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Warshaw EM, Schlarbaum JP, Maibach HI, Silverberg JI, Taylor JS, Atwater AR, Reeder MJ, DeKoven JG, Pratt MD, DeLeo VA, Zug KA, Fransway AF, Belsito DV, Mathias T, Fowler JF, Marks JG, Sasseville D, Zirwas MJ. Facial Dermatitis in Male Patients Referred for Patch Testing: Retrospective Analysis of North American Contact Dermatitis Group Data, 1994 to 2016. JAMA Dermatol 2020; 156:79-84. [PMID: 31774459 DOI: 10.1001/jamadermatol.2019.3531] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Facial dermatitis in women is well characterized. However, recent shifts in the men's grooming industry may have important implications for male facial dermatitis. Objective To characterize male patients with facial dermatitis. Design, Setting, and Participants A 22-year retrospective cross-sectional analysis (1994-2016) of North American Contact Dermatitis Group (NACDG) data, including 50 507 patients who underwent patch testing by a group of dermatology board-certified patch test experts at multiple centers was carried out. Facial dermatitis was defined as involvement of the eyes, eyelids, lips, nose, or face (not otherwise specified). Main Outcomes and Measures The main outcome was to compare characteristics (including demographics and allergens) between male patients with facial dermatitis (MFD) and those without facial dermatitis (MNoFD) using statistical analysis (relative risk, CIs). Secondary outcomes included sources of allergic and irritant contact dermatitis and, for occupationally related cases, specific occupations and industries in MFD. Results Overall, 1332 male patients (8.0%) were included in the MFD group and 13 732 male patients (82.0%) were included in MNoFD. The mean (SD) age of participants was 47 (17.2) years in the MFD group and 50 (17.6) years in the MNoFD group. The most common facial sites were face (not otherwise specified, 817 [48.9%]), eyelids (392 [23.5%]), and lips (210 [12.6%]). Participants in the MFD group were significantly younger than MNoFD (mean age, 47 vs 50 years; P < .001). Those in the MFD group were less likely to be white (relative risk [RR], 0.92; 95% CI, -0.90 to 0.95) or have occupationally related skin disease (RR, 0.49; 95% CI, -0.42 to 0.58; P < .001) than MNoFD. The most common allergens that were associated with clinically relevant reactions among MFD included methylisothiazolinone (n = 113; 9.9%), fragrance mix I (n = 27; 8.5%), and balsam of Peru (n = 90; 6.8%). Compared with MNoFD, MFD were more likely to react to use of dimethylaminopropylamine (RR, 2.49; 95% CI, -1.42 to 4.37]) and paraphenylenediamine (RR, 1.43; 95% CI, -1.00 to 2.04; P < .001). Overall, 60.5% of NACDG allergen sources were personal care products. Conclusions and Relevance Although many allergens were similar in both groups, MFD were more likely to react to use of dimethylaminopropylamine and paraphenylenediamine, presumably owing to their higher prevalence in hair products. Most sources of allergic and irritant contact dermatitis in MFD were personal care products. This study provides insight into the risks and exposures of the increasing number of grooming products used by male dermatology patients. This will enable clinicians to better identify male patients who would benefit from patch testing and treat those with facial dermatitis.
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Affiliation(s)
- Erin M Warshaw
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota.,Department of Dermatology, University of Minnesota, Minneapolis
| | - Jamie P Schlarbaum
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota.,University of Minnesota Medical School, Minneapolis
| | - Howard I Maibach
- Department of Dermatology, University of California, San Francisco
| | | | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Amber R Atwater
- Department of Dermatology, Duke University, Durham, North Carolina
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin Medical School, Madison
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California
| | - Kathryn A Zug
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | - Donald V Belsito
- Department of Dermatology, Columbia University, New York, New York
| | - Toby Mathias
- Department of Dermatology, University of Cincinnati, Cincinnati, Ohio
| | | | - James G Marks
- Department of Dermatology, Pennsylvania State University, State College, Pennsylvania
| | - Denis Sasseville
- Division of Dermatology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
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Warshaw EM, Kimyon RS, Silverberg JI, Belsito DV, DeKoven JG, Maibach HI, Zug KA, Atwater AR, Mathias T, Sasseville D, Fowler JF, Marks JG, Reeder MJ, DeLeo VA, Pratt MD, Zirwas MJ, Taylor JS, Fransway AF. Evaluation of Patch Test Findings in Patients With Anogenital Dermatitis. JAMA Dermatol 2020; 156:85-91. [PMID: 31774454 DOI: 10.1001/jamadermatol.2019.3844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Contact dermatitis in the anogenital area is associated with sleep disturbance and dyspareunia and can profoundly affect quality of life. The literature on anogenital contact dermatitis and culprit allergens is limited. The last large-scale study on common, relevant allergens in patients with anogenital dermatitis was published in 2008. Objectives To characterize patients with anogenital dermatitis referred for patch testing by the North American Contact Dermatitis Group, to identify common allergens, and to explore sex-associated differences between anogenital dermatitis and allergens. Design, Setting, and Participants A retrospective, cross-sectional analysis was conducted of the North American Contact Dermatitis Group database among 28 481 patients who underwent patch testing from January 1, 2005, to December 31, 2016, at outpatient referral clinics in the United States and Canada. Exposure Patch testing for allergens. Main Outcomes and Measures Currently relevant allergic patch test reactions in patients with anogenital dermatitis. Results Of 28 481 patients tested during the study period, 832 patients (336 men and 496 women; mean [SD] age, 50.1 [26.5] years) had anogenital involvement and 449 patients (177 men and 272 women; mean [SD] age, 49.6 [17.4] years) had anogenital dermatitis only. Compared with those without anogenital involvement, there were significantly more male patients in the group with anogenital dermatitis (177 [39.4%] vs 8857 of 27 649 [32.0%]; relative risk, 1.37; 95% CI, 1.14-1.66; P < .001). In the group with anogenital involvement, female patients were significantly less likely than male patients to have allergic contact dermatitis as a final diagnosis (130 [47.8%] vs 107 [60.5%]; relative risk, 0.78; 95% CI, 0.64-0.94; P = .01), whereas a final diagnosis of other dermatoses (eg, lichen planus, lichen sclerosus, or lichen simplex chronicus) was more frequent for female patients than for male patients (67 [24.6%] vs 28 [15.8%]; relative risk, 1.54; 95% CI, 1.02-2.31; P = .03). Of the 449 patients in the group with anogenital involvement only, 227 (50.6%) had 1 or more relevant reaction with patch testing. Allergens that were statistically significantly more common in patients with anogenital involvement compared with those without anogenital involvement included medicaments such as dibucaine (10 of 250 patients tested [4.0%] vs 32 of 17 494 patients tested [0.2%]; relative risk, 22.74; 95% CI, 11.05-46.78; P < .001) and preservatives such as methylchloroisothiazolinone and methylisothiazolinone (30 of 449 patients tested [6.7%] vs 1143 of 27 599 patients tested [4.1%]; relative risk, 1.61; 95% CI, 1.14-2.41; P = .008). A total of 152 patients met the definition for anogenital allergic contact dermatitis, which is defined as anogenital involvement only, allergic contact dermatitis as the only diagnosis, and 1 or more positive reaction of current clinical relevance. Conclusions and Relevance For patients with anogenital involvement only who were referred for patch testing, male patients were more likely to have allergic contact dermatitis, whereas female patients were more likely to have other dermatoses. Common allergens or sources consisted of those likely to contact the anogenital area. For individuals with anogenital involvement suspected of having allergic contact dermatitis, reactions to preservatives, fragrances, medications (particularly topical anesthetics), and topical corticosteroids should be tested.
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Affiliation(s)
- Erin M Warshaw
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota.,Department of Dermatology, University of Minnesota, Minneapolis
| | - Rebecca S Kimyon
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota.,University of Minnesota Medical School, Minneapolis
| | - Jonathan I Silverberg
- Feinberg School of Medicine, Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Donald V Belsito
- Department of Dermatology, Columbia University, New York, New York
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Howard I Maibach
- Department of Dermatology, University of California, San Francisco
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Amber R Atwater
- Department of Dermatology, Duke University, Durham, North Carolina
| | - Toby Mathias
- Department of Dermatology, University of Cincinnati, Cincinnati, Ohio
| | - Denis Sasseville
- Division of Dermatology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
| | - Joseph F Fowler
- Division of Dermatology, Department of Medicine, University of Louisville, Louisville, Kentucky
| | - James G Marks
- Department of Dermatology, Pennsylvania State University, State College
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin Medical School, Madison
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
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Warshaw EM, Schlarbaum JP, Silverberg JI, DeKoven JG, Maibach HI, Sasseville D, Fowler JF, Marks JG, Belsito DV, Reeder MJ, Mathias T, Atwater AR, Taylor JS, Fransway AF, Pratt MD, DeLeo VA, Zirwas MJ, Zug KA. Safety equipment: When protection becomes a problem. Contact Dermatitis 2019; 81:130-132. [PMID: 30809819 DOI: 10.1111/cod.13254] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/20/2019] [Accepted: 02/23/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Erin M Warshaw
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota.,Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Jamie P Schlarbaum
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota.,University of Minnesota Medical School, Minneapolis, Minnesota
| | - Jonathan I Silverberg
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Dennis Sasseville
- Division of Dermatology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
| | - Joseph F Fowler
- Department of Medicine, Division of Dermatology, University of Louisville, Louisville, Kentucky
| | - James G Marks
- Department of Dermatology, Pennsylvania State University, State College, Pennsylvania
| | - Donald V Belsito
- Department of Dermatology, Columbia University, New York, New York
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin Medical School, Madison, Wisconsin
| | - Toby Mathias
- Department of Dermatology, University of Cincinnati, Cincinnati, Ohio
| | - Amber R Atwater
- Department of Dermatology, Duke University, Durham, North Carolina
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | | | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California
| | - Matthew J Zirwas
- Department of Dermatology, Ohio State University, Columbus, Ohio
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
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Warshaw EM, Aschenbeck KA, DeKoven JG, Maibach HI, Taylor JS, Sasseville D, Belsito DV, Fowler JF, Zug KA, Zirwas MJ, Fransway AF, DeLeo VA, Marks JG, Pratt MD, Mathias T. Epidemiology of pediatric nickel sensitivity: Retrospective review of North American Contact Dermatitis Group (NACDG) data 1994-2014. J Am Acad Dermatol 2018; 79:664-671. [DOI: 10.1016/j.jaad.2018.02.071] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 02/02/2018] [Accepted: 02/09/2018] [Indexed: 11/29/2022]
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Aysenne A, Mathias T, Boehme A, Chang T, Albright K, Beasley T, Martin-Schild S. 24-Hour ICH Score Is a Better Predictor of Mortality Than Admission ICH Score (P01.015). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Sichieri R, Mathias T, Moura A. Stunting, high weight-for-height, anemia and dietary intake among brazilian students from a rural community. Nutr Res 1996. [DOI: 10.1016/0271-5317(96)00004-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
On the 7 December 1988 an earthquake struck a densely populated region in northern Armenia. Up to 50,000 people were killed and many thousands were seriously injured. At least 385 of these casualties developed acute renal failure secondary to crush syndrome and required dialysis. The Armenian renal unit at Yerevan, in common with units elsewhere, was already overstretched to cope with the dialysis requirements of their patients with chronic renal failure before the earthquake. Most of the patients requiring dialysis were transferred to other hospitals in the USSR but 120 patients remained in Yerevan, the majority at the regional renal unit, overwhelming the resources. We assisted by taking a team of dialysis personnel, equipped with portable haemodialysis machines, to Yerevan. We performed 57 haemodialysis sessions and treated 15 patients, 13 of whom ultimately survived. Valuable lessons were learnt about the medical management of disasters abroad.
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Mathias T. Mission of mercy. Interview by Toni Turner. Nurs Times 1989; 85:16-7. [PMID: 2522622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Mathias T. The leprosy control programme in the People's Republic of China. LEPROSY REV 1989; 60:62-3. [PMID: 2725173 DOI: 10.5935/0305-7518.19890010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Richards NT, Tattersall J, McCann M, Samson A, Mathias T, Johnson A. Dialysis for acute renal failure due to crush injuries after the Armenian earthquake. BMJ 1989; 298:443-5. [PMID: 2522803 PMCID: PMC1835675 DOI: 10.1136/bmj.298.6671.443] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Koch SE, Mathias T, Maibach HI. Chloracetamide: an unusual cause of cosmetic dermatitis. Arch Dermatol 1985; 121:172-3. [PMID: 3977330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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