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ispartof: CONTACT DERMATITIS vol:87 issue:5 pages:468-471 ispartof: location:England status: published

The varicella-zoster virus (VZV) infects over 95% of the population and establishes latency afterwards. Reactivation of VZV causes herpes zoster (HZ), commonly known as shingles, which presents as a painful rash in mostly the elderly and people with a weakened immune system. However, HZ might occur in otherwise healthy individuals too. In this study, we have studied the immune signature of HZ to better understand HZ’s pathophysiology. We provide a general overview of the antiviral state and the activation of innate and adaptive immune responses during HZ. Differential gene expression and gene ontology analyses revealed upregulation of several genes and host immune pathways during herpes zoster, especially related to type I IFN response but also related to adaptive immune responses. Intriguingly, no differences in gene expression were noted during convalescence between HZ patients and controls. Furthermore, we conducted the largest HLA association study on HZ to date using the UK Biobank and identified seven protective and four risk HLA alleles associated with the development of herpes zoster. These findings reveal key genes and pathways involved in the host immune response to symptomatic VZV reactivation and provide new molecular insights into the development of HZ.

Background Transcriptome profiling of blood cells is an efficient tool to study the gene expression signatures of rheumatic diseases. This study aims to improve the early diagnosis of pediatric rheumatic diseases by investigating patients' blood gene expression and applying machine learning on the transcriptome data to develop predictive models. Methods RNA sequencing was performed on whole blood collected from children with rheumatic diseases. Random Forest classification models were developed based on the transcriptome data of 48 rheumatic patients, 46 children with viral infection, and 35 controls to classify different disease groups. The performance of these classifiers was evaluated by leave-one-out cross-validation. Analyses of differentially expressed genes (DEG), gene ontology (GO), and interferon-stimulated gene (ISG) score were also conducted. Results Our first classifier could differentiate pediatric rheumatic patients from controls and infection cases with high area-under-the-curve (AUC) values (AUC = 0.8 +/- 0.1 and 0.7 +/- 0.1, respectively). Three other classifiers could distinguish chronic recurrent multifocal osteomyelitis (CRMO), juvenile idiopathic arthritis (JIA), and interferonopathies (IFN) from control and infection cases with AUC >= 0.8. DEG and GO analyses reveal that the pathophysiology of CRMO, IFN, and JIA involves innate immune responses including myeloid leukocyte and granulocyte activation, neutrophil activation and degranulation. IFN is specifically mediated by antibacterial and antifungal defense responses, CRMO by cellular response to cytokine, and JIA by cellular response to chemical stimulus. IFN patients particularly had the highest mean ISG score among all disease groups. Conclusion Our data show that blood transcriptomics combined with machine learning is a promising diagnostic tool for pediatric rheumatic diseases and may assist physicians in making data-driven and patient-specific decisions in clinical practice. We received fnancial support from the Research Foundation Flanders (1861219N to BO), Al Thrasher Early Career Grant, academic investigatorinitiated grants from AbbVie and charity support from “Cycling for the smile of a child”. The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication. We appreciate the participation of all patients and their families in this study. We are grateful to all unmentioned clinicians, nurses, and lab colleagues. We thank Yanick Crow for helping us with certain analyses and Yves Vandeputte who organised the charity support from “Cycling for the smile of a child”.

Background Isocyanates are well-known occupational allergens, but can also be present in medical devices. Objectives To highlight that contact sensitization to isocyanates might contribute to allergic contact dermatitis (ACD) from polyurethane (PU)-containing diabetes devices and wound dressings. Patients and Methods Nineteen patients with suspected ACD from diabetes devices and/or wound dressings were patch tested to an isocyanate series. Four wound dressings, six diabetes devices and four monomeric isocyanate patch test preparations were analysed with gas chromatography - mass spectrometry. Results Eight patients reacted to isocyanates and corresponding amines: 3 to isophorone diisocyanate (IPDI), 4 to 4,4 '-diaminodiphenylmethane (MDA), 4 to 2,4-toluene diisocyanate (TDI) and 1 to polymeric methylene diphenyl diisocyanate (PMDI). Three of four wound dressings contained isocyanates (methylene diphenyl diisocyanate [MDI], TDI and/or IPDI), whereas five of six diabetes devices contained 4,4 '-MDI, and one of them also IPDI. None of the medical devices contained 1,6-hexamethylene diisocyanate. Contrary to IPDI, and especially MDI, only the concentration of the TDI patch test preparation corresponded approximately (80%) to its label. Conclusion Patch tests with isocyanates may be worth-while in patients with suspected ACD from PU-containing medical devices. Besides MDA, and PMDI, also TDI might potentially be a marker for MDI-sensitization.

BACKGROUND: The reason why patients photosensitized to the drug ketoprofen (KP) may develop severe photoallergic skin reactions to octocrylene (OCT), an organic ultraviolet filter in sunscreens and cosmetics, remains largely unknown. OCT can be synthesized by using unsubstituted benzophenone (BP), a possible human carcinogen. OBJECTIVES: To verify if, and to what extent, BP residues are present in OCT-containing consumer products. METHODS: The raw material of OCT and 39 skincare products, of which 28 contain OCT, were chemically analysed for the presence of BP by means of liquid chromatography. RESULTS: In the OCT raw material and in all 28 OCT-containing products the presence of BP could be demonstrated, mostly in concentrations above 10 ppm (0.001%), whereas a majority of OCT-free products (8/11, 73%) did not contain BP. Moreover, BP concentrations significantly increased, in a time- and temperature-dependent manner, likely due to the additional degradation of OCT. CONCLUSIONS: Photoallergic contact dermatitis from OCT in patients photosensitized to KP might rely on residual BP impurities. Toxicological and ecological studies that evaluate the safety of OCT might also need to consider the concomitant presence of BP. ispartof: CONTACT DERMATITIS vol:85 issue:1 pages:69-77 ispartof: location:England status: published

Background Notwithstanding that concomitant exposure to different isothiazolinone derivatives may result in concomitant sensitization, clinical and animal studies have suggested cross-reactivity between these derivatives, notably between methylisothiazolinone (MI) and octylisothiazolinone (OIT). Objective To investigate if patients sensitized to MI show cross-reactions to OIT and/or to benzisothiazolinone (BIT) by applying the concept of the re-test method. Patients And Methods From March to October 2019 consecutive patients were patch tested with MI 0.2% aqueous in duplicate at the two lower corners of both shoulder blades. Patients sensitized to MI, but not to OIT 0.1% petrolatum (pet.) nor to BIT 0.1% pet., were re-tested, 2 months later, with the latter two derivatives at the skin sites where the MI reactions had fully disappeared. Results Of 116 patients, 15 (13%) were sensitized to MI, eight of these not sensitized to BIT nor to OIT. Of these, seven patients, all (very) strongly sensitized to MI, were re-tested: five patients showed positive patch test reactions to OIT 0.1% pet.; one patient to OIT 0.1% pet. and BIT 0.1% pet.; and one other patient showed no reactions. Conclusion This study suggests that patients primarily and strongly sensitized to MI may show immunologic cross-reactions to OIT, and to a far lesser extent to BIT.

In 2019, a number of allergens (haptens), henceforth, "the audit allergens," were considered as potential additions to the European Baseline Series (EBS), namely, sodium metabisulfite, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, imidazolidinyl urea, Compositae mix II (2.5% or 5% pet), linalool hydroperoxides (lin-OOH), limonene hydroperoxides (lim-OOH), benzisothiazolinone (BIT), octylisothiazolinone (OIT), decyl glucoside, and lauryl glucoside; Evernia furfuracea (tree moss), was additionally tested by some departments as well.To collect further data on patch test reactivity and clinical relevance of the audit allergens in consecutive patients across Europe.Patch test data covering the audit allergens in 2019 and 2020 were collected by those departments of the European Surveillance System on Contact Allergies testing these, as well as further collaborators from the EBS working group of the European Society of Contact Dermatitis (ESCD), and the Spanish Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea. As patch test outcome, reactions between day (D) 3 and D5 were considered.Altogether n = 12 403 patients were tested with any of the audit allergen. Positive reactions were most common to lin-OOH 1% pet. (8.74% [95%CI: 8.14-9.37%]), followed by lin-OOH 0.5% pet., and lim-OOH 0.3% pet (5.41% [95% CI: 4.95-5.89%]). Beyond these terpene hydroperoxides, BIT 0.1% pet. was the second most common allergen with 4.72% (95% CI: 4.2-5.28%), followed by sodium metabisulfite 1% pet. (3.75% [95%CI: 3.32-4.23%]) and Compositae mix 5% pet. (2.31% [95% CI: 1.84-2.87%]). For some allergens, clinical relevance was frequently difficult to ascertain.Despite many positive patch test reactions, it remains controversial whether lin- and lim-OOH should be tested routinely, while at least the two preservatives BIT and sodium metabisulfite appear suitable. The present results are a basis for further discussion and ultimately decision on their implementation into routine testing among the ESCD members.

BACKGROUND Besides being a potential component of (some species of) colophonium, D-limonene is also used as a tackifier in the production of adhesives. Hydroperoxides of limonene are well-known skin sensitizers. OBJECTIVES To show that D-limonene may be present in colophonium-containing but also colophonium-free ("hypoallergenic") adhesives, and that patients suffering from allergic contact dermatitis (ACD) from both types of adhesives might display positive patch test reactions to limonene hydroperoxides in this regard. PATIENTS AND METHODS Five patients with suspected ACD from adhesives were patch tested to the baseline series (containing limonene hydroperoxides 0.3 and 0.2% pet.), additional series, and, if available, to the culprit adhesives. The adhesives labelled as containing colophonium (n= 3) or free from it (n=2) were analysed with gas chromatography - mass spectrometry (GC-MS) for the presence of D-limonene. RESULTS All 5 patients sensitized to adhesives had (strong) positive patch test reactions to limonene hydroperoxides. The presence of D-limonene, and/or related components, could be demonstrated in all 3 colophonium-containing and, surprisingly, also in 2 colophonium-free ("hypoallergenic") tapes. CONCLUSIONS D-limonene may be present in both regular and "hypoallergenic" adhesives, with limonene hydroperoxides potentially contributing to ACD from such medical devices. The use of fragrance chemicals in adhesives deserves further research. This article is protected by copyright. All rights reserved.

OBJECTIVE Cutaneous adverse events (CAE) from FreeStyle Libre include allergic contact dermatitis (ACD) caused by the allergen isobornyl acrylate (IBOA). We aim to report CAE from this glucose sensor, ACD to IBOA in particular, and the outcome of using barrier films as a prevention. RESEARCH DESIGN AND METHODS A monocentric, retrospective review of medical files from adult and pediatric patients with diabetes using Freestyle Libre, in the period between December 2016 and April 2019, was performed with a focus on CAE. RESULTS Fifty-seven of 1,036 patients with diabetes (5.5%) were referred to our dermatology department because of CAE from FreeStyle Libre. Thirty-nine of 1,036 (3.8%) had ACD due to IBOA. Only two patients, of whom one sensitized to IBOA, had a benefit from using barrier films. CONCLUSIONS CAE occurred in 5.5% of FreeStyle Libre users, and 3.8% suffered from ACD due to IBOA. Barrier films had limited value in the prevention.

Eccrine porocarcinoma is a rare and potentially fatal malignant adnexal tumor that can arise de novo or develop from its benign precursor, poroma. Diagnosis is difficult due to its rarity and resemblance to many other (benign) skin tumors. We present the case of a 71-year-old woman presenting with a long-standing case of eccrine porocarcinoma on the scalp. After multiple incomplete excisions over the last 15 years, no metastases were found. Major reconstructive surgery was necessary after complete excision of the lesion. Complete removal of the eccrine porocarcinoma was achieved in 2 stages. The defect was closed with a large rotation flap of the scalp. No adjuvant radio- or chemotherapy was given. Twenty-one months later, the patient presented with a rapidly growing lymph node recurrence, which was treated by lymph node dissection followed by chemoradiation. This case demonstrates the consequences of suboptimal surgical treatments and follow-up of eccrine porocarcinoma and its benign precursor, poroma. Early recognition, proper pathological diagnosis, and adequate surgical treatment are highly recommended in order to obtain a good prognostic outcome. Level of evidence: Level V, Risk/Prognostic study.

Background Patients suffering from drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome caused by first‐line antituberculosis drugs often need to be retreated rapidly. Patch tests prior to the reintroduction of antituberculosis drugs are rarely performed. Objectives To highlight those drugs most often involved in DRESS caused by antituberculosis drugs, illustrate the potential value of patch tests to identify these culprit(s), and provide insights into how to rapidly retreat these patients. Methods A detailed description of the work‐up of two illustrative patients, together with a literature review of similar cases, is provided. Results All first‐line antituberculosis drugs may cause DRESS syndrome, but rifampicin and isoniazid are most frequently involved. Patch tests can be performed sooner than usually advised in the context of DRESS syndrome, and potentially with lower test concentrations, but false‐negative results are possible. Sequential reintroduction of patch test‐negative drugs is feasible, although the dose and order of drugs to be readministered, as well as the use of concomitant systemic corticosteroids, remain a matter of debate. Conclusion Patch tests in the context of DRESS syndrome caused by antituberculosis drugs, despite their shortcomings, may potentially guide rapid retreatment of these patients.

To date only three cases of allergic contact dermatitis (ACD) from the relatively new and potent skin-lightening agent phenylethyl resorcinol (PER) have been reported. We describe three additional cases of severe ACD from this substance contained in pigment-lightening cosmetics. [...]

Background Contact dermatitis to homemade slime has been frequently reported, with isothiazolinones as a likely sensitizer. Little is known on the presence of these preservatives in commercial, store-bought slime products. Objectives The aims of the study were to review the literature on "slime dermatitis" and to assess for the presence of isothiazolinones in commercially available slime products and homemade slime components. Methods An experimental, colorimetric spot test was used to verify the presence of isothiazolinones in 38 slime products of the 16 best-selling commercial slime kits, 1 finished homemade slime, and 4 common components of homemade slime. High-performance liquid chromatography with UV detection was performed on 8 commercial slime products. Results According to the spot test, 27 (71%) of the 38 commercial slime products contained isothiazolinones. High-performance liquid chromatography with UV detection analyses indicated, however, that false-positives and false-negatives readily occur: isothiazolinone content was correctly identified in only 4 (50%) of the 8 samples. Conclusions This study is the first to demonstrate the presence of isothiazolinones in commercial slime toys. Although the colorimetric spot test may have some utility as a screening assay, it is far from specific and likely not sensitive enough to reliably identify methylisothiazolinone.

Background The preservatives sorbic acid (SA) and potassium sorbate (PS) are considered rare skin sensitizers. PS-containing products always contain SA to a certain extent, and positivity to PS may reflect sensitization to SA. Their optimal patch-test conditions are unknown. Objectives To report on the outcome of testing with SA and PS in various concentrations and/or vehicles. Patients and methods Seventeen patients with allergic contact dermatitis from PS/SA-containing topical pharmaceuticals and medical devices were patch tested to SA 2% and 5% pet.; SA 1%, 2%, 3%, 5%. eth.; and/or SA 2% aq., whereas PS was patch tested 5% pet. and/or 5% aq. Results Only one patient, not tested to the ethanol preparations, presented with a (doubtful) positive reaction to SA 2% pet., while this remained negative in 13 patients who reacted to SA 2% eth. The preparations containing SA 5% pet.; 1%, 3%, and 5% eth.; and SA 2% aq. had little or no additional value. PS 5% pet. performed better than 5% aq., and always mirrored SA sensitization. Conclusions Sensitization to SA and PS is probably underestimated. SA 2% eth. and PS 5% pet. are preferred for patch testing, and patients sensitized to SA should avoid PS-containing products. Highlights Potassium sorbate (PS) and sorbic acid (SA) are widely used preservatives. PS-containing products always contain some SA. Both are considered rare skin sensitizers, but contact allergy in response to them might be underestimated. SA 2% eth. and PS 5% pet., rather than SA 2% pet. and PS 5% aq., respectively, may be required to diagnose contact allergy from PS/SA-containing topical pharmaceuticals and medical devices. A positive patch test to PS reflects sensitization to SA, and patients sensitized to SA should also avoid PS-containing products.

Multidisciplinary collaboration between several European dermatology departments has identified isobornyl acrylate (IBOA; CAS 5888-33-5), once deemed a low-risk sensitizer, as a major culprit contact allergen in glucose sensors and insulin pumps, medical devices used by diabetes patients worldwide. Although the patch test modalities of IBOA have been fairly well characterized, intriguing questions remain. For example, its cross-reactive profile to other acrylates remains to be determined, and the striking occurrence of concomitant positive patch test reactions to sesquiterpene lactones needs to be further elucidated. Importantly, the path to its discovery as a contact sensitizer in diabetes devices and the difficulties that were associated with this quest illustrate that apparent difficulties in obtaining sufficient cooperation from the medical device industry may seriously hamper the correct workup of cases of allergic contact dermatitis. The IBOA saga will convince companies to lend more cooperation to dermatologists and policymakers to side with patients and physicians when it comes to updating medical device regulations, including the compulsory labeling of medical devices in general and of diabetes devices in particular. © 2019 Lippincott Williams & Wilkins.

In the past decade, new diabetes technologies, including continuous glucose monitoring (CGM) systems, support patients with diabetes in their daily struggle with achieving a good glucose control. However, shortly after the first CGM systems appeared on the market, also the first concerns about adverse skin reactions were raised. Most patients claimed to suffer from (sometimes severe) skin irritation, or even allergy, which they related to the (acrylate-based) adhesive part of the device. For a long time the actual substance that caused these skin reactions with, for example, the Flash Glucose Monitoring system (iscCGM; Freestyle® Libre) could not be identified; however, recently Belgian and Swedish dermatologists reported that the majority of their patients that have developed a contact-allergic while using iscCGM react sensitively to a specific acrylate, that is, isobornyl acrylate (IBOA). Subsequently they showed by means of gas chromatography-mass spectrometry that this substance is present in the case of the glucose sensor attached by an adhesive to the skin. We report three additional cases from Germany, including a 10-year-old boy, suffering from severe allergic contact dermatitis to IBOA.

BACKGROUND Photoaggravated allergic contact dermatitis caused by methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) and MI has been reported. OBJECTIVES To describe the clinical characteristics and results of (photo)patch tests and photo-tests of 10 patients in Belgium and France suffering from photoaggravated contact dermatitis caused by MI. PATIENTS AND METHODS Five men and five women, with a median age of 49.5 years, were investigated between January 2012 and February 2017 because of suspected photoaggravated contact dermatitis. Patch tests, photopatch tests and/or photo-tests were performed. RESULTS Seven patients had positive patch test reactions to both MCI/MI and MI, whereas 3 patients had positive patch test reactions only to MI. In most cases, MI was the (strong) primary sensitizer. Photopatch tests with MCI/MI and/or MI gave stronger reactions than patch tests with these derivatives, indicating photoaggravation. Sensitization probably took place from cosmetics and work-related biocides, whereas elicitation of dermatitis was remarkably often related to airborne exposure to MI present in paints or industrial biocides. Four patients suffered from transient photosensitivity. CONCLUSION Photoaggravated allergic contact dermatitis and transient photosensitivity caused by MI is a peculiar clinical presentation of allergic contact dermatitis caused by this preservative, and should be considered in daily clinical practice.

SUMMARYBackground Glucose sensors, such as FreeStyle® Libre, are innovative medical devices developed for diabetes patients as a replacement for classic glucose meters, ensuring continuous glucose monitoring without the disadvantage of regular skin finger pricks. Objectives To report several cases of allergic contact dermatitis caused by FreeStyle® Libre, and to report on isobornyl acrylate as a culprit allergen. Patients and Methods Fifteen patients presented with allergic contact dermatitis caused by FreeStyle® Libre. All but 1 were patch tested with a baseline series, and with pieces and/or ultrasonic bath extracts of (the adhesive part of) the glucose sensor. Isobornyl acrylate was patch tested, in various concentrations and vehicles, in 13 patients. Gas chromatography–mass spectrometry (GC-MS) of the sensors was performed. Results All patients reacted to the adhesive part of the sensor, and 12 patients were shown to be sensitized to isobornyl acrylate. Simultaneous reactions to other allergens were rarely observed. GC-MS showed the presence of isobornyl acrylate in the sensors. Conclusions Cases of allergic contact dermatitis caused by FreeStyle® Libre are increasingly being observed, and isobornyl acrylate is a relevant culprit allergen. Cross-reactivity to other acrylates was infrequently observed, but other, hitherto unidentified, contact allergens may still be present in the device.

SummaryBackground Airborne allergic contact dermatitis caused by paints containing isothiazolinones has been recognized as a health hazard. Objectives To collect epidemiological, clinical and patch test data on airborne allergic contact dermatitis caused by isothiazolinone-containing paints in France and Belgium. Methods A descriptive, retrospective study was initiated by the Dermatology and Allergy Group of the French Society of Dermatology, including methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI)- and/or MI-sensitized patients who developed airborne allergic contact dermatitis following exposure to isothiazolinone-containing paint. Results Forty-four cases were identified, with mostly non-occupational exposure (79.5%). Of the patients, 22.5% of also had mucosal symptoms. In several cases, the dermatitis required systemic corticosteroids (27.3%), hospitalization (9.1%), and/or sick leave (20.5%). A median delay of 5.5 weeks was necessary to enable patients to enter a freshly painted room without a flare-up of their dermatitis. Approximately one-fifth of the patients knew that they were allergic to MI and/or MCI/MI before the exposure to paints occurred. Conclusion Our series confirms that airborne allergic contact dermatitis caused by paints containing isothiazolinones is not rare, and may be severe and long-lasting. Better regulation of isothiazolinone concentrations in paints, and their adequate labelling, is urgently needed.

The isothiazolinone derivatives, methylchloroisothiazolinone (MCI), methylisothiazolinone (MI), benzisothiazolinone (BIT), and octylisothiazolinone (OIT), owing to their strong bactericide, fungicide and algicide properties, are widely used in non-cosmetic products, such as chemical (industrial) products, household detergents, and water-based paints, and the former two derivatives are also used in cosmetic products. However, given their inherent sensitization potential (with MCI > MI > BIT > OIT), allergic contact dermatitis is frequently observed, both in consumers as well as workers in various industries. In this review, we provide an update on the use of MCI/MI and MI in cosmetics, highlighting certain aspects of MI; the use of excessive concentrations, the presence in some less familiar cosmetic products, and the association with unusual clinical manifestations. Furthermore, the use of isothiazolinones in dish-washing and washing-machine liquids, cleaning agents for dental care, and their general presence in multi-purpose household detergents, which may elicit (airborne) allergic contact dermatitis, is discussed. Finally, we provide a brief overview of the use of isothiazolinone derivatives in the paint and textile industry, and of OIT in the leather industry in particular.

Introduction Nous rapportons un premier cas d’allergie de contact a un brassard tensionnel jetable lie a un nouvel allergene acrylate. Observations Un jeune homme de 16 ans etait adresse en 2019 pour eczema en regard d’un brassard tensionnel jetable. Ce patient diabetique de type 1 avait ete hospitalise 3 fois en reanimation medicale pour acidocetose diabetique. A chaque hospitalisation, il avait developpe un eczema au contact du brassard tensionnel jetable Philips®, qu’il portait en continu. Le patient avait aussi presente un eczema en regard d’un capteur glycemique FreeStyle® fin 2017 apres quelques mois d’utilisation, ce qui en avait motive l’arret. Il tolerait par ailleurs les pansements. Nous avons realise des patch-tests avec une BSE, une batterie colles et plastiques, une batterie acrylates/methacrylates, l’isobornylacrylate 0,1 % (Chemotechnique Diagnostics®, Vellinge, Suede), le capteur Freestyle®, le brassard Philips® (faces interne et externe, tuyau), le sparadrap et tuyau du saturometre, les electrodes ECG et une lingette de desinfection, selon les recommandations de l’ESCD. Resultats Les resultats ont confirme l’eczema de contact au capteur et au brassard : patch-tests positifs au capteur (+++), aux faces et tuyau du brassard (++), electrodes ECG (++), tuyau du saturometre (++). Surtout, on trouvait une positivite a de nombreux acrylates et methacrylates : IBOA 0,1 % (+++), butyl-acrylate 0,1 % (++), tetrahydrofurfuryl methacrylate 2 % (++), ethyl acrylate 0,1 % (++), 2-hydroxyethyl acrylate 0,1 % (+), 2-hydroxypropyl methacrylate 2 % (+), ethyleneglycol dimethacrylate 2 % (+), 1,6-hexanediol diacrylate 0,1 % (+), trimethylolpropane triacrylate 0,1 % (+), triethyleneglycol diacrylate 0,1 % (+). Nous avons alors effectue une declaration a la materiovigilance et contacte Philips, ce qui ne nous a pas permis de savoir quel(s) allergene(s) potentiel(s) etaient dans le brassard. Nous avons donc adresse le brassard au Dr O. Aerts (Anvers, Belgique) pour analyse et recherche d’allergene(s). L’analyse a trouve de l’IBOA en faible quantite dans la colle servant a fixer le tuyau au brassard, et par contre en tres grande quantite du phenoxyethylacrylate (PEA) dans le velcro. Nous avons alors convoque notre patient pour un patch test au PEA 0,1 % vas. (fourni par O.A) qui s’est revele tres positif (+++). Le brassard contient donc au moins deux acrylates potentiellement responsables de l’eczema de contact chez notre patient, et pouvant probablement donner des reactions croisees. Nous pensons qu’il s‘est initialement sensibilise a l’IBOA par l’intermediaire du Freestyle et qu’il a ensuite developpe un eczema lie a la forte quantite de PEA dans le brassard. Discussion Nous rapportons un premier cas d’allergie de contact a un brassard tensionnel jetable, contenant deux allergenes acrylates pertinents et particulierement le phenoxy-ethyl-acrylate. A ce jour, aucun autre cas n’a ete mentionne en materiovigilance nationale, ni aupres du fabricant Philips.

SummaryBackground Octylisothiazolinone (OIT) (CAS no. 26530-20-1) is used as an antifungal agent by the leather industry. Objectives To show sensitization to OIT from leather, and to highlight the potential implications when cross-reactivity between OIT and methylisothiazolinone (MI) is studied. Methods Two patients with allergic contact dermatitis caused by a leather belt and shoes, respectively, were patch tested with methylchloroisothiazolinone (MCI)/MI, MI, MCI, OIT, and benzisothiazolinone (BIT). High-performance liquid chromatography with ultraviolet detection (HPLC-UV) was used to detect isothiazolinone derivatives in leather goods. Additionally, files of OIT-sensitized patients, observed at the KU Leuven department during the period 1990–2015, were retrospectively analysed. Results Both patients had been primarily sensitized to OIT, but the diagnosis in 1 of them could be achieved only when a higher patch test concentration of OIT (1000 ppm pet.) was used. HPLC-UV confirmed the presence of OIT in their leather goods. Non-relevant sensitization to MI was noted in both cases. Four additional cases of OIT sensitization from leather could be retrieved from the KU Leuven database. Conclusions Non-occupational sensitization to OIT from leather may occur. Patch test concentrations of >250 ppm pet. may be necessary for diagnosis, and to show cross-reactivity with MI. Safer use limits for OIT in the leather industry may be needed.