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Hair cosmetics are in fashion. Numerous products are commonly used in combination. Frequent allergens are present in hair cosmetics, which, with almost daily use, increase the risk of sensitization. Familiarity with the clinical distribution of the eczematous rash is necessary to seriously consider patch testing. Not all the products on the market are haptens. It is necessary to know how to patch your own products. When avoidance of the allergen is not possible, new treatments are evaluated to combat allergic contact dermatitis, mainly of the occupational type. In this manuscript, a complete and practical review of the main allergens and contact sources of hair cosmetic origin has been carried out. [ABSTRACT FROM AUTHOR]

Hair cosmetics are in fashion. Numerous products are commonly used in combination. Frequent allergens are present in hair cosmetics, which, with almost daily use, increase the risk of sensitization. Familiarity with the clinical distribution of the eczematous rash is necessary to seriously consider patch testing. Not all the products on the market are haptens. It is necessary to know how to patch your own products. When avoidance of the allergen is not possible, new treatments are evaluated to combat allergic contact dermatitis, mainly of the occupational type. In this manuscript, a complete and practical review of the main allergens and contact sources of hair cosmetic origin has been carried out.

Abstract Background Hand eczema (HE) is a highly prevalent, recurrent, and multifactorial disease. It encompasses a group of eczematous diseases that affect the hands, etiologically classified into irritant contact dermatitis (ICD), allergic contact dermatitis (ACD) and atopic dermatitis (AD). Few epidemiological studies in Latin America have investigated the characteristics of patients with this condition and the origin of the disease. Objectives To analyze the profile of patients diagnosed with HE submitted to patch tests aiming to determine its etiology. Methods A retrospective descriptive study was carried out on epidemiological data and patch tests of patients with HE treated at a tertiary hospital in the city of São Paulo from January 2013 to December 2020. Results A total of 173 patients were studied, whose final diagnosis was 61.8% of ICD, 23.1% of ACD and 5.2% of AD, with diagnostic overlap in 42.8% of the cases. The main positive and relevant patch tests were: Kathon CG (42%), nickel sulfate (33%), and thiuram mix (18%). Study limitations The number of treated cases and socioeconomic profile was limited to a vulnerable population group. Conclusion HE is a diagnosis in which overlapping etiologies are frequent, with the main sensitizers identified in ACD being Kathon CG, nickel sulfate and thiuram mix.

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]

Background: Allergic contact dermatitis (ACD) in paediatric patients is on the rise. Continuous identification of emerging allergens is of great importance to ensure accurate patch testing. Objectives: To assess the frequency and relevance of contact sensitivity in children and adolescents and evaluate changes in sensitization rates in the last decade. Methods: All patients with suspected ACD who underwent patch testing at the Amsterdam University Medical Centers between 2015 and 2021 were included. Results: Of 439 patients tested with the European Baseline Series (EBS) and additional series, 334 (76%) patients had at least 1 positive reaction and 172 patients (39%) had 1 or more relevant positive reactions. If additional series would have been omitted, 20% of patients would have been underdiagnosed. Compared to patients tested between 1996 and 2013, reactions to metal allergens, isothiazolinones, methyldibromo glutaronitrile, carba mix, amerchol L‐101, and benzophenone‐4 were more frequently observed. Conclusions: This study confirms the need for patch testing in paediatric patients suspected of having ACD. For accurate patch testing, it is advised to include additional series. [ABSTRACT FROM AUTHOR]

Objective: Some clinics interpret patch test results 48 hours after application and an additional reading is performed at 72 or 96 hours. Reports in the literature describe delayed positive reaction to some allergens in patients who underwent patch testing for suspected allergic contact dermatitis. However, an additional late reading may be neglected in some clinics. In this study we aimed to identify allergens with delayed positive patch test reactions and to determine the relevance of an additional day 7 (168 hours) patch test reading. Material and Methods: The data of 101 patients who underwent patch testing for suspected allergic contact dermatitis between January 2015 and July 2016 were analyzed retrospectively. Demographic data and patch test results of the patients were evaluated. Allergens without a positive reaction at the 48th and 96th hours but with a positive reaction at the 168th hour were considered as delayed positive patch test reaction. Results: Sixty-four (63.3%) of 101 patients had positive reactions to at least 1 allergen. A total of 125 positive reactions were detected. Of the 125 positive reactions, 85 (68%) were positive at 48 hours reading and 31 (24.8%) turned positive at 96 hours evaluation. Nine (7.2%) of 125 positive reactions were late reactions that turned positive at 168 hours. Nickel sulfate, gold sodium thiosulfate, Cl+Me-isothiazolinone, formaldehyde, tixocortol pivalate and hydrocortisone-17-butyrate, and fragrance mix were detected as allergens causing late positive reactions. Conclusion: We think that late reading at the 168th hour should not be neglected. [ABSTRACT FROM AUTHOR]

This article discusses a case of occupational contact dermatitis in a 44-year-old man who developed a recurrent facial rash after exposure to pyrethrum daisies (Tanacetum cinerariifolium) at his workplace. The man experienced symptoms for 2-4 weeks each summer, which improved but did not completely resolve after 2 months. Patch testing revealed positive reactions to the crop, as well as other substances. The patient was prescribed medication and provided with protective equipment to wear during exposure. The article emphasizes the importance of patch testing for specific allergens to which a patient may be exposed, rather than relying solely on commonly tested allergens. [Extracted from the article]

Background: Ammonium persulfate (APS), an oxidizing agent used in hair products, manufacturing, and pool/spa water, can cause skin reactions, including allergic contact dermatitis.Objective: To characterize positive patch test reactions to APS (2.5% petrolatum).Methods: Retrospective analysis of patients tested to the North American Contact Dermatitis Group screening series from 2015 to 2018.Results: Of 10,526 patients, 193 (1.8%) had positive patch test reactions to APS. Compared with APS-negative patients, APS-positive patients were significantly more likely to be male (43.2% vs 28.0%; P < .0001); have primary hand dermatitis (30.2% vs 22.0%; P = .0064), scattered generalized dermatitis (25.5% vs 17.9%; P = .0064), or trunk dermatitis (8.9% vs 4.9%; P = .0123); and have dermatitis that is occupationally related (22.2% vs 10.9%; P < .0001). More than half of the APS-positive reactions were currently relevant (57.0%); 19 (9.8%) were related to occupation, especially hairdressers (68.4%). Swimming pools/spas (23.3%) and hair care products (19.2%) were the most common sources of APS.Limitations: Immediate reactions and follow-up testing were not captured.Conclusion: The proportion of patients positive to APS was 1.8%. APS positivity was significantly associated with male sex and hand dermatitis. Swimming pool/spa chemicals were important sources of APS exposure. [ABSTRACT FROM AUTHOR]

Background: Patch testing is an important diagnostic tool for suspected allergic contact dermatitis (ACD) in occupational settings.Objective: Provide an overview of occupational skin disease (OSD) and an analysis of occupational ACD in North American patients undergoing patch testing between 2001and 2016.Methods: Patients with OSD were analyzed for frequency of allergic reactions to a screening series of allergens, occupational relevance, location of skin disease, and exposure sources. Demographic, occupation, and industry information were recorded.Results: Of 38,614 patients evaluated, 4471 (11.6%) had OSD, of whom 3150 (70.5%) had ACD. The most common occupationally related allergens included rubber accelerators, preservatives, and bisphenol A epoxy resin. Hands (75.8%), arms (30.0%), and face (15.9%) were common sites of dermatitis. The occupations most affected were service workers and machine operators.Limitations: Our cohort may not reflect the general working population.Conclusion: This study identified common occupational allergens, exposure sources, and occupations/industries at risk. This information may help the clinician evaluate and manage patients with occupational contact dermatitis. [ABSTRACT FROM AUTHOR]

Contact allergy to skin disinfectants is not often recognized in children. We report the cases of six children (1–16.5 years old) with allergic contact dermatitis to ingredients commonly contained in commercial antiseptic and cosmetic products. Patch test responses to chlorhexidine, benzyl alcohol, and benzalkonium chloride varied from one child to another one, but most children were sensitized to at least two components. In several of the cases, exposure had initially occurred in the neonatal period, but diagnosis occurred only after multiple reactions of increasing severity. [ABSTRACT FROM AUTHOR]

Patients with patch test reactions associated with eye care products: Retrospective analysis of North American contact dermatitis group data, 2001-2018 Keywords: allergic contact dermatitis; contact allergy; eye care products; patch tests EN allergic contact dermatitis contact allergy eye care products patch tests 712 715 4 11/18/21 20211201 NES 211201 Eye care products (ECP) may cause allergic contact dermatitis (ACD). Eighty-three of the 154 ECP-positive patients (53.9%) had 99 total reactions to NACDG screening allergens; the remainder (n = 71) had reactions to allergens/substances not on the screening series. [Extracted from the article]

Background: Methyldibromo glutaronitrile (MDBGN) was one of the most frequent and relevant allergens found in patch testing at the beginning of this century. In 2008, this preservative was banned from cosmetics in Europe and ever since the prevalence of contact allergy to MDBGN has progressively decreased. Despite that gradual decline, MDBGN is still patch‐tested in most baseline series. This study assessed the frequency of MDBGN sensitization, epidemiological characteristics of allergic patients, and the relevance of positive patch tests in a nationwide Spanish registry (REIDAC). Patients and methods: We evaluated consecutively patch‐tested patients in all participating centres. Using these data, we calculated the proportion of patients with positive patch tests to MDBGN from June 2018 to June 2020 and evaluated the relevance of the positive patch tests. Results: One hundred and fourteen out of 5072 (2.24 %) tested patients were sensitized to MDBGN. Clinical current relevance was confirmed in only one case. Conclusion: Although the frequency of contact allergy to MDBGN remains high, no clinical significance was found in most of these patients (5072 tests needed to obtain one relevant positive result). The clinical usefulness of this allergen seems weak and its continued inclusion in the European baseline series is questionable. [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]

Contact dermatitis in music professionals referred for patch testing: North American Contact Dermatitis Group data, 1996-2018 Keywords: allergic contact dermatitis; contact allergy; music professionals; musicians; patch tests EN allergic contact dermatitis contact allergy music professionals musicians patch tests 359 362 4 08/16/21 20210901 NES 210901 Music professionals (MPs) are at risk for both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD). Allergic contact dermatitis, contact allergy, music professionals, musicians, patch tests. [Extracted from the article]

Background: Contact sensitization is frequent among patients with frontal fibrosing alopecia (FFA) (52%–76%). Objective: To evaluate the frequency of sensitization/photosensitization in an FFA population. Methods: A population of FFA patients were patch tested (Spanish Contact Dermatitis Research Group [GEIDAC] baseline; cosmetic and fragrance series), and photopatch tested (sunscreen series). Results: Thirty‐six patients (mean age: 64.6 years; 35/36: women) were studied. A history of dermatitis was recorded in 69.4% (frequently involving the face). Overall, 80.5% patients showed positive patch‐test reactions. The most frequently positive allergens were nickel sulfate (25%), benzyl salicylate (22%), gallates (16.6%), propolis (16.6%), and limonene hydroperoxides (13.8%). Benzyl salicylate was likely relevant to the dermatitis (labeled on personal care products and most patients reporting clinical improvement with allergen avoidance). Patch tests with sunscreens showed positive reactions to 11 materials (five patients). Photopatch tests were positive in one case. Conclusion: We speculate a possible relationship between sensitization to benzyl salicylate and FFA. Hypothetically, the most likely explanation is that sensitization to benzyl salicylate involving FFA patients is a consequence of increased exposure to it. It is unclear whether allergen avoidance may impact the prognosis of alopecia. However, it seems to significantly improve the patients´ quality of life by lessening dermatitis and pruritus. [ABSTRACT FROM AUTHOR]

Introduction: The patterns of positive patch test in Nepal have not been defined so far. The aim of this study was to describe the patterns of patch test reactivity in suspected Allergic Contact Dermatitis (ACD) patients. Methods: This was a hospital based retrospective study performed to investigate patch test reactivity in patients with ACD from April, 2016 through October, 2016. The data of patients who underwent patch test during this period were extracted and analyzed. Results: A total of 35 patients were included in the study. Nineteen (54.3%) tested positive to either one or more allergens. Among them, 17 (89.4%) reacted positively to a single allergen. The following patterns of positives were seen: nickel sulfate, 5 (26.3%), fragrance mix 3 (15.7%), and parthenium 3 (15.7%). Cobalt sulfate, formaldehyde, potassium dichromate, benzocaine, nitrofurazone, chlorocresol each was positive in single patient. Majority of the patients were housewives (22.6%) followed by students and officers (13% each), farmers (10%), health care workers (9.7%), wet work (6.5%) and others (20). Less than half (45%) of the hand eczema showed positive patch test. Similarly,40% of the patient of scattered generalized dermatitis showed reactivity to parthenium, nickel sulfate and multiple antigens. Conclusions: The most common allergens identified were nickel sulfate, fragrance mix and parthenium. Since, there is no well defined contact allergen in the Nepalese community, so patch test kits developed elsewhere might not have been beneficial and calls for need of large scale investigation to identify the local allergens.

Background: Iodopropynyl butylcarbamate (IPBC) is a broad‐spectrum preservative for use in several product types, including cosmetics, in which its concentrations have been limited by EU legislation because of concerns related to its iodine content and release, and the risk of subsequent iodine overdose. Objectives: To report on concomitant patch test reactions observed with iodine and IPBC in patients sensitized to iodine‐containing antiseptics. Patients Between 2012 and 2018, seven patients, six from Belgium and one from France, two suffering from acute dermatitis during surgical interventions, four from dermatitis caused by wound treatment, and one from occupational dermatitis, were shown to be sensitized to iodine and/or povidone‐iodine (PVP‐I), which was considered to be relevant for their dermatitis. All patients were coincidentally also patch tested with IPBC. Results: All patients showed positive patch test reactions to several other allergens, including IPBC. No relevance could be detected for IPBC. Conclusions: We suspect that, notwithstanding the absence of firm evidence for IPBC being dehalogenated to produce free iodine in animals or in humans, the patch test reactions to IPBC in iodine‐allergic subjects were possibly caused by free iodine released from this preservative agent, thus underlining the EU restrictions regarding the use of this preservative in cosmetics. [ABSTRACT FROM AUTHOR]

Keywords: allergic contact dermatitis; case report; common ivy; erythema multiforme; patch tests; plant EN allergic contact dermatitis case report common ivy erythema multiforme patch tests plant 235 237 3 03/23/20 20200401 NES 200401 CASE REPORTS Case 1 A 50-year-old male with no significant medical history apart from contact cheilitis from scented lip balm was referred for investigation of an acute and widespread rash. Patch tests with plants and fragrance series were negative, while of the three plants handled during gardening, the only positive (+ at D2 and ++ at D4) were common ivy stalk and the related leaf, ++ at D2 and +++ at D4. Allergic contact dermatitis, case report, common ivy, erythema multiforme, patch tests, plant. [Extracted from the article]

Background: Preservatives present in cosmetics and other industrial products can cause allergic contact dermatitis. The aim of the study was to assess the frequency of allergy to selected preservatives in consecutive patients examined due to contact dermatitis in the Nofer Institute of Occupational Medicine, Łódź, and to establish whether individuals sensitized to formaldehyde react simultaneously to formaldehyde releasers. Material and Methods: A group of 405 patients (308 females and 97 males) was examined in 2011–2013. In all participants patch tests with a series of 13 preservatives (paraben mix, formaldehyde, Quaternium 15, chloromethylisothiazolinone/methylisothiazolinone mix, methyldibromoglutaronitrile, diazolidinyl urea, imidazolidinyl urea, DMDM hydantoin, 2-bromo-2-nitropropane-1,3-diol, iodopropynyl butylcarbamate, benzalkonium chloride, sodium metabisulfite, produced by Chemotechnique Diagnostics, Sweden) were performed. Results: Of the 405 patients 74 (including 52 females) showed positive results of patch tests. Contact allergy to at least 1 preservative was noted in 47 (11.6%) patients, including 34 (11%) females and 13 (13.4%) males. Methylisothiazolinone proved to be the most frequent sensitizer – 4.7% (5.2% females, 3.1% males) while parabens, 2-bromo-2-nitropropane-1,3-diol and imidazolidinyl urea (0.2%) were found to be the least frequent. Fourteen (3.4%) participants, 10 women and 4 men, were allergic to formaldehyde and/or formaldehyde releasers. In 11 (78.6%) of them monovalent hypersensitivity was observed. In 13 (3.2% of the examined group) patients allergy to preservatives might have been of occupational origin. Conclusions: Preservatives, particularly isothiazolinones, are significant causal factors of allergic contact dermatitis, including occupational cases. Individuals sensitized to formaldehyde may react simultaneously to formaldehyde releasers, however, such reactions are relatively rare. Med Pr 2015;66(3):327–332

The article presents a case study of a 39-year-old woman with a known history of atopic dermatitis (AD) and referred to the dermato-allergology department due to persistent, painful, hyperkeratotic palmoplantar eczema despite the use of betamethasone dipropionate ointment and emollients. The patient was treated with intramuscular injections of methotrexate (MTX) and folic acid. The treatment of MTX was stopped after one year due to the improvement in AD lesions.

Introduction: The patterns of positive patch test in Nepal have not been defined so far. The aim of this study was to describe the patterns of patch test reactivity in suspected Allergic Contact Dermatitis (ACD) patients. Methods: This was a hospital based retrospective study performed to investigate patch test reactivity in patients with ACD from April, 2016 through October, 2016. The data of patients who underwent patch test during this period were extracted and analyzed. Results: A total of 35 patients were included in the study. Nineteen (54.3%) tested positive to either one or more allergens. Among them, 17 (89.4%) reacted positively to a single allergen. The following patterns of positives were seen: nickel sulfate, 5 (26.3%), fragrance mix 3 (15.7%), and parthenium 3 (15.7%). Cobalt sulfate, formaldehyde, potassium dichromate, benzocaine, nitrofurazone, chlorocresol each was positive in single patient. Majority of the patients were housewives (22.6%) followed by students and officers (13% each), farmers (10%), health care workers (9.7%), wet work (6.5%) and others (20). Less than half (45%) of the hand eczema showed positive patch test. Similarly,40% of the patient of scattered generalized dermatitis showed reactivity to parthenium, nickel sulfate and multiple antigens. Conclusions: The most common allergens identified were nickel sulfate, fragrance mix and parthenium. Since, there is no well defined contact allergen in the Nepalese community, so patch test kits developed elsewhere might not have been beneficial and calls for need of large scale investigation to identify the local allergens. [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 Cross-reactions and co-sensitizations are of great importance in understanding contact allergy and exposure sources. Objectives To investigate common cross-reactions and co-sensitizations in p -phenylenediamine ( PPD)-sensitized and toluene-2,5-diamine ( TDA)-sensitized individuals. Methods From our patch test population, 8036 patients patch tested with the European baseline series were extracted. Readings had to be performed at least on day 3 according to ICDRG guidelines. Results Two hundred and fifty-one patients were sensitized to PPD and/or TDA; 231 patients were sensitized to PPD, and 109 to TDA. Significant differences were observed regarding the strengths of patch test reactions to PPD and number of cross-reactions. For TDA, a difference was found between all reaction strengths, except between + and ++ strengths. PPD-sensitized individuals were more likely to be sensitized to carba mix, cobalt chloride, colophonium, p- tert-butyl phenolformaldehyde resin, paraben mix, and methylisothiazolinone. TDA-sensitized individuals were more often sensitized to carba mix. Conclusions Cross-reactivity was commonly found among individuals sensitized to PPD or TDA, and was strongly related to the strength of the patch test reaction. Regarding co-sensitizations, a frequently appearing or common exposure source could not be determined. However, modification of the allergen by, for example, the skin microbiota may have caused the formation of molecules that are, for the human immune system, indistinguishable from PPD. [ABSTRACT FROM AUTHOR]

A case study is presented of two male patients, aged 53 years and 58 years, suffering severe dermatitis of the eyelids, lips, and nose along with eczema on the neck. It states both patients worked as laborers in a factory producing polyethylene terephthalate (PET) films after the composition of the powders changed. It mentions patch tests found that N-(4-hydroxyphenyl)benzenesulfonamide (HPBS), an intermediate used in production of PET films, was responsible for the allergic contact dermatitis.

Background Allergic contact dermatitis caused by p-phenylenediamine ( PPD) is common among all age groups and both sexes. Monitoring of prevalence and intensity of sensitization is important. Objective To evaluate contact allergy to PPD in Europe, and to compare reaction intensities in different European regions. Methods Data collected by the European Surveillance System on Contact Allergies ( ESSCA) network between 2002 and 2012 from 12 European countries were analysed regarding prevalence, grading of positive reactions to PPD, and relevance. Results A total of 99 926 PPD-positive patients from 63 departments were included for analysis. The overall (2002-2012) prevalence of PPD sensitization in Europe is ∼4%. Stratified for country, the highest overall standardized prevalence was found in Lithuania, and the lowest in Slovenia. The prevalence of PPD sensitization did not decline over the years. In the southern European countries, higher numbers of strong and extremely strong reactions were registered. The clinical relevance of PPD sensitization varied from half to three-quarters. Conclusion The prevalence of PPD sensitization has not changed over time. Strong and extremely strong patch test reactions are seen more often in the South, probably because of the higher number of PPD-containing hair dye products. [ABSTRACT FROM AUTHOR]

Introduction Allergic contact dermatitis ( ACD) in children appears to be on the increase, and contact sensitization may already begin in infancy. The diagnosis of contact dermatitis requires a careful evaluation of a patient's clinical history, physical examination, and skin testing. Patch testing is the gold standard diagnostic test. Methods Based on consensus, the EAACI Task Force on Allergic Contact Dermatitis in Children produced this document to provide details on clinical aspects, the standardization of patch test methodology, and suggestions for future research in the field. Results We provide a baseline list of test allergens to be tested in children with suspected ACD. Additional tests should be performed only on specific indications. [ABSTRACT FROM AUTHOR]

Allergic contact dermatitis, case report, patch tests, benzoic acid, CAS-No. 10310-32-4, serial dilutions, tribenoside Keywords: allergic contact dermatitis; benzoic acid; case report; CAS-No. 10310-32-4; patch tests; serial dilutions; tribenoside EN allergic contact dermatitis benzoic acid case report CAS-No. 10310-32-4 patch tests serial dilutions tribenoside 718 719 2 11/18/21 20211201 NES 211201 CASE REPORT A 48-year-old female patient presented to our clinic with a 2-week history of erythematous and itchy dermatitis around her anus (Figure 1). GLO:FQV/01dec21:cod13952-fig-0001.jpg PHOTO (COLOR): 1 Positive patch tests reactions to Procto-Glyvenol crème gl Patch tests were performed with the European baseline series complemented with lidocaine 5.0% pet., cetyl alcohol 5.0% pet., benzisothiazolinone 0.1% pet. [Extracted from the article]

Second, in our case report, the patch tests with splint scrapings were positive, but only because the splint had been contaminated with the genuine culprit, the diclofenac gel. Allergic contact dermatitis, case report, diclofenac, patch tests, propylene glycol, retained allergen, topical drug Keywords: allergic contact dermatitis; case report; diclofenac; patch tests; propylene glycol; retained allergen; topical drug EN allergic contact dermatitis case report diclofenac patch tests propylene glycol retained allergen topical drug 475 476 2 09/21/21 20211001 NES 211001 CASE REPORT A 45-year-old woman was referred to our department for the investigation of a localized eczema on the right ankle with secondary extension. [Extracted from the article]

Keywords: allergic contact dermatitis; benzoyl peroxide; case report; cosmetics; facial dermatitis; Glycyrrhiza inflata root extract; herbal extracts; liquorice; natural ingredients; patch tests EN allergic contact dermatitis benzoyl peroxide case report cosmetics facial dermatitis Glycyrrhiza inflata root extract herbal extracts liquorice natural ingredients patch tests 454 455 2 09/21/21 20211001 NES 211001 Plant-derived natural ingredients are frequently used in cosmetics. Further patch tests with their individual ingredients kindly provided by the manufacturers were positive to I Glycyrrhiza inflata i (G I inflata i ) root extract 1% alc. from Eucerin Dermopure Oil Control (++ on D4 and D7) and benzoyl peroxide 2.6% pet. from Epiduo (+ on D2, ++ on D4 and + D7) (Figure 1D-G). Allergic contact dermatitis, case report, Glycyrrhiza inflata root extract, benzoyl peroxide, cosmetics, facial dermatitis, liquorice, herbal extracts, natural ingredients, patch tests. [Extracted from the article]

Background The prevalence of p-phenylenediamine ( PPD) sensitization is 4% in the patch tested population and varies between zero and 1.5% in the general population. Hair dye is a recognised sensitization source. Objectives To define the prevalence rates of PPD sensitization in the general and patch tested populations of The Netherlands, and to gain insights into relationships between patch test strength and exposure sources. Methods Patch test database cases were matched with population-based controls. Analyses were performed based on demographic details, patch test reactions, and potential PPD exposure. Results PPD sensitization occurred in 3.3% of the patch tested population and in 1.3% of the general population. Hairdressers had a 4.4-fold increased chance of being sensitized to PPD ( p = 0.041), and black henna tattoos showed a tendency for a 2.3-fold increased chance of sensitization ( p = 0.081). Weak elicitation reactions were present in hairdressers and consumers. However, cases who had had black henna tattoos showed significantly more (extremely) strong patch test reactions upon elicitation ( p = 0.015). Conclusions The prevalence rates in the patch tested and general population of The Netherlands are comparable with the prevalence rates of other mid- European centres. PPD sensitization is often attributed to hair dye. However, this study shows that subjects sensitized by black henna tattoos present with very severe elicitation reactions, emphasizing the need for more strict policing the prohibition. [ABSTRACT FROM AUTHOR]

Background: Para-phenylenediamine (PPD) is the main allergen causing adverse reactions to hair dyes and a frequent cause of occupational-related skin sensitization among hairdressers and beauticians. The immunologic mechanism of the disease relies on the production of inflammatory cytokines by allergen-specific T cells, while regulatory T cells are thought to down-modulate the allergic response. This study was aimed at investigating the expression of effector or regulatory cytokines in exposed subjects in order to verify whether different cytokine profiles might predict distinct clinical outcomes. Peripheral blood mononuclear cells (PBMC) from 21 subjects occupationally exposed or not (10) to PPD were kept in short term cultures in the presence of optimized concentrations of NiSO4 × 6H2O or PPD. The production of IFN-γ and IL-10 elicited by antigens were analyzed by the ELISpot assay. Results:The presence of IFN-γ responses toward PPD was significantly correlated with a positive patch test (P = 0.002) and allergic symptoms, while IL10 responses were invariably found in PPD-exposed but clinically asymptomatic subjects with negative patch testing. We found concordance between the different cytokine profiles and patch test results. No false-positive results were found for the different cytokine profiles induced by PPD, resulting in 100% specificity. The sensitivity of the test was 87.5% (95% CI 65.9-100.0) with an overall test accuracy of 93.3%. Although larger prospective-retrospective studies are necessary to validate the predictive potential of the test, the negative and positive predicted values for PPD in this study were NPV = 87.5% and PPV = 100%, respectively. Conclusions: These data indicate that distinct cytokine profiles are associated with different clinical manifestations. The test, which is based on a simple and rapid profiling of cytokine responses by T lymphocytes against allergens, has proven to be a promising laboratory tool, useful for both the identification of previous contact with allergens and the etiologic diagnosis of contact allergies as well as capable of predicting the clinical outcome (development of an allergic or tolerant response). [ABSTRACT FROM AUTHOR]

Exposure to hair dye is the most frequent route of sensitisation to para-phenylenediamine ( PPD), a common contact allergen. International studies have examined the profile of PPD, but Australian-sourced information is lacking. Patients are often dissatisfied with advice to stop dyeing their hair. This study examines patients' characteristics, patch test results and outcomes of PPD allergy from a single Australian centre, through a retrospective analysis of patch test data from 2006 to 2013 at the Liverpool Hospital Dermatology Department. It reviews the science of hair dye allergy, examines alternative hair dyes and investigates strategies for hair dyeing. Of 584 patients, 11 were allergic to PPD. Our PPD allergy prevalence rate of 2% is at the lower end of international reported rates. About half these patients also react to para-toluenediamine ( PTD). Affected patients experience a significant lifestyle disturbance. In all, 78% tried alternative hair dyes after the patch test diagnosis and more than half continued to dye their hair. Alternative non- PPD hair dyes are available but the marketplace can be confusing. Although some patients are able to tolerate alternative hair dyes, caution is needed as the risk of developing an allergy to other hair dye ingredients, especially PTD, is high. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 69-year old female who was refereed with eczematous dermatitis affecting the temporal portion of forehead and cheeks. It states that she reported application of honey for cosmetic purpose. It mentions that the reaction to Myroxylon perierae resin was considered to be cross-reaction with propolis.

Allergic contact dermatitis, spongiosis, patch tests, red ink, tattoo Keywords: allergic contact dermatitis; spongiosis; patch tests; red ink; tattoo EN allergic contact dermatitis spongiosis patch tests red ink tattoo 453 454 2 05/06/21 20210601 NES 210601 Complications with red tattoo ink (RTI) can be cutaneous or systemic. [Extracted from the article]

The article presents several case studies of male with an allergic contact dermatitis through aftershave creams. Topics discussed include presence of Glycyrrhiza inflata in the aftershave act as an allergen for facial dermatitis; performance of patch test with different aftershaves along with cosmetics for assessment of their allergic reactions; and analysis of an anti-inflammatory effect with usage of liquorice in cosmetics.

The article presents a case study of a 31-year-old atopic male with eczematous dermatitis in both hands. Topics include the hand disease which was caused by benzisothiazolinone in printing ink and liquid soap; the reported cases of skin diseases that are mostly caused by direct skin contact and the patch test using the European baseline, oil and acrylates series.

Many strong and extreme sensitizing chemicals, such as para-phenylenediamine (PPD), toluene-2,5-diamine (TDA) and other aromatic amines or cross-reacting substances, are ingredients in hair dye products. The chemistry of hair dyeing and the immunological reactions to the potent sensitizing hair dye components are complex and have not been fully clarified up until now. Recently 2-methoxymethyl-p-phenylenediamine (ME-PPD), a PPD derivate with moderate skin-sensitizing properties, was developed. Although developed for the prevention of sensitization, ME-PPD appears to be tolerated in some PPD/TDA-allergic individuals.

Introduction: The aim of the study was to provide current data on the incidence of allergy to various contact allergens in patients with allergic contact eczema and the analysis of selected socio-demographic data of the patients. Material and methods: The study included 1532 patients (1010 women and 522 men) treated for allergic contact dermatitis at the Department of Dermatology and Venereology and at the Dermatology Outpatient Clinic in Bialystok in 2007-2011. The assessment of selected demographic data and skin lesions was based on the MOAHFLA index, while the results of patch tests were analyzed with modified Baseline European Series consisting of 31 allergens. Results: In the group of patients with eczema, 34. 1% were men, and 55% of all respondents were people over 40 years of age. The occupational character of skin lesions was found in 22. 5%. Most frequently (38. 9%) skin lesions were localized on the hands, rarely involved legs (3. 98%). Atopic dermatitis was diagnosed in 4. 5% of patients. The ten most frequent allergens were: nickel sulfate (24%), cobalt chloride (15. 3%), fragrance mix (8. 25%), potassium dichromate (6. 8%), balsam of Peru (5. 5%), neomycin (4. 42%), paraphenylenediamine (3. 85%), Quatermium-15 (2. 1%), detreomycin (1. 83%) and budesonide (1. 44% of tested patients). Conclusions: Frequent allergy to detreomycin indicates the need of patch testing for this allergen of all examined patients with allergic contact dermatitis. The increased frequency of the nickel allergy is a worrying problem and indicates the need for education about the risk factors for nickel allergy development and the implementation of appropriate legal regulations. [ABSTRACT FROM AUTHOR]

Contact dermatitis from Agave Americana Agave Americana. Keywords: Agave americana; allergic contact dermatitis; case report; itching; occupational; patch tests EN Agave americana allergic contact dermatitis case report itching occupational patch tests 196 197 2 02/25/21 20210301 NES 210301 A number of cases of irritant contact dermatitis caused by I Agave americana i have been reported, with various presentations, but very few of these1-3 have been investigated by patch testing of patient and controls. Irritant contact dermatitis from Agave Americana incorrect use of sap as "hair restorer". [Extracted from the article]

Abstract An interactive module with a realistic patient case, as well as questions and answers throughout the module, is better at engaging participants and hence contributes more to their learning. This PowerPoint module presents an important overview of contact dermatitis through a realistic clinical patient case, which can assist medical students, interns, residents, and fellows in gaining an understanding of this subspecialty. The module elucidates the epidemiology, pathogenesis, clinical presentation, diagnosis, and treatment of allergic contact dermatitis, comparing it to irritant contact dermatitis. Participants are engaged during the patient case by means of interactive questions and answers throughout the module. Users should allot around 45–60 minutes of their time to completing this module. If the module is used for a lecture or group session, the presenter/session leader should be knowledgeable in the subspecialty of contact dermatitis.

Allergic Contact Dermatitis ( ACD) in children is increasing. Sensitization to contact allergens can start in early infancy. The epidermal barrier is crucial for the development of sensitization and elicitation of ACD. Factors that may influence the onset of sensitization in children are atopic dermatitis, skin barrier defects and intense or repetitive contact with allergens. Topical treatment of ACD is associated with cutaneous sensitization, although the prevalence is not high. ACD because of haptens in shoes or shin guards should be considered in cases of persistent foot eruptions or sharply defined dermatitis on the lower legs. Clinical polymorphism of contact dermatitis to clothing may cause difficulties in diagnosing textile dermatitis. Toys are another potentially source of hapten exposure in children, especially from toy-cosmetic products such as perfumes, lipstick and eye shadow. The most frequent contact allergens in children are metals, fragrances, preservatives, neomycin, rubber chemicals and more recently also colourings. It is very important to remember that ACD in young children is not rare, and should always be considered when children with recalcitrant eczema are encountered. Children should be patch-tested with a selection of allergens having the highest proportion of positive, relevant patch test reactions. The allergen exposure pattern differs between age groups and adolescents may also be exposed to occupational allergens. The purpose of this review is to alert the paediatrician and dermatologist of the frequency of ACD in young children and of the importance of performing patch tests in every case of chronic recurrent or therapy-resistant eczema in children. [ABSTRACT FROM AUTHOR]

Background In 1995, we established a cohort of 1501 unselected eighth-grade schoolchildren to investigate the course of nickel allergy into adult life. Objectives To follow the course of nickel allergy and clinically relevant nickel dermatitis over 15 years from adolescence to adulthood, and the effect of ear piercing, atopic dermatitis and degree of nickel patch test reactivity. Methods One thousand two hundred and six young adults from the cohort were asked to complete a questionnaire and participate in a clinical examination including patch testing with TRUE Test® including a nickel dilution series. Results The questionnaire was answered by 899 (74.6%), and 442 (36.7%) had patch tests performed. The point prevalence of nickel allergy was 11.8% (clinical relevance 80.8%). The 15-year incidence rate was 6.7%. Most new sensitizations were clinically relevant with strong reactions, and many participants reacted to low concentrations. Only a few positive reactions were lost. Nickel allergy was more common among women with childhood atopic dermatitis, whereas no association with ear piercing was found. However, there was a significantly higher prevalence of nickel allergy among women ear pierced before implementation of the nickel regulation in Denmark. Conclusion This follow-up study in young adults 15 years after leaving primary school showed a high prevalence and a high incidence rate of nickel allergy, despite the nickel regulation. Most reactions from childhood could be reproduced and were clinically relevant. In women, childhood atopic dermatitis was associated with nickel allergy in adulthood, whereas only ear piercing before the Danish nickel regulation was associated with adult nickel allergy. [ABSTRACT FROM AUTHOR]

The correct selection of vehicles for patch testing is crucial in evaluating suspected allergic contact dermatitis. We reviewed literature by searching Pubmed and Embase for the years 1971-2011 utilizing the subjects 'vehicle,' 'allergic contact dermatitis' and 'patch test' for advances in knowledge of vehicles.' A universal optimal vehicle more efficient than petrolatum remains undiscovered. Literature provides research supporting alternate vehicles for specific allergens and insights on vehicle characteristics, such as influence on bioavailability of chemicals and subsequent percutaneous absorption or interaction with allergens. These findings should accelerate our ability to define, and thus determine, the optimum vehicle(s). [ABSTRACT FROM AUTHOR]

The article discusses the findings of a study which evaluated the reproducibility of patients' patch test results for nickel, chromate, and cobalt from 1992-2014. It notes that 819 patients were patch tested twice to determine if they were positive for allergic contact dermatitis (ACD) when exposed to nickel, chromate, or cobalt. The results confirmed that nickel had a reproducibility rate of 67 percent, while chromate and cobalt were rated at 62 and 61 percent, respectively.

Background: Propolis is widely used in ‘natural’ cosmetics, remedies, and over-the-counter products. The incidence of propolis allergy is increasing, and cross-reaction with fragrance mix I (FMII), colophonium, and Myroxylon pereirae can occur. Objectives: To find out the prevalence and clinical relevance of positive patch tests to propolis and assess cross-reactions with Myroxylon pereirae, colophonium, FMI, and beeswax. Methods: Two thousand eight hundred and twenty-eight subjects in 10 UK centres were patch tested with propolis and beeswax. Generic data were acquired from British Contact Dermatology Society (BCDS) database and further relevant information was requested by survey of participating centres. Results: The prevalence of propolis allergy was 1.9% (55/2828). Out of these 55 subjects, only 4 (7.2%) were allergic to beeswax, 22 (40%) to Myroxylon pereirae, 15 (27.2%) to colophonium, and 6 (10.9%) to FMI. Additional data for 41 propolis allergic subjects were collected by questionnaire. Hands were the most common sites of involvement, and cosmetics were the most common source of contact. Eight out of 12 subjects reported improvement in eczema following avoidance of propolis. Conclusions: Propolis is an important allergen of increasing frequency and its inclusion in BCDS baseline series is appropriate. Cross-sensitivity to beeswax is rare. [ABSTRACT FROM AUTHOR]

Background: Cobalt, nickel, and chromium are important skin sensitizers. However, knowledge about cobalt exposure and causes of cobalt sensitization is limited. Objectives: To study release of cobalt, nickel, and chromium from some cobalt-containing hard metal alloys and to test reactivity to the materials in cobalt-sensitized patients. Methods: Discs suitable for patch testing were made of some hard metal alloys. Cobalt, nickel, and chromium release from the materials was determined by immersion in artificial sweat (2 min, 1 hr, 1 day, and 1 week). Patch test reactivity to the discs and to serial dilutions of cobalt and nickel was assessed in previously patch-tested dermatitis patients (19 cobalt positive and 18 cobalt-negative controls). Results: All discs released cobalt, nickel, and chromium. Some discs released large amounts of cobalt (highest concentration: 290 μg/cm2/week). Seven discs elicited three or more positive test reactions. Conclusions: The concentration of released cobalt was high enough to elicit allergic contact dermatitis in cobalt-sensitized patients. As the materials in the discs are used in wear parts of hard metal tools, individuals with contact allergy to cobalt may develop hand eczema when handling such materials. [ABSTRACT FROM AUTHOR]

Background There are few studies comparing the incidence of allergic contact dermatitis among different racial groups living within the same community. Objectives The objectives of this study were to compare white European patients with Fitzpatrick's skin phototypes (FSP) I to IV and patients from Indian, Pakistan and Bangladesh with FSP V living within the same community. Referral rates for patch testing, incidence of contact allergies and differences in contact allergens found were assessed. Method All patients referred to the Contact Dermatitis Unit at Dewsbury and District Hospital between 2004 and 2006, inclusive, were included in the study. All patients were patch tested to the British Contact Dermatitis Society standard series, plus other series according to their clinical history, occupational history and clinical findings. Results Four hundred and thirty-five consecutive patients from the patch testing clinic were included in the study. Fewer patients from the Indian subcontinent underwent patch testing (11.5%) than would have been expected for the size of the local population (18%). Fewer patients from the Indian subcontinent (44%) had one or more positive reactions compared with the white European patients (56%). No significant differences in the contact allergens responsible were detected between the two racial groups. Conclusion There is a lower incidence of positive patch test results among patients with racial origins from the Indian subcontinent compared with white Europeans. This modest difference could be explained by a lower average age within the study population, and increased or differing exposure to contact allergens rather than demonstration of variability in the susceptibility to develop contact sensitivities following equal exposure. [ABSTRACT FROM AUTHOR]

Background The European Surveillance System on Contact Allergies (ESSCA) began in 2001 as project funded by a European Union grant to monitor and evaluate contact sensitization (CS) based on clinical data collected by participating European dermatology departments. Objectives ESSCA aims to detect trends in CS in an international patch test population, monitoring the frequency of CS to (standard series) allergens, evaluating the effectiveness of intervention (e.g. governmental regulations) and improving standardization of the patch test procedure on an international level. Methods In 2004, 31 ESSCA dermatology departments in 11 European countries collected patch test results and medical histories of patients tested with the European Standard Series (ESS) or a local standard allergen series using the multilingual Winalldat/ESSCA database, the German Winalldat/Information Network of Departments of Dermatology (IVDK) database or a locally created database including the items of the ESSCA ‘minimal data set’. Data were sent to the ESSCA data centre where they were imported, pooled, examined for quality and subsequently analysed. Results The departments patch tested 11 643 patients with a standard series, and 44% of the patients tested positive to one or more substances of the ESS. Nickel sulphate, the fragrance mix, Myroxylon pereirae resin, cobalt chloride, potassium dichromate, methyldibromoglutaronitrile and paraphenylenediamine are (still) the most important allergens detected. Several additional substances tested on consecutive patients in some clinics were also examined. Among these allergens, propolis and Compositae mix had a relatively high CS prevalence. Conclusions The expanding ESSCA network continues to provide up-to-date information regarding the pattern of CS diagnosed in participating departments across Europe. [ABSTRACT FROM AUTHOR]