheinman PL, Vocanson M, Thyssen JP, Johansen JD, Nixon RL, Dear K, Botto NC, Morot J, Goldminz AM. Contact dermatitis. Nat Rev Dis Primers 2021; 7:38. [PMID: 34045488 DOI: 10.1038/s41572-021-00271-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 02/04/2023]
Abstract
Contact dermatitis (CD) is among the most common inflammatory dermatological conditions and includes allergic CD, photoallergic CD, irritant CD, photoirritant CD (also called phototoxic CD) and protein CD. Occupational CD can be of any type and is the most prevalent occupational skin disease. Each CD type is characterized by different immunological mechanisms and/or requisite exposures. Clinical manifestations of CD vary widely and multiple subtypes may occur simultaneously. The diagnosis relies on clinical presentation, thorough exposure assessment and evaluation with techniques such as patch testing and skin-prick testing. Management is based on patient education, avoidance strategies of specific substances, and topical treatments; in severe or recalcitrant cases, which can negatively affect the quality of life of patients, systemic medications may be needed.
Collapse
Affiliation(s)
- Pamela L Scheinman
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Marc Vocanson
- CIRI - Centre International de Recherche en Infectiologie, INSERM, U1111; Univ Lyon; Université Claude Bernard Lyon 1; Ecole Normale Supérieure de Lyon; CNRS, UMR, 5308, Lyon, France
| | - Jacob P Thyssen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jeanne Duus Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Rosemary L Nixon
- Skin Health Institute - Occupational Dermatology Research and Education Centre, Carlton, VIC, Australia
| | - Kate Dear
- Skin Health Institute - Occupational Dermatology Research and Education Centre, Carlton, VIC, Australia
| | - Nina C Botto
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Johanna Morot
- CIRI - Centre International de Recherche en Infectiologie, INSERM, U1111; Univ Lyon; Université Claude Bernard Lyon 1; Ecole Normale Supérieure de Lyon; CNRS, UMR, 5308, Lyon, France
| | - Ari M Goldminz
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.
| |
Collapse
|
28
|
Kerre S, Aerts O. Disfiguring angioedema-like airborne dermatitis from methylisothiazolinone in paints: About time to regulate? Contact Dermatitis 2021; 85:578-579. [PMID: 34018222 DOI: 10.1111/cod.13905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 05/12/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Stefan Kerre
- Department of Dermatology, Imelda Hospital, Bonheiden, Belgium
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and Research group Immunology, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
29
|
Lee EB, Lobl M, Ford A, DeLeo V, Adler BL, Wysong A. What Is New in Occupational Allergic Contact Dermatitis in the Year of the COVID Pandemic? Curr Allergy Asthma Rep 2021; 21:26. [PMID: 33779825 PMCID: PMC8006117 DOI: 10.1007/s11882-021-01000-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW This article aims to summarize some recent trends in occupational allergic contact dermatitis (ACD), including dermatitis related to pandemic-level personal protective equipment in healthcare workers, hazards patients may experience when working from home, and occupational perspectives on the recent American Contact Dermatitis Society (ACDS) allergens of the year and ACDS Core Allergen Series updates. RECENT FINDINGS Recent ACDS Allergens of the Year may be particularly relevant to healthcare workers, including isobornyl acrylate, which is present in glucose sensors and propylene glycol present in hand cleansers and disinfectants. Lavender, limonene, and linalool, all of which are new additions to the ACDS Core Allergen Series, have been reported as causes for occupational ACD in massage therapists and aromatherapists. Isothiazolinone allergy continues to rise in both consumer and occupational settings. Finally, the COVID-19 pandemic has resulted in a wave of occupational ACD in healthcare workers to personal protective equipment, and revealed new potential allergens for individuals working from home. Occupational allergic contact dermatitis continues to exert a significant occupational disease burden. Remaining aware of the current trends in allergens may allow for earlier recognition, diagnosis, and treatment, subsequently helping our patients to work in healthier and safer environments.
Collapse
Affiliation(s)
- Erica B Lee
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA
| | - Marissa Lobl
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA
| | - Aubree Ford
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA
| | - Vincent DeLeo
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Brandon L Adler
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, 985645 Nebraska Medical Center, Omaha, NE, 68198-5645, USA.
| |
Collapse
|
30
|
Dear K, Palmer A, Nixon R. Contact allergy and allergic contact dermatitis from benzalkonium chloride in a tertiary dermatology center in Melbourne, Australia. Contact Dermatitis 2021; 85:146-153. [PMID: 33656745 DOI: 10.1111/cod.13826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/30/2021] [Accepted: 02/03/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Benzalkonium chloride (BAK) is a quaternary ammonium compound that is used widely as an antiseptic and preservative. It is a strong irritant and considered a weak sensitizer. OBJECTIVE To analyze the temporal trend of BAK sensitization and the demographics of sensitized patients. METHODS We conducted a single-center retrospective study of 7390 patients who were patch tested with BAK between January 1, 2003 and December 31, 2019. RESULTS Of the 7390 patients who were patch tested to BAK, 108 (1.5%) had a positive reaction, with 21 reactions deemed clinically relevant (0.3% of total patch tested) and a further 5 doubtful reactions deemed clinically relevant, resulting in a total of 26 relevant reactions (0.4% of total patch tested). Common sources of exposure were ophthalmic drops (30.8%), topical antiseptic preparations (26.9%), cosmetics (15.4%), disinfectant solutions (11.5%), hand sanitizers (11.5%), and hand washes (7.7%). One fifth of patients with relevant reactions were health care workers. There has been a dramatic increase in the number of positive reactions since 2017, for reasons not totally clear. CONCLUSION Contact allergy (CA) and allergic contact dermatitis (ACD) in response to BAK are now increasing at our center. Awareness of this trend is important, given that the coronavirus disease 2019 (COVID-19) pandemic is likely to further expose people to BAK.
Collapse
Affiliation(s)
- Kate Dear
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - Amanda Palmer
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| |
Collapse
|
31
|
|
32
|
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]
|
33
|
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]
|
34
|
Sukakul T, Dahlin J, Pontén A, Antelmi A, Bruze M, Hamnerius N, Hauksson I, Isaksson M, Lejding T, Svedman C. Contact allergy to polyhexamethylene biguanide (polyaminopropyl biguanide). Contact Dermatitis 2020; 84:326-331. [PMID: 33098110 PMCID: PMC8048451 DOI: 10.1111/cod.13728] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 12/20/2022]
Abstract
Background Polyaminopropyl biguanide (INCI name) and polyhexamethylene biguanide (PHMB) are polymeric biguanides. PHMB is a broad‐spectrum antimicrobial substance used as a preservative in many products. Due to our limited knowledge on PHMB contact allergy frequency and the fact that cases of allergic contact dermatitis to PHMB might be missed, we have included PHMB as a screening allergen since 2016. Objective To report the prevalence of positive patch test reactions to PHMB as a screening allergen in patients with suspected allergic contact dermatitis. Methods A retrospective analysis of 1760 patch tested patients from July 2016 to December 2018 was performed. Polyaminopropyl biguanide 2.0% aqua was included in the extended Malmö baseline series during the study period. Results Of all patients, 1204 (68.4%) were female. Positive patch test reactions were reported in 19 patients (1.1%). The most common sites of lesions were face, head, and neck (52.6%). There was a significant correlation between concomitant reactions to PHMB and other cosmetic‐related allergens. Conclusion The prevalence of positive reactions to PHMB was higher than that previously reported. Patch testing with PHMB should be performed in patients with dermatitis who have lesions on the face, head, and neck.
Collapse
Affiliation(s)
- Thanisorn Sukakul
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden.,Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jakob Dahlin
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Ann Pontén
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Annarita Antelmi
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Nils Hamnerius
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Inese Hauksson
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Marléne Isaksson
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Tina Lejding
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| |
Collapse
|
35
|
Pesonen M, Koskela K, Aalto-Korte K. Hairdressers' occupational skin diseases in the Finnish Register of Occupational Diseases in a period of 14 years. Contact Dermatitis 2020; 84:236-239. [PMID: 33104233 DOI: 10.1111/cod.13732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hairdressers have a high risk of occupational contact dermatitis caused by exposure to wet work and allergens in hairdressing chemicals. OBJECTIVES To examine the distribution of diagnoses of occupational skin diseases (OSDs) and their main causes in hairdressers based on a national register data on occupational diseases. METHODS We retrieved cases of recognized OSDs in hairdressers from the Finnish Register of Occupational Diseases (FROD) in years 2005-2018. RESULTS During the 14-year period, a total of 290 cases of recognized OSD in hairdressers were registered in the FROD. Allergic contact dermatitis (ACD) was diagnosed in 54%, irritant contact dermatitis in 44%, and contact urticaria (CU) in 5% of them. ACD was most commonly caused by hair dye products and their ingredients (N = 57), persulfates (N = 35), and preservatives (N = 35; mainly isothiazolinones). Acrylates emerged as hairdressers' occupational contact allergens (N = 8) probably due to introduction of structure nails into hair salons. Persulfates was the most common cause of CU. CONCLUSIONS ACD was the most common OSD in hairdressers. Our analysis confirms that preservatives are important causes of ACD in hairdressers in addition to hair dye products and persulfates. Acrylates emerged as hairdressers' occupational contact allergens, but contact allergy to perming agents remained rare.
Collapse
Affiliation(s)
- Maria Pesonen
- Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Kirsi Koskela
- Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Tampere, Finland
| | - Kristiina Aalto-Korte
- Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| |
Collapse
|
36
|
Havmose M, Thyssen JP, Zachariae C, Menné T, Johansen JD. The epidemic of contact allergy to methylisothiazolinone-An analysis of Danish consecutive patients patch tested between 2005 and 2019. Contact Dermatitis 2020; 84:254-262. [PMID: 33043989 DOI: 10.1111/cod.13717] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND In 2005, methylisothiazolinone (MI) was allowed as a stand-alone preservative in cosmetics. This resulted in an epidemic of allergic contact dermatitis to MI, mainly affecting women exposed to leave-on cosmetics. Consequently, a regulation of Annex V in the European Union in 2017 banned the use of MI in leave-on cosmetics and reduced the allowed concentration in rinse-off products. OBJECTIVE To analyze the temporal trends in contact allergy to MI in Danish patients in relation to key events including European regulations over time. METHODS A retrospective study of consecutive patients patch tested with methylisothiazolinone from 2005 to 2019. Demographics and clinical characteristics in terms of MOAHLFA (male, occupational, atopic dermatitis, hand dermatitis, leg dermatitis, facial dermatitis and age >40 years), sources of exposure, and clinical relevance were analyzed in relation to key historical events. RESULTS Three hundred eighty of 12 494 patients (3.0%, 95CI: 2.7-3.4%) tested from 2005 to 2019 were sensitized to MI. An increasing trend in the prevalence of MI contact allergy from 2005 to 2019 (P < .01) was observed, although a decline in the absolute number of patch-test positive patients was seen from 2013 and onward. A reduction in leave-on cosmetics as a source of exposure was observed following the legislative ban in 2017, from 24.8% from in 2010 to 2013 to 6.2% in 2017 to 2019 (P < .01). CONCLUSION The epidemic of MI contact allergy is declining in absolute terms, although the prevalence in the patch-tested population has not returned to its pre-epidemic levels. The legislative regulation of MI in 2017 has been effective in terms of leave-on cosmetics as a source of exposure in MI allergic patients. The process of post-marketing risk assessment of contact allergens in the European Union needs improvement.
Collapse
Affiliation(s)
- Martin Havmose
- National Allergy Research Center, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Torkil Menné
- National Allergy Research Center, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jeanne D Johansen
- National Allergy Research Center, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| |
Collapse
|
37
|
Uter W, Bauer A, Belloni Fortina A, Bircher AJ, Brans R, Buhl T, Cooper SM, Czarnecka-Operacz M, Dickel H, Dugonik A, Geier J, Giménez-Arnau AM, Gonçalo M, Johansen JD, Johnston GA, Mahler V, Rustemeyer T, Sanchez-Perez J, Schuttelaar MLA, Simon D, Spiewak R, Valiukevičienė S, Weisshaar E, White IR, Wilkinson M. Patch test results with the European baseline series and additions thereof in the ESSCA network, 2015-2018. Contact Dermatitis 2020; 84:109-120. [PMID: 32945543 DOI: 10.1111/cod.13704] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/12/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Clinical surveillance of the prevalence of contact allergy in consecutively patch tested patients is a proven instrument to continually assess the importance of contact allergens (haptens) assembled in a baseline series. OBJECTIVES To present current results from the European Surveillance System on Contact Allergies, including 13 countries represented by 1 to 11 departments. METHODS Anonymized or pseudonymized patch test and clinical data from various data capture systems used locally or nationally as transferred to the Erlangen data centre were pooled and descriptively analysed after quality control. RESULTS In the 4 years (2015-2018), data from 51 914 patients patch tested with the European baseline series (EBS) of contact allergens were analysed. Contact allergy to nickel was most frequent (17.6% positive), followed by contact allergy to fragrance mix I (6.9%), methylisothiazolinone (MI; 6.2%), and Myroxylon pereirae resin (balsam of Peru; 5.8%). CONCLUSIONS While the prevalence of MI contact allergy decreased substantially following regulatory intervention, the persistently high levels of allergy to metals, fragrances, other preservatives, and rubber chemicals point to problems needing further research and, potentially, preventive efforts. Results with national additions to the baseline series provide important information on substances possibly to be considered for inclusion in the EBS.
Collapse
Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Andrea Bauer
- Department of Dermatology, University Allergy Centre, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Anna Belloni Fortina
- Dermatology Unit, Department of Paediatrics, University of Padova, Padova, Italy
| | - Andreas J Bircher
- Allergy Unit, Department of Dermatology, University Hospital Basel, Basel, Switzerland.,Faculty of Biomedicine, Università della Svizzera Italiana, Lugano, Switzerland
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - 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
| | - Aleksandra Dugonik
- Department of Dermatology, University Medical Centre Maribor, Maribor, Slovenia
| | - Johannes Geier
- Information Network of Department of Dermatology, University Medical Center, Göttingen, Germany
| | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar. Universitat Autònoma and Pompeu Fabra, Barcelona, Spain
| | - Margarida Gonçalo
- Department of Dermatology, Coimbra University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Skin and Allergy, Gentofte Hospital, Hellerup, Denmark
| | | | - Vera Mahler
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany, Paul-Ehrlich-Institut, Langen, Germany
| | - Thomas Rustemeyer
- Department of Dermatology, Free University of Amsterdam, Amsterdam, The Netherlands
| | - Javier Sanchez-Perez
- Dermatology Department, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain
| | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Elke Weisshaar
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ian R White
- Cutaneous Allergy Team, St. John's Institute of Dermatology, Guy's Hospital, London, UK
| | - Mark Wilkinson
- Dermatology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | |
Collapse
|
38
|
Özkaya E, Kılıç Sayar S, Babuna Kobaner G, Pehlivan G. Methylchloroisothiazolinone/methylisothiazolinone and methylisothiazolinone contact allergy: A 24-year, single-center, retrospective cohort study from Turkey. Contact Dermatitis 2020; 84:24-33. [PMID: 32691417 DOI: 10.1111/cod.13656] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/25/2020] [Accepted: 07/08/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI allergy caused a global epidemic during the period 2010 to 2015, reaching its peak in 2013/14. OBJECTIVE To investigate the characteristics of MCI/MI and MI allergy in Turkey over 24 years. METHODS A total of 2310 patients patch tested between 1996 and 2019 with MCI/MI 0.01% aq. or MCI/MI 0.02% aq., with or without MI 0.2% aq., were analyzed. RESULTS The overall prevalence of contact sensitization was 3.3% (n = 77) with a peak level of 16.4% in 2015. The prevalence gradually decreased thereafter, but was still high (6.5%) in 2019. Seventy-three patients had clinically relevant sensitizations. MI could detect clinically relevant sensitizations in all seven patients with a negative patch test reaction to MCI/MI 0.02%. Non-occupational allergic contact dermatitis (ACD) was most frequently seen, mainly in women, with hand/face eczema from rinse-off or leave-on cosmetics, such as wet wipes. Occupational ACD was mainly seen among men with airborne eczema from wall paints in house painters, or with hand eczema from hair gel/wax in men's barbers. CONCLUSIONS The prevalence of MCI/MI and MI sensitization in Turkey following the peak in 2015 is still high. This is probably due to the currently allowed level of 100 ppm for MI in rinse-off cosmetics. This needs to be urgently reduced.
Collapse
Affiliation(s)
- Esen Özkaya
- Department of Dermatology and Venereology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Sıla Kılıç Sayar
- Department of Dermatology and Venereology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Goncagül Babuna Kobaner
- Department of Dermatology and Venereology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Gizem Pehlivan
- Department of Dermatology and Venereology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| |
Collapse
|
39
|
Russo JP, Aerts O. In vivo demonstration of immunologic cross-reactivity to octylisothiazolinone in patients primarily and strongly sensitized to methylisothiazolinone. Contact Dermatitis 2020; 83:391-397. [PMID: 32666548 DOI: 10.1111/cod.13661] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/05/2020] [Accepted: 07/13/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Notwithstanding that concomitant exposure to different isothiazolinone derivatives may result in concomitant sensitization, clinical and animal studies have suggested cross-reactivity between these derivatives, notably between methylisothiazolinone (MI) and octylisothiazolinone (OIT). OBJECTIVE To investigate if patients sensitized to MI show cross-reactions to OIT and/or to benzisothiazolinone (BIT) by applying the concept of the re-test method. PATIENTS AND METHODS From March to October 2019 consecutive patients were patch tested with MI 0.2% aqueous in duplicate at the two lower corners of both shoulder blades. Patients sensitized to MI, but not to OIT 0.1% petrolatum (pet.) nor to BIT 0.1% pet., were re-tested, 2 months later, with the latter two derivatives at the skin sites where the MI reactions had fully disappeared. RESULTS Of 116 patients, 15 (13%) were sensitized to MI, eight of these not sensitized to BIT nor to OIT. Of these, seven patients, all (very) strongly sensitized to MI, were re-tested: five patients showed positive patch test reactions to OIT 0.1% pet.; one patient to OIT 0.1% pet. and BIT 0.1% pet.; and one other patient showed no reactions. CONCLUSION This study suggests that patients primarily and strongly sensitized to MI may show immunologic cross-reactions to OIT, and to a far lesser extent to BIT.
Collapse
Affiliation(s)
- Juan Pedro Russo
- Department of Dermatology, Hospital Interzonal General de Agudos San Martin de La Plata, 10 1121, La Plata, Buenos Aires, 1900, Argentina
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and University of Antwerp, Research Group Immunology, Infla-Med Centre of Excellence, Antwerp, Belgium.,Research Group Immunology, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
40
|
Belloni Fortina A, Caroppo F, Tadiotto Cicogna G. Allergic contact dermatitis in children. Expert Rev Clin Immunol 2020; 16:579-589. [DOI: 10.1080/1744666x.2020.1777858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Anna Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Francesca Caroppo
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Giulia Tadiotto Cicogna
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| |
Collapse
|
41
|
Contact Allergy-Emerging Allergens and Public Health Impact. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072404. [PMID: 32244763 PMCID: PMC7177224 DOI: 10.3390/ijerph17072404] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 02/07/2023]
Abstract
Contact allergy (sensitisation) and allergic contact dermatitis (ACD) resulting from it have a considerable public health impact. For the present review, all pertinent articles were systematically searched via Medline and Web of Science™; additionally, all available issues of the journals "Contact Dermatitis" and "Dermatitis" were manually searched, covering the years 2018-2019, thereby extending and re-focusing a previous similar review. New allergens, or previously described allergens found in a new exposure context or of other current importance, are described in sections according to substance classes, e.g., metals, preservatives, fragrances. As a common finding in many investigations, a lack of information on product composition has been noted, for instance, regarding a newly described allergen in canvas shoes (dimethylthiocarbamylbenzothiazole sulfide) and, most notably, absence of co-operation from manufacturers of glucose-monitoring devices and insulin pumps, respectively. These latter devices have been shown to cause severe ACD in a considerable number of diabetic patients caused by the liberation of isobornyl acrylate and N,N'-dimethylacrylamide, respectively, as demonstrated by an international collaboration between dermatologists and chemists. Improved and complete ingredient labelling for all types of products, and not just cosmetics, must be put on the legislative agenda.
Collapse
|
42
|
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
| |
Collapse
|
43
|
Lachapelle JM. Methylisothiazolinone: the new star of contact dermato-allergology. J Eur Acad Dermatol Venereol 2020; 34:218. [PMID: 31997498 DOI: 10.1111/jdv.16174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J-M Lachapelle
- Department of Dermatology, Catholic University of Louvain, Brussels, Belgium
| |
Collapse
|
44
|
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]
|
45
|
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]
|
46
|
Goebel C, Kock M, Merk H. [Toxicological risk assessment using the example of potential contact sensitization to resorcinol]. Hautarzt 2019; 70:948-952. [PMID: 31754739 DOI: 10.1007/s00105-019-04510-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Resorcinol is a frequently used hair dye, whose quantitative risk assessment (QRA) for hair color products is presented in this review as an example to assess its skin sensitization risk after topical application. Its purpose is to determine the maximum concentration that can be used without expecting skin sensitization to occur. The focus is to prevent the de novo development of a contact allergy. Epidemiological data which are provided via dermatological surveillance, e.g., by the IVDK (Information Network of Departments of Dermatology) in Germany, are an important source of information that help to assess the quality and the effectivity of the QRA.
Collapse
Affiliation(s)
- C Goebel
- COTY Wella Toxicology, Berliner Allee 65, 64295, Darmstadt, Deutschland.
| | - M Kock
- COTY Wella Toxicology, Berliner Allee 65, 64295, Darmstadt, Deutschland
| | - H Merk
- Klinik für Dermatologie und Allergologie - Hautklinik, Universitätsklinikum Aachen, Aachen, Deutschland
| |
Collapse
|
47
|
Prävalenz der Kontaktsensibilisierung in der Allgemeinbevölkerung und in Klinikpopulationen. Hautarzt 2019; 71:166-173. [DOI: 10.1007/s00105-019-04506-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
48
|
Tautvydaitė L, Friis UF, Thyssen JP, Johansen JD. Usability of a spot test for isothiazolinones. Contact Dermatitis 2019; 82:165-167. [DOI: 10.1111/cod.13389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Laura Tautvydaitė
- Department of Dermatology and Allergy, Herlev and Gentofte HospitalNational Allergy Research Centre, University of Copenhagen Hellerup Denmark
- Department of Skin and Venereal DiseasesHospital of Lithuanian University of Health Sciences Kaunas Clinics Kaunas Lithuania
| | - Ulrik F. Friis
- Department of Dermatology and Allergy, Herlev and Gentofte HospitalNational Allergy Research Centre, University of Copenhagen Hellerup Denmark
| | - Jacob P. Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte HospitalNational Allergy Research Centre, University of Copenhagen Hellerup Denmark
| | - Jeanne D. Johansen
- Department of Dermatology and Allergy, Herlev and Gentofte HospitalNational Allergy Research Centre, University of Copenhagen Hellerup Denmark
| |
Collapse
|