ABSTRACT
After the meeting held by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) back in October 2021, changes were suggested to the Spanish standard series patch testing. Hydroxyethyl methacrylate (2% pet.), textile dye mixt (6.6% pet.), linalool hydroperoxide (1% pet.), and limonene hydroperoxide (0.3% pet.) were, then, added to the series that agreed upon in 2016. Ethyldiamine and phenoxyethanol were excluded. Methyldibromoglutaronitrile, the mixture of sesquiterpene lactones, and hydroxyisohexyl 3-cyclohexene (Lyral) were alo added to the extended Spanish series of 2022.
Subject(s)
Dermatitis, Allergic Contact , Patch Tests , Humans , Spain , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Allergens/adverse effectsABSTRACT
Allergic contact dermatitis induced by the use of ophthalmic topical drugs is one of the most common causes of eyelid dermatitis. The introduction of new formulations, both of active ingredients and excipients, and the lack of marketing in some of them, makes patch testing in patients whose source of contact are topical ophthalmic drugs truly challenging. Across this manuscript, most, if not all, topical ophthalmic drugs used in our national health system have been collected, including information on the allergens available, and the concentration and vehicle advised for those that still remain unavailable.
Subject(s)
Allergens , Dermatitis, Allergic Contact , Ophthalmic Solutions , Dermatitis, Allergic Contact/etiology , Humans , Spain , Allergens/adverse effects , Ophthalmic Solutions/adverse effects , Patch TestsABSTRACT
Introduction Shellac is a known allergen present mainly in cosmetics used on the eyelids and lips, although new sources of exposure have recently been described. Our objective was to assess the use of shellac as a contact allergen in Spain and the clinical profile of patients allergic to shellac. Methods This retrospective cross-sectional study included patients patch tested for shellac between 2018 and 2021 from the Spanish Registry of Contact Dermatitis and Cutaneous Allergy (REIDAC). Results A total of 980 patients were patch tested for shellac (20% in ethanol), and 37 (3.77%, 95% confidence interval [CI], 2.583.97%) showed positive results. Most of these patients were tested for shellac due to a suspicion of cosmetic contact dermatitis. Seven patients with present relevance were found, five with relation to cosmetics, and the other two with an occupational background of food handling. The reaction index for shellac was 0.51 and the positivity ratio was 67.56% (95% CI, 52.4882.65%). Conclusions Shellac appears to be a prevalent allergen in patients with suspected contact dermatitis related with cosmetics or foodstuff. However, further studies are needed to validate its use in other patients (AU)
El shellac es un alérgeno conocido por su presencia en cosméticos para labios y párpados, aunque en los últimos años se han descrito nuevas fuentes de exposición. El objetivo de nuestro trabajo fue evaluar cómo se está usando el shellac, como alérgeno de contacto en España, y las características clínicas de los pacientes alérgicos al shellac. Métodos Se realizó un estudio retrospectivo transversal con los pacientes incluidos en el Registro Español de Dermatitis de Contacto y Alergia Cutánea en los que se realizaron pruebas epicutáneas con shellac desde 2018 a 2021. Resultados El shellac (20% en etanol) fue usado en 980 pacientes, con resultados positivos en 37 de ellos (3,77%; intervalo de confianza [IC] del 95%: 2,58-3,97%). La mayoría de estos pacientes realizaron las pruebas epicutáneas por una sospecha de dermatitis de contacto por cosméticos. Se encontraron 7 pacientes con una relevancia presente, 5 de ellos en relación con el uso de cosméticos, y los otros 2 fueron dermatitis de contacto ocupacionales en el contexto de la manipulación de alimentos. El índice de reacción para el shellac fue del 0,51% y la ratio de positividad del 67,56% (IC 95%: 52,48-82,65%). Conclusiones El shellac parece un alérgeno frecuente en los pacientes con sospecha de dermatitis de contacto por cosméticos o alimentos. Sin embargo, se necesitan más estudios para validar su uso en otros pacientes (AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Allergens , Additives in Cosmetics , Cosmetics/adverse effects , Cross-Sectional Studies , Retrospective Studies , Patch Tests , Spain/epidemiology , PrevalenceABSTRACT
El shellac es un alérgeno conocido por su presencia en cosméticos para labios y párpados, aunque en los últimos años se han descrito nuevas fuentes de exposición. El objetivo de nuestro trabajo fue evaluar cómo se está usando el shellac, como alérgeno de contacto en España, y las características clínicas de los pacientes alérgicos al shellac. Métodos Se realizó un estudio retrospectivo transversal con los pacientes incluidos en el Registro Español de Dermatitis de Contacto y Alergia Cutánea en los que se realizaron pruebas epicutáneas con shellac desde 2018 a 2021. Resultados El shellac (20% en etanol) fue usado en 980 pacientes, con resultados positivos en 37 de ellos (3,77%; intervalo de confianza [IC] del 95%: 2,58-3,97%). La mayoría de estos pacientes realizaron las pruebas epicutáneas por una sospecha de dermatitis de contacto por cosméticos. Se encontraron 7 pacientes con una relevancia presente, 5 de ellos en relación con el uso de cosméticos, y los otros 2 fueron dermatitis de contacto ocupacionales en el contexto de la manipulación de alimentos. El índice de reacción para el shellac fue del 0,51% y la ratio de positividad del 67,56% (IC 95%: 52,48-82,65%). Conclusiones El shellac parece un alérgeno frecuente en los pacientes con sospecha de dermatitis de contacto por cosméticos o alimentos. Sin embargo, se necesitan más estudios para validar su uso en otros pacientes (AU)
Introduction Shellac is a known allergen present mainly in cosmetics used on the eyelids and lips, although new sources of exposure have recently been described. Our objective was to assess the use of shellac as a contact allergen in Spain and the clinical profile of patients allergic to shellac. Methods This retrospective cross-sectional study included patients patch tested for shellac between 2018 and 2021 from the Spanish Registry of Contact Dermatitis and Cutaneous Allergy (REIDAC). Results A total of 980 patients were patch tested for shellac (20% in ethanol), and 37 (3.77%, 95% confidence interval [CI], 2.583.97%) showed positive results. Most of these patients were tested for shellac due to a suspicion of cosmetic contact dermatitis. Seven patients with present relevance were found, five with relation to cosmetics, and the other two with an occupational background of food handling. The reaction index for shellac was 0.51 and the positivity ratio was 67.56% (95% CI, 52.4882.65%). Conclusions Shellac appears to be a prevalent allergen in patients with suspected contact dermatitis related with cosmetics or foodstuff. However, further studies are needed to validate its use in other patients (AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Allergens , Additives in Cosmetics , Cosmetics/adverse effects , Cross-Sectional Studies , Retrospective Studies , Patch Tests , Spain/epidemiology , PrevalenceABSTRACT
INTRODUCTION: Shellac is a known allergen present mainly in cosmetics used on the eyelids and lips, although new sources of exposure have recently been described. Our objective was to assess the use of shellac as a contact allergen in Spain and the clinical profile of patients allergic to shellac. METHODS: This retrospective cross-sectional study included patients patch tested for shellac between 2018 and 2021 from the Spanish Registry of Contact Dermatitis and Cutaneous Allergy (REIDAC). RESULTS: A total of 980 patients were patch tested for shellac (20% in ethanol), and 37 (3.77%, 95% confidence interval [CI], 2.58-3.97%) showed positive results. Most of these patients were tested for shellac due to a suspicion of cosmetic contact dermatitis. Seven patients with present relevance were found, five with relation to cosmetics, and the other two with an occupational background of food handling. The reaction index for shellac was 0.51 and the positivity ratio was 67.56% (95% CI, 52.48-82.65%). CONCLUSIONS: Shellac appears to be a prevalent allergen in patients with suspected contact dermatitis related with cosmetics or foodstuff. However, further studies are needed to validate its use in other patients.
Subject(s)
Cosmetics , Dermatitis, Allergic Contact , Dermatitis, Atopic , Humans , Cross-Sectional Studies , Retrospective Studies , Patch Tests , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/etiology , Allergens/adverse effects , Cosmetics/adverse effectsABSTRACT
INTRODUCTION: Shellac is a known allergen present mainly in cosmetics used on the eyelids and lips, although new sources of exposure have recently been described. Our objective was to assess the use of shellac as a contact allergen in Spain and the clinical profile of patients allergic to shellac. METHODS: This retrospective cross-sectional study included patients patch tested for shellac between 2018 and 2021 from the Spanish Registry of Contact Dermatitis and Cutaneous Allergy (REIDAC). RESULTS: A total of 980 patients were patch tested for shellac (20% in ethanol), and 37 (3.77%, 95% confidence interval [CI], 2.58-3.97%) showed positive results. Most of these patients were tested for shellac due to a suspicion of cosmetic contact dermatitis. Seven patients with present relevance were found, five with relation to cosmetics, and the other two with an occupational background of food handling. The reaction index for shellac was 0.51 and the positivity ratio was 67.56% (95% CI, 52.48-82.65%). CONCLUSIONS: Shellac appears to be a prevalent allergen in patients with suspected contact dermatitis related with cosmetics or foodstuff. However, further studies are needed to validate its use in other patients.
Subject(s)
Cosmetics , Dermatitis, Allergic Contact , Dermatitis, Atopic , Humans , Cross-Sectional Studies , Retrospective Studies , Patch Tests , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/etiology , Allergens/adverse effects , Cosmetics/adverse effectsABSTRACT
El objetivo de este estudio fue establecer los diagnósticos de los pacientes con eccema diseminado y analizar los alérgenos implicados en el eccema diseminado por dermatitis alérgica de contacto. Para ello, se analizaron los datos de los pacientes con diagnóstico de eccema diseminado/generalizado a los que se les había realizado anamnesis, exploración física y pruebas epicutáneas en una consulta de Dermatitis de Contacto en el periodo 2003-2019. El diagnóstico más frecuente fue dermatitis alérgica de contacto, seguido de dermatitis atópica, eccema asteatósico y eccema gravitacional. Los alérgenos más frecuentemente implicados en dermatitis de contacto alérgica fueron las isotiazolinonas, los medicamentos tópicos, la parafenilendiamina y las fragancias. La dermatitis alérgica de contacto causó casi la mitad de los casos de eccema diseminado. Por ello, consideramos conveniente que los pacientes con eccema diseminado sean valorados en una Unidad de Contacto y se sometan a la realización de pruebas epicutáneas.(AU)
The aim of this study was to establish the diagnoses of patients with disseminated eczema and analyze the allergens involved in disseminated eczema due to allergic contact dermatitis. We analyzed the data from patients with a diagnosis of disseminated / generalized eczema who had undergone anamnesis, physical examination and patch tests in a Contact Dermatitis consultation from 2003 to 2019. Allergic contact dermatitis was the most frequent diagnosis, followed by atopic dermatitis, asteatotic eczema, and gravitational eczema. The allergens most frequently involved in allergic contact dermatitis were isothiazolinones, topical medications, paraphenylenediamine, and fragrances. Allergic contact dermatitis caused almost half of the cases of disseminated eczema. It would be therefore advisable for patients with disseminated eczema to be assessed at a Contact Dermatitis unit and undergo patch tests.
Subject(s)
Humans , Health Sciences , Dermatitis, Allergic Contact , Patch Tests , Pruritus , Eczema , Dermatitis, ContactABSTRACT
Recent advances in our understanding of T2 inflammation have revealed more diseases in which T2 inflammation is involved. Dupilumabis a recently developed monoclonal antibody that blocks signaling of IL-4 and IL-13, both of which are crucial cytokines in the T2 response.New possible indications are increasingly explored and include skin diseases, such as prurigo nodularis, nummular eczema, allergic contactdermatitis, chronic hand eczema, spontaneous chronic urticaria, bullous pemphigoid, alopecia areata, and Netherton syndrome, as wellas respiratory diseases, such as allergic bronchopulmonary aspergillosis, chronic eosinophilic pneumonia, and allergic rhinitis. In addition,eosinophilic gastrointestinal disorders, particularly eosinophilic esophagitis, and food allergy, are also research fields of interest. Here, wereview published data and clinical trials examining the use of dupilumab in these disorders (AU)
Los recientes avances en la comprensión de la inflamación T2 han mostrado otras enfermedades en las que la inflamación T2 está involucrada.El dupilumab es un anticuerpo monoclonal recientemente desarrollado que bloquea la transmisión de señales de IL-4 e IL-13, dos citocinasesenciales en la respuesta T2. Se están investigando posibles nuevas indicaciones, que incluyen enfermedades cutáneas, como el prurigonodular, eccema numular, dermatitis alérgica de contacto, eccema crónico de manos, urticaria crónica espontánea, penfigoide ampolloso,alopecia areata y síndrome de Netherton, así como enfermedades respiratorias, como la aspergilosis broncopulmonar alérgica, neumoníaeosinofílica crónica y rinitis alérgica. Además, las enfermedades gastrointestinales eosinofílicas, en particular la esofagitis eosinofílica y laalergia alimentaria, también constituyen áreas de investigación. En esta publicación se revisan los datos publicados y los ensayos clínicosque evalúan el uso de dupilumab en estas entidade
Subject(s)
Humans , Eczema , Off-Label Use , Eczema/drug therapy , Antibodies, Monoclonal, Humanized/therapeutic use , InflammationABSTRACT
El linfoma cutáneo primario T CD8+ tipo acral ha sido incluido como entidad provisional dentro de la nueva clasificación revisada de las neoplasias linfoides de la Organización Mundial de la Salud en 20161. Inicialmente fue descrito como proliferación linfoide CD8+ indolente de la oreja2, y se han publicado en la literatura un total de 29 casos de dicha neoplasia. Ninguno de ellos se ha relacionado con reacciones de hipersensibilidad retardada de contacto. Presentamos un caso de linfoma cutáneo primario T CD8+ tipo acral auricular bilobular en clara relación etiológica con el uso prolongado de unos pendientes de oro confirmada con pruebas epicutáneas, estudio histológico, inmunohistoquímico y molecular. Las lesiones cutáneas bilobulares fueron inducidas de nuevo con un test de uso e idénticos resultados a los iniciales y misma clonalidad, lo cual terminó de confirmar tanto el diagnóstico del linfoma como su inducción por el estímulo antigénico del oro (AU)
Primary cutaneous CD8+ T-cell lymphoma has been included as a provisional entity within the new revised classification of lymphoid neoplasms of the World Health Organization in 20161. It was initially described as indolent CD8+ lymphoid proliferation of the ear2 and a total of 29 cases of such neoplasm have been published in the literature so far. None of them have been linked to delayed contact hypersensitivity reactions. We present a case of acral type primary cutaneous lymphoma T CD8+ involving both earlobes clearly related with the prolonged use of gold earrings, confirmed with epicutaneous tests, histopathology, immunohistochemical and molecular studies. Auricular skin lesions were induced again with a provocation test with identical histopathologycal and the same clonality, confirming both the diagnosis of lymphoma and its induction by the antigenic stimulus of gold (AU)
Subject(s)
Humans , Female , Adult , Lymphoma, T-Cell, Cutaneous/diagnosis , Lymphoma, T-Cell, Cutaneous/etiology , Dermatitis, Allergic Contact/complications , Dermatitis, Allergic Contact/diagnosis , Gold/adverse effects , Patch TestsABSTRACT
Primary cutaneous CD8+ T-cell lymphoma has been included as a provisional entity within the new revised classification of lymphoid neoplasms of the World Health Organization in 20161. It was initially described as indolent CD8+ lymphoid proliferation of the ear2 and a total of 29 cases of such neoplasm have been published in the literature so far. None of them have been linked to delayed contact hypersensitivity reactions. We present a case of acral type primary cutaneous lymphoma T CD8+ involving both earlobes clearly related with the prolonged use of gold earrings, confirmed with epicutaneous tests, histopathology, immunohistochemical and molecular studies. Auricular skin lesions were induced again with a provocation test with identical histopathologycal and the same clonality, confirming both the diagnosis of lymphoma and its induction by the antigenic stimulus of gold.
ABSTRACT
Dermatologic diagnosis and monitoring have been dependent largely on visual grading. A skin biopsy is performed in case of diagnostic uncertainty, but can be traumatic, and results are delayed due to time for specimen transport and processing. Biopsies also destroy specimens, prohibiting lesion evolution monitoring. In vivo reflectance confocal microscopy (RCM) offers a diagnostic alternative to skin biopsy. RCM captures real-time, high-resolution images, and has been piloted for the evaluation of various dermatologic conditions. Identification of unique RCM features may distinguish dermatoses with similar clinical morphologies. Allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) are diagnosed by patch testing that currently uses a subjective scoring system. RCM has increasingly been studied for early detection and severity grading of CD. Common RCM features shared by ACD and ICD are stratum corneum disruption, vesicle formation, exocytosis, spongiosis, and parakeratosis. Features unique to ACD are vasodilation, increased epidermal thickness, intercellular edema, and acanthosis. Features unique to ICD are detached corneocytes and targetoid keratinocytes. This review summarizes the use of RCM in evaluating contact eccematous conditions and aims to spark future research and interest in this promising tool.
Subject(s)
Dermatitis, Allergic Contact/diagnostic imaging , Dermatitis, Irritant/diagnostic imaging , Microscopy, Confocal/methods , Biopsy/adverse effects , Dermatitis, Allergic Contact/pathology , Dermatitis, Irritant/pathology , Diagnosis, Differential , HumansABSTRACT
The first reported cases of allergic contact dermatitis from acrylates in manicure procedures in relation to the application of porcelain nails were published decades ago. The frequency of sensitization has increased due to the introduction of the so-called permanent nail polish containing photo-bonded acrylates, mainly involving the beauticians who apply them, and to a lesser extent, the consumers. The recent commercialized permanent polish kits for domestic use could trigger even higher degrees of sensitization. In this article, the clinical features, diagnostic procedures, treatment and preventive measures are described. Acrylates are present in a wide range of sources including multiple medical materials. Sensitization caused by a merely aesthetic procedure might end up having an eventual important impact in the future consumer's health which is why restrictive policies should be implemented limiting its use to qualified professionals and banning the indiscriminate sale of domestic kits.
Subject(s)
Acrylates/adverse effects , Beauty Culture , Cosmetics/adverse effects , Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/etiology , Dermatitis, Allergic Contact/therapy , Dermatitis, Occupational/therapy , Humans , Nails , Practice Guidelines as TopicABSTRACT
INTRODUCTION: Although Mercromina Film and other topical antiseptics are widely used, they are not included in the standard series recommended by the Spanish Contact Dermatitis and Skin Allergy Research Group for testing suspected allergic contact dermatitis (ACD). Furthermore, no recent studies have investigated the allergenic potential of merbromin. OBJECTIVE: To determine the allergenic potential of merbromin and compare it with that of other topical antiseptics widely used in clinical practice, including povidone-iodine, chlorhexidine, and eosin. MATERIAL AND METHODS: Prospective single-center observational safety study of 105 patients with suspected ACD seen at the dermatology department of our hospital. RESULTS: Of the 105 patients studied, 1.9% had a positive patch test to merbromin and 12.4% were sensitized to povidone-iodine. The differences in the proportion of patients with ACD to Betadine Solución Dérmica (povidone-iodine) compared with the rest of the antiseptics was statistically significant (McNemar test, P<.05). No adverse reactions were observed in any of the patients. CONCLUSIONS: Based on the patch tests conducted, Mercromina Film has very low allergenic potential. The highest allergenic potential was observed for povidone-iodine.
Subject(s)
Anti-Infective Agents, Local/adverse effects , Dermatitis, Allergic Contact/etiology , Drug Eruptions/etiology , Merbromin/adverse effects , Anti-Infective Agents, Local/immunology , Chlorhexidine/adverse effects , Chlorhexidine/analogs & derivatives , Chlorhexidine/immunology , Dermatitis, Allergic Contact/diagnosis , Drug Eruptions/diagnosis , Eosine Yellowish-(YS)/adverse effects , Humans , Merbromin/immunology , Patch Tests , Povidone-Iodine/adverse effects , Povidone-Iodine/immunology , Prospective Studies , Thimerosal/adverse effects , Thimerosal/immunologyABSTRACT
BACKGROUND: Few epidemiological studies have investigated the incidence of allergic contact dermatitis in children. Underdiagnosis has been observed in some studies, with many cases in which the condition is not suspected clinically and patch tests are not performed. However, the prevalence of pediatric sensitization to allergens has been reported to be as high as 20%, and the diagnosis should therefore be contemplated as a possibility in this age group. MATERIAL AND METHODS: We performed a retrospective analysis of the skin allergy database of the Dermatology Department of Consorcio Hospital General Universitario de Valencia. Children between 0 and 16 years of age diagnosed with allergic contact dermatitis in the previous 15 years (between 2000 and 2015) were included in the analysis. Epidemiological (age, sex, history of atopy) and clinical (site of the lesions, allergen series applied, positive reactions, and their relevance) variables were gathered. RESULTS: Patch tests had been performed on 4,593 patients during the study period. Of these, 265 (6%) were children aged between 0 and 16 years. A positive reaction to at least one of the allergens tested was observed in 144 (54.3%) patients in that group. The allergens most frequently identified were the following (in decreasing order of frequency): thiomersal, cobalt chloride, colophony, paraphenylenediamine, potassium dichromate, mercury, and nickel. The sensitization was considered relevant in 177 (61.3%) cases. CONCLUSIONS: More than half of the children studied showed sensitization to 1 or more allergens, with a high percentage of relevant sensitizations. All children with a clinical suspicion of allergic contact dermatitis should be referred for patch testing. As no standardized test series have been developed for this age group, a high level of clinical suspicion and knowledge of the allergens most commonly involved are required when selecting the allergens to be tested.
Subject(s)
Dermatitis, Allergic Contact/epidemiology , Tertiary Care Centers , Adolescent , Allergens/adverse effects , Child , Child, Preschool , Databases, Factual , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Drug Hypersensitivity/epidemiology , Female , Humans , Hypersensitivity, Immediate/epidemiology , Infant , Infant, Newborn , Male , Patch Tests , Prevalence , Retrospective Studies , Spain/epidemiology , Tertiary Care Centers/statistics & numerical dataABSTRACT
INTRODUCTION: Henna tattoos are a very common practice in the adolescent population. Henna is very often admixed with para-phenylenediamine (PPDA) to improve the appearance of the tattoo. PPDA is a potent allergen, and is a frequent cause of allergic contact dermatitis (ACD). MATERIAL AND METHOD: A study was conducted on the results of 726 consecutive children who had been patch tested in the University General Hospital Consortium of Valencia between 1980 and 2015. RESULTS: Almost half (49.7%; (361 cases) of the children had one or more positive patch test findings, with 4.7% (34) being allergic to PPDA. Mean age of patients allergic to PPDA was 12.4 years, and 44.2% were male. There were 2 cases (5.9%) of atopic dermatitis. Of the positive reactions, 73.5% were considered to be current clinically relevant. The sensitisation origin was a Henna tattoo in 50% of cases. CONCLUSION: PPDA sensitisation is relatively common in the child and adolescent population. The most frequent origin is the performing of Henna tattoos adulterated with PPDA. Adolescents are at the higher risk of developing ACD due to Henna tattoos. Henna tattooing should be strongly discouraged in children.
Subject(s)
Coloring Agents/adverse effects , Dermatitis, Allergic Contact/etiology , Phenylenediamines/adverse effects , Tattooing/adverse effects , Adolescent , Child , Dermatitis, Allergic Contact/epidemiology , Female , Humans , Male , PrevalenceABSTRACT
The incidence of allergic contact dermatitis (ACD) to cosmetics in the general population is rising with the increasing use of cosmetic products and their proliferation and diversification. The aims of this study were to determine the prevalence of ACD to cosmetics in our setting, analyze changes over time, describe the clinical and epidemiological features of this allergic reaction, and identify the allergens and cosmetics involved. We performed a prospective study at the skin allergy unit in Hospital General Universitario de Valencia in Spain between 2005 and 2013 and compared our findings with data collected retrospectively for the period 1996 to 2004. The 5419 patients who underwent patch testing during these 2 periods were included in the study. The mean prevalence of ACD to cosmetics increased from 9.8% in the first period (1996-2004) to 13.9% in the second period (2005-2013). A significant correlation was found between ACD to cosmetics and female sex but not atopy. Kathon CG (blend of methylchloroisothiazolinone and methylisothiazolinone), fragrances, and paraphenylenediamine were the most common causes of ACD to cosmetics during both study periods, and acrylates and sunscreens were identified as emerging allergens during the second period.
Subject(s)
Cosmetics/adverse effects , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/etiology , Adult , Epidemiologic Studies , Female , Humans , Male , Prospective Studies , Retrospective Studies , Spain/epidemiology , Tertiary Care CentersABSTRACT
BACKGROUND: Methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) are heterocyclic compounds used as preservatives in cosmetic and industrial products. They continue to be common allergens, causing positive patch test reactions in 2% to 4% of patients tested. MATERIAL AND METHODS: We searched the database at our skin allergy unit for all cases of sensitization to MCI/MI and MI diagnosed between January 1980 and March 2013. RESULTS: Patch tests were performed with MCI/MI in 8705 patients and with MI in 404 patients. In total, 222 patients (2.55%) were sensitized to MCI/MI and 21 (5.19%) were sensitized to MI. The incidence of MCI/MI cases peaked between 1998 and 2005 and again between 2009 and 2013. Of the 222 patients with MCI/MI sensitization, 142 were women (64%) and 49 were men (36%); the mean age was 43 years. The most frequently affected areas were the hands (54% of cases), the arms (36%), and the face (35%); 75.67% of cases were due to cosmetics and 2.25% were due to paint. Of the 21 patients with MI sensitization (mean age, 50 years), 12 were women (57%) and 9 were men (43%). The most common site of involvement in this group was the face (71% of cases), followed by the arms (38%) and the hands (29%). All the cases were due to cosmetics. CONCLUSIONS: Our data show that sensitization to the combination of MCI and MI and MI alone has increased in recent years. It would appear to be necessary to add MI to the baseline patch test series, although the test concentration has yet to be determined.
Subject(s)
Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/etiology , Preservatives, Pharmaceutical/adverse effects , Thiazoles/adverse effects , Adult , Allergens/adverse effects , Cosmetics/adverse effects , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Occupational/diagnosis , Dermatitis, Occupational/epidemiology , Dose-Response Relationship, Drug , Female , Humans , Male , Middle Aged , Paint/adverse effects , Patch Tests , Preservatives, Pharmaceutical/administration & dosage , Retrospective Studies , Spain/epidemiology , Surface-Active Agents/adverse effects , Thiazoles/administration & dosageABSTRACT
INTRODUCTION AND OBJECTIVES: Reports show that between 25% and 78% of patients with anogenital dermatitis have positive patch test results. Consequently, patch testing would appear to be warranted in patients presenting with eczema in the anogenital region. The objectives of the present study were to identify the most common allergens in patients with perianal eczema and to determine which allergen series are most useful for patch testing in patients with this condition. MATERIAL AND METHODS: We performed a retrospective review of patch test results in patients with only perianal eczema between 2001 and 2012. RESULTS: Of the 37 patients with perianal eczema, 16 had a positive reaction; methylchloroisothiazolinone/methylisothiazolinone was the main allergen involved. With the exception of 1 case of sensitization to gentamicin, all the positive results with present relevance were to allergens from the standard series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) or to the patient's own products. CONCLUSIONS: In our experience, methylchloroisothiazolinone/methylisothiazolinone is the main allergen involved in perianal eczema, and sensitization often results from using wet wipes. Patch testing in perianal eczema should be based on the GEIDAC standard series and the patient's own products.
