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Objective: To analyse the clinical characteristics and sensitivity of an essential oil patch test series (EOS) in patients sensitized to their own essential oils (EOs). Method: We analysed the clinical data and patch test results obtained with the European baseline series (BSE) and an EOS, as well as the mode of use of EOs, through a questionnaire included in the patient file. Results: The study included 42 patients (79% women, average age 50 years) with allergic contact dermatitis (ACD), 8 patients required hospitalization. All patients were sensitized to the EO they used, primarily lavender (Lavandula augustifolia, 8000‐28‐0), tea tree (Melaleuca alternifolia leaf oil, 68647‐73‐4), ravintsara (Cinnamomum camphora oil, 92201‐50‐8), and 2 cases were attributed to helichrysum (helichrysum italicum flower absolute, 90045‐56‐0). 71% had positive patch tests to fragrance mix I or II, 9 only to the EOS and 4 only with their personal EO. Interestingly, 40% of patients did not spontaneously mention the use of EOs, and only 33% received advice on their use at the time of purchase. Conclusion: Patch tests with the BSE, limonene and linalool HP, and oxidized tea tree oil is sufficient to detect most EO‐sensitized patients. The most important is to test the patient's own used EOs. [ABSTRACT FROM AUTHOR]

Keywords: allergic contact dermatitis; CAS no. 78336-31-9; case report; copolymers; cosmetic products; PEG-22/dodecyl glycol copolymer; PEG-45/dodecyl glycol copolymer EN allergic contact dermatitis CAS no. 78336-31-9 case report copolymers cosmetic products PEG-22/dodecyl glycol copolymer PEG-45/dodecyl glycol copolymer 213 215 3 08/04/23 20230901 NES 230901 We report a case of allergic contact dermatitis (ACD) caused by PEG-22/dodecyl glycol copolymer and PEG-45/dodecyl glycol copolymer contained in two different "skin-repairing" creams. Allergic contact dermatitis, CAS no. 78336-31-9, case report, copolymers, cosmetic products, PEG-22/dodecyl glycol copolymer, PEG-45/dodecyl glycol copolymer Allergic contact dermatitis caused by PEG-22 and PEG-45 dodecyl glycol copolymers in two skin-repairing creams. [Extracted from the article]

Skin tests, including patch tests (PTs), prick tests, and intradermal tests (IDTs), are useful in identifying the culprits of cutaneous adverse drug reactions (CADRs), and determining safer, alternative drugs. PTs have a low sensitivity but are valuable in investigating maculopapular exanthema (MPE), as well as severe CADR, including toxic epidermal necrolysis (TEN), Stevens‐Johnson syndrome (SJS), and in particular, acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic symptoms (DRESS). To ensure their specificity, at least 10 control tests should be performed. Prick tests are mainly used in the evaluation of immediate‐type hypersensitivity and can be performed with all drugs, except opiates. IDTs can be used to explore immediate and delayed‐type hypersensitivity, if an injectable form of the drug exists. Except for SJS/TEN, IDTs should be performed by injecting 0.02 mL of the drug. We here provide a practical, up‐to‐date review on the use of these skin tests in the work‐up of CADRs. Numerous negative controls for drug PTs, as well as criteria for the immediate and delayed positivity of prick tests and IDT, are included. It should be emphasized that a negative result never excludes the potential responsibility of a drug in a CADR. [ABSTRACT FROM AUTHOR]

Background and Objectives: The repeated open application test (ROAT) is an adjuvant investigation measure to patch testing in the diagnosis of allergic contact dermatitis. ESCD recommends a 15 days duration but its overall duration varies according to publications and patients hardly adhere to prolonged ROAT duration beyond 1 week. Materials and Methods: The Dermatology and Allergy Group of the French Society of Dermatology performed a prospective study with the aim of determining the best duration for the ROAT. Results: A total of 328 ROAT results were collected for topical products, including cosmetics (60%) and topical medications (31.1%). Fifty‐nine (18%) ROATs were positive, and 16 (5%) were doubtful. All the positive ROATs occurred within 10 days, with a median time to positivity of 3 days. Conclusion: According to our results, a minimum duration of 10 days is necessary to achieve a positive ROAT to a topical product. [ABSTRACT FROM AUTHOR]

Background: An aqueous antiseptic containing "chlorhexidine digluconate/benzalkonium chloride/benzyl alcohol" (CBB) is widely used in France. The only previous documented study dealing with allergic contact dermatitis (ACD) to this antiseptic is one small case series in children. The French Vigilance Network for Dermatology and Allergy (REVIDAL‐GERDA) has collected many cases in the last few years. Objectives: To evaluate the clinical and sensitization profiles of patients diagnosed with ACD to CBB. Methods: We performed a retrospective study of patients with contact dermatitis to CBB and positive tests to CBB and/or at least one of its components. All patients had to be tested with all components of CBB. Results: A total of 102 patients (71 adults and 31 children) were included. The lesions were extensive in 63% of patients and 55% had delayed time to diagnosis. CBB patch tests were positive in 93.8% of cases. The allergen was identified in 97% of patients, mainly benzyl alcohol in adults (81.7%) and chlorhexidine digluconate in children (54.8%). About 32.4% of the patients were sensitized to several components. Conclusion: CBB is a cause of ACD at all ages. The components of the antiseptic should be tested. The sensitization profile seems to be different between adults and children. [ABSTRACT FROM AUTHOR]

(C) Positive prick test with undiluted Desomedine on delayed reading at day 2 (same prick test as in B) gl Prick tests were performed with undiluted Desomedine (hexamidine 0.1%), and these confirmed both immediate and delayed type hypersensitivity on immediate (Figure 1B) and delayed readings on day (D)2 (Figure 1C). Although allergic contact dermatitis in response to antiseptics is common, we should be aware that occasionally this may co-exist with immediate-type hypersensitivity, and also with molecules frequently sold over the counter. Keywords: case report; delayed hypersensitivity; hexamidine; immediate hypersensitivity EN case report delayed hypersensitivity hexamidine immediate hypersensitivity 580 582 3 10/22/21 20211101 NES 211101 CASE REPORT A 66-year-old man with a history of arterial hypertension (treated by dietary approaches only), allergic rhinitis, asthma, and atopic dermatitis, developed a grade II anaphylactic reaction 5 minutes after the first intranasal application of hexamidine (Desomedine, Chauvin Bausch & Lomb laboratory, Montpellier, France) for a cold. [Extracted from the article]

Keywords: allergic contact dermatitis; alternative medicine; black cumin; essential oil; Nigella sativa oil; t-butylhydroquinone; thymoquinone EN allergic contact dermatitis alternative medicine black cumin essential oil Nigella sativa oil t-butylhydroquinone thymoquinone 132 134 3 07/27/20 20200801 NES 200801 Thymoquinone (TQ), the main constituent of I Nigella sativa i L. oil (NSO), was investigated for therapeutic use in different diseases for its antioxidant, anti-inflammatory, antiproliferative, and proapoptotic properties.1 Several cases of allergic contact dermatitis (ACD) and bullous eruption from NSO have been published, and the hypothesis of TQ being the causative substance was suggested but not confirmed.2,3 We report a case of ACD caused by NSO with a positive patch test to TQ. Strong or extreme-positive patch-test reactions were observed to NSO (++/++), I t i ert-butylhydroquinone (TBHQ) (++/++) (in the cosmetic series), carvone (++/++), amyl cinnamal (-/++), and TQ (+++/+++) (Figure 1). Allergic contact dermatitis, alternative medicine, black cumin, essential oil, Nigella sativa oil, t-butylhydroquinone, thymoquinone. [Extracted from the article]

The article lists the names of reviewers including Barbaud Annick, Olivier Aerts and Tove Agner for reviewing articles of the periodical "Contact Dermatitis" from October 15, 2015 to October 15, 2016.

Thereby, the similar patch test profile results in our five patients support the hypothesis that TBHQ is a good marker for NSO allergy through a TQ sensitization. Keywords: allergic contact dermatitis; Cas number 1948-33-0; patch test; Nigella sativa oil; tert-butylhydroquinone; thymoquinone EN allergic contact dermatitis Cas number 1948-33-0 patch test Nigella sativa oil tert-butylhydroquinone thymoquinone 447 449 3 05/06/21 20210601 NES 210601 Use of complementary and alternative medicine has increased in industrialized countries.1,2 I Nigella sativa i oil (NSO), used as an herbal medicine for thousands of years, has drawn interest for its immunoregulatory, antimicrobial, cardiovascular, and antitumoral properties.3 Although patients expect alternative medicine to be safe,4 allergic contact dermatitis (ACD) and bullous dermatitis with NSO have been reported.5,6 The hypothesis that thymoquinone (TQ), its major component, is the causative substance of allergic reaction to NSO was proposed,7 but thymoquinone is not yet available in France for patch tests. These five cases and the previously published one support the hypothesis that due to chemical similarities with TQ, which is supposed to be the responsible for NSO sensitization, TBHQ would be a good marker for NSO allergy. [Extracted from the article]

Background: Eyelids are frequent sites of contact dermatitis. No prospective study focused on eyelid allergic contact dermatitis (EACD) has yet been published, and this topic has never been studied in French patients. Objectives: To prospectively evaluate the usefulness of an eyelid series in French patients patch tested because of EACD, and to describe these patients. Methods: We prospectively analysed standardized data for all patients referred to our departments between September 2014 and August 2016 for patch testing for suspected EACD as the main reason. All patients were patch tested with an eyelid series, the European baseline series (EBS), the French additional series, and their personal products. Patch testing with additional series and repeated open application tests (ROATs) or open tests were performed if necessary. A standardized assessment of the relevance was used, and the analysis of the results was focused on patients having positive test results with a current certain relevance. Results: Two‐hundred and sixty‐four patients (238 women and 26 men) were included. Three‐hundred and twenty‐two tests gave positive results in 167 patients, 84 of whom had currently relevant reactions: 56 had currently relevant positive test reactions to the EBS, 16 had currently relevant positive test reactions to their personal products, 8 had currently relevant positive test reactions to the French additional series, and 4 had currently relevant positive test reactions to the eyelid series. Sixty‐seven per cent of all relevant cases were related to cosmetic products. The most frequent allergens with current relevance were methylisothiazolinone (10.2%), fragrance mix I (3%), nickel (2.7%), hydroxyperoxides of linalool (2.7%) and limonene (2.3%), and Myroxylon pereirae (2.3%). Current atopic dermatitis was found in 9.5% of patients. The duration of dermatitis was shorter (23.2 vs 34.2 months; P = .035) in patients with currently relevant test reactions. The percentage of currently relevant tests remained the same when atopic patients or dermatitis localized only on the eyelids were taken into account. Conclusion: In French patients, testing for EACD with the extended baseline series and personal products, also including ROATs and use tests, appears to be adequate, considering the currently relevant positive test reactions. The regular addition of an eyelid series does not seem to be necessary. [ABSTRACT FROM AUTHOR]

Allergic contact dermatitis, case report, cosmetics, patch tests A 53-year-old woman experienced a widespread eczema after application of two Tamanu oils on insect bites, with positive patch test results to the two Tamanu oils at 1% in olive oil. Keywords: allergic contact dermatitis; case report; cosmetics; patch tests EN allergic contact dermatitis case report cosmetics patch tests 99 100 2 06/14/22 20220701 NES 220701 Allergic contact dermatitis (ACD) to Tamanu oil is rare, but two recent cases underline that an increase in frequency of use could bring out more cases of ACD to this vegetable oil. [Extracted from the article]

Background Modern dressings ( MDs) may have a low sensitization rate, but there is a lack of prospective studies in patients with chronic leg ulcers ( CLUs) to evaluate this. Objectives To determine the rate of sensitization (contact allergy) to MDs and substances present in dressings. Patients and methods A prospective multicentre study was carried out in patients with CLUs at five French dermatology departments; patch tests were performed with the European baseline series and with an additional 27 individual allergens and 10 MDs. Results Among 354 patients (226 women and 128 men) with CLUs, 59.6% had at least one positive patch test reaction to an MD and 19% had at least one sensitization to an MD. The number of positive test reactions per patient was correlated with the duration of ulcerative disease, but not with ulcer duration, the cause of the ulcer, or the presence of surrounding eczematous lesions. For 11 of 45 patients sensitized to Ialuset cream®, more detailed information could be obtained with sensitization to sodium dehydroacetate (5 cases) or Lanette SX® (3 cases). Conclusions Sensitization to MDs is not rare. It is absolutely necessary to label all components of MDs on their packaging and to avoid some sensitizing molecules, such as colophonium derivatives or any strong sensitizers. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 28-year-old woman who had history of pruritic erythematous scaly dermatitis on both hands and on the neck, after keeping a rabbit as pet. She fed her rabbit with chicory leaves, dandelion, hay, and dry food, and the dermatitis disappeared when the patient stopped feeding her rabbit with chicory.

The article presents a case study of a woman with acute eczema of upper and lower eyelids which caused Allergic contact dermatitis (ACD) was given intravitreal injections containing aflibercept and ranibizumab. It notes that IQ Ultra Chambers was applied with Mefix and repeated open application tests. The article discusses ACD is caused by an anti-vascular endothelial growth factor (VEGF) intravitreal injection.

Patch tests (PT) were performed with the European Baseline, a cosmetic and an EO series (Chemotechnique Diagnostics, Vellinge, Sweden), and the personal beard products. 3 Kurihara F, Soria A, Lepoittevin JP, Chasset F, Barbaud A, Pecquet C. Thymoquinone as a causative allergen in Nigella sativa oil contact dermatitis with cross-reactivity to tert-butylhydroquinone. Allergic contact dermatitis from Nigella Sativa Seed Oil (NSO) may present in different patterns such as severe polymorphic lesions mimicking acute bullous drug reactions.[[1], [3]] However, proving its use and its responsibility may be difficult. [Extracted from the article]

Keywords: acyclovir; adverse drug reaction; allergic contact dermatitis; antiviral drugs; case report; drug allergy EN acyclovir adverse drug reaction allergic contact dermatitis antiviral drugs case report drug allergy 203 205 3 02/25/21 20210301 NES 210301 CASE REPORT A 27-year-old woman was referred to our department because of a 1-year history of recurrent episodes of edema and eczema of the face. 7 Vernassiere C, Barbaud A, Trechot PH, Weber-Muller F, Schmutz JL. Systemic acyclovir reaction subsequent to acyclovir contact allergy: which systemic antiviral drug should then be used? Acyclovir, adverse drug reaction, allergic contact dermatitis, antiviral drugs, case report, drug allergy. [Extracted from the article]

The article presents a case study of a 22-year-old female lottery employee with airborne facial dermatitis that spread over her trunk and limbs. She had a history of contact allergy to nickel and was diagnosed with airbone occupational contact dermatitis (OCD) caused by nickel exposure in lottery scratchcards. The role of nickel in the development of OCD and rare cases of OCD caused by nickel are discussed.

Background: Allergic contact dermatitis to gloves is mostly induced by rubber accelerators. The European baseline series (EBS) appears insufficient to detect glove allergy. Since 2017, it is recommended to use the European rubber series (ERS) and to test the patients' own gloves. Objectives: To investigate the clinical profile of glove‐wearing patients with hand eczema (HE) and to evaluate their sensitisation profile to glove allergens and the value of testing the patients' own gloves. Methods: We conducted a French multicentre study of patients evaluated for HE between 2018 and 2020 and tested with the EBS, the ERS and their own gloves in patch tests and semi‐open (SO) tests. Results: A total of 279 patients were included; 32.6% of patients had positive tests to their own gloves or to glove allergens. Almost 45% of the sensitisations to glove allergens were detected only by the ERS. Among the patients tested both in patch tests and SO tests with their own gloves with positive results, 28% had positive SO tests only. Polyvinylchloride (PVC) gloves were positive in four patients. Conclusion: Our series confirms the need to test the ERS. All the patients' gloves must also be tested including PVC gloves. SO tests with gloves are useful as a complement to patch tests. [ABSTRACT FROM AUTHOR]

Keywords: case report; cimetidine; DRESS; patch test; polysensitization; racecadotril EN case report cimetidine DRESS patch test polysensitization racecadotril 451 452 2 10/06/22 20221101 NES 221101 Allergy to cimetidine or racecadotril is rarely encountered in clinical practice. In our case, we did not perform OPT for racecadotril because of the positive PT, knowing that we already had six negative PT controls (personal unpublished data), in addition to the negative control reported by Nucera et al.,3 emphasizing the good value of our positive PT. Patch tests (PT) and oral provocation tests (OPT) are both useful to detect the culprit drug(s) in cutaneous adverse drug reactions (CADR). [Extracted from the article]

The article presents a case study of 88 year old patient with hypersensitivity reactions to iodinated contrast media (ICM) with acute exanthema, temperature and intraepidermal pustule with numerous polymorphonuclear cells. Patch test confirmed acute generalized exanthematous pustulosis (AGEP), hence coronary stenting and endovascular valvuloplasty, including ICM administration of iopromide and oral prednisone was recommended.

Allergic contact dermatitis, case report, microbiome, nummular dermatitis, persulphate, spa Keywords: allergic contact dermatitis; case report; microbiome; nummular dermatitis; persulphate; spa EN allergic contact dermatitis case report microbiome nummular dermatitis persulphate spa 128 130 3 07/11/23 20230801 NES 230801 CASE REPORTS Case 1 A 59-year-old man, with a past history of seborrheic dermatitis, was referred for an extended fluctuating dermatitis with multiple erythematous and itchy coin-shaped lesions. [Extracted from the article]

The article presents a 32-year-old woman with a history of fever with a generalized eruption of non-follicular pustules and erythema. Topics discussed include acute generalized exanthematous pustulosis caused by oxacillin, increased white blood cell count with neutrophilia, and appearance of lesional pattern after patch testing with oxacillin.

Patch tests with the oral liquid formulations of alprazolam (0.75 mg/mL), diazepam (5 mg/mL) delorazepam (1 mg/mL), lormetazepam (2.5 mg/mL), bromazepam (2.5 mg/mL), triazolam (0.375 mg/mL), clotiazepam (10 mg/mL) and lorazepam (2 mg/mL) were performed.[6] For diazepam and midazolam also injectable formulations (5 mg/mL) were used. Even if the clinical picture was not typical, clinical history and patch test results were suggestive of a delayed-type hypersensitivity to alprazolam, with eventually cross-reactivity to diazepam, delorazepam, lormetazepam ad bromazepam. Keywords: alprazolam; benzodiazepines; case report; delayed-type hypersensitivity EN alprazolam benzodiazepines case report delayed-type hypersensitivity 56 58 3 06/12/23 20230701 NES 230701 Allergic reactions to benzodiazepines are relatively rare. [Extracted from the article]

Antibiotics, case series, children, cutaneous adverse drug reactions, drug hypersensitivity, maculopapular exanthema, patch test, DRESS syndrome, Stevens-Johnson syndrome, toxic epidermal necrolysis Keywords: antibiotics; case series; children; cutaneous adverse drug reactions; DRESS syndrome; drug hypersensitivity; maculopapular exanthema; patch test; Stevens-Johnson syndrome; toxic epidermal necrolysis EN antibiotics case series children cutaneous adverse drug reactions DRESS syndrome drug hypersensitivity maculopapular exanthema patch test Stevens-Johnson syndrome toxic epidermal necrolysis 373 376 4 09/08/22 20221001 NES 221001 Non-immediate cutaneous adverse drug reactions (CADRs) are mostly clinical manifestations of a Type IV hypersensitivity reaction.1,2 In children, diagnosing CADRs is a common challenge for physicians, as childhood rashes are more often due to viral infections but frequently mimic CADRs.1,2 A proper diagnosis and identification of the culprit drug avoids misdiagnosis, therefore, preventing unnecessary drug avoidance or replacement, and guides for potential alternatives reducing morbidity from CADRs.1-3 Patch tests (PT) are considered useful for diagnosing non-immediate CADRs, however, few paediatric studies have been published.2-6 This may be related to the lower incidence of CADRs in children, the lack of PT standardization especially for severe cutaneous adverse reactions (SCARs) and controversies on PT safety, particularly in this population.3-5,7 This study aimed to evaluate the sensitivity and safety of PT for paediatric CADRs. [Extracted from the article]

The literature on positive patch‐test results in acute generalized exanthematous pustulosis (AGEP) is reviewed. Ninety‐three drugs were identified that have together caused 259 positive patch tests in 248 patients with AGEP. The drug classes causing the highest number of reactions are beta‐lactam antibiotics (25.9%), other antibiotics (20.8%), iodinated contrast media (7.3%), and corticosteroids (5.4%), together accounting for nearly 60% of all reactions. The highest number of reactions to individual drugs was to amoxicillin (n = 36), followed by pristinamycin (n = 25), diltiazem (n = 14), amoxicillin‐clavulanic acid (n = 13), clindamycin (n = 11), and iomeprol (n = 8); 59 of the 93 drugs each caused a single case only. The "Top‐10" drugs together caused over 50% of all reactions. The sensitivity of patch testing (percentage of positive reactions) in patients with AGEP is largely unknown, but may generally be ~50%, which also applies to pristinamycin. Patch testing in AGEP appears to be safe, although mild recurrence of AGEP skin symptoms or other rashes may occur occasionally. Clinical aspects of AGEP, including epidemiology, etiology and pathophysiology, clinical features, histology, treatment, and prognosis are briefly presented, as are diagnosing the disease and identifying the culprit drugs with patch tests, intradermal tests, in vitro tests, and challenge tests. [ABSTRACT FROM AUTHOR]

The literature on positive patch test results in drug reaction with eosinophilia and systemic symptoms (DRESS) is reviewed. One hundred and five drugs were identified that have together caused 536 positive patch tests in 437 DRESS patients. By far, the most reactions (n = 145) were caused by carbamazepine, followed by amoxicillin, isoniazid, phenytoin, ethambutol, fluindione, phenobarbital, rifampicin, and ceftriaxone; 43 drugs each caused a single case only. The drug classes causing the highest number of reactions were anticonvulsants (39%), beta-lactam antibiotics (20%), antituberculosis agents (11%), non-beta-lactam antibiotics (6%), and iodinated contrast media (5%). The sensitivity of patch testing (percentage of positive reactions) is high for anticonvulsants (notably carbamazepine), beta-lactam antibiotics (notably amoxicillin), and, possibly, iodinated contrast media. Allopurinol and sulfasalazine frequently cause DRESS but never give positive patch tests. Patch testing in DRESS appears to be safe, although mild recurrence of DRESS symptoms, mostly skin reactions, may not be rare. Multiple drug hypersensitivity was found to occur in 16% of all patients, but it is argued that the true frequency is higher. Clinical aspects of DRESS, including diagnosing the disease and identifying culprit drugs (patch tests, intradermal tests, in vitro tests, challenge tests) are also provided, emphasizing the role of patch testing. [ABSTRACT FROM AUTHOR]

Background: Hand eczema is a common inflammatory skin disorder. Health care providers need continuously updated information about the management of hand eczema to ensure best treatment for their patients. Objectives: To update the European Society of Contact Dermatitis guideline on the diagnosis, prevention, and treatment on of hand eczema. Method: The Guideline Development Group (GDG) was established on behalf of the ESCD. A call for interest was launched via the ESCD website and via the ESCD members' mailing list. Appraisal of the evidence for therapeutic and preventive interventions was applied and a structured method of developing consensus was used and moderated by an external methodologist. The final guideline was approved by the ESCD executive committee and was in external review on the ESCD webpage for 1 month. Results: Consensus was achieved for several statements and management strategies. Conclusion: The updated guideline should improve management of hand eczema. [ABSTRACT FROM AUTHOR]

The literature on systemic allergic dermatitis (SAD; also known as systemic contact dermatitis) is reviewed. Both topical drugs (from absorption through mucosae or skin) and systemic drugs (oral, parenteral, rectal) may be responsible for the disorder. The topical route appears to be rare with 41 culprit topical drugs found to cause SAD in 95 patients. Most reactions are caused by budesonide (especially from inhalation), bufexamac, and dibucaine. SAD from systemic drugs is infrequent with 95 culprit drugs found to cause SAD in 240 patients. The drugs most frequently implicated are mitomycin C, methylprednisolone (salt, ester), and hydrocortisone (salt). The largest group of culprit drugs consisted of corticosteroids (19%), being responsible for >30% of the reactions, of which nearly 40% were not caused by therapeutic drugs, but by drug provocation tests. The most frequent manifestations of SAD from drugs are eczematous eruptions (scattered, widespread, generalized, worsening, reactivation), maculopapular eruptions, symmetrical drug‐related intertriginous and flexural exanthema (SDRIFE [baboon syndrome]) and widespread erythema or erythroderma. Therapeutic systemic drugs hardly ever cause reactivation of previously positive patch tests and infrequently of previous allergic contact dermatitis. The pathophysiology of SAD has received very little attention. Explanations for the rarity of SAD are suggested. [ABSTRACT FROM AUTHOR]

Background: Patch tests (PTs) with two readings have been used for decades to identify the culprit drug in nonimmediate cutaneous adverse drug reactions (NICADRs), followed more recently by late reading of intradermal tests (IDTs). Some teams tend to perform PTs with only one reading before IDTs or even directly perform IDTs. Objectives: To evaluate the relevance of a late PT reading on day 4 (D4) in NICADRs. Methods: We retrospectively selected patients who had a PT for an NICADR between July 2014 and March 2020. Results: During the study period, 328 patients had a PT with available results. Among the 75 positive‐PT patients with available data for the two readings, 41 (54.7%) had positive results on D2 and D4 and 34 (45.3%) had negative results on D2 but positive results on D4. No patient had positive results on D2 and negative results on D4. Conclusion: This study shows that a D4 reading enhanced the PT‐positive results. A positive PT result allows for reducing the number of IDTs, which are more difficult and costly to perform. Our series suggests that a late PT reading at D4 should be performed for exploring NICADRs. [ABSTRACT FROM AUTHOR]

Background: Sodium disulfite (SD), also known as sodium metabisulfite, is an increasingly recognized cause of allergic contact dermatitis. Objectives: The objective of this work was to characterize individuals with positive patch test reactions to SD as well as analyse reaction strength, clinical relevance, and sources. Methods: This is a retrospective analysis of patients patch tested with SD (1% petrolatum) by the North American Contact Dermatitis Group (NACDG), 2017 to 2018. Results: Of 4885 patients patch tested with SD, 132 (2.7%) had a positive reaction. Common primary anatomic sites of dermatitis were face (28.8%), hands (20.5%), and a scattered/generalized distribution (13.6%). Compared with SD‐negative patients, SD‐positive patients were more likely male (odds ratio 2.81, 95% confidence interval 1.98‐4.00) and/or over 40 years (odds ratio 1.95, 95% confidence interval 1.30‐2.94). Reactions were most commonly + (50.4%) or ++ (34.1%); 65.2% were considered currently relevant. About 15.2% were definitively confirmed in sources, commonly personal care products (18.9%, especially hair dye), and drugs/medications/alcoholic beverages (9.1%). Only 2.3% of positive reactions were linked to occupation. Conclusions: Positive reactions to SD occurred in 2.7% of tested patients. Reactions were often clinically relevant and linked to personal care products and drugs/medications/alcoholic beverages. [ABSTRACT FROM AUTHOR]

Background: Benzalkonium chloride (BAK) is a quaternary ammonium compound that is used widely as an antiseptic and preservative. It is a strong irritant and considered a weak sensitizer. Objective: To analyze the temporal trend of BAK sensitization and the demographics of sensitized patients. Methods: We conducted a single-center retrospective study of 7390 patients who were patch tested with BAK between January 1, 2003 and December 31, 2019. Results: Of the 7390 patients who were patch tested to BAK, 108 (1.5%) had a positive reaction, with 21 reactions deemed clinically relevant (0.3% of total patch tested) and a further 5 doubtful reactions deemed clinically relevant, resulting in a total of 26 relevant reactions (0.4% of total patch tested). Common sources of exposure were ophthalmic drops (30.8%), topical antiseptic preparations (26.9%), cosmetics (15.4%), disinfectant solutions (11.5%), hand sanitizers (11.5%), and hand washes (7.7%). One fifth of patients with relevant reactions were health care workers. There has been a dramatic increase in the number of positive reactions since 2017, for reasons not totally clear. Conclusion: Contact allergy (CA) and allergic contact dermatitis (ACD) in response to BAK are now increasing at our center. Awareness of this trend is important, given that the coronavirus disease 2019 (COVID-19) pandemic is likely to further expose people to BAK. [ABSTRACT FROM AUTHOR]

(D) Pustular patch-test reactions (++) on day (D)3 to (benzyl alcohol-containing) Amycor cream "as is" (Merck Serono SAS, Lyon, France), to (benzyl alcohol-containing) Terbinafine cream "as is", and to benzyl alcohol 10% sof. Keywords: acute generalized exanthematous pustulosis; AGEP; allergic contact dermatitis; benzyl alcohol; CAS no. 100-51-6; case report EN acute generalized exanthematous pustulosis AGEP allergic contact dermatitis benzyl alcohol CAS no. 100-51-6 case report 100 102 3 06/14/22 20220701 NES 220701 Benzyl alcohol is a preservative often used in topical drugs and cosmetics and occasionally responsible for allergic contact dermatitis (ACD).1 We report a peculiar case of ACD from benzyl alcohol mimicking acute generalized exanthematous pustulosis (AGEP), which highlights that common topical drug excipients may occasionally be important culprit sensitizers. [Extracted from the article]

Typically, generalized pustular psoriasis also needs to be considered; a family or past history of psoriasis might argue for pustular psoriasis, while a history of recent drug exposure, as in the present case, rather favours AGEP. Keywords: acute generalized exanthematous pustulosis; case report; patch test; transdermal ketoprofen patch EN acute generalized exanthematous pustulosis case report patch test transdermal ketoprofen patch 425 427 3 04/14/22 20220501 NES 220501 Acute generalized exanthematous pustulosis (AGEP) is considered a severe, type IVd cutaneous adverse drug reaction.1 Ketoprofen is well known to induce photo (-aggravated) allergic contact dermatitis.2 To the best of our knowledge, AGEP due to a transdermal ketoprofen patch has never been reported before. She did not take any systemic medication, but she had applied transdermal ketoprofen patches (MOHRUS TAPE L; Hisamitsu Pharmaceutical Co., Inc., Tokyo, Japan) for a bruise on the right thigh 3 days before the onset of symptoms. [Extracted from the article]

Background: There is considerable variability across European patch test centres as to which allergens are included in local and national cosmetics series. Objectives: To propose a standardized, evidence‐based cosmetic series for Europe based on up‐to‐date analysis of relevant contact allergens. Methods: We collated data from the European Surveillance System on Contact Allergies (ESSCA) from 2009 to 2018 to determine which cosmetic allergens produce a high yield of contact allergy. Contact allergens with a prevalence of >0.3% that were considered relevant were included. Rare contact allergens were excluded if deemed no longer relevant or added to a supplemental cosmetic series for further analysis. Results: Sensitization prevalences of 39 cosmetic contact allergens were tabulated. Thirty of these allergens yielded >0.3% positive reactions and are therefore included in our proposed European cosmetic series. Six were considered no longer relevant and therefore excluded. Three were included in a supplementary European cosmetic series. An additional nine allergens were included in either the core or supplemental European cosmetic series following literature review. Conclusion: We have derived a potential European cosmetic series based upon the above methods. This will require ongoing investigation based upon the changing exposure profiles of cosmetic allergens as well as new and evolving substances. [ABSTRACT FROM AUTHOR]

The Editors thank the reviewers for their valuable support (October 15, 2018 to October 15, 2019); in alphabetical order: Cohen, David. Gawkrodger, David. Thomas, Peter. [Extracted from the article]

We report two patients with contact allergy to diclofenac and subsequent tolerance in oral challenge tests. Allergic contact dermatitis (ACD) after topically applied diclofenac1,2 and type IV reactions after oral intake are rarely reported.3 To date, no study exists on possible oral tolerance in patients with contact allergy to topical diclofenac. Keywords: allergic contact dermatitis; case report; diclofenac; systemic tolerance EN allergic contact dermatitis case report diclofenac systemic tolerance 41 43 3 12/17/21 20220101 NES 220101 Diclofenac (CAS 15307-86-5) is a widely used non-steroidal anti-inflammatory drug (NSAID). [Extracted from the article]

Background: Although occupational contact urticaria (CU) and protein contact dermatitis (PCD) are considered frequent among workers with exposure to proteinaceous materials, data on occupations at risk and the main causes of these occupational skin diseases are relatively limited. Objectives: To report the causative agents and risk occupations for CU and PCD in the Finnish Register of Occupational Diseases (FROD). Methods: We retrieved from the FROD all recognized cases of CU/PCD in the years 2005–2016. Results: With 570 cases, CU and PCD constituted 11% of all recognized cases of occupational skin diseases in the study period. Occupations with the highest incidence of CU/PCD included bakers, chefs and cooks, farmers and farm workers, veterinarians, gardeners, and hairdressers. The most common causative agents were cow dander and flour and grain, followed by natural rubber latex (NRL) and other food. In food‐related occupations, wheat and other flours were by far the most common cause of CU/PCD, with 76 cases, whereas fish and other animal‐derived food caused 33 and other plant‐derived food caused 23 cases. Conclusions: Apart from the Finnish peculiarity of cow dander allergy, a striking finding was a large share of CU/PCD caused by flours in food handlers as compared to other food. [ABSTRACT FROM AUTHOR]

Background: In Europe, contact photosensitivity to phenothiazines is well‐known, particularly in southern countries. Topical phenothiazines are widely used and sold over‐the‐counter (OTC) for the treatment of mosquito bites and pruritus in France. Objective: To report a series of cases with photodermatitis following use of topical phenothiazines. Method: A retrospective study of cases of contact dermatitis from phenothiazines seen in French photodermatology centers was performed. Results: In all, 14 patients with a diagnosis of contact dermatitis from phenothiazines were included. These patients developed eczema on the application sites, and in 13 the eruption spread to photodistributed sites. Topical products containing isothipendyl were the most common cause of photodermatitis. One patient had photoaggravated eczema due to promethazine cream. All patients stopped using topical phenothiazines and were treated successfully with topical corticosteroids. One patient relapsed and developed persistent light eruption. In all of the nine cases tested, photopatch testing to the topical phenothiazine used "as is" was positive. Isothipendyl, chlorproethazine, and the excipients were not tested. Photopatch tests to chlorpromazine and promethazine were positive in 8 of 12 and 7 of 13 tested, respectively. Conclusion: Use of isothipendyl and promethazine as OTC (or even prescribed) drugs needs to be limited due to severe reactions and sensitization to other phenothiazines that consequently will have to be avoided. [ABSTRACT FROM AUTHOR]

Background: Antibiotics have been implicated in the reactivation of exanthema and systemic involvement in drug reaction with eosinophilia and systemic symptoms (DRESS); however, it is not clear whether these patients become sensitized to the antibiotic. Objective: To evaluate if, after DRESS, patients become sensitized to antibiotics. Methods: We retrospectively reviewed the patch test (PT) data and clinical files of DRESS patients who were administered antibiotics during DRESS from other culprits. Results: Nine patients out of 17 (53%) were positive to antibiotics in PT: six to the penicillin group and three to cephalosporins (including one patient with additional positivity to vancomycin). Considering the eight patients who were negative to antibiotics in PT, seven were exposed to a fluoroquinolone. Four cases were patch tested again and three remained positive to antibiotics 2 to 5 years thereafter. Two patients with positive PT results had an accidental re‐exposure to antibiotics and developed a maculopapular exanthema without systemic symptoms. Conclusion: Exposure to antibiotics during DRESS or its prodromal phase could enhance sensitization to antibiotics, as confirmed by a positive PT. Reproducibility of positive PTs to antibiotics after several years and reactivation after re‐exposure support that T‐cell‐mediated hypersensitivity to antibiotics in the setting of DRESS is a specific reaction. Highlights: Exposure to antibiotics during drug reaction with eosinophilia and systemic symptoms (DRESS) could induce a new sensitization, confirmed by 53% positivity in patch tests (PTs).Sensitization to antibiotics could explain cases of exacerbations following discontinuation of the culprit drug and reinforce the need to avoid antibiotics during DRESS.Reproducibility of positive PTs after several years and reactivation after re‐exposure to antibiotics support that T‐cell‐mediated hypersensitivity to antibiotics in the setting of DRESS is a specific reaction. [ABSTRACT FROM AUTHOR]

Paracetamol-induced symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) in a psoriasis patient receiving apremilast therapy However, we are unsure if any kind of relationship between apremilast, paracetamol intake, and SDRIFE exists, that is, whether apremilast could have facilitated the patient's reaction to paracetamol. Baboon syndrome resulting from systemic drugs: is there strife between SDRIFE and allergic contact dermatitis syndrome?. [Extracted from the article]