Rate of Patch Testing Induced Anaphylaxis.

Background: Although allergic contact dermatitis is a type IV hypersensitivity reaction, type I hypersensitivity reactions, such as anaphylaxis, have been reported during patch testing. Objective: The aim of this study was to identify reported cases of anaphylaxis from patch testing and estimate its rate. Methods: A literature review was conducted on PubMed to identify previously reported cases of anaphylaxis after patch testing and suspected allergens. In addition, a survey was distributed to expert patch testing dermatologists to determine the rate of anaphylaxis after patch testing. Results: Three anaphylaxis cases due to patch testing were found in the literature. Twenty-seven of 36 expert patch testers completed the survey for a 75% response rate. These dermatologists have tested an estimated 201,720 patients in their combined careers. From them, 2 cases of patch test anaphylaxis were reported. The rate of anaphylaxis from patch testing was calculated to be 1 in 100,860 tests among our cohort. Conclusions: Patch testing induced anaphylaxis is rare and may be more likely in patients with a history of anaphylaxis. Although rare, dermatologists should have a management plan in place.

Contact Allergens in Top-Selling Textile-care Products.

BACKGROUND: Chemicals in textile manufacturing and laundering products are important sources of allergens triggering allergic contact dermatitis. Allergens corresponding to the textile production process have been well recognized. However, there is limited information regarding potential allergens in laundering products. OBJECTIVE: The aim is to investigate the presence and prevalence of potential allergens in commonly used laundering products. METHODS: An Internet-based search was performed to identify the current best-selling laundering products in the United States. Subsequent inquiry of common allergens for each product was collected through a review of ingredients listed by manufacturers. RESULTS: Sixty-five laundering products were examined: 30 laundry detergents, 10 fabric softeners, 8 dryer sheets, and 17 stain removers. Ten common allergens were identified: benzisothiazolinone, benzyl benzoate, cocamidopropyl betaine, decyl glucoside, "fragrances," lauryl glucoside, methylisothiazolinone, methylchloroisothiazolinone, phenoxyethanol, and propylene glycol. Fragrances and essential oils are the top allergens in laundry detergents (66.7%), fabric softeners (90%), dryer sheets (75%), and stain removers (58.8%). Laundry detergents labeled as "baby safe" and "free and gentle" contained common allergens, with methylisothiazolinone being the most prevalent, in 80% and 57.1%, respectively. CONCLUSIONS: Textile dermatitis can negatively impact quality of life and function. Aside from textile dyes and finishing resins, laundering products should also be considered.