A case-control analysis of skin contact allergy in children and adolescents

High prevalence but no current clinical relevance of methyldibromo glutaronitrile since its ban in Turkey in 2015

BACKGROUND

Regulatory actions significantly reduced methyldibromo glutaronitrile (MDBGN)-induced allergic contact dermatitis (ACD) from cosmetics in Europe. Turkey banned MDBGN in 2015.

OBJECTIVES

To assess sensitization and ACD rates to MDBGN before and after its ban in Turkey.

METHODS

Data from 2653 consecutively patch tested patients between 1996 and 2023 with MDBGN 0.1% pet. (n = 573) or 0.2%-0.3% pet. (n = 1310) or 0.5% pet. (n = 770) were analysed. MDBGN was tested as MDBGN/phenoxyethanol (PE) in 1434 patients.

RESULTS

The sensitization prevalence was 1.7% (45/2653), peaking at 5.3% in 2018 and 2023 with MDBGN 0.3% pet. There was a two-fold male predominance, with patients exclusively ≥20 years old. None of the patients reacted to PE. ACD occurred in 0.7% (19/2653), mainly affecting hands and linked to non-occupational exposure (78.9%), particularly from rinse-off/leave-on cosmetics. The pattern of 'middle-aged men with hand eczema and fragrance allergy' was particularly notable. Occupational ACD was rare (21.1%), occurring mainly in hairdressers from hair gel. Positive reactions with current clinical relevance dropped from 48.3% (1996-2014) to zero after 2015 (p < 0.001).

CONCLUSIONS

The ban effectively reduced MDBGN-induced ACD in Turkey, yet the prevalence of positive patch test reactions remains high, likely due to past exposures or other undisclosed sources. We suggest continued testing of MDBGN in the EBS in Turkey.

Contact allergy in atopic dermatitis: A prospective study on prevalence, incriminated allergens and clinical insights

BACKGROUND

The relationship between atopic dermatitis (AD) and allergic contact dermatitis (ACD) is a matter of debate.

OBJECTIVES

The purpose of our study is to assess the frequency of ACD in patients with AD, the incriminated allergens and the potential risk factors.

METHODS

This is a prospective study, including cases of AD diagnosed based on Hanifin and Rajka's criteria. All patients were patch tested to the European baseline series and corticosteroid series.

RESULTS

Ninety-three patients were included. Fifty-six patients (60.2%) had positive patch test results of which 71.4% were relevant. The most frequent allergens were: textile dye mix (24.7%), nickel (20.4%), cobalt (12.9%), isothiazolinone (8.6%), quanterium 15 (4.3%) and balsam of Peru (4.3%). Chromium, fragrance mix I, fragrance mix II and PTBP were positive in three cases (3.2%). Two cases of allergy to corticoids were identified. Facial involvement and duration of AD were significantly associated with contact sensitization (p = 0.04 and p = 0.005, respectively). Avoidance of relevant allergens resulted in a statistically significant decrease in SCORAD (p < 0.001).

CONCLUSIONS

ACD remains an important co-morbidity of AD. We observed a high frequency of ACD to textile dyes, isothiazolinones and fragrances. Avoidance of relevant allergens has resulted in an improvement of patients' skin symptoms.

Association Between Heavy Metals Exposure and Height in Chinese Preschoolers

OBJECTIVES

This study aimed to explore the association between multiple metals' exposure and children's height.

METHODS

We collected urine samples and physical measurement data of 1477 preschoolers in China. Children's actual height was measured, and whether reached target height was also assessed. Logistic regression analysis was performed to explore the association between heavy metals and height. The least absolute shrinkage and selection operator regression was used to select the urinary metals, which were highly correlated.

RESULTS

In the single-metal model after adjusting for potential confounders, urinary iron, aluminum, nickel, chrome, titanium, vanadium, selenium, rubidium, and thallium levels were negatively associated with actual height. Urinary iron, aluminum, nickel, and chrome concentrations were also negatively associated with target height.

CONCLUSIONS

The findings suggested that some urinary metal exposure might be associated with height in preschoolers.

Sensitizing agents found in children and adolescents with recalcitrant atopic dermatitis: a cross-sectional study with a pediatric battery

BACKGROUND

Atopic dermatitis is the most common inflammatory skin disease in childhood and has an important impact on quality of life, especially severe cases or those that are recalcitrant to treatments. Sensitization to allergens with the potential for allergic contact dermatitis is a factor associated with cases of recalcitrant atopic dermatitis. Understanding the relationship between atopic dermatitis, allergens, and allergic contact dermatitis is essential. In Brazil, there are no studies on sensitization to allergens found in patch tests with pediatric batteries in patients with atopic dermatitis.

OBJECTIVES

To verify the main sensitizing agents, the prevalence of allergic contact dermatitis and the epidemiological and clinical profile of children and adolescents with atopic dermatitis.

METHODS

Cross-sectional, prospective study in patients between 4 and 18 years of age, with recalcitrant atopic dermatitis, treated at the Sanitary Dermatology Outpatient Clinic (RS). All patients underwent patch tests with a battery of pediatric allergens.

RESULTS

The prevalence of sensitization and allergic contact dermatitis in the evaluated patients was 37.07% (20/54) and 27.7% (15/54), respectively. The most frequent allergens were: nickel sulfate (16.7%), disperse blue (5.6%), and fragrance mix I (5.6%). Nickel was associated with the female sex (p = 0.019).

STUDY LIMITATIONS

Sample size and selection, absence of a control group.

CONCLUSIONS

A proportion of patients with recalcitrant atopic dermatitis may be sensitized to different allergens and may even have developed allergic contact dermatitis. Recognizing this context is important in the prevention strategy and management of the disease.

Contact allergy in a paediatric population observed in a tertiary referral centre in Belgium

BACKGROUND

Contact allergy is increasingly recognized as being important in children with eczema.

OBJECTIVES

To retrospectively analyse the patch test results in children over the past 10 years, aiming to (1) evaluate demographic characteristics and lesion locations, (2) describe frequencies of positive patch test reactions, and (3) investigate the relationship with atopic dermatitis (AD).

METHODS

A total of 329 children were patch tested between January 2010 and December 2019 with the European (children) baseline series and/or other series, and the personal product(s) used.

RESULTS

A total of 119 (36%) children presented with at least one positive reaction. Children with AD had a higher prevalence of positive reactions compared with the non-AD group (P = .002), but without statistically significant difference regarding sensitization to more than one hapten (P = .39). The face (20.2%), hands (19.3%), feet (16.8%), arms (12.6%), and body folds (10.9%) were the most common sites of primary localizations. The most frequent contact allergens were nickel sulfate and linalool hydroperoxide (both 16%), limonene hydroperoxide (13.5%), and para-phenylenediamine (10.9%). No statistically significant difference for nickel sulfate was found between the AD and non-AD group (P = .20).

CONCLUSIONS

Contact allergy in children with eczema was frequently observed in our tertiary referral centre in Belgium as well, confirming the need for patch testing.

Propolis antiviral and immunomodulatory activity: a review and perspectives for COVID-19 treatment

OBJECTIVES

Viral outbreaks are a frequent concern for humans. A great variety of drugs has been used to treat viral diseases, which are not always safe and effective and may induce adverse effects, indicating the need for new antiviral drugs extracted from natural sources. Propolis is a bee-made product exhibiting many biological properties. An overview of viruses, antiviral immunity, propolis safety and its immunomodulatory and antiviral action is reported, as well as perspectives for coronavirus disease 2019 (COVID-19) treatment. PubMed platform was used for data collection, searching for the keywords "propolis", "virus", "antiviral", "antimicrobial" and "coronavirus".

KEY FINDINGS

Propolis is safe and exerts antiviral and immunomodulatory activity; however, clinical trials should investigate its effects on individuals with viral diseases, in combination or not with antiviral drugs or vaccines.

SUMMARY

Regarding COVID-19, the effects of propolis should be investigated directly on the virus in vitro or on infected individuals alone or in combination with antiviral drugs, due to its immunomodulatory and anti-inflammatory action. Propolis administration simultaneously with vaccines should be analyzed, due to its adjuvant properties, to enhance the individuals' immune response. The search for therapeutic targets may be useful to find out how propolis can help to control COVID-19.

Pediatric contact allergy: A comparative study with adults

BACKGROUND

Pediatric allergic contact dermatitis is increasing. The patch test allergens included in pediatric baseline series vary globally. The worldwide prevalence of pediatric reactions to allergens needs clarification.

OBJECTIVES

Identify the prevalence, associated factors, and culprit allergens for contact allergy among patch-tested Thai children, and compare with those for adults.

METHODS

Baseline series patch test results from 2010-2019 were collected for patients younger than 18 years of age. As a control group, sex-matched adult patients were randomly selected. The results and characteristics of the two groups were compared.

RESULTS

The median age of 112 patch tested pediatric patients was 16 (range 2-17) years. Of the children, 35.5% had at least one positive reaction, significantly less than the 56.6% for adults. The five most common pediatric allergens were nickel sulfate (12.1%), potassium dichromate (8.0%), methylisothiazolinone (7.1%), fragrance mix II (6.0%), and carba mix (5.4%). Although similar, the 10 most common allergens of the groups differed in order. Positive reactions to cosmetic allergens were significantly less frequent among the children. Many allergens remained entirely negative.

CONCLUSIONS

The prevalence of positive reactions was lower in children, varying by population and region. The top-10 pediatric and adult causative allergens were almost identical. We recommend using the same baseline patch test series for children and adults in our region.