Subject(s)
Dermatitis, Allergic Contact , Dermatitis, Occupational , Humans , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Rubber/adverse effects , N95 Respirators , Dermatitis, Occupational/diagnosis , Dermatitis, Occupational/etiology , Health Personnel , Patch TestsABSTRACT
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.
Subject(s)
COVID-19 , Dermatitis, Allergic Contact , Dermatitis, Occupational , Facial Dermatoses , Humans , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/diagnosis , Dermatitis, Occupational/epidemiology , Dermatitis, Occupational/etiology , Pandemics , Masks/adverse effects , COVID-19/epidemiology , COVID-19/prevention & control , Patch Tests/methods , Facial Dermatoses/epidemiology , Facial Dermatoses/etiology , Health PersonnelABSTRACT
Objective: Skin of color patients face important health issues relevant to dermatologists, such as allergic contact dermatitis; however, there is a lack of information surrounding common allergens causing contact dermatitis that disproportionately affect skin of color patients, as well as interpreting patch testing in this population. Methods: Covidence, Embase, MEDLINE, PubMed, Web of Science, and Google Scholar were searched to identify relevant articles studying allergic and irritant contact dermatitis in skin of color patients. Results: The most common positive reactions in African American patients included PPD, balsam of Peru, bacitracin, fragrance mix, and nickel. The most common positive reactions in Hispanic patients included Carba mix, nickel sulfate, and thiuram mix. The most common positive reactions in Asian patients included nickel sulfate, fragrance mix, and potassium dichromate. When interpreting patch test results in patients with higher Fitzpatrick skin types, positive patch tests presented with lichenification and hyperpigmentation, rather than erythema and vesicles. Furthermore, characteristic bright red or pink hues for positive results may appear violaceous or faint pink. Conclusions: Awareness of the common allergens associated with allergic contact dermatitis in patients of skin of color can help guide patch testing as an important diagnostic tool. Further research must be conducted regarding contact dermatitis in this patient population, especially given the relative lack of data surrounding Hispanic, Asian and Pacific Islander, and Native American patients.
Subject(s)
Dermatitis, Allergic Contact , Skin Pigmentation , Humans , Patch Tests/methods , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/epidemiology , Allergens/adverse effects , ExcipientsABSTRACT
Objectives: Sexual and gender minority (SGM) patients face health issues relevant to dermatologists, such as allergic contact dermatitis (ACD); however, there is a lack of information surrounding common allergens causing ACD that disproportionally affect SGM patients. Methods: Covidence, Embase, MEDLINE, PubMed, Web of Science, and Google Scholar were searched to identify relevant articles studying ACD in the SGM population. Results: Common allergens associated with ACD in SGM patients include nitrates, fragrance mix, methylisothiazolinone, methylisothiazolinone-methylchloroisothiazolinone, topical antibiotics, and allergens seen in chest binders. Common anatomic sites included the chest, cheeks, perioral region, nasal orifices, and the anogenital region. Conclusions: Certain allergens and body sites affected by ACD are more common among the SGM community. This can help guide patch testing as a diagnostic tool. Further research must be conducted regarding ACD in SGM patients.
Subject(s)
Dermatitis, Allergic Contact , Humans , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/etiology , Allergens/adverse effects , Patch Tests/adverse effects , Anti-Bacterial Agents , Retrospective StudiesSubject(s)
COVID-19 , Dermatitis, Allergic Contact , Adult , Allergens , Dermatitis, Allergic Contact/epidemiology , Humans , Pandemics , Patch Tests/methodsSubject(s)
Dermatitis, Allergic Contact , Dermatitis, Occupational , Disinfectants , Hand Dermatoses , Hand Sanitizers , Dermatitis, Allergic Contact/complications , Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/complications , Disinfectants/adverse effects , Ethylenediamines , Hand Dermatoses/chemically induced , Hand Sanitizers/adverse effects , Humans , Patch Tests/adverse effectsABSTRACT
BACKGROUND: Apprentice nurses are considered at high risk to developing occupational skin diseases. OBJECTIVES: This study assessed the frequency and origin of hand eczema, and work-related risk factors in apprentice nurses. METHODS: The study involved 240 final-year apprentice nurses (females 75%, median age 19 years) from vocational schools in Zagreb, Croatia. The study was performed in 2020/2021 and included a questionnaire and clinical examination by means of the Osnabrück Hand Eczema Severity Index (OHSI). Skin prick test (SPT) with natural rubber latex (NRL) allergen, and patch test with the basic series of allergens, and disinfectants, were performed in 42 apprentice nurses with hand eczema that lasted more than 3 months. RESULTS: Clinically observed and self-reported hand eczema were found in 49% and 46% of apprentice nurses, respectively. Those with observed changes were older and reported more days per month spent on practical work than those with healthy skin (P = .001). Median OHSI was 4 (interquartile range 2-6). There were no positive SPTs to latex, and 11 (26%) apprentice nurses had positive patch test reactions to one or more tested allergens, mostly nickel. CONCLUSIONS: Hand eczema was common in final-year apprentice nurses during the COVID-19 pandemic. It was mostly of irritative origin, associated with the duration of practical training, confirming cumulative effect of hazards on skin barrier.
Subject(s)
COVID-19/nursing , Dermatitis, Occupational/etiology , Eczema/etiology , Hand Dermatoses/etiology , Students, Nursing , Croatia , Female , Humans , Male , Pandemics , Patch Tests , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Young AdultSubject(s)
COVID-19 , Dermatitis, Occupational , Case-Control Studies , Dermatitis, Occupational/epidemiology , Disease Outbreaks , Humans , Masks , Patch Tests , SARS-CoV-2Subject(s)
Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/etiology , Personal Protective Equipment/adverse effects , Urticaria/etiology , COVID-19 , Cobalt/adverse effects , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Occupational/diagnosis , Female , Humans , Nursing Staff, Hospital , Patch Tests , Urticaria/diagnosis , Young Adult , Chronic Inducible UrticariaSubject(s)
Allergens/administration & dosage , Anti-Infective Agents, Local/administration & dosage , COVID-19/epidemiology , Dermatitis, Allergic Contact/diagnosis , Patch Tests/methods , Allergens/adverse effects , Anti-Infective Agents, Local/adverse effects , Dermatitis, Allergic Contact/prevention & control , Humans , New Zealand , Retrospective StudiesSubject(s)
Acute Generalized Exanthematous Pustulosis/diagnosis , Acute Generalized Exanthematous Pustulosis/etiology , Anti-Bacterial Agents/adverse effects , COVID-19 Drug Treatment , Ceftriaxone/adverse effects , Patch Tests , Acute Generalized Exanthematous Pustulosis/drug therapy , Aged , Antiviral Agents/therapeutic use , COVID-19/diagnosis , Drug Therapy, Combination , Female , Humans , SARS-CoV-2ABSTRACT
PURPOSE OF REVIEW: This article aims to summarize some recent trends in occupational allergic contact dermatitis (ACD), including dermatitis related to pandemic-level personal protective equipment in healthcare workers, hazards patients may experience when working from home, and occupational perspectives on the recent American Contact Dermatitis Society (ACDS) allergens of the year and ACDS Core Allergen Series updates. RECENT FINDINGS: Recent ACDS Allergens of the Year may be particularly relevant to healthcare workers, including isobornyl acrylate, which is present in glucose sensors and propylene glycol present in hand cleansers and disinfectants. Lavender, limonene, and linalool, all of which are new additions to the ACDS Core Allergen Series, have been reported as causes for occupational ACD in massage therapists and aromatherapists. Isothiazolinone allergy continues to rise in both consumer and occupational settings. Finally, the COVID-19 pandemic has resulted in a wave of occupational ACD in healthcare workers to personal protective equipment, and revealed new potential allergens for individuals working from home. Occupational allergic contact dermatitis continues to exert a significant occupational disease burden. Remaining aware of the current trends in allergens may allow for earlier recognition, diagnosis, and treatment, subsequently helping our patients to work in healthier and safer environments.