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Background: Parents report that children with aluminium contact allergy and vaccination granulomas may react to aluminium‐containing sunscreen following application. Objectives: To evaluate whether contact dermatitis develops following repeated application of aluminium‐containing sunscreens in children with aluminium sensitization and vaccination granulomas. Methods: Sixteen children aged 2‐9 years (mean age 5 years) with vaccination granulomas and a positive patch test reaction to aluminium chloride hexahydrate 2%/10% petrolatum completed a blinded repeated open application test (ROAT) with two daily applications of two sunscreens for 14 days. One cream contained aluminium and the other did not. The children served as their own controls. Results: Sixteen children completed the study. Only one child (6%) had a positive skin reaction during ROAT on day 2 to the sunscreen with aluminium. None reacted to the sunscreen without aluminium. Conclusions: Use of aluminium‐containing sunscreens may on a case basis lead to allergic contact dermatitis in aluminium allergic children. [ABSTRACT FROM AUTHOR]

Background: Polyethylene glycols (PEGs) are widely used as excipients in drugs, cosmetics and household products. Immediate‐type allergy to PEGs including anaphylaxis is rare. The recent introduction of the mRNA‐based COVID‐19 vaccines has led to an increased focus on PEG as a possible culprit of allergic reactions to the vaccines. A low awareness of the allergenic potential of PEG among consumers, manufacturers and doctors leads to under‐diagnosis and under‐reporting of allergy to PEGs, putting patients at risk of repeated severe reactions. Objectives: To investigate clinical manifestations, time to diagnosis and impact of a PEG allergy diagnosis on the daily life of patients diagnosed with allergy to PEG from 2010 to 2019. Method: Ten patients diagnosed with allergy to PEG were included. Detailed clinical history was obtained, and allergy investigations had been performed at the time of diagnosis. All patients were contacted and asked to retrospectively complete a questionnaire about causes and impact on daily life of an allergy to PEG, scored on a likert scale (0–10) before and after diagnosis. Results: Eight patients had experienced at least one anaphylactic reaction requiring adrenaline treatment. Anaphylaxis was primarily caused by antibiotic/analgesic tablets, depot‐steroids, antacids and laxatives. Seven patients reported repeated reactions before diagnosis (median 3, range 2–6). Median time from first reaction to diagnosis was 20 months (range 2–120). None of the patients experienced severe allergic reactions after the diagnosis. Median likert score of the impact on daily life before diagnosis was 7 compared with 4 after diagnosis. Conclusion and clinical relevance: The clinical manifestations of PEG allergy are often dramatic. Improved awareness about the clinical presentation and common culprits, clear product labelling and a standardized nomenclature is needed to ensure the timely diagnosis of PEG allergy to prevent repeated anaphylactic reactions with severe impact on patients' lives. [ABSTRACT FROM AUTHOR]

Background Chromium coatings on metal alloys can be decorative, and prevent corrosion and metal ion release. We recently showed that handling of a chromium-containing disc resulted in chromium deposition on the skin. Objectives To examine patch test reactivity to chromium-coated discs. Methods We included 15 patients: 10 chromium-allergic patients, and 5 patients without chromium allergy. All were patch tested with potassium dichromate, cobalt chloride, nickel sulfate, and nine different metallic discs. The chromium-allergic patients were also patch tested with serial dilutions of potassium dichromate. Results Positive/weaker reactions were observed to disc B (1 of 10), disc C (1 of 10), and disc D, disc E, and disc I (4 of 10 each). As no controls reacted to any of the discs, the weak reactions indicate allergic reactions. Positive patch test reactions to 1770 ppm chromium(VI) in the serial dilutions of potassium dichromate were observed in 7 of 10 patients. When the case group was narrowed down to include only the patients with a current positive patch test reaction to potassium dichromate, elicitation of dermatitis by both chromium(III) and chromium(VI) discs was observed in 4 of 7 of patients. Conclusions Many of the patients reacted to both chromium(III) and chromium(VI) surfaces. Our results indicate that both chromium(VI) and chromium(III) pose a risk to chromium-allergic patients. [ABSTRACT FROM AUTHOR]

Background Chromium is an important skin sensitizer. Exposure to it has been regulated in cement, and recently in leather. Studies on the deposition of chromium ions on the skin as a result of handling different chromium-containing materials are sparse, but could improve the risk assessment of contact sensitization and allergic contact dermatitis caused by chromium. Objectives To determine whether the handling of chromium-containing samples of leather and metal results in the deposition of chromium onto the skin. Methods Five healthy volunteers participated. For 30 min, they handled samples of leather and metal known to contain and release chromium. Skin deposition of chromium was assessed with the acid wipe sampling technique. Results Acid wipe sampling of the participants' fingers showed chromium deposition on the skin in all participants who had been exposed to leather (range 0.01-0.20 µg/cm2) and in 3 of 5 participants after they had manually handled metal discs (range 0.02-0.04 µg/cm2). Conclusions We found that samples of leather and metal had the ability to deposit chromium on the skin at significant levels, in spite of a short duration of exposure. [ABSTRACT FROM AUTHOR]

The history of chromium as an allergen goes back more than a century, and includes an interventional success with national legislation that led to significant changes in the epidemiology of chromium allergy in construction workers. The 2015 EU Leather Regulation once again put a focus on chromium allergy, emphasizing that the investigation of chromium allergy is still far from complete. Our review article on chromium focuses on the allergen's chemical properties, its potential exposure sources, and the allergen's interaction with the skin, and also provides an overview of the regulations, and analyses the epidemiological pattern between nations and across continents. We provide an update on the allergen from a dermatological point of view, and conclude that much still remains to be discovered about the allergen, and that continued surveillance of exposure sources and prevalence rates is necessary. [ABSTRACT FROM AUTHOR]

Background Cobalt is a strong skin sensitizer and a prevalent contact allergen. Recent studies have recognized exposure to leather articles as a potential cause of cobalt allergy. Objectives To examine the association between contact allergy to cobalt and a history of dermatitis resulting from exposure to leather. Methods A questionnaire case-control study was performed: the case group consisted of 183 dermatitis patients with a positive patch test reaction to cobalt chloride and a negative patch test reaction to potassium dichromate; the control group consisted of 621 dermatitis patients who did not react to either cobalt or chromium in patch testing. Comparisons were made by use of a χ2-test, Fisher's exact, and the Mann-Whitney test. Logistic regression analyses were used to test for associations while taking confounding factors into consideration. Results Leather was observed as the most frequent exposure source causing dermatitis in the case group. Although the case group significantly more often reported non-occupational dermatitis caused by leather exposure ( p < 0.001), no association was found between cobalt allergy and dermatitis caused by work-related exposure to leather. Conclusions Our study suggests a positive association between cobalt allergy and a history of dermatitis caused by non-occupational exposure to leather articles. [ABSTRACT FROM AUTHOR]

Background Chlorhexidine may cause type I and type IV allergy. Some chlorhexidine-allergic individuals have been exposed in the healthcare setting as patients or healthcare workers, but for others the source of sensitization is unknown. Chlorhexidine may be used as a preservative or an antimicrobial agent in cosmetic products at a concentration up to 0.3%, as set by the European Cosmetics Directive (now Regulations). Objectives To identify cosmetic product types containing chlorhexidine, and to measure the concentration of chlorhexidine in selected products. Methods Between February 2013 and April 2013, we checked for chlorhexidine in cosmetic products in 14 supermarkets, one hairdressing salon and one beauty and retail store in Copenhagen, Denmark by reading the ingredient labels. The chlorhexidine concentration was measured in 10 selected products by high-performance liquid chromatography ( HPLC) with an ultraviolet ( UV) detector. Results Chlorhexidine was found in 80 of 2251 checked products (3.6%) in the following categories: hair products (57/760), creams (9/324), face washes (4/24), wet wipes (4/63), skin tonics (3/22), make-up removers (2/25), and mouth washes (1/17). Chlorhexidine concentrations were 0.01-0.15%. Conclusions We found chlorhexidine in various cosmetic product types, predominantly aimed at females, and in hair products. The measured chlorhexidine concentrations were all within the permitted limit. The relevance for allergic sensitization should be further explored. [ABSTRACT FROM AUTHOR]

Background Chromium-tanned leather articles currently constitute the most important cause of contact allergy to chromium in Denmark. A regulation on the content of hexavalent chromium in leather was adopted in November 2013 by the EU member states. Objectives To characterize patients with chromium allergy and their disease, to serve as a baseline for future studies on the potential effect of the new regulation on chromium in leather. Methods A questionnaire case-control study was performed on 155 dermatitis patients with positive patch test reactions to potassium dichromate and a matched control group of 621 dermatitis patients. Comparisons were made by use of a χ2-test and the Mann- Whitney U-test. Logistic regression analyses were used to test for associations. Results Sixty-six per cent of chromium-allergic patients had a positive history of contact dermatitis caused by leather exposure. They had a significantly lower quality of life ( p < 0.001), a higher prevalence of dermatitis during the last year ( p = 0.008), a higher use of medication during the past 12 months ( p = 0.001) and a higher prevalence of sick leave ( p = 0.007) than patients in the control group. Conclusions Chromium-allergic patients have more severe and more chronic contact dermatitis. Their primary chromium exposure comes from leather articles. [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 Fragrance allergy is a lifelong condition that may give rise to permanent or recurrent contact dermatitis and may affect quality of life ( QoL). The effect on QoL has not yet been investigated, and no disease-specific QoL instrument for fragrance allergy exists. Objective To develop and validate a disease-specific instrument to investigate QoL among fragrance-allergic subjects. Method A fragrance QoL instrument ( FQL index) was developed on the basis of narratives from 68 fragrance-allergic subjects, and consisted of 13 items. It was tested in a postal survey among 1650 participants patch tested at Gentofte University Hospital (2000-2010). The survey included other QoL instruments [Dermatology Life Quality Index ( DLQI) and Short Form 36 ( SF36) version 2] and questions on eczema severity (response rate of 66%). A retest was conducted after 3-6 months (response rate of 72.5%). Results The FQL index showed a significant and strong correlation with the DLQI ( rS = 0.70), and disease severity, but a weak correlation with SF36 [mental component summary score, rS = − 0.22; physical component summary score, rS = − 0.31]. Good reliability and responsiveness to changes in disease severity were seen. Conclusion The FQL index is a good instrument with which to investigate QoL in subjects with fragrance allergy. Good correlations with the DLQI and self-estimated disease severity were seen, and it showed good reliability, reproducibility and ability to distinguish changes in disease severity. [ABSTRACT FROM AUTHOR]

It was recently shown that filaggrin null mutation carrier status was associated with nickel allergy and self-reported intolerance to costume jewellery. Because of the biochemical characteristics of filaggrin, it may show nickel barrier properties in the stratum corneum. To investigate whether subjects with filaggrin null mutations report nickel dermatitis at an earlier age than wild-type individuals, and to analyse whether null mutation carriers have stronger patch test reactivity to nickel sulfate than do wild-type individuals. A total of 3471 Danes (18-69 years of age) answered a questionnaire about general health, and underwent patch testing and filaggrin genotyping. The mean number of years at risk of developing nickel dermatitis was significantly lower for the filaggrin null genotype than for the wild-type genotype when ear piercing status was considered. In positive patch test readings, the proportion of null mutants increased with increasing reaction strength. Filaggrin null mutations may lower the age of onset of nickel dermatitis. The hypothesis that ear piercings obscure the effect of filaggrin null mutations on the development of nickel allergy in statistical analyses was supported. An association between the null genotype and increased nickel sensitivity was indicated by patch test reading and questionnaire data. [ABSTRACT FROM AUTHOR]

Background: It is often difficult to establish clinical relevance of metal exposure in cobalt-allergic patients. Dermatologists and patients may incorrectly assume that many metallic items release cobalt at levels that may cause cobalt dermatitis. Cobalt-allergic patients may be unaware that they are exposed to cobalt from handling work items, causing hand dermatitis. Objectives: To present early findings with a newly developed cobalt spot test. Methods and Results: A cobalt spot test based on disodium-1-nitroso-2-naphthol-3,6-disulfonate was able to identify cobalt release at 8.3 ppm. The test may also be used as a gel test if combined with an agar preparation. We found no false-positive reactions when testing metals and alloys known not to contain cobalt. However, one cobalt-containing alloy, which elicited cobalt dermatitis in cobalt-allergic patients, was negative upon cobalt gel testing. Conclusions: The cobalt test detects amounts of cobalt release that approximate the elicitation concentration seen in cobalt-allergic patients. It may serve as a useful tool in dermatology offices and workplaces. [ABSTRACT FROM AUTHOR]

The article presents case study of a 21-year-old male gardener having 4-day history of widespread dermatitis, which proved to be due to being in contact with common ivy or Hedera helix. It discusses symptoms of the patient as well as various tests and their results which eventually found that it was an airborne contact dermatitis caused by common ivy. It is noted that it was first report of airborne elicitation of dermatitis caused by common ivy.