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

Contact dermatitis is a common disease that is caused by repeated skin contact with contact allergens or irritants, resulting in allergic contact dermatitis (ACD) and/or irritant contact dermatitis. Attempts have been made to identify biomarkers to distinguish irritant and allergic patch test reactions, which could aid diagnosis. Some promising candidates have recently been identified, but verification and validation in clinical cases still need to be done. New causes of ACD are constantly being recognized. In this review, 10 new contact allergens from recent years, several relating to anti-aging products, have been identified. Frequent allergens causing considerable morbidity in the population, such as the preservative methylisothiazolinone, have been regulated in the European Union. A significant drop in the number of cases has been seen, whereas high rates are still occurring in other areas such as North America. Other frequent causes are fragrance allergens, especially the widely used terpenes and acrylates found in medical devices for control of diabetes. These represent unsolved problems. Recent advances in immunology have opened the way for a better understanding of the complexity of contact dermatitis, especially ACD—a disease that may be more heterogenous that previous understood, with several subtypes. With the rapidly evolving molecular understanding of ACD, the potential for development of new drugs for personalized treatment of contact dermatitis is considerable. [ABSTRACT FROM AUTHOR]

Artificial nail modelling systems (ANMS), encompassing artificial nails and long-lasting nail polish, are sources of acrylate exposure in beauticians and users of ANMS. Hairdressers' exposure to ANMS from self-use and occupational exposure is currently unknown. In 2020 a questionnaire was sent to all hairdressers graduating during 2008 to 2018 in Denmark (n = 4,830). Selfuse of ANMS was reported by 87.6% of respondents (1,251/1,428), and application of ANMS to others was reported by 22.1% (316/1,428). Of these, application to others was performed in a salon by 37.1% (109/294), privately by 51.0% (150/294) and in both settings by 11.9% (35/294). Compliance with glove use was seen in 23.0% (67/291) among those applying ANMS to others. Among hairdressers exposed to ANMS, 4.3% (52/1,218) reported ANMS-related hand eczema. Being a trained beautician (adjusted odds ratio 3.26, 95% confidence interval 1.06-9.99) and having had a positive patch-test to acrylates (adjusted odds ratio 7.70, 95% confidence interval 1.44-41.13) were associated with ANMS-related hand dermatitis. In conclusion, hairdressers have a high prevalence of exposure to ANMS and ANMS-related hand dermatitis. Compliance with glove use when applying ANMS to others is poor. Patch-testing with acrylates is valuable in the diagnostic work-up of hand eczema in hairdressers. [ABSTRACT FROM AUTHOR]

Background: In March 2014, the European Commission issued a new regulation restricting the content of hexavalent chromium (Cr) in leather to no more than 3 mg/kg. We previously performed a questionnaire study in January 2014 to characterize our patients with Cr contact allergy prior to regulatory intervention. Objectives: To assess whether clinical characteristics, self‐reported sources of Cr exposure, and burden of disease changed in patients with Cr allergy over time. Methods: A questionnaire study was performed among 172 adult dermatitis patients with Cr allergy and 587 age‐ and sex‐matched dermatitis patients without Cr allergy. A questionnaire was sent to all dermatitis patients patch tested from 2003 to 2018 in August 2019. Results: The overall response rate was 61.2% (759/1241). Patients with Cr allergy were still more commonly affected by current foot dermatitis (odds ratio [OR] 3.82, 95% confidence interval [CI] 2.07‐7.08) and hand dermatitis (OR 1.98, 95% CI 1.13‐3.49) compared with controls diagnosed during 2013 to 2018. The proportion of patients with Cr allergy reporting dermatitis caused by leather exposure did not change during 2003 to 2012 vs 2013 to 2018 (71.0% vs 66.2%, P =.5). Furthermore, estimates on occupational performance and disease severity (eg, current dermatitis), number of anatomical locations with dermatitis, worst‐case dermatitis, and effect on work were similar in patients with Cr allergy for 2003 to 2012 vs 2013 to 2018. Conclusion: No immediate sign of improvement was found in patients with Cr allergy concerning severity of disease and dermatitis from leather exposures 5 years after adoption of the regulation against hexavalent Cr in leather. The regulation may have to be revised for better protection of those already sensitized. [ABSTRACT FROM AUTHOR]

Background: Patch testing is the gold standard for identifying culprit allergens in allergic contact dermatitis; however, it is laborious and positive reactions are difficult to quantitate. Development of complementary in vitro tests is, therefore, of great importance. Objectives: This study aimed to improve the in vitro lymphocyte proliferation test (LPT) to detect allergic responses to nickel (Ni), cobalt (Co), and chromium (Cr). Methods: Twenty‐one metal allergic patients with a positive patch test to Ni (n=16), Co (n=8), and Cr (n=3) and 13 controls were included. All were tested by a flow cytometric LPT. Results: Metal‐reactive cells were identified as T helper (Th) cells with high expression of the memory marker CD45RO. Skin‐homing (cutaneous lymphocyte‐associated antigen positive [CLA+]) Ni‐reactive memory Th (Thmemhi) cells identified individuals with a positive patch test for Ni with 100% sensitivity (95% confidence interval [CI] 81%‐100%) and 92% specificity (95% CI 67%‐100%). Moreover, Co‐specific Thmemhi cells expressing CCR6 identified patients with a positive patch test for Co with 63% sensitivity (95% CI 31%‐86%) and 100% specificity (95% CI 77%‐100%). In Cr allergic individuals, Cr‐reactive Thmemhi cells tended to increased CLA and CCR6 expression. Conclusion: Metal‐reactive Th cells with high expression of CD45RO and coexpression of CLA and CCR6 improved the LPT, making it an attractive supplement to the patch test. [ABSTRACT FROM AUTHOR]

Background: Aluminum contact allergy is mostly seen in children with vaccination granulomas, following immunization with aluminum‐adsorbed childhood vaccines. Objectives: To characterize a cohort of children with vaccination granulomas and aluminum allergy concerning early life conditions, exacerbating factors, avoidance behavior, treatments, and potential impact on quality of life. Methods: A questionnaire study was conducted among 177 children aged 0 to 15 years with vaccination granulomas and aluminum allergy, and a reference group of 61 children aged 3 to 14 years with various types of dermatitis undergoing patch testing. Results: All children in the granuloma group were reportedly affected by itch. Infection exacerbated the itch in 59%. Other worsening factors were eating tin‐foiled/canned food (31%) and use of aluminum‐containing sunscreen (46%). Many parents took precautions to avoid aluminum exposure. Children with granulomas were more likely to be nonadherent to the National Vaccination Program than the reference group (27% vs 2%, P <.001). Parents in the granuloma group reported a decreased life quality for both parents and children compared with the reference group. Conclusions: Itching vaccination granulomas and aluminum allergy have a considerable negative impact on affected children and their families, causing avoidance behavior, reduced adherence to vaccination programs, and a negative effect on the overall life quality. [ABSTRACT FROM AUTHOR]

Background: Exposure to metalworking fluids (MWFs) is a well‐known cause of occupational contact dermatitis. Objectives: We aimed to (1) determine the amount of nickel, chromium, and cobalt in large samples of used and unused MWFs collected from metalworking plants in Denmark, and (2) evaluate a handheld x‐ray fluorescence (XRF) device as a screening instrument for metals in MWFs. Methods: A handheld XRF device was used to screen for metals in MWFs. All samples were also analyzed for concentrations of nickel, chromium, and cobalt using graphite furnace atomic absorption spectroscopy (GFAAS). Results: GFAAS analysis showed that 13 of 80 samples (16.3%) contained >1 mg/kg (ppm) nickel (range: 6.4‐17.7 mg/kg), 3 of 80 (3.8%) contained >1 (range: 1.4‐3.1) mg/kg chromium, and 1 of 80 (1.3%) contained 1.3 mg/kg cobalt. XRF‐screening detected nickel in eight samples (range: 2.5‐15.5 mg/kg), but only one sample with 3.0 (±0.5) mg/kg was found subsequently to contain 9.9 (0.02) mg/kg nickel by GFAAS. Although no chromium was found by XRF analysis, cobalt was found in two samples with 6 (±1.5) mg/kg and 5 (±1.5) mg/kg, subsequently found to contain 0.1 (±0.01) mg/kg and 0.08 (±0.01) mg/kg by GFAAS. Similar concentrations of nickel were found in used (N = 6, range: 6.4‐17.7 mg/kg) and unused MWFs (N = 7, range: 9.1‐17.3 mg/kg). Conclusion: Considerable levels of nickel, chromium, and cobalt were found in some used and unused MWFs indicating that these might represent a source of metal allergy. The XRF device is a poor screening test for these metals in MWFs. [ABSTRACT FROM AUTHOR]

Background: Nickel allergy and dermatitis have been associated with filaggrin gene mutations in epidemiological studies, but the mechanisms mediating these associations are unknown. Objectives: To investigate whether filaggrin‐deficient flaky tail (ft/ft) mice show increased immune reactivity to nickel and elucidate the mechanisms mediating this. Methods: The immune responses to nickel, 2,4‐dinitrofluorobenzene (DNFB), cinnamal and p‐phenylenediamine were assessed in ft/ft and wild‐type (WT) mice. The amounts of nickel in the skin of ft/ft and WT mice were determined 20 hours after nickel exposure. The effect of blocking either the interleukin (IL)‐17A pathway or the IL‐1 pathway on the response to nickel in ft/ft mice was evaluated. Results: Increased responsiveness to nickel, DNFB and cinnamal was observed in ft/ft mice as compared with controls. A reduced amount of nickel was found in the skin of ft/ft mice as compared with WT mice, suggesting increased nickel absorption by the skin of ft/ft mice. Blocking either the IL‐17A pathway or the IL‐1 pathway reduced nickel responsiveness in ft/ft mice. Conclusions: These findings suggest that the increased nickel responsiveness associated with epidermal filaggrin deficiency is mediated by a combination of increased nickel penetration and the steady‐state inflammation found in the skin of filaggrin‐deficient mice. [ABSTRACT FROM AUTHOR]

Background: Contact allergy is common in children, but may be underdiagnosed. Importantly, the clinical relevance of specific allergies is subject to constant change, and it is therefore important to continuously monitor the trends and changes of contact allergies in the paediatric population. Objectives: To identify possible changes in contact allergy and allergic contact dermatitis among Danish children referred for patch testing. Methods: A retrospective study was performed based on patch test data from the Danish National Database of Contact allergy. The current data were compared with previously published data on Danish children referred for patch testing. Results: Between 2012 and 2016, 1573 children and adolescents were patch tested. Overall, 385 (24.5%) had at least 1 positive patch test reaction. The overall prevalence was similar in boys and girls, across age groups, and in patients with and without atopic dermatitis. Statistically significant increases in contact allergy to fragrances and isothiazoliones were seen, whereas a decrease in nickel allergy was found. Conclusion: Allergic contact dermatitis continues to be a common disease in children, and is even significantly increasing for some allergens. [ABSTRACT FROM AUTHOR]

Keywords: allergic contact dermatitis; biologic; case report; dupilumab; sesquiterpene lactones; treatment EN allergic contact dermatitis biologic case report dupilumab sesquiterpene lactones treatment 137 139 3 07/27/20 20200801 NES 200801 Sesquiterpene lactones (SLs) are a group of allergenic secondary plant metabolites represented in about 10% of all flowers.1,2 SLs are abundant in the sunflower family, but also exist in vegetables, cosmetics, and herbal medicine.3 Airborne spread of SLs typically causes allergic contact dermatitis in exposed skin areas including face, V-line of the neck, hands, and forearms, and with a distinct seasonal variation in terms of worsening in the plant-growing season.4 Affected patients develop severe and widespread, often treatment-resistant eczema that can severely affect their daily lives with the need for systemic treatment.2 Even though allergic contact dermatitis is predominately a T SB H sb 1-cell mediated process, certain allergens activate the T SB H sb 2-pathway.5 Dupilumab, a monoclonal antibody, binds to the interleukin (IL)-4 receptor alpha and inhibits IL-4 and IL-13 signaling and thus the T SB H sb 2-mediated pathway. Dupilumab treatment was paused during the winter and the future plan is to resume treatment in spring. [Extracted from the article]

This study examined trends in prevalence of HEMA allergy as well as the characteristics of patients with contact allergy to HEMA. Because there was only one male patient with contact allergy to HEMA during the study period, we studied all female patients who were patch tested with HEMA between January 1, 2017 and July 1, 2019. GLO:FQV/01apr20:cod13439-fig-0001.jpg PHOTO (COLOR): A history of using UV nail polish in patch test HEMA-positive and HEMA-negative patients. [Extracted from the article]

Exposure analysis using X-ray fluorescence device and a cobalt spot test in four patients with cobalt allergy We showed that potential sources of exposure to cobalt could be identified by use of XRF and a cobalt spot test, with leather being the most common item. We found over 10 wt% cobalt in a cobalt drill along with a positive result in the cobalt spot test of the drill (Figure). Hard metal alloys constitute the primary cause of occupational allergic contact dermatitis to cobalt.[5] Consumer exposure to cobalt has been described as well, including jewelry and more recently leather objects. [Extracted from the article]

Abstract: Skin diseases represent one of the most common work‐related diseases and may have a detrimental effect on social, personal and occupational aspects of life. Contact dermatitis (CD), which comprises predominately irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD), accounts for vast majority of occupational skin diseases, especially in occupations associated with frequent skin contact with irritants and contact allergens. Although ICD and ACD have similar clinical manifestation, their pathophysiology and the role of the skin barrier are different. In ICD, perturbation of the skin barrier is the primary event which sets into motion diverse metabolic processes and triggers activation of innate immunity without the involvement of adaptive immune system. In ACD, a type IV hypersensitivity reaction induced by contact allergens, the skin barrier impairment may evoke innate signalling pathways during the sensitization phase required for the activation of T‐cell adaptive response. Thus, skin barrier impairment may increase the risk of ICD or ACD not only because of enhanced permeability and ingress of irritants and allergens but also by the generation of innate immune signal needed for the induction of allergic response. Hence, an efficient way to prevent CD is to avoid skin barrier damage in the workplace. This review focuses on the skin barrier, how it is affected by skin irritants and how its impairment contributes to the development of ICD and ACD. [ABSTRACT FROM AUTHOR]

The article focuses on a study which investigate consumer cobalt exposure from paints sold in the U.S. by using cobalt indicator solution (CIS) and X-ray fluorescence spectroscopy (XRF). Topics discussed include occupational exposure to cobalt in paints, inks and dyes in industrial workers and painters, relevance of contemporary consumer cobalt exposure from paints and consumer allergic contact dermatitis caused by cobalt from paints.

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]

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]

A case study is presented for a 24-year-old male patient with acute dermatitis. It states he was a marine engineer on a container ship who developed severe oozing dermatitis on the forearms, dorsa of the hands, and thighs after he was exposed to warm oil from a centrifuge he was cleaning. It mentions that clinical presentation and patch testing results gave a suspicion of cobalt contamination and suggests the machine oils acted as a surfactant to allow the skin absorption of cobalt contaminants.

Background In view of the current and unprecedented increase in contact allergy to methylisothiazolinone ( MI), we characterized and evaluated two recent epidemics of contact allergy to preservatives used in cosmetic products to address failures in risk assessment and risk management. Objective To evaluate temporal trends of preservative contact allergy. Methods The study population included consecutive patch tested eczema patients seen at a university hospital between 1985 and 2013. A total of 23 138 patients were investigated for a contact allergy. Results The overall prevalence of contact allergy to at least one preservative increased significantly over the study period, from 6.7% in 1985 to 11.8% in 2013 ( p < 0.001). Importantly, the preservatives methyldibromo glutaronitrile and MI rapidly resulted in high sensitization prevalence rates, which reached epidemic proportions. Although the proportion of patients with current clinical disease attributable to methyldibromo glutaronitrile contact allergy decreased significantly following the ban on its use in cosmetic products ( p < 0.001), the sudden and high proportion of current sensitization to MI requires immediate attention ( p < 0.001). Conclusions The introduction of new preservatives in Europe with inadequate pre-market risk assessment has rapidly increased the overall burden of cutaneous disease caused by preservatives. We suggest that the cosmetic industry has a responsibility to react faster and replace troublesome preservatives when a preservative contact allergy epidemic is recognized, but the European Commission has the ultimate responsibility for failures in risk management after new, major sensitizing preservatives are introduced onto the market. [ABSTRACT FROM AUTHOR]

Background Blue-collar workers have a high risk of occupational contact dermatitis, but epidemiological studies are scarce. Objectives To investigate allergic contact dermatitis in blue-collar workers with dermatitis registered by the Danish Contact Dermatitis Group. Methods A retrospective analysis of patch test data from 1471 blue-collar workers and 1471 matched controls tested between 2003 and 2012 was performed. A logistic regression was used to test for associations. Results The blue-collar workers often had occupational hand dermatitis ( p < 0.001). Atopic dermatitis was less commonly observed among blue-collar workers (19.6%) than among controls (23.9%) ( p = 0.005). Allergens with a statistically significant association with the occupational group of blue-collar workers were epoxy resins, methyldibromo glutaronitrile, 2-bromo-2-nitro-1,3-propanediol, potassium dichromate, and methylchloroisothiazolinone ( MCI)/methylisothiazolinone ( MI). The following occupations were additionally identified as risk factors for contact sensitization to MCI/ MI and MI, epoxy resins, and potassium dichromate, respectively: painting, construction work, and tile setting/terrazzo work. Conclusion Contact allergy is a major problem among blue-collar workers. The data indicate a healthy worker effect among blue-collar workers diagnosed with dermatitis, as blue-collar workers were diagnosed significantly less often with atopic dermatitis than were controls. [ABSTRACT FROM AUTHOR]

The article presents case studies of two patients a non-atopic 12-year-old boy and non-atopic 70-year-old man, presented with a history of contact dermatitis. Topics discussed include observation of positive test results with cobalt chloride and from piece of leather, instructions for not using cushions and treated with topical betamethasone valerate and clearing of dermatitis after a follow-up 4months and stopped use of topical corticosteroids.

Background Hair dye products constitute an important source of allergen exposure, and contribute importantly to allergic contact dermatitis in consumers and hairdressers. Objectives To evaluate the presence of potent contact sensitizers in oxidative hair dye products intended for home use on the US market. Methods Ingredient labels of 107 hair dyes from 10 major brands were examined and used to assess the prevalence of hair dye substances known to be potent contact sensitizers. Results One hundred and six of 107 (99%) products contained at least one potent sensitizer, and the average product contained six (range 0-11). p-Phenylenediamine ( PPD) was found in 83 products (78%), but resorcinol (89%), m-aminophenol (75%), p-aminophenol (60%) and toluene-2,5-diamine (21%) were also frequently identified. Conclusions Potent contact sensitizers were almost universally included in the hair dyes investigated in the United States. Although PPD is a common allergen, resorcinol and m-aminophenol were found more frequently. In total, 30 potent sensitizers were found. Clinicians should consider other allergens in addition to PPD when evaluating patients with suspected hair dye allergy. [ABSTRACT FROM AUTHOR]

Background Occupational contact dermatitis among hairdressers is frequent, owing to daily exposure to irritants and allergens. Objectives To identify sensitization to the most common allergens associated with the occupation of hairdressing. Methods Patch test results of 399 hairdressers and 1995 matched controls with contact dermatitis, registered by the Danish Contact Dermatitis Group between January 2002 and December 2011, were analysed. All patients were patch tested with the European baseline series, and hairdressers were additionally tested with the hairdressing series. Results Occupational contact dermatitis ( p < 0.001) and hand eczema ( p < 0.001) were observed significantly more often among hairdressers than among controls. Atopic dermatitis was less commonly observed among hairdressers (21.3%) than among controls (29.4%) ( p < 0.01). Allergens from the European baseline series with a statistically significant association with the occupation of hairdressing were p-phenylenediamine, thiuram mix, and benzocaine. Frequent sensitizers from the hairdressing series were ammonium persulfate, toluene-2,5-diamine, 3-aminophenol, and 4-aminophenol. Cysteamine hydrochloride and chloroacetamide emerged as new sensitizers. Conclusions These results indicate a healthy worker effect among hairdressers diagnosed with eczema. Ammonium persulfate and p-phenylenediamine remain frequent sensitizers in hairdressers with contact dermatitis. Cysteamine hydrochloride and chloroacetamide should be included in future surveillance studies. [ABSTRACT FROM AUTHOR]

Background. Protein contact dermatitis is a frequent disorder among hand eczema patients who have occupational food contact. Knowledge about the consequences of having protein contact dermatitis is lacking. Objectives. To investigate the consequences of having occupational skin disease on the hands resulting from food handling, with a focus on protein contact dermatitis. Material and methods. One hundred and seventy-eight patients who were identified as having skin disease related to occupational food exposure and who answered a questionnaire concerning the consequences of their skin disease were included in the study. The patients were consecutively examined at Gentofte Hospital, Denmark between 2001 and 2010. Results. Seventy-five per cent of patients with protein contact dermatitis had to wear gloves at work, and 62.5% reported sick leave lasting for >3 weeks, as compared with 60.2% and 30%, respectively, of the patients with other occupational food-related hand dermatoses ( p = 0.02). Sixty-two per cent and 43%, respectively, had to change job because of skin problems ( p = 0.02). Atopic dermatitis was equally common in the two groups. Conclusion. We found that the patients with protein contact dermatitis experienced more severe and frequent consequences than patients with other food-related hand dermatoses. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 76-year-old man with facial allergic contact dermatitis induced by fragrance chemicals during electric shaving. The patient was experiencing impegnitized dermatitis in the beard region of his face three weeks after using a new electric shaver that releases scented lotion into the skin. The patient underwent a patch testing with European baseline series and Gentofte extended patch test series.

Background. Protein contact dermatitis was originally defined in 1976 by Hjorth and Roed-Petersen as a distinct kind of dermatitis seen in patients with occupational food contact. Even though occupational skin diseases are frequent in Denmark, little attention has been paid to protein contact dermatitis, and the frequency is unknown. Objectives. To evaluate the frequency of occupational food-related hand dermatoses and test results in patients occupationally exposed to foods. Materials and Methods. This was a retrospective study based on examinations, including skin prick testing and patch testing, performed at the Department of Dermato-Allergology, Gentofte University Hospital, Denmark between 2001 and 2010. Results. Of all patients (n = 372), 57.0% had irritant contact dermatitis, 22.0% had protein contact dermatitis, 2.4% had contact urticaria, and 1.8% had allergic contact dermatitis. A suggestion for diagnostic criteria is presented. Frequent risk occupations were cooking in restaurants, baking, and kitchen work. Substantially more patients reacted in skin prick testing with fresh foods than with food extracts. Conclusion. Protein contact dermatitis is a frequent disorder among patients who professionally handle foods, and should be considered to be a distinct clinical entity. When diagnosing protein contact dermatitis and in other food-related skin prick testing procedures, it is important to include fresh foods. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Nickel and cobalt allergy remain frequent in dermatitis patients. It is important to determine possible nickel and cobalt exposures at work as these may offer important information to regulators and physicians who perform patch testing. Clinical relevance of metal exposure is usually assessed by the treating physician via the medical history and by presentation of allergic contact dermatitis. Objectives: To screen unused non-powered hand-held work tools for nickel and cobalt release by using colorimetric spot tests. Materials & methods: A random selection of 200 non-powered hand-held work tools for sale in 2 retailers of home improvement and construction products were analyzed qualitatively for metal release using the colorimetric nickel and cobalt spot tests. Results: Nickel release was identified from 5% of 200 work tools using the dimethylglyoxime (DMG) test. In 8 of 10, positive results were located to the metal ring that acts like a cuff and is located at the end of the grip. The positive DMG test results were not related to specific categories of work tools. The cobalt spot test gave no positive test reactions. Conclusions: It appears that the proportion of work tools that release nickel, in amounts that may result in allergic nickel dermatitis, has decreased markedly, when results were compared with a Swedish study performed more than a decade ago. No cobalt release was detected but it should be underscored that hard-metal tools were not examined. Other sources of cobalt may explain the relatively high levels of cobalt allergy in dermatitis patients. [Copyright &y& Elsevier]

EU legislation has reduced the epidemic of nickel contact allergy affecting the consumer, and shifted the focus towards occupational exposure. The acid wipe sampling technique was developed to quantitatively determine skin exposure to metals. To assess the clinical usefulness of the acid wipe sampling technique as part of the diagnostic investigation for occupational nickel allergy-associated hand dermatitis. Six patients with vesicular dermatitis on the hands were included. Acid wipe sampling of skin and patch testing with a nickel sulfate dilution series were performed. Nickel was detected in all samples from the hands. In all patients, the nickel content on the hands was higher than on the non-exposed control area. Occupational exposure to nickel-releasing items raised the nickel content on exposed skin as compared with a non-exposed control site. Nickel-reducing measures led to complete symptom relief in all cases. In cases of a positive nickel patch test reaction and hand eczema, patients should perform the dimethylglyoxime (DMG) test on metallic items at home and at work. The acid wipe sampling technique is useful for the diagnosis of occupational hand eczema following screening with the inexpensive DMG test. [ABSTRACT FROM AUTHOR]

Background: Filaggrin null (FLG) mutations lead to skin barrier disruption with a reduced resistance towards exogenous agents and also influence the course of disease in atopic dermatitis. Objectives: To examine the association between FLG mutations and contact allergy, polysensitization, hand eczema at first appearance of disease, occurrence, and course of dermatitis. Methods: A venous blood sample from 430 individuals was genotyped for FLG mutations R501X and 2282del4 with polymerase chain reaction followed by typing through hybridization to paramagnetic polystyrene beads and analysis on a BioPlex 200. All individuals had a minimum of one positive patch test reaction. Results: In all, 3.5% were 2282del4 heterozygote and 5.1% were R501X heterozygote. An odds ratio (OR) of 1.49 [95% confidence interval (CI) 0.74–3.00] was found for nickel allergy, OR 0.84 (95% CI 0.41–1.74) for polysensitization, OR 0.78 (95% CI 0.25–2.43) for dermatitis, OR 0.96 (95% CI 0.48–1.92) for hand eczema at debut, OR 1.25 (95% CI 0.99–1.57) for duration of disease, and OR 0.76 (95% CI 0.59–0.97) for age at onset. Conclusions: No association between nickel allergy, polysensitization, hand eczema at first appearance or occurrence of dermatitis, and FLG mutations was found. However, patients with FLG mutations had an earlier age of onset compared with the wild-type genotype and a trend towards longer duration of disease. [ABSTRACT FROM AUTHOR]

The article offers information on the application Allergyapp that was developed to assist contact-allergic patients in reading and interpreting ingredient list on cosmetic products. Topics discussed include the web-based survey conducted to determine whether the Allergyapp concept would be useful and valuable for consumers, the companies engaged in the development of the application, and the use of the application and future expansion.

Contact allergy to aluminium may develop following vaccination with aluminium-adsorbed vaccines. To rule out contact allergy as a cause of the patient's hand eczema, patch testing was performed with the European baseline series adapted for children, including the department's extension with topical medicament allergens. In our clinic, the present patient is the only who has shown patch test reactivity to aluminium chambers without vaccination granulomas. [Extracted from the article]

The article offers information on the Cobalt allergic contact dermatitis (ACD) caused by leather in furniture upholstery has been reported in Denmark, It mentions cobalt in a substantial proportion of leather consumer goods in Denmark; and also mentions the data showed that cobalt is present in leather products for personal use, and highlight the fact that this may cause cobalt allergy and dermatitis.

A case study of a 34-year-old woman with a childhood history of atopic dermatitis who was diagnosed of thiuram contact dermititis caused by a rubber cellphone case is presented. The unilateral distribution of the initial contact dermatitis corresponded to her common practice of holding her phone with her left hand. Her symptoms subsided after removing the case.

The article presents a case study of a 64-year-old male patient with no history of atopic dermatitis. It mentions that the patients had developed severe dermatitis on lower legs and forearms over the last seven years of working as a painter. It states that the patient was exposed to methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) on a daily basis.

The article presents a case study o a 54-year-old man who is a manufacturer and seller of electric guitars with eczema on the fingertips on his left hand. The patient was tested with the European baseline series by his referring dermatologist and reveals that he was positive to nickel (++) on day 3. It mentions that a new sweat test was also performed to the patient for three days which showed nickel release.

The article presents two case studies of allergic contact dermatitis caused by exposure to methyldibromo glutaronitrile (MDBGN) in a cleaning detergent and sunscreen agent. The first case was that of a 62-year-old woman, who was presented with chronic hand eczema and periodic flares during the past 3 years. Another case involved a 41-year-old woman who complained of a generalized eczematous rash starting during a 1-month vacation in Guatemala.

A case study of 9-year-old non-atopic boy developed eczema on his face, chest, arms and legs, after his bedroom had been painted with Flügger Flutex. is presented. It discusses importance of a complete declaration of isothiazolinones in products beyond cosmetics. It further discusses risk of sensitization for contact allergens.

The article presents a case study of a 53-year-old man presented with pain and bleeding during defecation. Topics include general practitioner suspected with haemorrhoids and began treatment with doloproct and proctosedy and then treated with a gel containing the calcium channel blocker diltiazem by gastrointestinal surgeon, systemic allergic dermatitis due to application of diltiazem and neomycin in the gel used to treat anal fissures and dermatitis from other agents such as amlodipine.

The article presents a case study of a 66-year-old non-atopic woman suffered with dermatitis on the face and neck and orbital oedema, accompanied by a burning skin sensation, after the use of Eucerin volume-filler day and night cream on her face. The article discusses use of magnolia officinalis bark extractin traditional Chinese medicine and skin care products because of its anti-inflammatory and anti ageing effect.

The article presents a case study of a 68-year-old non-atopic woman was presented with recurrent perioral and lip dermatitis and oedema of the oral mucosa following dental treatments. It mention that she had been using protective rubber gloves and experienced fluctuating hand eczema with erythema and vesicles on the dorsal aspects of the hands.

The article presents the case of a 61-year-old man with occupational allergic contact dermatitis after exposure to the Central American hardwood cocobolo. He was referred with a relapsing eczematous rash on the face and hands with spread to the arms and genital region. Being a woodwork teacher, he was able to link four episodes of dermatitis to occupational exposure.

The article presents a case study of a 9-year-old boy who developed severe vesicular and bullous dermatitis on his arms and trunks caused by a temporary henna tattoo. He was diagnosed with acute allergic contact dermatitis and was treated with topical corticosteroids and clobetasone under occlusion by his general physician.

The article presents a case study of 48 year old non-atopic women, suffering from hand eczema and periorbital dermatitis. The article reports that a patch test was performed on patient and found that contact dermatitis was due to air borne thiuram exposure from latex gloves used in the occupation. The patient was advised to use accelerator free nitrile gloves after which she had not reported any complaint of hand eczema and periorbital dermatitis.

The article presents a case study of Christmas tree dermatitis caused by colophonium allergy. It cites the case of a 28-year-old atopic woman, who was diagnosed with colophonium allergy as a child and was referred to a dermatology due to acute onset of dermatitis on her hands, arms, and face after decorating a Christmas tree. It also discusses the causes of the condition of the patient and indicates that they should be informed about the risk of allergic contact dermatitis with Christmas trees.

The article presents a case study of a 65-year-old male worker who was injured after riding a mechanical rodeo bull. It mentions that the accident led to him to surgery which later developed erythema and a scar. It also notes that the patient underwent physical examination diagnosing him with allergic nickel dermatitis.

The article focuses on the study related to occupational hand eczema caused by nickel allergy and semi-quantified from dimethylglyoxime testing of the skin. It mentions that nickel is an important cause of occupational allergic contact dermatitis. It states that excessive nickel exposure is shown in many occupations.

The article presents case study of a 59-year-old female with uncommon case of allergic airborne contact dermatitis caused by exposure to the volatile anaesthetic sevoflurane. Topics discussed include details of symptoms and occurrence of the dermatitis in the patient, finding of diagnostics tests and probable treatment options for the disease.

The article discuses the findings of a study which showed that excessive nickel release from metallic components of mobile phones remains frequent. It indicated that up to one-quarter of mobile phones for sale in Denmark in 2013 reveals positive dimethylglyoxime (DMG) test results in repeated market surveys. It noted that the iPhone 5 mobile phones from Apple Inc. releases excessive amounts of nickel, as shown by a positive DMG test result .