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Sukakul T, Uter W, Gonçalo M, Huggard J, Ljubojević Hadžavdić S, Schuttelaar MLA, Svedman C, Vey M, Isaksson M, Niklasson B, Rustemeyer T, Bruze M. Results of patch testing with five fragrance materials hitherto not tested: A dose-finding study in the clinical population. Contact Dermatitis 2024; 90:566-573. [PMID: 38387040 DOI: 10.1111/cod.14525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/18/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Quantitative risk assessment (QRA) for skin sensitization is used to derive safe use levels of sensitising fragrance ingredients in products. Post-marketing surveillance of the prevalence of contact allergy to these ingredients provides relevant data to help evaluate the performance of these measures. OBJECTIVES To determine a suitable patch test concentration for five fragrance materials that had hitherto not been tested on a regular basis. These concentrations are then to be used in a surveillance study with patch testing consecutive patients over an extended monitoring period. MATERIALS AND METHODS Furaneol, CAS.3658-77-3; trans-2-hexenal, CAS.6728-26-3; 4,8-dimethyl-4,9-decadienal, CAS.71077-31-1; longifolene, CAS.475-20-7; benzaldehyde, CAS.10052-7, were patch tested with other fragrance allergens in four clinics. Patch testing was conducted in three rounds, starting with the lowest concentrations of the five ingredients. The doses were increased in the subsequent rounds if no late-appearing positive reactions and virtually no irritant reactions were reported. RESULTS Overall, 373 patients were tested. No positive allergic reaction was reported to the five ingredients. Patch test results of other fragrance allergens are reported. CONCLUSIONS The highest test concentrations are each considered safe for patch testing consecutive patients. Further surveillance based on these preparations will evaluate the hypothesis that QRA-driven consumer product levels of these fragrances can prevent sensitization.
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Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Margarida Gonçalo
- Department of Dermatology, Coimbra University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Joseph Huggard
- The Huggard Consulting Group, S.A.R.L., Itzig, Luxembourg
- IFRA VP Scientific Affairs and IDEA Management Team, Brussels, Belgium
| | - Suzana Ljubojević Hadžavdić
- Department of Dermatology and Venereology, School of Medicine University of Zagreb, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marie L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, Groningen, The Netherlands
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Matthias Vey
- The Huggard Consulting Group, S.A.R.L., Itzig, Luxembourg
- IFRA VP Scientific Affairs and IDEA Management Team, Brussels, Belgium
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | | | - Thomas Rustemeyer
- Department of Dermatology-Allergology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
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Mowitz M, Hosseini S, Siemund I, Ulriksdotter J, Svedman C. New device, 'old' allergens. Allergic contact dermatitis caused by the Dexcom G7 glucose sensor. Contact Dermatitis 2024; 90:495-500. [PMID: 38316128 DOI: 10.1111/cod.14514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) has been reported as an adverse effect from the use of several glucose sensors and insulin pumps from different manufacturers. Isobornyl acrylate (IBOA) has been identified as a major culprit sensitizer, but also other acrylates and (modified) colophonium have been reported as causes of ACD. OBJECTIVES To report the two first cases diagnosed with ACD caused by the Dexcom G7 (DG7) glucose sensor. PATIENTS AND METHODS Two children with suspected ACD from DG7 were patch tested with our medical device series with an addition of selected test preparations including two variants of modified colophonium - methyl hydrogenated rosinate (MHR) and glyceryl hydrogenated rosinate (GHR). Both patients were also tested with acetone extracts made from different parts of the DG7 sensor. The extracts were analysed by gas chromatography-mass spectrometry (GC-MS). RESULTS Both patients tested positive to IBOA, hydroabietyl alcohol and GHR. In addition, patient 1 had a positive reaction to MHR and patient 2 had a positive reaction to colophonium. The GC-MS analyses showed the presence of IBOA and colophonium-related substances in the DG7 extracts. CONCLUSIONS Both patients were diagnosed with contact allergy to well-known medical device-related sensitizers. The presence of IBOA and (modified) colophonium in a newly introduced (on the Swedish market in 2023) glucose sensor is remarkable and indicates an inadequate toxicological assessment of the materials used in the sensor.
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Affiliation(s)
- Martin Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Sarah Hosseini
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Dermatology and Venereology, Ryhov County Hospital, Jönköping, Sweden
| | - Ingrid Siemund
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Josefin Ulriksdotter
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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Siemund I, Dahlin J, Mowitz M, Hamnerius N, Svedman C. Allergic contact dermatitis due to 1,6-hexanediol diacrylate in ostomy patients. Contact Dermatitis 2024; 90:501-506. [PMID: 38332444 DOI: 10.1111/cod.14516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/13/2023] [Accepted: 01/26/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Many people live with ostomies after life-saving surgery. Ostomy patients often suffer from peristomal dermatitis. Allergic contact dermatitis (ACD) has been reported, mostly due to contact allergy (CA) to topical agents. OBJECTIVES We present three patients with therapy resistant peristomal dermatitis, suggesting ACD caused by different stoma products. METHODS Patch testing was performed with baseline series, additional series, and selected allergens. They were also tested with their own ostomy products as is and separate extracts of the products. Extracts were analysed using Gas Chromatography-Mass Spectrometry (GC-MS). RESULTS In all three patients we diagnosed CA to 1,6-hexanediol diacrylate (HDDA), +++ in case (C) 1 and 3, ++ in C 2. HDDA was detected in C 2's ostomy pouch adhesive and in C 1's and 3's flange extenders used to improve the adhesion of the ostomy pouches. CONCLUSION Therapy resistant peristomal dermatitis should always be suspected of ACD and patch testing, especially with the patient's own products, should be performed.
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Affiliation(s)
- Ingrid Siemund
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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Ljungberg Silic L, Persson C, Pesonen M, Suuronen K, Svedman C, Bergendorff O. 2-Cyanoethyl dimethyldithiocarbamate, a new contact allergen found in accelerator-free nitrile gloves. Contact Dermatitis 2024. [PMID: 38602297 DOI: 10.1111/cod.14553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) from rubber glove usage is usually caused by rubber additives such as the accelerators. However, in analyses of the suspected gloves, ordinary rubber allergens are not always found. Accelerator-free rubber gloves are available, but some patients with accelerator allergy do not tolerate them and might also be patch test positive to them. OBJECTIVES To identify and chemically characterize a new allergen, 2-cyanoethyl dimethyldithiocarbamate (CEDMC), in rubber gloves. We describe two patient cases: patient 1 that led us to the identification of CEDMC and patient 2 with occupational ACD caused by CEDMC. METHODS The patients were examined with patch testing including baseline and rubber series, and their own rubber gloves. High-performance liquid chromatography (HPLC) was used for chemical analysis of rubber gloves. The allergen was synthesized and identified by nuclear magnetic resonance, mass spectrometry and infrared spectrometry, and tested on patient 2. RESULTS CEDMC was identified by HPLC in a nitrile glove associated with hand eczema in patient 1. Patient 2 whose nitrile gloves contained CEDMC was patch test positive to CEDMC. CONCLUSIONS CEDMC is a new contact allergen in nitrile gloves and probably forms during vulcanization from residual monomer acrylonitrile and rubber additives.
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Affiliation(s)
- Linda Ljungberg Silic
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Christina Persson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Maria Pesonen
- Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Katri Suuronen
- Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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Bruze M, Isaksson M, Svedman C, Engfeldt M. Occlusion of sensitizers in the baseline series for 48 h detects more contact allergy than occlusion for 24 h. Contact Dermatitis 2024; 90:426-428. [PMID: 38148318 DOI: 10.1111/cod.14484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/28/2023]
Affiliation(s)
- Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Malin Engfeldt
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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Ulriksdotter J, Sukakul T, Bruze M, Mowitz M, Ofenloch R, Svedman C. Contact Allergy to Allergens in the Swedish Baseline Series Overrepresented in Diabetes Patients with Skin Reactions to Medical Devices - A Retrospective Study from Southern Sweden. Acta Derm Venereol 2024; 104:adv19676. [PMID: 38551376 PMCID: PMC11000652 DOI: 10.2340/actadv.v104.19676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/23/2024] [Indexed: 04/02/2024] Open
Abstract
Allergic contact dermatitis is reported among individuals using continuous glucose monitoring systems and insulin pumps. The aim of this study was to describe contact allergy patterns for allergens in the Swedish baseline series and medical device-related allergens among users. Contact allergy to baseline series allergens and isobornyl acrylate was compared between diabetes patients and dermatitis patients patch-tested at the Department of Occupational and Environmental Dermatology during 2017 to 2020. Fifty- four diabetes patients and 2,567 dermatitis patients were included. The prevalence of contact allergy to fragrance mix II and sesquiterpene lactone mix was significantly higher in diabetes patients compared with dermatitis patients. Of the diabetes patients 13.0% and of the dermatitis patients 0.5% tested positive to sesquiterpene lactone mix (p < 0.001). Of the diabetes patients 7.4% and of the dermatitis patients 2.3% tested positive to fragrance mix II (p = 0.041). Of the diabetes patients 70.4% tested positive to medical device-related allergens. Of the diabetes patients 63.0% and of the dermatitis patients 0.2% were allergic to isobornyl acrylate (p < 0.001). In conclusion, not only medical device-related contact allergies, but also contact allergy to baseline series allergens (fragrance mix II and sesquiterpene lactone mix), is overrepresented in diabetes patients who use medical devices.
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Affiliation(s)
- Josefin Ulriksdotter
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Dermatology, Helsingborg Hospital, Helsingborg, Sweden .
| | - Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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Samaran Q, Raison-Peyron N, Dereure O, Svedman C, Dahlin J. Allergic contact dermatitis to isobornyl acrylate in a hospital wristband. Contact Dermatitis 2024. [PMID: 38448369 DOI: 10.1111/cod.14539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Quentin Samaran
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, France
| | - Nadia Raison-Peyron
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, France
| | - Olivier Dereure
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, France
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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von Kobyletzki LB, Ulriksdotter J, Sukakul T, Aerts O, Agner T, Buhl T, Bruze M, Foti C, Gimenez-Arnau A, Gonçalo M, Hamnerius N, Johansen JD, Rustemeyer T, Stingeni L, Wilkinson M, Svedman C. Prevalence of dermatitis including allergic contact dermatitis from medical devices used by children and adults with Type 1 diabetes mellitus: A systematic review and questionnaire study. J Eur Acad Dermatol Venereol 2024. [PMID: 38400603 DOI: 10.1111/jdv.19908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/23/2024] [Indexed: 02/25/2024]
Abstract
Use of medical devices (MDs), that is, glucose sensors and insulin pumps, in patients with Type 1 diabetes mellitus (T1D) has proven an enormous advantage for disease control. Adverse skin reactions from these MDs may however hamper compliance. The objective of this study was to systematically review and analyse studies assessing the prevalence and incidence of dermatitis, including allergic contact dermatitis (ACD) related to MDs used in patients with T1D and to compare referral routes and the clinical investigation routines between clinics being part of the European Environmental and Contact Dermatitis Research Group (EECDRG). A systematic search of PubMed, EMBASE, CINAHL and Cochrane databases of full-text studies reporting incidence and prevalence of dermatitis in persons with T1D using MDs was conducted until December 2021. The Newcastle-Ottawa Scale was used to assess study quality. The inventory performed at EECRDG clinics focused on referral routes, patient numbers and the diagnostic process. Among the 3145 screened abstracts, 39 studies fulfilled the inclusion criteria. Sixteen studies included data on children only, 14 studies were on adults and nine studies reported data on both children and adults. Participants were exposed to a broad range of devices. Skin reactions were rarely specified. It was found that both the diagnostic process and referral routes differ in different centres. Further data on the prevalence of skin reactions related to MDs in individuals with T1D is needed and particularly studies where the skin reactions are correctly diagnosed. A correct diagnosis is delayed or hampered by the fact that, at present, the actual substances within the MDs are not declared, are changed without notice and the commercially available test materials are not adequately updated. Within Europe, routines for referral should be made more standardized to improve the diagnostic procedure when investigating patients with possible ACD from MDs.
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Affiliation(s)
- L B von Kobyletzki
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - J Ulriksdotter
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - T Sukakul
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - O Aerts
- Contact Allergy Unit, Department of Dermatology, University Hospital Antwerp (UZA) and Research Group Immunology, University of Antwerp, Antwerp, Belgium
| | - T Agner
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - T Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - M Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - C Foti
- Section of Dermatology, DIMEPREJ Department, University "Aldo Moro", Bari, Italy
| | - A Gimenez-Arnau
- Department of Dermatology, Hospital del Mar and Research Institute de Barcelona, Universitat Pompeu Fabra, Barcelona, Spain
| | - M Gonçalo
- Clinic of Dermatology, Coimbra University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - N Hamnerius
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - J D Johansen
- Department of Dermatology, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - T Rustemeyer
- Dermato-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - L Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - M Wilkinson
- Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - C Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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Sukakul T, Bruze M, Mowitz M, Kiuru A, Svedman C. Allergic Contact Dermatitis to Linalool Hydroperoxides: Pitfalls in the Diagnostic Process-Findings from a Repeated Open Application Test Study. Dermatitis 2024. [PMID: 38386591 DOI: 10.1089/derm.2023.0286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Background: Increasing trends of oxidized linalool contact allergy have been reported. However, the impact of reactivity and dose in eliciting allergic contact dermatitis caused by linalool hydroperoxides is insufficiently investigated. Objectives: To perform repeated open application tests (ROATs) using the real-world concentrations of linalool hydroperoxides in patients and control participants. Materials and Methods: Patients who previously had a positive (patients) and a negative (controls) patch test reaction to linalool hydroperoxides 1.0% in petrolatum were patch tested with a dilution series of linalool hydroperoxides preparations and asked to perform ROAT twice daily with 3 concentrations of linalool hydroperoxides creams and a negative control cream for 28 days. The creams contain 44, 140, and 440 PPM of linalool hydroperoxides, representing real-world doses reported in consumer products. Results: Of all 47 participants, 31 were linalool hydroperoxides contact allergy patients, and 16 were controls. One patient had a positive ROAT reaction in the area where cream at the highest concentration of linalool hydroperoxides was applied for 28 days. Conclusions: Repeated exposure to creams containing linalool hydroperoxides at real-life concentrations could rarely elicit an allergic reaction on intact skin after 4 weeks.
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Affiliation(s)
- Thanisorn Sukakul
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Mowitz
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Anna Kiuru
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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10
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Sukakul T, Bruze M, Mowitz M, Bergendorff O, Björk J, Dahlin J, Svedman C. Patterns of simultaneous contact allergies in patients with contact sensitization to oxidised linalool and oxidised limonene. Contact Dermatitis 2024; 90:134-142. [PMID: 37852634 DOI: 10.1111/cod.14445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/03/2023] [Accepted: 10/08/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Contact allergy rates of linalool and limonene hydroperoxides (HPs) have increased. OBJECTIVES To demonstrate the patterns of simultaneous positive patch test (PT) reactions and prevalences of multiple contact allergies (MCAs) in patients with contact allergy to linalool and/or limonene HPs. METHODS A retrospective analysis of consecutive dermatitis patients in 2015-2020 was performed. RESULTS Of all 4192 patients, 1851 had at least one positive PT reaction. Of these, 410 (22.2%) had MCAs, significantly related to a higher age (p-value = 0.003). Patients with an exclusively positive reaction to linalool HPs but not limonene HPs were shown to have MCAs (p-value <0.001, odds ratio (95% confidence interval) = 4.15 (3.01-5.73)). Patients with simultaneous contact allergies to both linalool and limonene HPs had contact allergies to many other screening and fragrance allergens. CONCLUSIONS Simultaneous positive PT reactions to allergens in baseline series and fragrances are common in patients with the HPs contact allergy, especially linalool HPs. The pattern of simultaneous PT reactions principally suggested the co-sensitization of the cosmetic allergens.
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Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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11
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Adwa U, Antelmi A, Sukakul T, Dahlin J, Bruze M, Svedman C. Oral lichenoid lesions in two snuff users with contact allergy to carvone. Contact Dermatitis 2024; 90:74-78. [PMID: 37915267 DOI: 10.1111/cod.14448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 09/01/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Contact allergy to the mint-tasting flavour carvone has been observed in patients with oral lichenoid lesions (OLL). Mint-flavoured products such as toothpaste frequently contain carvone. Snuff is a smokeless tobacco product that is chewed or placed in the mouth rather than smoked. In Sweden, the use of snuff and its flavoured versions is extremely common. OBJECTIVES To investigate whether the consumption of mint-flavoured snuff is associated with contact allergy to carvone and subsequently plays a role in the aetiology of OLL. METHODS Regarding the two patients, patch testing with snuff pouches was performed. High-performance liquid chromatography and gas chromatography-mass spectrometry analysis were used for identification of carvone in different snuff samples. RESULTS Two patients with OLL were contacted allergic to carvone when patch tested. Both were using mint-flavoured snuffs several hours a day for many years. One patient was contacted allergic to the snuff pouch tested as is. Carvone was detected in the snuff samples of both patients. CONCLUSIONS The patients were recommended to avoid the use of mint-flavoured snuffs, toothpaste and foodstuffs. At follow-up 3 months later, the patients had a dramatic clinical improvement of the OLL and oral symptoms. Exposure to mint-flavoured snuffs can be overlooked as a possible aggravating/provoking factor in OLL.
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Affiliation(s)
- Usamah Adwa
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmo, Sweden
- Department of Dermatology, Helsingborg Hospital, Helsingborg, Sweden
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmo, Sweden
| | - Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmo, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmo, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmo, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmo, Sweden
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12
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Bruze M, Marmgren V, Zimerson E, Antelmi A, Svedman C, Mowitz M. Contact allergy to oxidised geraniol may be over-represented in individuals with photocontact allergy to ketoprofen. Contact Dermatitis 2024; 90:79-83. [PMID: 37840237 DOI: 10.1111/cod.14437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/07/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Simultaneous overrepresentations of contact allergies and photocontact allergies are common in individuals with photocontact allergy to ketoprofen. AIMS To investigate whether contact allergy to oxidised (ox.) geraniol, geraniol, geranial, neral and citral is overrepresented in individuals with photocontact allergy to ketoprofen. METHODS The contact allergy rates to ox. geraniol, geraniol, geranial, neral and citral in routinely patch tested dermatitis patients were compared with the corresponding rates in individuals with photocontact allergy to ketoprofen. RESULTS Allergic patch test reactions were noted to ox. geraniol 11% (n = 39, 5.8%), ox. geraniol 6% (n = 12, 1.8%), geraniol 6% (n = 2, 0.3%), geranial (n = 18, 2.7%), neral (n = 7, 1.0%) and citral (n = 15, 2.2%). In those four patients who were diagnosed with photocontact allergy to ketoprofen during the test period, a significant overrepresentation (p = 0.020) of simultaneous contact allergy to ox. geraniol 11% was demonstrated. Overrepresentation of simultaneous contact allergy to various combinations of ox. geraniol, ox. limonene and ox. linalool was also noted in ketoprofen-photoallergic patients. CONCLUSIONS Contact allergy to ox. geraniol, geranial and citral is common in routinely tested dermatitis patients. There is an overrepresentation of simultaneous contact allergy to ox. geraniol, ox. limonene and ox. linalool in patients with photocontact allergy to ketoprofen.
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Affiliation(s)
- Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Victoria Marmgren
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Erik Zimerson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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Hopkins K, Antelmi A, Dahlin J, Olsson K, Svedman C, Åstrand J, Bruze M. Increased Rates of Gold and Acrylate Allergy in Individuals with Fibromyalgia Tested with an Extended Dental Patch Test Series. Acta Derm Venereol 2023; 103:adv22336. [PMID: 38078690 PMCID: PMC10726376 DOI: 10.2340/actadv.v103.22336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Fibromyalgia is a common chronic pain condition. Rates of contact allergy in individuals with fibromyalgia have not been widely studied. Systemic contact allergy can present with muscle and joint pain and general malaise. The aim of this study is to investigate contact allergy rates in individuals with fibromyalgia to the sensitizers in an extended dental series and compare with control groups. Contact allergy to gold was significantly more common in the fibromyalgia group than the dermatitis control group. When corrected for patch test system, contact allergy to gold was significantly more common in the fibromyalgia group than the dental control group. Contact allergy to hydroxyethyl methacrylate and grouped acrylates and methacrylates was significantly more common in the fibromyalgia group than the dental control group. In conclusion, individuals with fibromyalgia may have a propensity to sensitization to gold, either via an increased exposure or an alteration in the oral environment. Gold is also implicated in systemic contact dermatitis and may be a factor in elicitation of symptoms in individuals with fibromyalgia. Acrylate allergy is also common in the fibromyalgia population and may be a consequence of occupational exposure or dental treatment.
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Affiliation(s)
- Katharine Hopkins
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Karin Olsson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jacqueline Åstrand
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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14
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Hamnerius N, Dahlin J, Bruze M, Nilsson K, Sukakul T, Svedman C. Colophonium-related Allergic Contact Dermatitis Caused by Medical Adhesive Tape Used to Prevent Skin Lesions in Soldiers. Acta Derm Venereol 2023; 103:adv18428. [PMID: 38059803 PMCID: PMC10719863 DOI: 10.2340/actadv.v103.18428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/25/2023] [Indexed: 12/08/2023] Open
Abstract
Medical adhesive tapes are commonly recommended for the prevention of friction blisters during hiking and military marches. The aim of this paper is to report on the results of investigations into an outbreak of tape-related foot dermatitis in 26 military conscripts following continuous use of medical adhesive tapes for several days during a field exercise. Patch tests were performed using baseline series and aimed testing was performed with colophonium-related substances and different medical adhesive tapes. Contact allergy to the adhesive tapes used was found in 20 (77%) subjects, and contact allergy to colophonium in 16 (61%). Chemical analysis detected colophonium-related substances in the culprit tapes. Compared with consecutive dermatitis patients investigated at our Department of Occupational and Environmental Dermatology in the previous 10 years, conscripts with colophonium allergy had increased odds ratios for concomitant contact allergy to phenol formaldehyde resins and fragrance substances including hydroperoxides of limonene and linalool. The results show that prolonged use of medical adhesive tapes on intact skin carries a high risk for allergic contact dermatitis. Prior to their introduction on the market, medical devices should be assessed for possible side-effects.
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Affiliation(s)
- Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Kristina Nilsson
- Department of Current Operations, Army Command, Swedish Armed Forces, Sweden
| | - Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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15
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Svedman C, Dahlin J, Hamnerius N, Adwa UNAR, Bruze M. Occupational allergic contact dermatitis induced by adhesives used for prevention of chafing in the military forces-A case report. Contact Dermatitis 2023; 89:391-393. [PMID: 37574207 DOI: 10.1111/cod.14398] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/15/2023]
Affiliation(s)
- Cecilia Svedman
- Department of Occupational and Environmental Dermatology Skåne University Hospital, Lund University, Malmo, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology Skåne University Hospital, Lund University, Malmo, Sweden
| | - Nils Hamnerius
- Department of Occupational and Environmental Dermatology Skåne University Hospital, Lund University, Malmo, Sweden
| | - Usamah N A R Adwa
- Department of Occupational and Environmental Dermatology Skåne University Hospital, Lund University, Malmo, Sweden
- Department of Dermatology, Helsingborg Hospital, Helsingborg, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology Skåne University Hospital, Lund University, Malmo, Sweden
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16
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Bruze M, Antelmi A, Dahlin J, Hamnerius N, Hauksson I, Hindsén M, Isaksson M, Lejding T, Mowitz M, Svedman C, Bergendorff O. Should acetophenone azine be inserted in a baseline patch test series? Contact Dermatitis 2023; 89:295-297. [PMID: 37401042 DOI: 10.1111/cod.14378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/05/2023]
Affiliation(s)
- Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Inese Hauksson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Monica Hindsén
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Tina Lejding
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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17
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Persad S, Lejding T, Svedman C, Mowitz M. The missing link: Allergic contact dermatitis caused by 1,6-hexanediol diacrylate in a glucose sensor transmitter. Contact Dermatitis 2023; 89:303-305. [PMID: 37470167 DOI: 10.1111/cod.14385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Shayan Persad
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, SUS, University of Lund, Malmö, Sweden
- Department of Dermatology, Helsingborg Hospital, Sweden University of Lund, Malmö, Sweden
| | - Tina Lejding
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, SUS, University of Lund, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, SUS, University of Lund, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, SUS, University of Lund, Malmö, Sweden
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18
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Lejding T, Persson L, Andersen KE, Bruze M, Derevyanko L, Elsner P, Goh CL, Gonçalo M, Goossens A, Gülgün MA, Isaksson M, Ljubojevic Hadzavdic S, Maibach H, Matsunaga K, Mowitz M, Nixon R, Pailin P, Pratt M, Schuttelaar MLA, Sukakul T, Verma K, Zimerson E, Özkaya E, Svedman C. Analysis of Hexavalent Chromium in Cement Samples From Countries Within and Outside the EU: A Study From the International Contact Dermatitis Research Group. Dermatitis 2023; 34:323-328. [PMID: 37001151 DOI: 10.1089/derm.2022.0053] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Background: Allergic contact dermatitis (ACD) caused by hexavalent chromium (Cr(VI)) is often severe and difficult to treat. The content of Cr(VI) in cement can be reduced by, for example, addition of iron(II) sulfate. Since 2005 the content of Cr(VI) in cement is regulated in the EU Directive 2003/53/EC and must not exceed 2 ppm. Since this regulation came into force, ACD caused by cement has markedly been reduced. Objective: To investigate Cr(VI) and total chromium content in samples of cement from countries within and outside the EU. Methods: The members of the International Contact Dermatitis Research Group (ICDRG) were invited to participate in the study with the aim to collect cement samples from geographically different areas. The content of Cr(VI) in the samples was estimated by the diphenyl carbazide spot test, atomic absorption spectroscopy was used to assess the total chromium content. Results: Forty-five cement samples were analyzed, containing amounts of Cr(VI) from <0.1 to >70 ppm. Twenty-one samples contained >2 ppm Cr(VI), 24 contained less. Four of 17 samples from within the EU contained >2 ppm Cr(VI), that is, higher amounts than stipulated in the EU directive, as compared with 17 samples from countries outside the EU. Conclusion: In countries outside the EU, significantly more cement samples contained >2 ppm Cr(VI).
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Affiliation(s)
- Tina Lejding
- From the Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Lena Persson
- From the Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Klaus Ejner Andersen
- Department of Dermatology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Magnus Bruze
- From the Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ludmyla Derevyanko
- Department of Dermatovenereology, Kyiv Medical University, Kyiv, Ukraine
| | - Peter Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | | | - Margarida Gonçalo
- University Hospital and Faculty of Medicine University of Coimbra, Coimbra, Portugal
| | - An Goossens
- Department of Dermatology, KU Leuven, Leuven, Belgium
| | - Mehmet Ali Gülgün
- Sabancı University, Faculty of Engineering and Natural Sciences Materials Science and Nano Engineering, Tuzla-Istanbul, Turkey
| | - Marléne Isaksson
- From the Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Suzana Ljubojevic Hadzavdic
- Department of Dermatovenereology, University Hospital Center Zagreb, University of Zagreb, School of Medicine, Kišpatićeva, Zagreb, Croatia
| | - Howard Maibach
- Department of Dermatology, University of California Medical Center, San Francisco, California, USA
| | - Kayoko Matsunaga
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Japan
| | - Martin Mowitz
- From the Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Melbourne, Victoria, Australia
| | | | - Melanie Pratt
- University of Ottawa, The Ottawa Hospital, Ottawa, Canada
| | | | - Thanisorn Sukakul
- From the Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Kaushal Verma
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Erik Zimerson
- From the Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Esen Özkaya
- Department of Dermatology and Venereology, Istanbul University, Istanbul Faculty of Medicine, Çapa-Istanbul, Turkey
| | - Cecilia Svedman
- From the Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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19
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Ofenloch RF, Andersen KE, Foti C, Giménez-Arnau AM, Mowitz M, Salvador JFS, Svedman C, Bruze M. Allergic reactivity for different dilutions of eugenol in repeated open application test and patch testing. Contact Dermatitis 2023. [PMID: 37218587 DOI: 10.1111/cod.14333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Eugenol is a known contact sensitiser included in fragrance mix I. OBJECTIVE To assess the allergic reactivity to eugenol in different concentrations using patch test as well as repeated open application test (ROAT). METHODS Overall 67 subjects from 6 European dermatology clinics participated in the study. The ROAT was performed for 21 days twice a day, applying 3 dilutions of eugenol (2.7%-0.5%) and a control. Before and after the ROAT, patch testing with 17 dilutions of eugenol (2.0%-0.00006%) and controls was performed. RESULTS Out of the 34 subjects with contact allergy to eugenol, 21 (61.8%) showed a positive patch test before ROAT was performed, the lowest positive concentration was 0.031%. The ROAT was positive in 19 (55.9%) of the 34 subjects, the time until a positive reaction occurred was negatively associated with the concentration of the ROAT solution, as well as with the allergic reactivity of the subjects as defined by patch testing. In the patch test after ROAT, 20 of the 34 test subjects (58.8%) showed a positive reaction. In 13 (38.2%) of the 34 test subjects, the patch test result was not reproduceable, still 4 (31.0%) of these 13 subjects developed a positive ROAT. CONCLUSION Eugenol can provoke a positive patch test reaction in a very low dose; besides, this hypersensitivity may persist even if a former positive patch test is not reproduceable.
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Affiliation(s)
- Robert F Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Klaus Ejner Andersen
- Department of Dermatology, Odense University Hospital, Odense, Denmark
- Department of Dermatology, University of Southern Denmark, Odense, Denmark
| | - Caterina Foti
- Department of Dermatology, Universitaria di Bari, Bari, Italy
| | | | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Lund, Sweden
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | | | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Lund, Sweden
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Lund, Sweden
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
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20
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Brynolf A, Hauksson I, Bergendorff O, Svedman C, Hamnerius N. Contact allergy investigations in healthcare workers with face mask-related skin disease. Contact Dermatitis 2023. [PMID: 37072615 DOI: 10.1111/cod.14318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, the use of face masks has increased among healthcare workers (HCWs). Questionnaire studies have shown a high frequency of self-reported facial adverse skin reactions. Case reports have been published on face mask-induced allergic contact dermatitis and urticaria. OBJECTIVES To describe the results of the contact allergy investigations in consecutive HCWs investigated for skin reactions to face masks during the COVID-19 pandemic and the results of the chemical investigations of face masks supplied by the hospital. METHODS Participants were patch tested with baseline series and chemicals previously reported in face masks not included in the baseline series. Face mask(s) brought by the HCW were tested as is and/or in acetone extract. Chemical analyses were performed on nine different face masks for potential allergens. RESULTS Fifty-eight HCWs were investigated. No contact allergies were found to the face mask(s) tested. Eczema was the most common type of skin reaction, followed by an acneiform reaction. Colophonium-related substances were found in one respirator and 2,6-di-t-butyl-4-methylphenol (BHT) were found in two respirators. CONCLUSION Based on this report, contact allergies to face masks is uncommon. Patch test with colophonium-related substances and BHT should be considered when investigating adverse skin reactions to face masks.
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Affiliation(s)
- Andreas Brynolf
- Department of Dermatology, Helsingborg Hospital, Helsingborg, Sweden
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Inese Hauksson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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21
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Isaksson M, Bergendorff O, Hamnerius N, Pontén A, Svedman C, Hauksson I, Bruze M. Active sensitization to dimethylthiocarbamylbenzothiazol sulphide: An unexpectedly strong rubber contact allergen. Contact Dermatitis 2023; 88:472-479. [PMID: 36975130 DOI: 10.1111/cod.14311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND The two dialkylthiocarbamyl benzothiazole sulphides, dimethyl-thiocarbamylbenzothiazole sulphide (DMTBS) and diethylthio-carbamylbenzothiazole sulphide (DETBS) were shown to be good markers of both thiuram and mercaptobenzothiazole sensitivity. OBJECTIVES To investigate if DMTBS and/or DETBS could be better markers of contact allergy to common rubber additives than the ones currently used. METHODS Sixty-eight dermatitis patients were patch tested with DMTBS and DETBS, both at 1% in petrolatum (pet). Because of late reactions in 10 patients, these were retested to DMTBS and DETBS in serial dilutions. Tetramethylthiuram monosulphide (TMTM) 1.0% pet was also tested. RESULTS At the initial reading Days 3 and 7, no reactions were noted to DMTBS or DETBS. At retesting, 10 of the 68 (15%) patients reacted positively to lower concentrations of DMTBS than the initial test concentration. Seven of 8 also reacted to TMTM. Three of them had positive reactions to DEBTS. All 10 patients had reactions to more diluted solutions to DMBTS than to DEBTS (p = 0.0077; Mc-Nemar test, two-sided). CONCLUSIONS Results speak for patch test sensitization to DMTBS with cross-reactivity to TMTM and also DEBTS. DMTBS and DEBTS could be new markers of rubber allergy but a safe test concentration must be found.
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Affiliation(s)
- Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden
| | - Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden
| | - Ann Pontén
- Department of Occupational and Environmental Dermatology, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden
| | - Inese Hauksson
- Department of Occupational and Environmental Dermatology, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden
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22
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Antelmi A, Dahlin J, Hopkins K, Svedman C, Bruze M. Contact allergy to gold simultaneously patch tested in two different chambers. Contact Dermatitis 2023. [PMID: 36942432 DOI: 10.1111/cod.14310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/23/2023]
Affiliation(s)
- Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Katharine Hopkins
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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Enberg J, Hamnerius N, Kroona L, Svedman C. The use of carvone in consecutive patch testing. Contact Dermatitis 2023; 88:206-211. [PMID: 36399045 PMCID: PMC10098734 DOI: 10.1111/cod.14249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/30/2022] [Accepted: 11/16/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Carvone (l-carvone) is a mint-tasting flavour additive that most of us is exposed to and can cause allergic contact reactions. OBJECTIVES To analyse the frequency and the relevance of positive carvone reactions in a dermatitis population. METHOD A retrospective analysis of dermatitis patients consecutively tested with carvone from 2017 to 2021. Data were retrieved from the department's patch-test database. RESULTS Of 3554 patients tested with carvone, 28 (0.79%) had a positive reaction. Carvone-positive patients had higher mean age, were significantly more likely female (p < 0.001) and had often an intraoral/lip involvement (p < 0.001). In the carvone-positive group, 50% (n = 14) had a relevant reaction, and in 4 of 14, the relevance was first revealed after test reading. Of the carvone-positive patients, 18 of 28 did not have a coexisting allergy to a fragrance/flavour allergen and of these 44% had a relevant allergy. CONCLUSIONS The study suggests that a significant fraction of relevant carvone contact allergies may be overlooked if the allergen is not tested. Furthermore, as the exposure is widespread, inclusion of carvone in the Swedish baseline series may be justified even if the contact allergy prevalence is below 1%.
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Affiliation(s)
- Johanna Enberg
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden.,Helsingborg's Hospital, Helsingborg, Sweden
| | - Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Liv Kroona
- Department of Oral Pathology, Malmö University, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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Comstedt LR, Siemund I, Dahlin J, Bruze M, Svedman C. Effects of aluminium chloride added to common patch test substances. Contact Dermatitis 2023; 88:456-462. [PMID: 36840428 DOI: 10.1111/cod.14299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND A modulating effect of aluminium regarding type IV reactions might exist but has not been further investigated. OBJECTIVES The aim of this study was to investigate the effect on patch test reactions when adding aluminium chloride hexahydrate (Al-Cl) to common test preparations. MATERIALS AND METHODS Al-Cl in different concentrations was added to nickel sulphate 15.0% aqua (Ni), methylisothiazolinone 0.2% aqua (MI) and fragrance mix I 10.0% aqua/ethanol (FM I). The Ni preparations were tested in 120 consecutive patients. MI and FM I were tested in participants known to have contact allergy to the respective allergen. McNemar's test was used to decide which Ni preparation had the highest sensitivity. Wilcoxon signed-rank test was used to calculate pairwise comparison in summarized test score for the preparations with MI and FM I. RESULTS Adding Al-Cl 20.0%/30.0% to Ni identified twice as many patients with contact allergy to nickel compared to Ni without Al-Cl. Adding Al-Cl 20.0%/10.0% to MI, decreased the patch test reactivity compared to MI without Al-Cl. No differences in patch reactivity were noticed when adding Al-Cl to FM I. CONCLUSION Al-Cl 20.0% or 30.0% seems to enhance the patch test reactivity to Ni 15.0% aqua.
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Affiliation(s)
- Lisbeth Rosholm Comstedt
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ingrid Siemund
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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25
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Lejding T, Källberg K, Bergendorff O, Jacobsson S, Svedman C, Bruze M. Epoxy allergy, investigation of a modern industry. Contact Dermatitis 2023; 88:383-388. [PMID: 36802059 DOI: 10.1111/cod.14293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/20/2023]
Abstract
BACKGROUND Five workers from an industry manufacturing various articles from carbon fibre reinforced epoxy plastics were referred to our department because of suspected occupational allergic contact dermatitis (OACD). When patch tested, four of them had positive reactions to components of epoxy resin systems (ERSs) that could explain their current skin problems. All of them had been working at the same workstation at a specially designed pressing machine, with operations including manually mixing epoxy resin with hardener. Multiple cases of OACD in the plant prompted an investigation including all workers with possible risk exposures at the plant. OBJECTIVES To investigate the prevalence of occupational dermatoses and contact allergies among the workers at the plant. MATERIALS AND METHODS Totally 25 workers underwent investigation that included a brief consultation with a standardized anamnesis and clinical examination followed by patch testing. RESULTS ERSs-related reactions were found in 7 of the 25 investigated workers. None of the seven had a history of previous exposure to ERSs and they are regarded as sensitized through work. CONCLUSIONS Twenty-eight percent of investigated workers showed reactions to ERSs. Of these the majority would have been missed if supplementary testing would not have been added to testing with the Swedish base line series.
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Affiliation(s)
- Tina Lejding
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Kajsa Källberg
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Susanne Jacobsson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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26
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Sukakul T, Bruze M, Mowitz M, Svedman C. Use of sorbitan sesquioleate in patch test preparations and patch testing with the substance-What do our results mean? Contact Dermatitis 2023; 88:134-138. [PMID: 36305668 PMCID: PMC10092872 DOI: 10.1111/cod.14239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/12/2022] [Accepted: 10/23/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Sorbitan sesquioleate (SSO) is a sorbitan fatty acid ester, an emulsifier used in topical products and certain patch test preparations. SSO may affect the patch test results. It has been debated whether to include the substance in the baseline series to avoid misinterpretation of the results. OBJECTIVES To report the prevalence and simultaneous reactions of SSO with other patch test preparations containing SSO as an emulsifier. MATERIALS AND METHODS A retrospective analysis of 3539 dermatitis patients who underwent patch testing from 2016 to 2020 was performed. RESULTS The 5-year SSO contact allergy prevalence was 0.48%, and 1.3% had a doubtful reaction. Patients with a stronger positive reaction (2+, 3+) were more likely to react simultaneously to other allergen preparations containing SSO (p value = 0.018). One patient with a strong reaction to SSO reacted positively to all SSO-containing patch test preparations. Definite fragrance allergens could not be identified in the patients who had simultaneous reactions to SSO and fragrance mix (FM) I. CONCLUSIONS Patch testing with allergen preparations containing SSO affected the patch test interpretation. Fragrance contact allergy could not be ruled out when a patient simultaneously reacted to SSO and FM I. Changing emulsifiers in patch test preparations would be advantageous.
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Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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27
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Bruze M, Hopkins K, Dahlin J, Olsson K, Åstrand J, Svedman C, Ofenloch R, Antelmi A. Increased rates of fragrance allergy in fibromyalgia individuals tested with the Swedish baseline patch test series. J Eur Acad Dermatol Venereol 2023; 37:104-113. [PMID: 36018078 DOI: 10.1111/jdv.18562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/27/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Contact allergy can manifest in a variety of ways clinically. Systemic contact allergy may occasionally present with pain in muscles and joints. Fibromyalgia is a chronic rheumatic disease characterized by pain and with virtually unknown aetiology. OBJECTIVES The aim of this study was to investigate the contact allergy rates to the sensitizers in a baseline series and compare with corresponding rates in dermatitis patients and the general population. METHODS Patch testing with the Swedish baseline series was performed in 120 individuals with fibromyalgia. Fisher's exact test was used for pair-wise comparisons of contact allergy rates between the fibromyalgia group and two control groups, dermatitis patients and individuals in the general population. RESULTS Contact allergy was significantly more common in the fibromyalgia group compared to the general population concerning nickel and the fragrance markers Myroxolon pereirae and fragrance mix I. There were fewer allergic reactions to preservatives in the fibromyalgia group compared with the dermatitis group. CONCLUSIONS Myroxolon pereirae and fragrance mix I represent besides fragrance allergy also allergy to flavouring substances which indicate that oral exposure to flavouring substances and hygiene products might be important for sensitization and possibly elicitation of systemic contact allergy symptoms in fibromyalgia individuals.
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Affiliation(s)
- Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Katharine Hopkins
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.,Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Karin Olsson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jacqueline Åstrand
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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28
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Mose AP, Adwa U, Svedman C. Allergic Contact Dermatitis to Topical Clindamycin in a Patient with Hidradenitis Suppurativa. Acta Derm Venereol 2022; 102:adv00779. [DOI: 10.2340/actadv.v102.3425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missing (Short communication)
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Raison-Peyron N, Mowitz M, Dereure O, Svedman C. Allergic Contact Dermatitis in a Patient After Five Years of Use of Omnipod Insulin Pump. J Diabetes Sci Technol 2022; 16:1342-1343. [PMID: 36048581 PMCID: PMC9445354 DOI: 10.1177/19322968221110578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Nadia Raison-Peyron
- Department of Dermatology, Hôpital Saint Eloi, Montpellier University Hospital, Montpellier University, Montpellier, France
- Nadia Raison-Peyron, MD, Department of Dermatology, Hôpital Saint Eloi, Montpellier University Hospital, Montpellier University, 80 Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, University of Lund, Malmö, Sweden
| | - Olivier Dereure
- Department of Dermatology, Hôpital Saint Eloi, Montpellier University Hospital, Montpellier University, Montpellier, France
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, University of Lund, Malmö, Sweden
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30
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Linauskiene K, Zimerson E, Sörensen Ö, Antelmi A, Bruze M, Dahlin J, Malinauskiene L, Stenton J, Svedman C, Isaksson M. Patch test results to extracts of synthetic garments in textile dye positive patients. Contact Dermatitis 2022; 87:325-330. [PMID: 35818106 DOI: 10.1111/cod.14182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/31/2022] [Accepted: 07/04/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Disperse dyes (DDs) are the most prevalent causes of textile-related allergic contact dermatitis and are used for coloring synthetic textile materials based on fibers such as polyester, acrylic, acetate and polyamide. Eight DDs are included in a textile dye mix (TDM) 6.6% petrolatum (pet.) in the European baseline patch test series. OBJECTIVES The aim of this study was to patch test TDM 6.6% pet. Positive individuals with the extracts of synthetic fiber clothes that do not contain any of the pure DDs present in the TDM 6.6% to study the reactivity pattern. METHODS Seventy-three TDM-positive former patients tested between 2012-2017 at the Department of Occupational and Environmental Dermatology in Malmö, Sweden were invited to join the study, 10 participated. Twenty-four textile items (collected in 9 countries in Europe, Asia and North America in 2012) were extracted in dichloromethane. The TDM 6.6% was patch tested simultaneously with the 24 textile item preparations in petrolatum made from the extracts. Prior to patch testing the participants filled the 7-question questionnaire regarding possible symptoms from textile exposure. RESULTS Ten individuals, agreed to join the study. Eight of them reacted to TDM 6.6%. Nine participants reacted to 20 of 24 extracts. One reacted to 19 extracts, another to 14, 3 to 5 extracts, 1 to 4, 1 to 3 extracts and 2 to 2 extracts. One was negative to all tested preparations including TDM 6.6%. The participants mainly reacted to 6 textile extracts. All controls tested negatively to tested extracts. Four individuals of the 10 TDM-allergic individuals previously had had problems after wearing clothes. Four out of the 10 participants had had atopic eczema in childhood. All women had dyed their hair with permanent hair dyes but none of the males. CONCLUSION TDM - positive patients react to textile extracts made from synthetic garments, even if they do not contain any of the pure DDs present in TDM 6.6%. More studies are needed to pin-point the culprit haptens in these extracts.
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Affiliation(s)
- Kotryna Linauskiene
- Vilnius University Faculty of Medicine, Institute of Clinical Medicine, Clinic of Chest diseases, Immunology and Allergology, Vilnius, Lithuania.,Lund University, Skane University Hospital Department of Occupational and Environmental Dermatology, Malmö, Sweden
| | - Erik Zimerson
- Lund University, Skane University Hospital Department of Occupational and Environmental Dermatology, Malmö, Sweden
| | - Östen Sörensen
- Lund University, Skane University Hospital Department of Occupational and Environmental Dermatology, Malmö, Sweden
| | - Annarita Antelmi
- Lund University, Skane University Hospital Department of Occupational and Environmental Dermatology, Malmö, Sweden
| | - Magnus Bruze
- Lund University, Skane University Hospital Department of Occupational and Environmental Dermatology, Malmö, Sweden
| | - Jakob Dahlin
- Lund University, Skane University Hospital Department of Occupational and Environmental Dermatology, Malmö, Sweden
| | - Laura Malinauskiene
- Vilnius University Faculty of Medicine, Institute of Clinical Medicine, Clinic of Chest diseases, Immunology and Allergology, Vilnius, Lithuania.,Lund University, Skane University Hospital Department of Occupational and Environmental Dermatology, Malmö, Sweden
| | - Joanna Stenton
- Lund University, Skane University Hospital Department of Occupational and Environmental Dermatology, Malmö, Sweden
| | - Cecilia Svedman
- Lund University, Skane University Hospital Department of Occupational and Environmental Dermatology, Malmö, Sweden
| | - Marléne Isaksson
- Lund University, Skane University Hospital Department of Occupational and Environmental Dermatology, Malmö, Sweden
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31
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Ljungberg Silic L, Lefevre M, Bergendorff O, De Bernard S, Nourikyan J, Buffat L, Nosbaum A, Bruze M, Nicolas J, Svedman C, Vocanson M. Gene profiling reveals a contact allergy signature in most positive Amerchol L‐101 patch‐test reactions. Contact Dermatitis 2022; 87:40-52. [DOI: 10.1111/cod.14077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/19/2022] [Accepted: 02/07/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Linda Ljungberg Silic
- Department of Occupational and Environmental Dermatology, Lund University Skåne University Hospital Malmö Sweden
| | - Marine‐Alexia Lefevre
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy); Univ Lyon; Inserm, U1111; Université Claude Bernard Lyon 1; CNRS, UMR5308; ENS de Lyon Lyon France
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Lund University Skåne University Hospital Malmö Sweden
| | | | | | | | - Audrey Nosbaum
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy); Univ Lyon; Inserm, U1111; Université Claude Bernard Lyon 1; CNRS, UMR5308; ENS de Lyon Lyon France
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University Skåne University Hospital Malmö Sweden
| | - Jean‐François Nicolas
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy); Univ Lyon; Inserm, U1111; Université Claude Bernard Lyon 1; CNRS, UMR5308; ENS de Lyon Lyon France
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University Skåne University Hospital Malmö Sweden
| | - Marc Vocanson
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy); Univ Lyon; Inserm, U1111; Université Claude Bernard Lyon 1; CNRS, UMR5308; ENS de Lyon Lyon France
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Herreros‐Montejano F, Mowitz M, Heras‐Mendaza F, Sanz‐Sánchez T, Gatica‐Ortega ME, López‐Mateos A, Valenzuela‐Oñate C, Faura‐Berruga C, Zaragoza‐Ninet V, Bruze M, Svedman C, Pastor‐Nieto MA. Outbreak of Occupational Allergic Contact Dermatitis from a Smartphone Screen Protector Glue. Contact Dermatitis 2022; 87:53-61. [PMID: 35184294 PMCID: PMC9313874 DOI: 10.1111/cod.14079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
Abstract
Background Sensitization to acrylates is a concern in the occupational/environmental dermatology field. Objective To describe an occupational allergic contact dermatitis (ACD) outbreak from a smartphone screen protector glue. Methods Thirteen affected workers of a chain store selling phone screen protectors were investigated in five Spanish dermatology departments. The glue datasheet and label were assessed. A chemical analysis of the glue was performed. Based on this, some patients underwent additional testing. Results All patients (all female, mean age: 25) had severe fingertip dermatitis. The datasheet/label indicated that the glue contained isobornyl acrylate (IBOA), a “photoinitiator” and polyurethane oligomer. The company informed us that the ingredients were polyurethane acrylate, “methacrylate” (unspecified), acrylic acid, hydroxyethyl methacrylate, propylmethoxy siloxane, and photoinitiator 184. Isobornyl acrylate (or IBOA) and N,N‐dimethylacrylamide (DMAA) were patch tested in eight and two cases, respectively, with negative results. A chemical analysis revealed 4‐acryloylmorpholine (ACMO); isobornyl methacrylate (IBMA), and lauryl acrylate in one glue sample. Seven patients were patch tested with dilutions of the identified substances and six of seven were positive for ACMO 0.5% pet. Conclusion An outbreak of occupational ACD, likely from ACMO in a glue is described. Further investigations are needed to corroborate the role played by each compound identified in the chemical analyses.
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Affiliation(s)
| | - Martin Mowitz
- Dept. of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | | | | | | | | | | | | | | | - Magnus Bruze
- Dept. of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Cecilia Svedman
- Dept. of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - María Antonia Pastor‐Nieto
- Dermatology Dept. Hospital Universitario de Guadalajara Guadalajara Spain
- Faculty of Medicine and Health Sciences. Medicine and Medical Specialties Department Universidad de Alcalá Alcalá de Henares, Madrid Spain
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33
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Sukakul T, Bruze M, Mowitz M, Antelmi A, Boonchai W, Dahlin J, Hamnerius N, Hauksson I, Lejding T, Svedman C. Simultaneous patch testing with fragrance markers in the baseline series and the ingredients of fragrance mixes ‐ an update from southern Sweden. Contact Dermatitis 2022; 86:514-523. [PMID: 35152428 PMCID: PMC9314710 DOI: 10.1111/cod.14072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 11/28/2022]
Abstract
Background Regularly updating the prevalence of fragrance contact allergy (CA) is important. Patch testing with fragrance markers in the baseline series and the ingredients of fragrance mixes (FMs) is still debated. Objectives To update the prevalence and clinical characteristics of patients with fragrance CA. To establish the results of patch testing with individual allergens of FMs. Methods A retrospective analysis of 3539 patients with dermatitis who were patch tested with the baseline series and FMs ingredients during 2016 to 2020 was performed. Results The prevalence of fragrance CA was 13%. About 10% of these patients with fragrance CA would be missed if the individual ingredients were not tested. Unlike hydroxyisohexyl 3‐cyclohexene carboxaldehyde, there was no decreasing trend of CA to Evernia prunastri (oakmoss) extract after the EU regulation came into force. Patients with CA from only one ingredient of the mixes or having a weak positive reaction to the ingredients were significantly missed when tested with only the fragrance markers in the baseline series. Conclusions Patch testing with individual fragrance allergens is crucial for experts to expand knowledge in the fragrance CA field. The concentrations of the allergens in FMs may need to be adjusted to detect patients with fragrance CA, since some were significantly overlooked.
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Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Waranya Boonchai
- Department of Dermatology Faculty of Medicine Siriraj Hospital, Mahidol University Bangkok Thailand
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Nils Hamnerius
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Inese Hauksson
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Tina Lejding
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology Lund University, Skåne University Hospital Malmö Sweden
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34
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Ogueta IA, Christensson JB, Giménez-Arnau E, Brans R, Wilkinson M, Stingeni L, Foti C, Aerts O, Svedman C, Gonçalo M, Giménez-Arnau A. Limonene and linalool hydroperoxides review: pros and cons for routine patch testing. Contact Dermatitis 2022; 87:1-12. [PMID: 35122274 DOI: 10.1111/cod.14064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/29/2022] [Accepted: 02/02/2022] [Indexed: 12/01/2022]
Abstract
Limonene and linalool are among the most common fragrance terpenes used in products of everyday life. They are pre-haptens forming hydroperoxides (Lim-OOHs, Lin-OOHs) upon oxidation inducing frequent positive patch test reactions in patients with dermatitis. Still, they are not yet routinely tested in Europe. This review evaluates the patch testing experience with Lim-OOHs and Lin-OOHs by answering key questions such as whether hydroperoxide patch testing is warranted, understand difficulties or challenges related to the reading and interpretation of hydroperoxide patch test results with currently available material, assessing their relevance. Studies are increasingly pointing out to high percentages of positive reactions in patients consecutively patch tested with these oxidized products. An association between a positive clinical history and a strong patch test reaction has been described, but problems with doubtful/irritant reactions have also been reported. Considering the high frequencies of relevant positive reactions, the incorporation of Lim-OOHs 0.3% and Lin-OOHs 1% in the baseline series could be discussed and is maybe justified. Since exposure, sensitization and elicitation limits of Lim-OOHs and Lin-OOHs in the products still need to be better determined, an assessment of previous exposure, possible sensitizations and reactions may help to improve the clinical assessment. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Isabel A Ogueta
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Autònoma. Barcelona, Spain.,Department of Dermatology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - Johanna Brared Christensson
- Dermatochemistry and Skin Allergy, Department of Chemistry and Molecular Biology, University of Gothenburg, Gothenburg, Sweden. Citysjukhuset +7, Gothenburg, Sweden
| | - Elena Giménez-Arnau
- Dermatochemistry Laboratory, University of Strasbourg, Institute of Chemistry CNRS UMR 7177, Strasbourg, France
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Mark Wilkinson
- Dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Caterina Foti
- Department of Biomedical Science and Human Oncology, Dermatology Section, University of Bari "Aldo Moro", Bari, Italy
| | - Olivier Aerts
- University Hospital Antwerp (UZA) and University of Antwerp, Antwerp, Belgium
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skane University Hospital, Lund University, Malmö, Sweden
| | - Margarida Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Giménez-Arnau
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Autònoma. Barcelona, Spain
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Samaran Q, Raison-Peyron N, Clark E, Svedman C, Dahlin J, Dereure O, Bruze M, Bourrain JL. A new case of photoallergic contact dermatitis caused by benzophenones in magazine covers. Contact Dermatitis 2022; 86:300-307. [PMID: 35089601 DOI: 10.1111/cod.14057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/17/2022] [Accepted: 01/26/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) and photoallergic contact dermatitis (PACD) to benzophenone present in printing ink have been reported. However, precise chemical analyses and extended photo-patch tests have not been performed in these cases. OBJECTIVES To determine which component present in a magazine cover are responsible for a patient's skin reaction, determine the primary sensitiser and precisely diagnose ACD and PACD PATIENT AND METHODS: After initial photopatch tests were performed on a patient with a history of reaction to magazine covers after sun exposure, gas chromatography-mass spectrometry and high-performance liquid chromatography analyses of the magazine covers and additional photopatch tests were performed. RESULTS The first photopatch test results confirmed PACD to ketoprofen and fenofibrate, and evoked PACD to the magazine covers. 4-methyl benzophenone (4-MBP) and 1-hydroxy-cyclohexyl-phenyl-ketone (1-HCPK) were found in the magazine cover. Additional photopatch tests confirmed PACD to 1-HCPK and to benzophenone, and photo-aggravated ACD to 4-MBP. The primary sensitiser was ketoprofen. CONCLUSIONS Benzophenones are present in a wide variety of products, without always being listed on the packaging. Patients previously sensitised to other ketones, such as ketoprofen, may react to benzophenones without being able to avoid contact with these molecules. New regulations may be needed for more efficient eviction advice. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Quentin Samaran
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, FRANCE
| | - Nadia Raison-Peyron
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, FRANCE
| | - Evangeline Clark
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, FRANCE
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, SWEDEN
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, SWEDEN
| | - Olivier Dereure
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, FRANCE
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, SWEDEN
| | - Jean Luc Bourrain
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, FRANCE.,Department of Pulmonology, Allergology Division, Montpellier University Hospital and Montpellier University, Montpellier, FRANCE.,IDESP, Institut Desbrest d'Epidémiologie et de Santé Publique, UMR INSERM - Montpellier University, Montpellier, FRANCE
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36
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Bach RO, Svendsen MT, Mose KF, Bruze M, Svedman C, Andersen KE. A comparison of patch testing with nickel sulfate in TRUE Test and in petrolatum at 2.5% and 5% concentrations. Contact Dermatitis 2021; 86:233-234. [PMID: 34800302 DOI: 10.1111/cod.14013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/16/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Rasmus Overgaard Bach
- Department of Dermatology and Allergy Centre, Odense University Hospital Denmark, Odense, Denmark
| | - Mathias Tiedemann Svendsen
- Department of Dermatology and Allergy Centre, Odense University Hospital Denmark, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kristian Fredløv Mose
- Department of Dermatology and Allergy Centre, Odense University Hospital Denmark, Odense, Denmark
| | - Magnus Bruze
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Cecilia Svedman
- Lund University, Department of Occupational and Environmental Dermatology, Skåne University Hospital, Malmö, Sweden
| | - Klaus Ejner Andersen
- Department of Dermatology and Allergy Centre, Odense University Hospital Denmark, Odense, Denmark
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Andernord D, Bruze M, Bryngelsson IL, Bråred Christensson J, Glas B, Hagvall L, Isaksson M, Matura M, Nyman G, Stenberg B, Svedman C, Lindberg M. Contact allergy to haptens in the Swedish baseline series: Results from the Swedish Patch Test Register (2010 to 2017). Contact Dermatitis 2021; 86:175-188. [PMID: 34704261 DOI: 10.1111/cod.13996] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Allergic contact dermatitis has considerable public health impact and causative haptens vary over time. OBJECTIVES To report the prevalence of contact allergy to allergens in the Swedish baseline series 2010 to 2017, as registered in the Swedish Patch Test Register. METHODS Results and demographic information for patients tested with the Swedish baseline series in 2010 to 2017 were analysed. RESULTS Data for 21 663 individuals (females 69%) were included. Females had significantly more positive patch tests (54% vs 40%). The reaction prevalence rates were highest for nickel sulfate (20.7%), fragrance mix I (7.1%), Myroxylon pereirae (6.9%), potassium dichromate (6.9%), cobalt chloride (6.8%), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI; 6.4%), MI (3.7%), colophonium (3.5%), fragrance mix II (3.2%), and formaldehyde (3.2%). Myroxylon pereirae reaction prevalence increased from 5% in 2010 to 9% in 2017 and that for methyldibromo glutaronitrile from 3.1% to 4.6%. MCI/MI and MI reactions decreased in prevalence after 2014. Nickel reaction prevalence decreased among females aged 10 to 19 years. CONCLUSIONS Nickel remains the most common sensitizing agent, with reaction prevalence decreasing among females younger than 20 years. The changes in MCI/MI and MI reaction prevalence mirrored those in Europe. The register can reveal changes in contact allergy prevalence over time among patients patch tested in Sweden.
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Affiliation(s)
- Daniel Andernord
- Department of Dermatology, Central Hospital, Karlstad, Sweden.,Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ing-Liss Bryngelsson
- Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Johanna Bråred Christensson
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Bo Glas
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Lina Hagvall
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Mihály Matura
- Department of Dermatology, Skaraborg Hospital Skövde, Skövde, Sweden
| | - Gunnar Nyman
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Berndt Stenberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Magnus Lindberg
- Department of Dermatology, Örebro University Hospital and Department of Dermatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Ulriksdotter J, Mowitz M, Bruze M, Löndahl M, Svedman C. [Not Available]. Lakartidningen 2021; 118:21046. [PMID: 34637129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Josefin Ulriksdotter
- doktorand, ST-läkare, hudmottagningen, Helsingborgs lasarett; Yrkes- och miljödermatologiska avdelningen (YMDA), Skånes universitetssjukhus Malmö; institutionen för kliniska vetenskaper i Malmö, Lunds universitet
| | - Martin Mowitz
- PhD, kemist, Yrkes- och miljödermatologiska avdelningen (YMDA), Skånes universitetssjukhus Malmö; institutionen för kliniska vetenskaper i Malmö, Lunds universitet
| | - Magnus Bruze
- senior professor, överläkare, Yrkes- och miljödermatologiska avdelningen (YMDA), Skånes universitetssjukhus Malmö; institutionen för kliniska vetenskaper i Malmö, Lunds universitet
| | - Magnus Löndahl
- docent, överläkare, VE endokrinologi, VO EHRÖ, Skånes universitetssjukhus, Lund; institutionen för kliniska vetenskaper i Lund, Lunds universitet
| | - Cecilia Svedman
- professor, överläkare, Yrkes- och miljödermatologiska avdelningen (YMDA), Skånes universitetssjukhus Malmö; institutionen för kliniska vetenskaper i Malmö, Lunds universitet
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Sukakul T, Bruze M, Mowitz M, Antelmi A, Bergendorff O, Björk J, Dahlin J, Hamnerius N, Hauksson I, Isaksson M, Lejding T, Pontén A, Svedman C. Contact allergy to oxidized linalool and oxidized limonene: Patch testing in consecutive patients with dermatitis. Contact Dermatitis 2021; 86:15-24. [PMID: 34561893 DOI: 10.1111/cod.13980] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/26/2021] [Accepted: 09/19/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Contact allergy to oxidized (ox.) linalool and ox. limonene has been reported to have a high prevalence, raising the question of inclusion into the baseline series. However, several important issues should be clarified and further investigated before inclusion can be warranted. OBJECTIVES To report the trends of ox. terpenes allergy in patients with dermatitis, features of the patch test reactions, and clinical characteristics of the patients. METHODS A retrospective analysis of 5773 patients was performed. All patients were patch tested with baseline series, individual ingredients of fragrance mix I and II, ox. linalool, and ox. limonene from 2013 to 2020. RESULTS The prevalence rates of contact allergy to ox. linalool and ox. limonene were 7.0% and 5.1%, respectively. Significantly increasing trends of contact allergy were observed. More than 95% of contact allergy cases were identified on Day 3/4. Patients with contact allergy to ox. linalool and ox. limonene were significantly younger than those with contact allergy to other fragrances and were predominantly female. Strong reactions were associated with older age and multiple fragrance allergies. CONCLUSIONS Contact allergy to ox. linalool and ox. limonene is becoming increasingly important, and findings show intriguing features. More studies concerning the clinical relevance before recommending these substances for screening are required.
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Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.,Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Inese Hauksson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Tina Lejding
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ann Pontén
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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40
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Ulriksdotter J, Svedman C, Bruze M, Mowitz M. Allergic contact dermatitis caused by dipropylene glycol diacrylate in the Omnipod® insulin pump. Br J Dermatol 2021; 186:334-340. [PMID: 34510410 DOI: 10.1111/bjd.20751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cases of allergic contact dermatitis (ACD) caused by isobornyl acrylate (IBOA) in the Omnipod® insulin pump have previously been reported. OBJECTIVES To present three cases of patients with ACD caused by a new allergen in the pump, and results from chemical analyses. METHODS Omnipod pumps from different batches were analysed by gas chromatography-mass spectrometry. Aimed testing, with the department's medical device (MD) series and substances identified in the pump including dipropylene glycol diacrylate (DPGDA) at 0·01% and 0·1% in petrolatum (pet.), was performed. Patch testing also included extracts from the device, the adhesive patch as is, and allergens from baseline series. RESULTS All patients tested positive to 0·1% DPGDA in pet., and two patients additionally to a 0·01% concentration. DPGDA was found in extracts of the Omnipod pumps brought by the patients. An Omnipod pump from an earlier batch contained tripropylene glycol diacrylate, IBOA, N,N-dimethylacrylamide, di(ethylene glycol)ethyl ether acrylate (DEGEA) but no DPGDA. One of the patients reacted positively to all of these allergens except DEGEA, which was not tested. CONCLUSIONS When suspecting ACD to MDs, DPGDA at 0·1% in pet. should be tested. The contents of Omnipod have changed over time. Patch testing with updated test series and relevance assessment of positive reactions is a delicate task. Children, with lifelong use of MDs, risk contracting many allergies with potential cross-allergies. A question should be raised as to whether these low molecular weight acrylates should be used at all in devices constantly worn on the skin.
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Affiliation(s)
- J Ulriksdotter
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.,Department of Dermatology, Helsingborg Hospital, Bergaliden 14, 251 87, Helsingborg, Sweden
| | - C Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - M Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - M Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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Hamnerius N, Pontén A, Bergendorff O, Bruze M, Björk J, Svedman C. Skin Exposures, Hand Eczema and Facial Skin Disease in Healthcare Workers During the COVID-19 Pandemic: A Cross-sectional Study. Acta Derm Venereol 2021; 101:adv00543. [PMID: 34427318 PMCID: PMC9425594 DOI: 10.2340/00015555-3904] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has led to enhanced hygiene procedures and use of personal protective equipment, but also to increased attention to occupational skin disease in healthcare workers. The occurrence of hand and facial skin disease in > 5,000 Swedish healthcare workers was investigated in a questionnaire survey. Levels of skin exposure related to hygiene procedures and personal protective equipment were recorded. Caring for patients with COVID-19 entailed higher levels of wet work and face mask exposures, and was associated with higher 1-year prevalence of both hand eczema (36%) and facial skin disease (32%) compared with not being directly engaged in COVID-19 care (28% and 22%, respectively). Acne and eczema were the most common facial skin diseases; for both, a dose-dependent association with face mask use was found. Dose-dependent associations could be shown between hand eczema and exposure to soap and gloves, but not to alcohol-based hand disinfectants.
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Affiliation(s)
- Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, SE-214 28 Malmö, Sweden. E-mail:
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Mowitz M, Ulriksdotter J, Bruze M, Svedman C. In Response to the Letter to the Editor on Minimizing Adverse Skin Reactions to Wearable Continuous Glucose Monitoring Sensors. J Diabetes Sci Technol 2021; 15:978-979. [PMID: 33880949 PMCID: PMC8258509 DOI: 10.1177/19322968211008241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Martin Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Josefin Ulriksdotter
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Dermatology, Helsingborg Hospital, Helsingborg, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
- Cecilia Svedman, PhD, YMDA, VO EHRÖ Skåne University Hospital, SUS. Jan Waldenströmsg 16, Malmö, 205 02, Sweden.
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Gatica-Ortega ME, Mowitz M, Pastor-Nieto MA, Navarro-Triviño FJ, Fernández-Redondo V, Hernández-Cano N, Borrego L, Gómez-de-la-Fuente E, Torralba M, Svedman C, Giménez-Arnau A. Contact Dermatitis From Glucose Sensors In Spain: A Multicentric Approach. Contact Dermatitis 2021; 85:554-562. [PMID: 34185891 DOI: 10.1111/cod.13924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/06/2021] [Accepted: 06/27/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Allergic contact dermatitis from glucose sensors may interfere with their ongoing application. OBJECTIVE To evaluate a series of Spanish patients with contact dermatitis to glucose sensors regarding former sources of contact allergens, patch test results and outcomes from the ongoing use of the device. METHODS A series of patients with contact dermatitis from glucose sensors was investigated in eight dermatology departments across Spain epidemiologic features, brands, latency time to develop dermatitis, the ability to continue using the devices as well as the patch test results. RESULTS Thirty patients were evaluated mean age: 20 .93 years. 66 .7 % were children and 66 .7 % female. 90 .0 % used Freestyle Libre FSL. 8 /26 30 .8 % reacted to isobornyl acrylate IBOA and 2 /20 10 .0 % to N,N dimethylacrylamide DMAA. The mean latency time to develop dermatitis was 9 months. 16 /29 55 .2 % patients continued using the same sensor causing the reaction. 13 /29 44 .8 % were unable to continue using the sensor due to severe reactions. Of them, 5 were positive to IBOA, one to IBOA and DMAA; one to DMAA; one to colophony and 1 to isopropyl alcohol wipes. In one patient the outcome was unknown. CONCLUSION The frequency of sensitization to IBOA and DMAA, was lower than in other European series, but similar to a previously published Spanish article. Legislation requiring manufacturers to provide information regarding medical devices composition and cooperate with the investigation of contact dermatitis is urgently needed. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | - Martin Mowitz
- Dept. of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - María A Pastor-Nieto
- Dermatology Dept. Hospital Universitario de Guadalajara Guadalajara, Spain.,Dept. of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, Faculty of Medicine, Alcalá University Alcalá de Henares, Madrid, Spain
| | | | | | | | - Leopoldo Borrego
- Universidad de Las Palmas de Gran Canaria. Dermatology Dept. Hospital Universitario Insular Dermatology Dept. Hospital Universitario Insular
| | | | - Miguel Torralba
- Dept. of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, Faculty of Medicine, Alcalá University Alcalá de Henares, Madrid, Spain.,Internal Medicine Dept., University Hospital of Guadalajara, Spain
| | - Cecilia Svedman
- Dept. of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ana Giménez-Arnau
- Dermatology Dept. Hospital del Mar, IMIM, Universitat Autònoma de Barcelona
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Bruze M, Marmgren V, Antelmi A, Hindsén Stenström M, Svedman C, Zimersson E, Mowitz M. Contact Allergy to Oxidized Linalool and Oxidized Limonene is Over-represented in Individuals with Photocontact Allergy to Ketoprofen. Acta Derm Venereol 2021; 101:adv00454. [PMID: 33846762 PMCID: PMC9367042 DOI: 10.2340/00015555-3799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Simultaneous contact allergies are common in individuals with photocontact allergy to ketoprofen. The rate of contact allergy to the fragrance substances oxidized linalool and oxidized limonene in ketoprofen-photoallergic individuals were investigated in comparison with the corresponding rates in individuals without photocontact allergy to ketoprofen, using Fisher’s exact test. A total of 4,021 patients were routinely tested with oxidized linalool; of whom 190 (4.7%) tested positively. For oxidized limonene the numbers were 3,797 patients and 111 positive reactions (2.9%). A total of 19 contact allergic reactions to oxidized linalool were noted in 29 patients (65.5%) who also had photocontact allergy to ketoprofen (p < 0.0001). The corresponding figures for oxidized limonene were 10 positive reactions in 24 ketoprofen-photoallergic individuals (41.7%) (p < 0.0001). Contact allergy to oxidized linalool and/or oxidized limonene is common in routinely tested patients with dermatitis and, particularly, in those patients who are photoallergic to ketoprofen.
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Affiliation(s)
- Magnus Bruze
- Department of Occupational and Enironmental Dermatology, Clinical Sciences, Lund University, SE-205 02 Malmö, Sweden
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Bruze M, Engfeldt M, Elsner P, Gonçalo M, Naldi L, Schuttelaar MLA, Svedman C, Svensson Å, Ofenloch R. Validation of questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix II: the EDEN Fragrance Study. J Eur Acad Dermatol Venereol 2021; 35:1692-1701. [PMID: 33914959 DOI: 10.1111/jdv.17315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND In a European study on contact allergy in the general population, it has been hypothesized that the combination of contact allergy to a fragrance together with a history indicating dermatitis at exposure and thereafter subsequent avoidance of scented products implied a diagnosis of allergic contact dermatitis. OBJECTIVES The primary aim of this study was to validate this hypothesis/algorithm. The secondary aim was to investigate whether there was any association between the outcome of the recent repeated open application test (ROAT) and the patch test reactivity. METHODS One hundred nine subjects with and without contact allergy to fragrance mix II (FM II) were recruited. Volunteers from six European dermatology clinics participated in the study including a patch test and a ROAT. RESULTS Twenty-four positive ROAT reactions were noted in total including 20 of those 32 with contact allergy to FM II. None of the volunteers reacted to the vehicle (P < 0.001). More individuals with a positive algorithm had positive ROATs when compared with those with a negative algorithm. However, the difference was not statistically significant (P = 0.12). The lower the patch test concentration eliciting a positive test reaction, the more likely was a positive ROAT and the more likely that the positive ROAT appeared early during the investigative period. CONCLUSIONS The algorithm used in this study was not validated but it was indicated in this ROAT setup. The stronger the patch test reactivity the more likely was a positive ROAT and the more likely it was that the positive ROAT appeared early during the application period.
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Affiliation(s)
- M Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - M Engfeldt
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - P Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - M Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - L Naldi
- Centro Studi GISED - FROM Presidio Ospedaliero Matteo Rota, Bergamo, Italy
| | - M L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - C Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Å Svensson
- Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - R Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
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Rosholm Comstedt L, Dahlin J, Bruze M, Hedberg Y, Matura M, Svedman C. Patch testing with aluminium Finn Chambers could give false-positive reactions in patients with contact allergy to aluminium. Contact Dermatitis 2021; 85:407-414. [PMID: 33896001 DOI: 10.1111/cod.13870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Earlier laboratory studies have shown that sodium tetrachloropalladate, Myroxylon pereirae, caine mix II, and palladium chloride trigger the release of aluminium (Al) from Finn Chambers (FC). OBJECTIVES To investigate whether aluminium realease from FC could influence the diagnostic outcome of patch testing with FC. METHOD A retrospective analysis of patch test results from 2010 to 2019 was performed. A two-sided Fisher's exact test was used to calculate any overrepresentation of contact allergy to Al among patients with positive reactions to sodium tetrachloropalladate, Myroxylon pereirae, caine mix II, and palladium chloride. RESULTS A total of 5446 patients had been tested with FC during the study period. There was a significant overrepresentation of contact allergy to Al among patients with positive reactions to sodium tetrachloropalladate, Myroxylon pereirae, caine mix II, and palladium chloride. Patients with a strong Al allergy had significantly higher amounts of concomitant reactions to sodium tetrachloropalladate, Myroxylon pereirae, caine mix II, and palladium chloride compared to patients with weak Al allergy. These results were not seen for patients tested with Finn Chambers AQUA. CONCLUSION In patients with contact allergy to Al, patch testing with Finn chambers could give false-positive reactions to sodium tetrachloropalladate, Myroxylon pereirae, caine mix II, and palladium chloride.
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Affiliation(s)
- Lisbeth Rosholm Comstedt
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Yolanda Hedberg
- Department of Chemistry, The University of Western Ontario, London, Ontario, Canada
| | - Mihály Matura
- Department of Dermatology, Skaraborg Hospital Skövde, Skövde, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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Haulrig MB, Dahlin J, Svedman C, Johansen JD. Cocamidopropyl betaine, cocamidopropylamine oxide, and disodium cocoamphodiacetate cause false-positive reactions with an isothiazolinone spot test. Contact Dermatitis 2021; 85:249-251. [PMID: 33675556 DOI: 10.1111/cod.13830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Morten Bahrt Haulrig
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Lund, Sweden
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Lund, Sweden
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jeanne D Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
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Svedman C, Bruze M, Antelmi A, Hamnerius N, Hauksson I, Ulriksdotter J, Mowitz M. Continuous glucose monitoring systems give contact dermatitis in children and adults despite efforts of providing less ‘allergy‐ prone’ devices: investigation and advice hampered by insufficient material for optimized patch test investigations. J Eur Acad Dermatol Venereol 2021; 35:730-737. [DOI: 10.1111/jdv.16981] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/18/2020] [Indexed: 02/06/2023]
Affiliation(s)
- C. Svedman
- Department of Occupational and Environmental Dermatology Lund UniversitySkåne University Hospital Malmö Sweden
| | - M. Bruze
- Department of Occupational and Environmental Dermatology Lund UniversitySkåne University Hospital Malmö Sweden
| | - A. Antelmi
- Department of Occupational and Environmental Dermatology Lund UniversitySkåne University Hospital Malmö Sweden
| | - N. Hamnerius
- Department of Occupational and Environmental Dermatology Lund UniversitySkåne University Hospital Malmö Sweden
| | - I. Hauksson
- Department of Occupational and Environmental Dermatology Lund UniversitySkåne University Hospital Malmö Sweden
| | - J. Ulriksdotter
- Department of Occupational and Environmental Dermatology Lund UniversitySkåne University Hospital Malmö Sweden
- Department of Dermatology Helsingborg Hospital Helsingborg Sweden
| | - M. Mowitz
- Department of Occupational and Environmental Dermatology Lund UniversitySkåne University Hospital Malmö Sweden
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Svedman C, Ulriksdotter J, Lejding T, Bruze M, Mowitz M. Changes in adhesive ingredients in continuous glucose monitoring systems may induce new contact allergy pattern. Contact Dermatitis 2021; 84:439-446. [PMID: 33421157 DOI: 10.1111/cod.13781] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Medical devices (MD) in close skin-contact for a prolonged time, such as glucose monitoring (CGM) systems, are a risk factor for contact allergy, and there has been an increase in patients using these. Correct diagnosis demands targetted testing. OBJECTIVES We report a new allergen in a continuous CGM system in which the adhesive was changed. The allergy pattern of the patients diagnosed is reported. METHODS The three patients reported were patch tested with an MD series, own material, and possible allergens found through analysis with gas chromatography-mass spectrometry, comparing analysis from the CGM system before and after change. RESULTS The patients were sensitized to isobornyl acrylate (IBOA), found in previously used devices and the present CGM. Apart from IBOA, the culprit allergen was found to be 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate. CONCLUSION Allergic contact dermatitis due to CGM systems and insulin pumps are difficult to investigate and require chemical analysis. Because of the lack of information on substances used in the production, and when changes with MDs are initiated, it is difficult to advise patients, especially since they risk sensitization to several allergens. The use of MDs has increased and, thus, the need for collaboration between manufacturers, clinicians, and patient organizations.
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Affiliation(s)
- Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, SUS, University of Lund, Malmö, Sweden
| | - Josefin Ulriksdotter
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, SUS, University of Lund, Malmö, Sweden.,Department of Dermatology, Helsingborg Hospital, Helsingborg, Sweden University of Lund, Malmö, Sweden
| | - Tina Lejding
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, SUS, University of Lund, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, SUS, University of Lund, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, SUS, University of Lund, Malmö, Sweden
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Luu H, Mowitz M, Bruze M, Engfeldt M, Isaksson M, Svedman C. A comparative study between the two patch test systems Finn chambers and Finn chambers AQUA. Contact Dermatitis 2021; 84:290-298. [PMID: 33368411 DOI: 10.1111/cod.13766] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/17/2020] [Accepted: 12/20/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Finn Chambers AQUA (FCA) is a development of the Finn Chambers (FC) test system in which the test chambers are mounted on a moisture-resistant adhesive patch. FCA has pre-fixed filter papers. Because the use of FCA does not require any extra taping or use of separate filter papers, a change from FC to FCA chambers may be beneficial for both patients and patch test technicians. OBJECTIVES To investigate whether there are any differences regarding detection of contact allergy when simultaneous patch testing is performed with FC and FCA. MATERIALS AND METHODS Results from 434 dermatitis patients simultaneously tested with 10 allergens in both FC and FCA were evaluated. RESULTS There were no significant differences regarding detection of positive reactions between the two test systems. There were significantly more doubtful reactions to methylisothiazolinone, fragrance mix I and hydroperoxides of linalool when testing with FCA. We only observed significantly more doubtful reactions in FC regarding nickel(II)sulfate. Irritant reactions to formaldehyde were also significantly more common when using FCA. CONCLUSION The FC and FCA had good agreement in detection of positive reactions. However, the results including doubtful and irritant reactions justify further research regarding optimization of the dose.
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Affiliation(s)
- Henrik Luu
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Malin Engfeldt
- Department of Occupational and Environmental Medicine, Lund University, Skåne University Hospital, Lund, Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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