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Background: Psoriasis and allergic contact dermatitis are 2 very common dermatoses. The relationship between them has not yet been fully understood. Contact dermatitis can be an additional cause of epidermal disruption in psoriasis patients, resulting in poor management of the disease. Objective: To analyze the tendencies of contact sensitization in a cohort of psoriasis patients with suspected allergic contact dermatitis. Methods: Psoriasis patients (n = 85) with suspected contact dermatitis underwent patch testing with European Baseline allergen series S-1000 in Vilnius University Hospital Santaros Klinikos Centre of Dermatovenereology from August 2020 to August 2021. Their results are presented in this study. Results: The patch test was positive in 43.5% (n = 37) of patients. Contact sensitization was more prevalent in patients with mild psoriasis, as characterized by Psoriasis Area Surface Index scores ≤10, compared to those with moderate-to-severe psoriasis (P

Allergic contact dermatitis (ACD) is a common cutaneous inflammatory skin disorder that is diagnosed via epicutaneous patch testing (PT). ACD may also coexist with other systemic inflammatory conditions such as atopic dermatitis and psoriasis. Many of the treatments used to manage severe ACD, along with other systemic conditions, interact with and suppress the immune system, thereby potentially interfering with the mechanism of PT. There is uncertainty in the literature regarding the effects of immunosuppression on the results of PT. A comprehensive literature review was conducted using PubMed and Google Scholar to identify articles relevant to the topic of this review. Only articles available in English were included. This review discusses the impact of immunomodulating therapies on the results of PT. We summarize the available evidence and provide updated recommendations for several immunomodulating drugs commonly used in patients undergoing PT. In general, the results of PT are most reliable when performed without immunosuppression. If this is not feasible, it is best to have patients on as low a dose of immunosuppression as possible, but it may not be necessary to stop or change an immunomodulating drug prior to PT. [ABSTRACT FROM AUTHOR]

To evaluate the prevalence of contact sensitization to selected preservatives as cosmetic ingredients among cosmeticians and cosmetology students and to identify the most common allergens in occupational and non-occupational exposures.

Propyl, octy-and dodecyl gallates are largely used in food, cosmetic and pharmaceutical industry as additives - preservatives. The main source of exposure non-related with food consumption is their use of cosmetic products. Gallates are classified as skin sensitization human health hazard. This research aims to evaluate the prevalence of contact sensitization to gallates and to estimate the possible cross/ concomitant sensitization to gallate mix and other cosmetics ingredients among cosmeticians and cosmetology students. Skin patch testing with Gallate mix along with 19 other haptens was performed among 109 participants - 37 cosmetology students, 26 cosmeticians, and 46 controls. The study established high prevalence of contact sensitization to gallates, with higher risk for students (45.9%) and cosmeticians (38.5%). A significantly higher (p = 0.008) prevalence of co-sensitization to decyl glucoside was established for the control group. Proper risk information, with complex programs for prevention of occupational skin diseases should be provided. [ABSTRACT FROM AUTHOR]

Background: It is known that a large number of hairdressing apprentices (HA) develop occupational contact dermatitis (OCD) during schooling, but studies that address prevalence of contact sensitization in HAs with hand eczema are missing. Objectives: To assess the prevalence, incidence rate and clinical characteristics of OCD, including contact sensitization, in a sample of Croatian HAs. Materials and Methods: A total of 408 HAs from 25 Croatian towns were examined at the beginning of education and monitored at the end of each school year. Clinical evaluation of skin changes was performed using the Osnabrueck Hand Eczema Severity Index (OHSI). Standard patch test (PT) with baseline and hairdresser series of contact allergens was performed in 46 HAs with skin changes lasting ≥3 months. Results: The overall incidence rate of OCD was 32.3/100 person‐years, and the 3‐year prevalence 50.3%. Contact sensitization was found in 14 out of 46 (30.3%) HAs, with 10 of these 14 HAs (71.4%) sensitized to specific hairdressing allergens. The strongest reactions were found to PPD. HAs with positive PT had higher OHSI than HAs with negative patch test (median, IQR: 3, 2–4 vs. 2, 2–4). Conclusions: Contact sensitization to specific hairdressing chemicals was found in 71.4% of HAs with a positive patch test, supporting evidence on the early contact sensitization to occupational allergens among HAs. [ABSTRACT FROM AUTHOR]

Background: The European baseline series (EBS) of contact allergens is subject to change. An allergen is considered for inclusion when routine patch testing of patients with suspected contact dermatitis results in ≥0.5% prevalence rate. Objectives: We aimed to determine the frequency of sensitizations to 30 EBS allergens and 10 locally added allergens. Additionally, we assessed the strength and evolution of reactions to all tested allergens and co‐reactivity of additional allergens. Methods: Patch testing with our baseline series of 40 allergens was done in 748 consecutive adults. Tests were applied to the upper back and removed by patients after 48 h. Readings were done on Day 3 (D3) and D6 or D7 (D6/7). Positive reactions fulfilled the criteria of at least one plus (+) reaction. A retrospective analysis was done. Results: Eight allergens not listed in the EBS had ≥0.5% prevalence rate (i.e., cocamidopropyl betaine, thiomersal, disperse blue mix 106/124, 2‐bromo‐2‐nitropropane‐1,3‐diol, diazolidinyl urea, propylene glycol, Compositae mix II and dexamethasone‐21‐phosphate), and 16.6% of positive reactions would have been missed without D6/7 readings. Conclusion: We propose further studies to evaluate whether cocamidopropyl betaine, disperse blue mix 106/124, 2‐bromo‐2‐nitropropane‐1,3‐diol, diazolidinyl urea and Compositae mix II need to be added to the EBS. [ABSTRACT FROM AUTHOR]

Purpose: Sensitization to metals is a significant problem in dental, occupational exposures. The purpose of this study was to evaluate the prevalence of contact sensitization to selected metals during the course of study among students from dental technician school and the prevalence of co- sensitization. Material and Methods: Skin patch testing with potassium dichromate, cobalt, gold, nickel, copper, palladium, aluminium, tin and sodium tetrachloropalladate(II)hydrate was performed among 150 dental technician students (38 – 1st year of study,40 – 2nd year of study and 38 – 3rd year of study); the control group included 34 students without educational exposure to metals. Chi-square test, Fisher Exact Test and multiple binary logistic regression were used in data analysis. Results: During the educational course of dental technician students, a clear tendency of increase in the prevalence of sensitization to nickel (1st year of study - 10.5%, 3rd year of study - 36.8% cobalt (13.2% vs 39.5%) and palladium(II)chloride (10.5% vs 26.3%) was established. For the whole studied population, the prevalence of positive reactions to sodium tetrachloropalladate (II) hydrate was the highest – 30%; the highest recorded value was among the 2nd year students – 57.5%. The prevalence of sensitization to more than one metal allergen among the studied population was high (66.7%), the highest value was reported among 3rd-year dental technician students (78.9%). Conclusions: Our data indicate a high risk of contact sensitization to metals relevant for the dental technician students, which increases in the course of educational exposure for some of the metal haptens. Sodium tetrachloropalladate(II) hydrate could be outlined as a sensitizer of prominent importance, probably due to the increased sensitivity of this test salt. Additional and studies, including more respondents from the othe Colleges in Bulgaria are recommended. Adequate prevention programs and information should be provided, and the European Union regulations should be properly applied.

Introduction: Alopecia areata (AA) in its extensive and severe forms is treatment‐challenging, especially in pediatrics. Method: A PRISMA‐compliant systematic review of seven electronic databases was searched by the terms "alopecia areata," "pediatric," "topical immunotherapy," "Anthralin," and "light therapy" from inception until March 2021. All the alternative names of the disease and therapies have been included in the search terms. 790 articles went to title abstract review by two independent reviewers. In the subsequent level, a review of the full text of studies was conducted. Results: Finally, 10 relevant articles in terms of content structure, subject coverage, and purpose, were selected for further review. The highest percentages of complete hair regrowth were 79.6% and 63.61% by SADBE (topical immunotherapy) and laser therapy. By Anthralin (contact sensitization), the complete response rate was below 50% (between 30 and 35%). Regarding average response, the most effective methods were local immunotherapy (with an average effectiveness of 53.8%), laser therapy (52.55%), and the use of Anthralin‐induced contact dermatitis (30.86%), respectively. However, recurrence rate—after treatment with induced contact dermatitis by topical medications like Anthralin (contact sensitization)—was lower (mean 43.53%) in comparison with local immunotherapy (57%). In topical immunotherapy, light base therapy, and contact sensitization, the highest percentage of complete hair regrowth and the average response rate were (63.61% and 52.55%), (79.6% and 53.8%) and (32% and 30.8%), respectively. These methods are considered safe in children. Conclusion: A high and more than 50% efficacy in hair regrowth could be expected by topical immunotherapy and light/laser therapy method. No serious side effects have been observed by these methods that are well tolerated in children. Therefore, a combination of local immunotherapy and light/laser therapy could be suggested for the treatment of extensive AA in children. The use of Anthralin could be associated with a lower but more durable response. These points are important for patient selection in individualized situations. [ABSTRACT FROM AUTHOR]

Introduction: Patients who receive orthopedic implants have been shown to develop sensitivity to its components and there are concerns that this sensitivity might lead to contact dermatitis or implant-related problems like loosening and/or failure. The objective of the study was to determine the sensitizing potential of orthopedic implants.Methods: Fifty-four patients undergoing knee, hip, or shoulder replacement surgeries between July 2014 and July 2015 were recruited. Patch tests were performed before the implant surgery with 10 allergens likely to be implicated in metal hypersensitivity. Postimplant patch test was performed 6 months after surgery. A majority of the patch tests were applied on the arms.Results: Four positive reactions were recorded in the preimplant patch tests - three positive reactions to nickel and one to chromium. Thirty patients made themselves available for the follow-up patch test. The incidence of new contact sensitivity to components of implants was 13.8% (4/29) at 6 months. One patient who had undergone knee replacement developed eczematous lesions around the knee joint after surgery. This patient tested negative to patch test at both the times.Limitations: Short follow-up duration and performing patch tests on the arms, a site known to elicit less positive patch test response compared to the back in sensitized individuals, are limitations of the study.Conclusion: There is an increase in the sensitivity to implanted components after 6 months of joint replacement surgery. The incidence of new sensitivity to a component of the implant was 13.8% (4/29). In this context, nickel is a good sensitizer and could sensitize 50% of patients who received a nickel-containing implant. [ABSTRACT FROM AUTHOR]

Background: Allergic contact dermatitis to cosmetics (ACDC) complicates the diagnosis and treatment of rosacea, and is increasingly observed in daily practice. Aims: The present study aimed to identify the contact allergens responsible for ACDC in Chinese female rosacea patients with or without suspected ACDC (SACDC). Methods: From a total of 1267 women with rosacea, 122 with SACDC, 145 without SACDC, and 100 age‐matched healthy controls without rosacea or SACDC were examined on a voluntary basis. Skin patch tests with C‐1000 cosmetic series (Chemotechnique Diagnostics, Malmo, Sweden) were conducted, including 20 selected allergens. Results: Positive allergic reaction was found in 85.2% and 33.8% of SACDC and non‐SACDC (P <.001), respectively, and 27.0% of healthy volunteers. Most reactions occurred at day 3, and the majority of all the examinees including normal controls reacted to more than 1 allergen. In SACDC patients, leading allergens were methylchloroisothiazolinone/methylisothiazolinone (28.7%), linalool hydroperoxide (27.1%), fragrance mix I (21.3%), methylisothiazolinone (17.2%), limonene hydroperoxides (16.4%), formaldehyde (14.8%), myroxylon pereirae (13.9%), and propolis (10.7%); the overall allergic reaction rate positively correlated with new onset of facial pruritus (P <.001). The occurrence of irritant contact reactions correlated with positive allergic reactions in rosacea patients with or without SACDC (P =.032 or P <.001, respectively). Conclusions: Preservatives and fragrances are primary culprits for ACDC in Chinese female rosacea patients. Patch testing should be considered in the suspected patients. [ABSTRACT FROM AUTHOR]

Purpose: Sensitization to methacrylic monomers is a significant problem in dental occupational exposures. The purpose of the present study was to evaluate the dynamics in contact sensitization incidence to methacrylic monomers during the educational course of dental technician students. Material and Methods: Skin patch testing with methyl methacrylate, triethylene glycol dimethacrylate, ethylene glycol dimethacrylate, 4-tolyldiethanolamine, N,N-Dimethyl-4-toluidine, 1,4-butanediol dimethacrylate, tetrahydrofurfuryl methacrylate, formaldehyde and glutaraldehyde was performed among 150 dental technician students (38 – 1st, 40 – 2nd and 38 – 3rd year of education); 34 students without educational exposure to metals served as controls.. Chi square test and Fisher Exact Test were used in data analysis (p < 0.05). Results: The incidence of sensitization to 4-tolyldiethanolamine in the group of dental technician students 2nd and 3rd year of education was significantly higher, if compared with those from the 1st year, as well as with the control group (P=0.042). The sensitization rate to 4-tolyldiethanolamine was the highest recorded among all methacrylic monomers tested for the whole tested population. The incidence of positive patch tests to formaldehyde was the highest recorded for all defined groups. Higher were sensitization rates among dental technician students 2nd year of education vs. no cases in the control group. Conclusions: Our data indicate high and increasing with the duration of educational exposure risk of contact sensitization to 4-tolyldiethanolamine among dental technician students, and this substance could be outlined as a sensitizer of prominent importance. No significant differences were established concerning the other tested methacrylic monomers. We accept the main role of consumer and environmental exposures for the manifestation of formaldehyde sensitization. Adequate preventive measures and information should be provided during the practical educational course of dental technician students. General population need to be well informed and the European Union regulations to be properly applied.

Abstract Cosmetics and skin care products for neonates and infants are considered as ‘‘hypoallergenic’’, “tested” or ‘‘safe’’. Nevertheless, the prevalence of haptens in these products is a matter of concern, since allergic contact dermatitis in children is gaining an importance. We aimed to assess the prevalence of haptens in cosmetics designed for children younger than 1 year. To identify haptens, the components of the cosmetics listed on packaging were compared with substances from European baseline series, Cosmetics series and Fragrance series. Survey comprised 212 cosmetics among which 186 (87.7%) contained at least one hapten from reference lists. Altogether there were 41 different haptens found in cosmetics. Number of sensitizers per product ranged between 1–12 and, each product contained 2.51 haptens on average. The most abundant sensitizers were cocamidopropyl betaine, tocopherol, propylene glycol, fragrances, lanolin. Majority of products for children were labeled as hypoallergenic/dermatologically tested/safe for children etc. from which 85% contained haptens. This survey highlights the extent of presence of haptens in cosmetics for children under the first year of age.

Background: In Sweden, cobalt chloride 0.5% has been included in the baseline series since the mid‐1980s. A recent study from Stockholm showed that cobalt chloride 1% petrolatum (pet.) was more suitable than 0.5%. Cobalt chloride at 1.0% has been patch tested for decades in many European countries and around the world. Objectives: To study the suitability of patch testing to cobalt 1.0% vs 0.5% and to analyze the co‐occurrence of allergy to cobalt, chromium, and nickel. Results: Contact allergy to cobalt was shown in 90 patients (6.6%). Eighty (5.9%) patients tested positive to cobalt 1.0%. Thirty‐seven of the 90 patients (41.1%) with cobalt allergy were missed by cobalt 0.5% and 10 (0.7%) were missed by cobalt 1.0% (P <.001). No case of patch test sensitization was reported. Allergy to chromium was seen in 2.6% and allergy to nickel in 13.3%. Solitary allergy to cobalt without nickel allergy was shown in 61.1% of cobalt‐positive individuals. Female patients had larger proportions of positive reactions to cobalt (P =.036) and nickel (P <.001) than males. Conclusion: The results speak in favor of replacing cobalt chloride 0.5% with cobalt chloride 1.0% pet. in the Swedish baseline series, which will be done 2021. Highlights: Contact allergy to cobalt was shown in 6.6% of patients; 5.9% were test positive to cobalt 1.0% and 0.7% to cobalt 0.5% only, P <.001.Solitary allergy to cobalt without nickel allergy was shown in 61.1% of cobalt‐positive individuals. Corresponding comparison with nickel and/or chromium was shown in 54.4% of cobalt‐positive individuals.Female patients had larger proportions of positive reactions to cobalt (P =.036) and nickel (P <.001) than males. [ABSTRACT FROM AUTHOR]

Background: Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and methylisothiazolinone (MI) are tested to detect contact allergy to these isothiazolinones. Objectives: To study if an aqueous patch test preparation with MCI and MI in a mix of 0.015% and 0.2%, respectively, detects more contact allergies than the commonly used preparations of MCI/MI in 0.02% aq. and MI in 0.2% aq. Methods: A total of 1555 patients with dermatitis in five Swedish dermatology departments were tested consecutively with MCI/MI 0.215% aq., MCI/MI 0.02% aq., and MI 0.2% aq. Results: The share of contact allergy to MCI/MI 0.215% aq., MCI/MI 0.02% aq., and MI 0.2% aq. varied in the test centers between 7.9% and 25.9%, 3.2% and 10.3%, and 5.8% and 12.3%, respectively. MCI/MI 0.215% aq. detected significantly more patch‐test positive individuals than both MCI/MI 0.02% aq. (P <.001) and MI 0.2% aq. (P <.001), as well as either one of MCI/MI and MI (P <.001). In the patients only reacting to MCI/MI 0.215% aq., 57.7% were recorded as having a dermatitis that was explained or aggravated by exposure to either MCI/MI or MI. Conclusion: The results speak in favor of replacing the preparations MCI/MI 0.02% aq. and MI 0.2% aq. with MCI/MI 0.215% aq. as the screening substance in the Swedish baseline series, which has been implemented in 2020. [ABSTRACT FROM AUTHOR]

Background: Sensitization to methylisothiazolinone (MI) has seen an exceptional epidemic, mainly attributed to its use in cosmetics. Objectives: To trace the epidemic of MI allergy (2009–2018), and to analyze a possible change of patients' characteristics. Methods: Informationsverbund Dermatologischer Kliniken‐data of patients patch tested between 2009 and 2018 with MI (0.05% aq.) were analyzed concerning anamnestic items and sensitization frequencies. Results: Overall, 4.9% reacted positive to MI. Comparing sensitization to MI in three periods (2009, 2013/14, and 2017/18), there was an increase to 7% in 2013 and a decrease to 3.4% in 2018. The MOAHLFA Index (M=Men, O=Occupational Dermatitis, A=Atopic Dermatitis, L=Leg Dermatitis, F=Face Dermatitis, A= Age > 40) for the period 2013/14 is characterized by a lower proportion of occupational dermatitis and a higher proportion of face dermatitis. The period 2017/18 is characterized by increases of occupational dermatitis and hand dermatitis, and a decrease of face dermatitis. Painters, personal care workers, and hairdressers were particularly affected. Sensitization in hairdressers and personal care workers (mostly cosmeticians) decreased after the peak in 2013/14, whereas sensitization to MI in painters continued to increase. Conclusions: After an unprecedented epidemic of MI allergy, mainly caused by its use in cosmetics, the continuous use of MI in industrial applications, for example, paints, and subsequent sensitization remain a matter of concern. Highlights: After an epidemic of MI allergy mainly caused by its use in cosmetics, the continuous use of MI in industrial applications, for example, paints, and subsequent sensitization remain a matter of concern. [ABSTRACT FROM AUTHOR]

Keywords: allergic contact dermatitis; clinical epidemiology; commerce; contact sensitization; export; import; propolis; trade EN allergic contact dermatitis clinical epidemiology commerce contact sensitization export import propolis trade 722 724 3 11/18/21 20211201 NES 211201 Propolis is a natural product that consists of more than 100 compounds and shows great compositional variation depending on its origin.1 The most common poplar-type propolis is produced by honeybees in China, Europe, and North America, and is characterized by several caffeates as major allergens.2 The Information Network of Departments of Dermatology (IVDK) and others recently observed increasing rates of propolis sensitization.3,4 We aimed to identify causes of increasing sensitization to propolis using IVDK and German trade data. Since 2016, increased import and decreased export of propolis to and from Germany, respectively, probably indicate increased propolis use and exposure, which most likely explains the upward trend of propolis sensitization. [Extracted from the article]

Background: Professional musicians have prolonged and intense physical contact with their instruments. This can lead to occupational skin diseases, particularly irritant and allergic contact dermatitis. Objectives: To assess the skin diseases and sensitization patterns common among professional musicians. Methods: A retrospective analysis of the data of the Information Network of Departments of Dermatology (IVDK) was performed, including data from 1997 to 2017. Results: We identified 236 professional musicians. In this group, male sex (58.6%) and younger age (60.6% aged < 40 years) were common. The musicians suffered more frequently from facial dermatitis (23.7% vs 15.7%) and less often from leg dermatitis (5.1% vs 10.7%) than the control group (the non‐musicians in the IVDK database). The most frequent diagnoses were allergic contact dermatitis, atopic dermatitis, and irritant contact dermatitis. The sensitization profile of the professional musicians was similar to that of the control group. In 8.9% of cases, an occupational background of skin disease was confirmed. Conclusions: Severe occupational skin diseases among professional musicians are not as common as in classic "skin‐damaging" professions. However, as these skin conditions can mostly be controlled with simple preventive measures, we recommend that this group should be patch tested and treated by a specialist. [ABSTRACT FROM AUTHOR]

In the first conundrum, permanent hair dyeing involves the use of aromatic amines such as p‐phenylenediamine (PPD), whose oxidation is pivotal to the dyeing process, but also generates potent allergens. Despite prolonged efforts by industry to search for safer alternatives, hair dyeing is still reliant on this type of aromatic amine. In the second conundrum, patch testing with 1% PPD remains the most useful screen for hair dye contact allergy. However, there is a very small but real risk of actively sensitizing the patient. Lowering the PPD concentration below 1% significantly reduces test sensitivity and diagnostic utility. Here, we argue that by applying Friedmann's principles of contact sensitization each conundrum can be addressed from a new perspective. These principles indicate that, when the exposed area of skin is small (<1 cm2), induction of contact allergy is sharply reduced, whereas elicitation of allergy is unaffected. Careful reflection on this principle suggests that we can predict where hair dye sensitization is most likely to occur, indicates a strategy to reduce the chance of contact sensitization occurring in consumers as a result of hair dyeing, and how we might mitigate the risk of active sensitization resulting from diagnostic patch testing. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the rate of contact sensitization to selected cosmetic allergens, i.e. ingredients of dental materials, in students of dental medicine and dental patients.Methods: A total of 50 participants were included in the study: 40 students of dental medicine exposed to the studied allergens during the course of practical education; and 10 randomly selected dental patients without occupational exposure to the investigated substances served as a control group. All of them were patch-tested with colophonium, myroxylon pereirae resin, paraben mix, fragrance mix I, isopropyl myristate, triclosan, polysorbate 80, compositae mix II, and hydroperoxides of limonene.Results: The sensitization rates for colophonium and polysorbate 80 were the highest. For the group of dental students, we established significantly higher sensitization rate for colophonium compared to the ones for myroxylon pereirae resin and hydroperoxides of limonene (χ2 = 4.93; p = 0.026), paraben mix (χ2 = 3.6; p = 0.05), isopropyl myristate (χ2 = 6.56; p = 0.01), and triclosan (χ2 = 8.5; p < 0.001); and to polysorbate 80 compared to the ones for myroxylon pereirae resin and hydroperoxides of limonene (χ2 = 3.97; p = 0.046), isopropyl myristate (χ2 = 5.47; p = 0.02) and triclosan (χ2 = 7.34; p = 0.007). Significantly increased concomitant sensitization rate to compositae mix and to hydroperoxides of limonene was established (χ2 = 12.55; p < 0.001). Generally, the incidence of concomitant sensitization to the studied allergens in the whole studied population was high.Conclusions: Colophonium and polysorbate 80 could be outlined as sensitizers of paramount importance for both dental students and dental patients. We consider the major importance of exposure to colophonium during the course of practical education in dentistry for the onset of the sensitization. Sensitization to compositae mix was observed only among dental students. We consider the leading role of consumer exposure for the onset of the sensitization to triclosan and to hydroperoxides of limonene. Unexpected and unreported reactions of concomitant sensitization were observed. [ABSTRACT FROM AUTHOR]

Introduction: Occupational allergic contact sensitization is common in dental personnel. Some of the most common occupational allergens in dental practice are some formaldehyde-releasers, formaldehyde and glutaraldehyde. Aim: The aim of the present study was to evaluate the rate of contact sensitization to formaldehyde, quaternium-15, imidazolidinyl urea, diazolidinyl urea, and to glutaraldehyde in students of dental medicine and dental patients. Material and methods: A total of 50 participants were included in the study: 40 students of dental medicine exposed to formaldehyde-releasers, formaldehyde and glutaraldehyde during the course of their education; 10 dental patients without occupational exposure to the latter substances served as a control group. All of them were patch-tested with the studied allergens. Results: The sensitization rate to formaldehyde was significantly higher in the group of dental patients if compared to the one of dental students (χ2=5.37; p=0.021). Positive skin patch test reactions to quaternium-15 and to imidazolidinyl urea were observed only in the group of dental students. A significantly higher rate of sensitization to diazolidinyl urea, if compared to the one to imidazolidinyl urea (χ2=5.4; p=0.02) and to quaternium-15 (χ2=6.76; p=0.009), as well as to glutaraldehyde, if compared to the one to quaternium-15 (χ2=3.96; p=0.04) for the whole studied population was established. For the whole studied population, significantly increased rate of concomitant sensitization to formaldehyde and glutaraldehyde (χ2=6.18 p=0.013), as well as to diazolidinyl urea and to glutaraldehyde was established (χ2=9.12 p=0.003). Conclusions: We consider the importance of exposure to diazolidinyl urea, quaternium-15, imidazolidinyl urea and glutaraldehyde during the course of practical education in dentistry for the onset of sensitization. The exposure to formaldehyde is ubiquitous and is difficult to distinguish the roles of environmental and occupational exposures. The promotion of proper personal protection as well as adequate information on occupational chemical hazards should start as early as during the first years of education in dentistry.

Cosmetics and skin care products for neonates and infants are considered as "hypoallergenic", "tested" or "safe". Nevertheless, the prevalence of haptens in these products is a matter of concern, since allergic contact dermatitis in children is gaining an importance. We aimed to assess the prevalence of haptens in cosmetics designed for children younger than 1 year. To identify haptens, the components of the cosmetics listed on packaging were compared with substances from European baseline series, Cosmetics series and Fragrance series. Survey comprised 212 cosmetics among which 186 (87.7%) contained at least one hapten from reference lists. Altogether there were 41 different haptens found in cosmetics. Number of sensitizers per product ranged between 1–12 and, each product contained 2.51 haptens on average. The most abundant sensitizers were cocamidopropyl betaine, tocopherol, propylene glycol, fragrances, lanolin. Majority of products for children were labeled as hypoallergenic/dermatologically tested/safe for children etc. from which 85% contained haptens. This survey highlights the extent of presence of haptens in cosmetics for children under the first year of age. [ABSTRACT FROM AUTHOR]

Numerous mechanisms have been postulated to play an important role in the pathogenesis of poikiloderma of Civatte (PC), including chronic exposure to ultraviolet radiation, menopause-related hormonal changes, contact hypersensitivity and genetic predisposition. Herein, we report a case of contact sensitization to fragrances and commonly used preservatives, methylchloroisothiazolinone and methylisothiazolinone, also widely known as Kathon CG, in a post-menopausal woman with PC, who denied excessive sun exposure and a family history. After abstaining from the use of her personal care products containing the documented allergens, not only the itching and burning symptoms, but also the cutaneous changes appeared to improve partially. This report underlines the possible influence of contact hypersensitivity in the pathogenesis of PC.

Background Patients with lower leg dermatitis, chronic venous insufficiency or chronic leg ulcers have a high prevalence of contact sensitization. Objectives To identify the current spectrum of contact allergens in these patients. Patients and methods Data of the Information Network of Departments of Dermatology on 5264 patients with the above diagnoses from the years 2003 to 2014 (study group) were compared with data on 4881 corresponding patients from 1994 to 2003 (historical control group) and with a current control group without these diagnoses (n = 55 510). Results Allergic contact dermatitis was diagnosed less frequently in the study group than in the historical control group (25.9% versus 16.9%; p < 0.001), and contact sensitization to most allergens had declined. The allergen spectrum, however, was largely unchanged. Important allergens are Myroxylon pereirae (balsam of Peru) (14.8% positive reactions), fragrance mix I (11.4%), lanolin alcohol (7.8%), colophonium (6.6%), neomycin sulfate (5.0%), cetearyl alcohol (4.4%), oil of turpentine (3.1%), and paraben mix (2.6%). Patch testing with additional series showed sensitization to Amerchol L-101 (9.7%), tert-butyl hydroquinone (8.7%), framycetin sulfate (5.0%), and gentamicin sulfate (3.1%). Conclusions Topical preparations for treating the above-mentioned conditions should not contain fragrances, Myroxylon pereirae, and colophonium. The special allergen spectrum has to be considered in patch testing. [ABSTRACT FROM AUTHOR]

Context: The prevalence of sensitive skin among the general population in industrialized countries is reported to be over 50%. Sensitive skin subjects often report significant reactions to contact with cosmetics, soaps and other consumer products. Objective: This paper describes the overall skin compatibility and mildness program for a newly developed, lightly fragranced, colorant free laundry product (i.e. Arm & Hammer™ Sensitive Skin plus Skin-Friendly Fresh Scent), specially formulated for individuals with sensitive skin. The skin mildness of the product was compared to Arm & Hammer™ Free & Clear liquid laundry detergent with no fragrance or colorant, and an established history of safe use by sensitive skin consumers. Materials and methods: The test material was a liquid laundry product with a light scent formulated for sensitive skin consumers (Arm & Hammer™ Sensitive Skin plus Skin-Friendly Fresh Scent). The product was compared to commercially marketed products for sensitive skin with a history of skin safety in the marketplace, including: a very similar product formulation (Arm & Hammer™ Free & Clear with no fragrance), and several selected competitors’ products. Studies were conducted among individuals with self-assessed sensitive skin (based on a questionnaire) using standard protocols for the Human Repeat Insult Patch Test (HRIPT), 10-Day Cumulative Irritation, the Wrist Band Wear test, and the Safety In-Use testing. Responses in all protocols were evaluated by visual scoring of potential dermatologic reactions, and recording any sensory effects at the time of the examination. In addition, sensory effects collected from panelists’ daily diaries were also evaluated. Results: The HRIPT confirmed that neither the fragrance alone, nor the product formulation with fragrance, induced contact sensitization in sensitive skin subjects. The 10-Day cumulative irritation study conducted using sensitive skin subjects showed highly favorable skin compatibility, and the test product was comparable to the control product (Arm & Hammer Free & Clear) and other nonirritant controls. In the Wrist Band Wear test, exposure to laundered fabrics under exaggerated conditions gave similar results for the test and control products, with no objective signs of skin irritation, and no self-reported persistent adverse sensory effects. Very mild, transient and isolated sensory effects were noted in daily diaries by a small proportion of subjects, and were similar for the test and control products. The Safety In-Use tests evaluated 4-week exposure to product and laundered fabrics under realistic use conditions. There were no clinically objective signs of skin irritation, and reports of transitory, mild sensory effects were minimal and similar for the test and controls. Discussion and conclusion: A comprehensive skin safety program on a lightly scented sensitive skin laundry formulation (i.e. Arm & Hammer™ Sensitive Skin plus Skin-Friendly Fresh Scent) conducted among panels of self-assessed sensitive skin subjects demonstrated that the presence of a light fragrance did not adversely impact skin compatibility in any of the testing protocols when the product was compared to a similar product with no fragrance. The lightly fragranced product demonstrated overall skin compatibility and mildness when tested in a self-assessed sensitive skin population, and compared favorably to currently marketed sensitive skin products. [ABSTRACT FROM AUTHOR]

Contact sensitization is common and affects up to 20% of the general population. The clinical manifestation of contact sensitization is allergic contact dermatitis. This is a clinical expression that is sometimes difficult to distinguish from other types of dermatitis, for example irritant and atopic dermatitis. Several studies have examined the pathogenesis and severity of allergic contact dermatitis by measuring the absence or presence of various biomarkers. In this review, we provide a non-systematic overview of biomarkers that have been studied in allergic contact dermatitis. These include genetic variations and mutations, inflammatory mediators, alarmins, proteases, immunoproteomics, lipids, natural moisturizing factors, tight junctions, and antimicrobial peptides. We conclude that, despite the enormous amount of data, convincing specific biomarkers for allergic contact dermatitis are yet to be described. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether patients with atopic dermatitis (AD) have an altered prevalence or risk for contact sensitization. Increased exposure to chemicals in topical products together with impaired skin barrier function suggest a higher risk, whereas the immune profile suggests a lower risk.Objective: To perform a systematic review and meta-analysis of the association between AD and contact sensitization.Methods: The PubMed/Medline, Embase, and Cochrane databases were searched for articles that reported on contact sensitization in individuals with and without AD.Results: The literature search yielded 10,083 citations; 417 were selected based on title and abstract screening and 74 met inclusion criteria. In a pooled analysis, no significant difference in contact sensitization between AD and controls was evident (random effects model odds ratio [OR] = 0.891; 95% confidence interval [CI] = 0.771-1.03). There was a positive correlation in studies that compared AD patients with individuals from the general population (OR 1.50, 95% CI 1.23-1.93) but an inverse association when comparing with referred populations (OR 0.753, 95% CI 0.63-0.90).Limitations: Included studies used different tools to diagnose AD and did not always provide information on current or past disease. Patch test allergens varied between studies.Conclusion: No overall relationship between AD and contact sensitization was found. We recommend that clinicians consider patch testing AD patients when allergic contact dermatitis is suspected. [ABSTRACT FROM AUTHOR]

Background: Chronic eczema is commonly encountered in the Indian set up. So also is atopic dermatitis. House dust mites (Dermatophagoides) are implicated in various diseases like atopic dermatitis, asthma, and perennial rhinitis. It has also been proven that patch testing with Dermatophagoides pteronyssinus (DP) is important for detection of contact sensitization in chronic dermatitis. Aims: To study clinical characteristics of DP mix positive patients with regards to chronic dermatitis and atopic dermatitis. Methods: Dermatology outpatients presenting to the department of Skin and STD of Kasturba Medical College (KMC), with clinically diagnosed atopic dermatitis and chronic eczema were chosen for the study. Inclusion and exclusion criteria were well demarked. Eighty six randomly selected patients of dermatitis were subjected to patch testing with standard series and DP mix. Results: Of the 86, 50 (58%) showed positive reaction to DP mix. Among these positive patients, chronic dermatitis was seen in 42 (84%) with involvement of exposed parts in 37 (74%). Atopic dermatitis was seen in 19 patients (38%) from DP positive group whereas it was observed in 4 patients (17%) from the other group. Conclusion: Dermatophagoides mix positivity was statistically significant in chronic eczema as well as atopic dermatitis. Patch testing is an important tool to detect delayed type allergy to house dust mite.

Background Contact allergy to rubber additives is common, particularly in patients with occupational dermatitis. Objectives To descriptively analyse and compare patch test reactions in patients patch tested both with the baseline series and with an additional 'rubber series' as used in the department. Methods Patch test data from those members of the European Surveillance System on Contact Allergies ( ESSCA) network () who also contributed data on rubber series patch test results were retrospectively analysed. Results Among 29 522 patients patch tested, 2870 were eligible, that is, patch tested both with the baseline series and with a special rubber series. Of these, 8.8% had positive reaction(s) to one of the baseline screening rubber allergens (as compared with 4.2% in all patients), most often to carba mix, 12.3% had positive reaction(s) to allergens from an additional rubber series, and 6.4% had positive reaction(s) to both. Conclusions Additional testing with a dedicated rubber series, containing break-down single ingredients of mixes from the baseline series and additional rubber allergens, is warranted in patients with suspected contact allergy to rubber, to avoid false-negative results. [ABSTRACT FROM AUTHOR]

Context: We have developed a line of products designed to better meet the overall needs of women suffering from urinary incontinence. The products are more discrete and contain a unique odor neutralizing technology (ONT). Objective: This paper describes the overall skin compatibility program for this product line in which the new products were compared to negative controls and/or commercially marketed reference products with an established history of safe use. Materials and methods: Test products consisted of several product forms (light pads/pantiliners, moderate pads, briefs and taped diapers) with ONT and having various degrees of protection. Studies were conducted using standard protocols for 4-day and 21-day cumulative irritation, the Human Repeat Insult Patch Test (HRIPT), and the Behind-the-Knee (BTK) test for mechanical and chemical irritation. In one 4-day irritation study and one HRIPT, test subjects consisted of individuals with self-assessed sensitive skin. In addition, one 4-day study was conducted using normal skin sites, and sites compromised by tape stripping. Nonirritant controls were physiologic saline and/or current, commercially marketed incontinence products. All responses were evaluated by visual scoring of erythema. In addition, in the BTK, transepidermal water loss (TEWL) and adverse sensory effects collected from panelists’ daily diaries were also evaluated. Results and discussion: Two 4-day cumulative irritation studies and one 21-day study demonstrated that a wide range of product forms (liners, light and moderate pads, briefs and adult diapers) produced skin reactions similar to the nonirritant controls. The 4-day study conducted using sensitive skin subjects showed good skin compatibility, and the test products were comparable to the nonirritant controls. In the 4-day study with both normal and compromised skin sites, test products produced mean erythema scores similar to the nonirritant controls. Three HRIPT separate studies confirm that the products do not induce contact sensitization, including one study conducted on individuals with self-assessed sensitive skin. In the BTK, test and control products produced similar irritation, as assessed by erythema, TEWL and sensory effects. Conclusion: The results from the patch tests and mechanical irritation test demonstrate good skin compatibility of the new line of products with the unique ONT. In addition, the forms of the product (i.e. liner, pad or brief), were equally compatible with skin. [ABSTRACT FROM AUTHOR]

The risks related to the use of essential oils are difficult to ascertain at present, due in part to the large number of different oils available on the market, making it difficult for the risk assessor. Essential oils may contain skin allergens in significant amounts, and could thus pose a risk to the consumer. The aim of our study was to collect as much qualitative and quantitative data as possible on allergens present in essential oils. 11 types of essential oils, with 25 respective subspecies, were taken into account based on a previous survey. Based on the literature, 517 dosages were recorded from 112 publications, providing precious information for probabilistic exposure assessment purposes. 22 substances recognized as established allergens were found in the essential oils we included. Of these, 11 are also found in cosmetics as fragrance components. These results are of major importance regarding co-exposure to fragrance allergens. Moreover, this could lead to regulatory measures for essential oils in the future, as it is the case for cosmetic products, in order to better protect consumers against skin allergy. [ABSTRACT FROM AUTHOR]

Background There are no studies on contact allergy in patients with prurigo. With itch being important in the pathophysiology of prurigo diseases and being a symptom of allergic contact dermatitis, we aimed to investigate contact allergy in patients suffering from prurigo. Objectives Exploratory analysis of patch test results in prurigo patients. Materials and methods A retrospective analysis of data of the Information Network of Departments of Dermatology, 2005-2014, was performed. Results Of 116 744 patch tested patients, 639 (0.55%) were diagnosed with prurigo. The median age was 61 years, 286 (45%) were pensioners, and 252 (39.5%) had generalized prurigo. The indication for patch testing was exclusion of contact allergy in 412 patients (64.5%), and 223 patients (35%) had at least one positive patch test reaction. There was no distinctive pattern of sensitization. Prurigo patients had significantly more (and stronger) reactions to the irritant control patch test with sodium lauryl sulfate than a control group (27.6% versus 21.0%). Conclusions Although prurigo is not a typical clinical manifestation of contact sensitization, our results indicate that patch testing in these patients may be helpful. [ABSTRACT FROM AUTHOR]

The article presents the results of the metal sensitization tests conducted by the European Surveillance System on Contact Allergies (ESSCA) from 2009-2012. It notes that patients were tested for allergic reaction to nickel, cobalt and chromium. It shows that Italy had the highest prevalence of nickel allergy at 25.9 percent, while Poland had the highest sensitivity to cobalt at 15.3 percent. It cites the need to implement regulation aimed at reducing causative exposure to metal allergens.

Reports of contact dermatitis from ivy have regularly appeared since 1899, but only once in a child with concomitant Compositae sensitization.1-3 Allergic contact dermatitis may be caused by the leaves and roots. Keywords: allergic contact dermatitis; common ivy; contact sensitization; patch test EN allergic contact dermatitis common ivy contact sensitization patch test 315 316 2 03/16/22 20220401 NES 220401 CASE REPORT An otherwise healthy 8-year-old boy, with atopic disposition from his father, was referred with a recurring painful blistering rash for 2 years, primarily located on his hands and fingers, and to a lesser degree on his feet and around his mouth. [Extracted from the article]

Nickel sulfate in TRUE Test and nickel sulfate 2.5% pet. gave comparable test results. Keywords: allergic contact dermatitis; contact sensitization; nickel sulfate hexahydrate; patch test; TRUE Test EN allergic contact dermatitis contact sensitization nickel sulfate hexahydrate patch test TRUE Test 233 234 2 02/24/22 20220301 NES 220301 Despite the European Union (EU) Nickel Directive introduced in 2009, nickel contact allergy is still frequent and represents a health concern in the EU.1 Therefore, it is important to evaluate test methods and concentrations.2 Nickel sulfate 2.5% pet. is included in the ICDRG baseline patch test series. Allergic contact dermatitis, contact sensitization, nickel sulfate hexahydrate, patch test, TRUE Test. [Extracted from the article]

The article focuses on effectiveness of Amerchol L101, a preparation of lanolin alcohols, and tested children and adolescents, particularly in those with atopic dermatitis. It mentions Information Network of Departments of Dermatology (IVDK) data for cross-reactivity between the two derivatives, and associations with patients' profiles. It also mentions positive patch test reactions than lanolin alcohols in aimed testing and the atopic eczema.

Background Contact allergy to fragrances is common, and impairs quality of life, particularly in young women. Objective To provide current results on the prevalences of sensitization to fragrance allergens used as markers in the baseline series of most European countries. Methods Data of patients consecutively patch tested between 2009 and 2012 in 12 European countries with fragrance allergens contained in the baseline series were collected by the European Surveillance System on Contact Allergies network and descriptively analysed. Four departments used the TRUE Test® system. Results The 'basic markers' were tested on 51 477 [fragrance mix II ( FM II)] to 57 123 [ Myroxylon pereirae, balsam of Peru] patients, and yielded positive reactions as follows: fragrance mix I 6.9%, Myroxylon pereirae 5.4%, FM II 3.8%, colophonium 2.6%, and hydroxyisohexyl 3-cyclohexene carboxaldehyde 1.7%, with some regional differences. Prevalences with TRUE Test® allergens were lower. Additional fragrances were tested on 3643 (trimethylbenzenepropanol) to 14 071 (oil of turpentine) patients, and yielded between 2.6% ( Cananga odorata) and 0.7% (trimethylbenzenepropanol) positive reactions. Conclusions Contact allergy to fragrances is common throughout Europe, with regional variation probably being explained by patch test technique, and differences in exposure and referral patterns. The current basic markers of fragrance sensitivity in the baseline series should be supplemented with additional fragrance allergens. [ABSTRACT FROM AUTHOR]

Fragrances are among the most common contact sensitizers. Changes in exposure lead to subsequent changes of sensitization incidence; patterns of exposure may be reflected in certain surrogate markers such as affected anatomical site or occupation. The objective of this study was to provide current results on sensitization prevalences to the fragrance allergy screening markers of the patch test baseline series, on time trends and on risk factors associated with sensitization. Data of all patients tested between 1999 and 2012 with fragrance mix I (8% petrolatum (pet.) n = 130 325), fragrance mix II (14% pet., since 2005, n = 81 290), Myroxylon pereirae resin (25% pet., n = 130 258) and oil of turpentine (10% pet., n = 131 595), respectively, in the Information Network of Departments of Dermatology (IVDK, ) were subject to descriptive and log-binomial regression analysis. Overall, 16.31% of patients had a positive patch test reaction to at least one of the four markers. The prevalence to each of the four single markers was 8.71, 4.87, 8.36 and 1.95%. A peculiar downward trend of FM I until around 2006/2007 with subsequent increase, both significant, was noted. Mostly, sensitization risk was higher in older patients and females, and was to a varying extent associated with certain anatomical sites. The mostly stable or even increasing time trends warrant further in-depth research into causative exposures, addressing the effectiveness of (self-) regulation, aggregate exposure and 'cocktail effect'. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background Allergic contact dermatitis caused by (meth)acrylates used in artificial nails is a relevant problem in both nail artists and consumers. Objective To analyse the frequency of this problem in the contact allergy surveillance network Information Network of Departments of Dermatology in 2004-2013, and address possible time trends and patterns of co-sensitization. Methods A retrospective analysis of patch test results with (meth)acrylates, along with clinical and demographic data, was performed. These were used to subdivide patients according to (i) a potentially exposed occupation and (ii) nail cosmetics as the suspected cause of contact dermatitis. Results Among the 114 440 patients patch tested, 72 244 were female and were considered further. Eighty-seven patients both worked as nail artists/cosmetologists and suspected nail cosmetics as the cause of dermatitis. Among these, 47.1% reacted to at least one (meth)acrylate, most often to 2-hydroxyethyl methacrylate (n = 27), 2-hydroxypropyl methacrylate, and hydroxyethyl acrylate (n = 26 each), with marked coupled reactivity. In other subgroups of interest, frequencies of sensitization to (meth)acrylates were less elevated but higher than in all remaining female patients (n = 69 419). Conclusions The results indicate a not entirely common, but potentially serious, problem, especially concerning occupationally exposed, and sensitized, nail artists. Adequate protective measures should be taught as part of the vocational training. [ABSTRACT FROM AUTHOR]

Allergic contact dermatitis (ACD) is an inflammatory reaction affecting all age groups and both sexes. ACD is characterized by a delayed-type hypersensitivity reaction IV caused by skin contact with haptens. Chronic exposure typically leads to a decrease in erythema accompanied by lichenification (thickening and hardening of the skin) and persistent itching. The current study aims to investigate the patterns of contact sensitization in the Greek population using patch test data analysis. Patch test data from 240 patients (120 Males/120 Females) with allergic contact dermatitis were collected at the Laboratory for Patch Testing, National Reference Center for Occupational Dermatoses "Andreas Syggros" Hospital in Athens Greece. The contact allergic reactions were caused by ethylenediamine dihydrochloride 1%, thimerosal 0.5%, and methyldibromo-glutaronitrile 0.1% from the European baseline series of allergens; information was also collected for ICDRG evaluation, an extended MOAHLFA index and patient-reported outcomes (daily routine questionnaire). The chi-square test for independence and Spearman's rank were used to evaluate the association and correlation, respectively, between patient characteristics and ACD-related factors. Multiple correspondence analysis (MCA), which is a data analysis approach, was used to find and depict underlying structures in the data collection for nominal categorical data. Statistically significant associations were found between the following pairs of characteristics: eczema triggers and gender and eczema triggers and hand dermatitis. The results from MCA showed that there is correlation between allergic contact dermatitis onset, allergens, and demographic variables., (© 2023. The Author(s), under exclusive license to Springer Nature Switzerland AG.)