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

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

Összefoglaló. Bevezetés: A nikkel széleskörűen elterjedt fém és kontaktallergén. Megtalálható mindennapi használati tárgyainkban, feldolgozza az ipari termelés, és az egészségügyben is rendre bővül alkalmazási köre. Egyidejűleg a társadalom növekvő hányadánál fordul elő nikkel-kontaktszenzibilizáció. Célkitűzés: Az epicutan tesztelt betegcsoport adatainak feldolgozása, kiemelve a nikkelpozitív betegek megoszlását nem, életkor, diagnózis, a klinikai tünetek lokalizációja és a társult fémérzékenység szerint, továbbá a 2004 óta érvényes európai uniós Nikkel Direktívák hatásainak tanulmányozása. Módszer: A közlemény a Semmelweis Egyetem Bőr-, Nemikórtani és Bőronkológiai Klinikájának Allergológia Laboratórium és Szakambulanciáján 1994-től 2014-ig 13 693 fő (10–87 év közötti) standard környezeti epicutan sorral tesztelt beteg adatait vizsgálja retrospektív módon. Eredmények: Az összes vizsgált bőrbeteg nikkelszenzibilizációs aránya 1994-ben 13,1%, 2004-ben 11,5%, 2014-ben 19,1% volt. A nikkel-kontaktdermatitis főként nőbetegeknél (93,0%) fordul elő. A klinikai tünetek elsősorban a karokra és az arcra lokalizálódnak. Nikkelérzékenyeknél az allergiás kontaktdermatitis diagnózisa 65,8%, atopiás dermatitis 9,7%-nál fordul elő. A nikkelérzékenységhez leggyakrabban társult fémallergének a kobalt és a króm. Az 1994–2004-es periódushoz képest az európai uniós Nikkel Direktívákat követő 10 évben a szenzibilizáció százalékos emelkedése szignifikáns volt, ugyanakkor a nikkelpozitívak évenkénti száma csökkent. 1994-ben a betegek legnagyobb hányada (26,5%) a 20–24 éves korcsoportba tartozott, 2004-ben szintén (20,8%), 2014-ben azonban a 35–39 éves korosztályhoz (15,1%). Következtetések: A nikkelszenzibilizáció korban eltolódást mutat az idősebb korosztály felé, a 35 évesnél fiatalabb betegek száma mérséklődött. A Nikkel Direktívák révén a fiatalabbak későbbi életkorban és kisebb mértékű nikkelexpozíciónak vannak kitéve. A vizsgált betegek nikkelérzékenységének százalékos emelkedése miatt azonban újabb szabályozások bevezetése és a hatályban lévők módosítása szükségszerű. Orv Hetil. 2021; 162(16): 629–637. Summary. Introduction: Nickel is a widely used metal and contact allergen. It can be found in our everyday objects and it is becoming more prevalent in healthcare. Simultaneously, nickel contact sensitization occurs more frequently. Objective: Analysis of data of patch tested patients by gender, age, diagnosis, localization of skin lesions, and associated metal sensitivity. Furthermore, to study the effects of the European Nickel Directives in force since 2004. Method: Retrospective analysis of data of 13 693 patients (aged 10–87) tested with a standard series of contact allergens at the Allergy Outpatient Unit and Laboratory of the Department, Venereology and Dermatooncology, Semmelweis University. Result: Nickel sensitization of all examined patients was 13.1% in 1994, 11.5% in 2004, and 19.1% in 2014. Contact dermatitis occurred mainly in females (93.0%). Skin lesions are primarily localized to the arms and face. Diagnosis of allergic contact dermatitis occurred in 65.8%, and atopic dermatitis in 9.7% of tested patients. Commonly associated metal sensitivities were cobalt and chromium. In the 10 years following the Nickel Directives, the increase of the ratio of sensitized patients was significant while the number of nickel-positives per year decreased. Both in 1994 and 2004, the largest proportion of patients belonged to the 20–24 age group (26.5% and 20.8%, respectively), but in 2014, to the 35–39 age group (15.1%). Conclusion: Nickel sensitization shifts towards the older age group, with a decrease in young patients. Because of the Nickel Directives, people are exposed to nickel at a later age and to a lesser extent. Due to the increase of the ratio of nickel-sensitive patients, it is necessary to introduce new regulations and amend the existing ones. Orv Hetil. 2021; 162(16): 629–637.

Background/Aim. Development of allergic contact der-matitis as a complication of treatment of chronic venous insufficiency (CVI) is well known. The aim of this study was to determine the incidence and risk of eczematous contact sensitization in patients with CVI, as well as the correlation between disease duration and contact sensitization. Methods. The study involved 266 subjects examined during three-year-period who were divided into two groups: the study group included patients with CVI referred for allergy testing due to suspected contact dermatitis, and the control group included the ones without CVI patch tested for suspected contact dermatitis. The severity of CVI was assessed by Clinical Etiology-Anatomy-Pathophysiology (CEAP) classification. Thereafter, each patient underwent patch testing. Results. The incidence of contact sensitization among patients with CVI was 49.3%. In these patients, the incidence of contact sensitization to the European standard battery of allergens was 31.55%; to the battery specific for CVI it was 28.45%. Patients with CVI had a 2.45-fold higher risk for developing contact sensitization to two or more allergens, and a 3.69-fold higher risk for developing contact sensitization to five or more allergens compared to those without CVI. The prevalence of contact sensitization in patients with CVI was not significantly different from those without CVI. There was a positive correlation between the incidence of contact sensitization and the duration of the disease. Conclusion. Patients with CVI had no statistically significantly distinct contact sensitization prevalence and had 2.45 and 3.69 times higher risk to manifest contact sensitization to two and more allergens and five and more allergens, respectively, than patients with no CVI. The positive correlation between frequency of contact sensitization and disease duration was found.

Background Metalworkers are exposed to a variety of contact allergens by handling tools, metals, metalworking fluids (MWFs), oils and greases, rubber materials, and so on. Most large‐scale reports on contact allergy due to MWFs are more than 10‐years‐old, and there are only few studies on contact allergy in mechanics and other metal workers not exposed to MWFs. Objectives To describe a current spectrum of contact sensitization in metalworkers with occupational dermatitis (OD). Patients and Methods Retrospective analysis of patch test data collected by the Information Network of Departments of Dermatology (IVDK; 2010–2018), stratifying for 804 cutting metalworkers, 2197 mechanics, and 355 other metalworkers. Results Cutting metalworkers were most frequently sensitized to monoethanolamine (12.6%), colophonium/abietic acid (11.4%) and formaldehyde releasers (up to 8.5%) from the MWF series, and formaldehyde (4.6%) and iodopropynyl butylcarbamate (4.6%) from the baseline series. Sensitization among mechanics and other metalworkers indicates possible occupational exposure to MWFs, glues, and resins, although this may not be expected from their job titles. Conclusions The spectrum of MWF contact allergens remained largely unchanged during the last years. Taking a comprehensive occupational history is indispensable in order to not miss relevant allergen exposures.

The design and development of insulin pumps and various glucose sensor systems has an enormous impact on life quality of diabetic patients. Surveillance and therapy of diabetes has improved due to the new diabetic devices, which are affixed to the patients' skin for several days. Since their introduction, irritant and allergic contact dermatitis have been frequently reported. Patients often acquire contact sensitization to isobornyl acrylate, N,N-dimethylacrylamide or formerly to 2‑ethyl-cyanoacrylate. These contact allergens were found in the patch, in the glue to affix the box on the patch or in the casing of the system itself. Development of contact allergy to substances of these systems may result in the need to abandon modern diabetic devices.

Duftstoffe gelten nach Nickel als die haufigsten Kontaktallergene. Als Beleg hierfur wird oft die Haufigkeit positiver Epikutantestreaktionen auf den Duftstoff-Mix angefuhrt. Gemas der EU-Verordnung Nr. 1223/2009 mussen 26 Duftstoffe auf kosmetischen Produkten deklariert werden, die als signifikante Allergene gelten. Es erfolgt die Uberprufung der Haufigkeit im Epikutantest nachgewiesener Sensibilisierungen gegen Duftstoffe und die Differenzierung zwischen haufig und selten sensibilisierenden Duftstoffen. Er wird eine retrospektive Analyse von Daten des Informationsverbundes Dermatologischer Kliniken (IVDK), uberwiegend der Jahre 2016 bis 2018 vorgenommen. Die Haufigkeit positiver Reaktionen auf den Duftstoff-Mix I hat in den dem IVDK angeschlossenen dermatologischen Abteilungen 2018 mit 5,4 % einen historischen Tiefstand erreicht. Positive Reaktionen auf den Duftstoff-Mix II gehen seit 2013 zuruck und liegen 2018 bei 3,2 %. Das Allergen aus dem Duftstoff-Mix I mit den meisten positiven Testreaktionen ist nicht mehr Eichenmoos absolue, sondern Isoeugenol. Im Duftstoff-Mix II ist Hydroxyisohexyl-3-cyclohexen-carboxaldehyd (HICC) nach wie vor fuhrend. Nur 11 der 26 deklarationspflichtigen Duftstoffe losten bei mehr als 1 % der getesteten Patienten allergische Testreaktionen aus. Der Ruckgang der positiven Testreaktionen auf die Duftstoff-Mixe ist wesentlich auf den verringerten Einsatz von Atranol- und Chloratranol-haltigem Eichenmoos und von HICC zuruckzufuhren. Seit August 2019 ist der Einsatz dieser Stoffe in kosmetischen Mitteln EU-weit vollstandig verboten. Mit einem weiteren Ruckgang der Sensibilisierungshaufigkeit ist daher zu rechnen. Eine differenzierte Betrachtung der einzelnen Duftstoffe unter allergologischen Gesichtspunkten ist dringend geboten.

Am Beispiel von Resorcinol, einem weitverbreiteten Haarfarbstoff, stellt dieser Ubersichtbeitrag dar, wie die Daten zur Hautsensibilisierung und Hautexposition aus der SCCS (Scientific Committee on Consumer Safety) opinion (Wissenschaftliches Berater-Gremium bei der Europaischen Union [EU]) und aus anderen Quellen verwendet werden, um eine quantitative Risikobewertung (QRA) durchzufuhren. Hierbei wird bewertet, welche Konzentration in Haarfarbprodukten maximal eingesetzt werden kann, ohne dass die Neuentstehung einer Hautsensibilisierung zu erwarten ist. Hierbei liegt der Fokus darauf, die Entstehung (Induktion) einer Kontaktallergie zu vermeiden. Epidemiologische Daten zur Kontaktallergie gegen Resorcinol – wie sie z. B. in Deutschland vom IVDK (Informationsverbund Dermatologischer Kliniken) erarbeitet werden, sind dabei eine wichtige Informationsquelle, die hilft, die Qualitat und Effektivitat des QRA zu beurteilen.

Kontaktsensibilisierungen sind nicht selten, und das Spektrum der wichtigsten Allergene kann sich im Lauf der Zeit durch geanderte Expositionen verschieben. Unter Einsatz der kontinuierlich angepassten sog. Standardreihe der wichtigsten Kontaktallergene wurden sowohl bevolkerungsbezogene als auch klinisch epidemiologische Studien durchgefuhrt. Es erfolgt eine einfuhrende Darstellung der wichtigsten epidemiologischen Grundbegriffe sowie spezieller Aspekte in der Epidemiologie der Kontaktsensibilisierung. Eine Aufbereitung von Handbuchwissen und eine selektive Literaturrecherche wurden vorgenommen. Auf Bevolkerungsebene weisen ca. 25 % mindestens eine Kontaktsensibilisierung gegen Substanzen der Standardreihe auf, weit uberwiegend gegen Nickel. Duftstoffe stellen mit einer Pravalenz von ca. 4 % ebenfalls wichtige Allergene dar, zusammen mit Konservierungsmitteln. Bei wegen Verdacht auf ein allergisches Kontaktekzem epikutan getesteten Patienten ist die Rangfolge dieser wichtigsten Allergengruppen ahnlich, jedoch sind die Pravalenzen in der Regel (deutlich) hoher. Kurzfristige Veranderungen der Exposition und nachfolgend des Spektrums der wichtigsten Kontaktallergene lassen sich am besten durch klinische Surveillance auf der Basis von Routinedaten darstellen und ggf. praventive Masnahmen anstosen. Neben der Analyse von Zeittrends spielt die Auswertung bestimmter Subgruppen eine wichtige Rolle bei der Identifikation allergieauslosender (sensibilisierender und elizitierender) Expositionen.

Background Allergic contact dermatitis (ACD) has become more frequent in children. The prevalence of contact sensitization varies with respect to age, sex, and geographic localization. Objective The aim of the study was to investigate the experience of a tertiary health center regarding the patch test results of contact sensitization in children without atopic dermatitis. Methods This is a retrospective review of 89 children (30 boys and 59 girls) who were aged between 3 and 18 years and who were diagnosed with ACD between July 2013 and July 2017. Children with a known history of atopic dermatitis were excluded. All patients were tested with the TRUE (Thin-layer Rapid Use Epicutaneous) test series. Results The most frequently determined allergens by TRUE test were methylchloroisothiazolinone (n = 7 [16.3%]), disperse blue 106 (n = 5 [11.6%]), and bacitracin (n = 5 [11.6%]). Formaldehyde-related allergens produced 15 positives. Conclusions Preservatives, such as methylchloroisothiazolinone, formaldehyde, and formaldehyde releasers, emerge as the most frequent allergens in children who undergo patch testing because of ACD. This finding might be attributed to the increase in the utilization of these chemical compounds in personal hygiene products for children.

Die Pathogenese des Handekzems ist multifaktoriell. Exogene Faktoren wie Hautirritation oder Kontaktsensibilisierung tragen ebenso dazu bei wie eine endogene Pradisposition im Sinne von Atopie. Es wird eine Ubersicht uber die fur die Entstehung eines Handekzems bedeutsamen pathogenetischen Faktoren gegeben. Es erfolgt eine Auswertung der aktuellen Literatur zur Pathogenese des Handekzems. Eine Storung der epidermalen Barrierefunktion spielt eine essenzielle Rolle fur die Handekzementstehung. Die molekularbiologischen Grundlagen und die mogliche Bedeutung einer genetischen Pradisposition jenseits der Atopie sind noch nicht im Detail geklart. Immunologische Prozesse, wie sie an der Pathogenese von allergischer Kontaktdermatitis und atopischem Ekzem beteiligt sind, spielen fur die Entstehung bestimmter Handekzemsubtypen wahrscheinlich eine Rolle und ermoglichen evtl. kunftig eine Erweiterung des therapeutischen Armamentariums. Das genaue Verstandnis der individuellen Pathogenese beim einzelnen Handekzempatienten ist essenziell wichtig, um eine gezielte Beratung zu Allergenkarenz, Hautschutz und Basistherapie zu geben und entsprechende Therapiemasnahmen einzuleiten.

BACKGROUND Variables traditionally reported to influence the prognosis of occupational hand eczema (OHE) are atopic dermatitis (AD) and contact sensitization. However, recent studies indicate that lifestyle factors may be of major importance. OBJECTIVES To identify factors influencing the prognosis in a cohort of patients with recognized OHE. METHODS In this register-based cohort study, individuals with hand eczema recognized as occupational disease in the period January 2010-December 2011 were identified using files from Labor Market Insurance Denmark and included in the study. At baseline, information on sex, age, occupation, wet work, AD and contact sensitization was collected. In 2015 participants received a questionnaire with questions about lifestyle factors, current occupation and healing of OHE. RESULTS In total, 2703 patients received the questionnaire; 1491 responded to the question about healing of OHE and were included in the study. Altogether, 19·3% of patients reported complete healing at follow-up. Current tobacco smoking and a high level of stress were factors inversely associated with healing of hand eczema (P < 0·001 and P = 0·030, respectively), while a high level of exercise was significantly related to healing of eczema (P = 0·011). Change of profession was a favourable prognostic factor, while age, sex, AD, contact sensitization and education did not significantly influence prognosis. CONCLUSIONS Traditionally important risk factors such as AD and contact sensitization had no marked influence on prognosis, while lifestyle factors were of major importance. Our findings indicate that risk factors may vary over time, allowing for new perspectives on prevention. What's already known about this topic? Occupational hand eczema has a relapsing course and a poor overall prognosis. Atopic dermatitis and contact sensitization have previously been reported as risk factors for a poor prognosis. What does this study add? The results indicate that lifestyle factors are of importance for the prognosis of occupational hand eczema. Traditionally reported risk factors such as atopic dermatitis and contact sensitization do not currently influence prognosis.

Background Acquired dermal macular hyperpigmentation (ADMH) is an umbrella term including lichen planus pigmentosus, erythema dyschromicum perstans and pigmented contact/cosmetic dermatitis. Objective To establish contact sensitization to hair colours as an aetiological factor for ADMH. Methods Detailed clinical examination, skin biopsies, and patch and photo-patch testing with Indian standard series and patient's own cosmetic products were performed. Results Thirty-nine (36.1%) patients were found to demonstrate a positive patch/photo-patch test with 35/39 reacting to their own products (all were hair colours) and 16/39 reacting to antigens from commercial series (commonly paraphenylenediamine). Fourteen patients developed delayed hyperpigmentation on positive patch-test sites at 1 month. Higher mean age, symptomatic pigmentation (pruritus, burning and photosensitivity), hair margins involvement (outer surface, helix and lobule of ear; temples and preauricular area), ill-defined lesions, epidermal atrophy and epidermal melanization extending >3 layers were significantly common in patch-test-positive patients. Well-defined lesions, perioral involvement and associated lichen planus were clinical pointers towards patch-test negativity. Conclusion Index study exemplifies that patch-test results have distinct clinical and histopathological correlates in ADMH. Hair dye contact sensitization appears to be an important aetiological factor in about one-third patients presenting with ADMH.

Background Allergic contact dermatitis is a challenging diagnostic problem in children. Although epicutaneous patch testing is the diagnostic standard for confirmation of contact sensitization, it is less used in children by dermatologists treating children, pediatric dermatologists, and pediatricians, when compared with adult practitioners. Objective The aim of the study was to create and evaluate standardization of a pediatric patch test series for children older than 6 years. Methods We surveyed dermatologists and allergists conducting epicutaneous patch testing in children attending the 2017 American Contact Dermatitis Society meeting held in Washington, DC. This was followed by discussion of collected data and consensus review by a pediatric contact dermatitis working group at the conference. Conclusions A baseline pediatric patch test panel was established through working group consensus.

Occupational exposure of hairdressers to hair dyes has been associated with the development of allergic contact dermatitis (ACD) involving the hands. p-Phenylenediamine (PPD) and toluene-2,5-diamine (PTD) have been implicated as important occupational contact allergens. To conduct a quantitative risk assessment for the induction of contact sensitization to hair dyes in hairdressers, available data from hand rinsing studies following typical occupational exposure conditions to PPD, PTD and resorcinol were assessed. By accounting for wet work, uneven exposure and inter-individual variability for professionals, daily hand exposure concentrations were derived. Secondly, daily hand exposure was compared with the sensitization induction potency of the individual hair dye defined as the No Expected Sensitization Induction Levels (NESIL). For PPD and PTD hairdresser hand exposure levels were 2.7 and 5.9 fold below the individual NESIL. In contrast, hand exposure to resorcinol was 50 fold below the NESIL. Correspondingly, the risk assessment for PPD and PTD indicates that contact sensitization may occur, when skin protection and skin care are not rigorously applied. We conclude that awareness of health risks associated with occupational exposure to hair dyes, and of the importance of adequate protective measures, should be emphasized more fully during hairdresser education and training.

The purpose of this study was to evaluate the incidence of contact sensitization to metals used in dental practice among students of dental medicine, students from a dental technician school, dental professionals and patients. A total of 128 participants: 28 dental professionals, 40 students of dental medicine, 38 students from a dental technician school and 22 patients without occupational exposure to metals, were patch tested with potassium dichromate, cobalt(II)chloride hexahydrate, copper(II)sulfate pentahydrate, palladium(II)chloride, aluminium(III)chloride hexahydrate, gold(I)sodium thiosulfate dehydrate, tin and nickel(II)sulfate hexahydrate. The main metal allergens for students of dental medicine were cobalt(II)chloride hexahydrate, gold(I)sodium thiosulfate dehydrate, nickel(II)sulfate hexahydrate and potassium dichromate; for students from the dental technician school – cobalt(II)chloride hexahydrate, nickel(II)sulfate hexahydrate and gold(I)sodium thiosulfate dehydrate; for dental professionals – cobalt(II)chloride hexahydrate, palladium(II)chloride and nickel(II)sulfate hexahydrate, and for dental patients – cobalt(II)chloride hexahydrate, nickel(II)sulfate hexahydrate and copper(II)sulfate pentahydrate. There was a significantly higher incidence of sensitization to potassium dichromate (χ2 = 10.497, p = 0.012), palladium(II)chloride (χ2 = 5.381, p = 0.02) and gold(I)sodium thiosulfate dehydrate (χ2 = 6.347, p = 0.018) in the group of students of dental medicine. Our findings confirm the importance of cobalt(II)chloride hexahydrate as contact sensitizer for all the studied groups. Students of dental medicine could be defined as a group of particular risk of contact sensitization with metals. We recommend that knowledge on the sensitizing properties of metals be provided at the very beginning of the course of practical education in dentistry, together with application of adequate preventive measures.

Resume Introduction L’eczema de contact allergique peri-ulcereux est une complication frequente des ulceres de jambe (UDJ), retardant leur cicatrisation. Le but de l’etude etait de decrire la frequence de sensibilisation aux pansements utilises chez ces malades et d’evaluer s’il existait une relation entre le nombre de sensibilisations et l’etiologie de l’ulcere, sa duree d’evolution, l’âge ou le sexe des malades. Malades et methodes Cette etude retrospective menee au CHU de Reims de 2010 a 2014 incluait tous les malades porteurs d’un UDJ d’etiologie vasculaire complique de dermite eczematiforme peri-ulcereuse et ayant eu des tests allergologiques parmi une des trois batteries suivantes : standard europeenne, UDJ, corticoides. Resultats Parmi les 73 malades inclus, 43 % etaient polysensibilises. Trente-trois (45 %) etaient sensibilises aux pansements (38 % aux hydrocolloides, 18 % aux hydrogels, 7 % aux hydrocellulaires, 7 % aux hydrofibres, 5 % aux interfaces, 3 % aux alginates). L’âge median et le sexe des malades ne differaient selon qu’ils etaient polysensibilises ou non (p = 0,84 et p = 0,25, respectivement). Les malades etaient plus souvent polysensibilises lorsque l’ulcere evoluait depuis plus de 5 ans (p = 0,032). Conclusion Pres d’un malade sur deux presentant une dermite eczematiforme autour d’un UDJ est sensibilise aux pansements, notamment hydrocolloides et hydrogels. Le risque de sensibilisation est d’autant plus important que la duree de la maladie ulcereuse est plus longue.

Purpose: Sensitization to metals is a significant problem for both dental patients treated with dental materials and for dental professionals in occupational exposures. The purpose of the present study was to evaluate the incidence of concurrent contact sensitization to relevant for dental practice metals among students of dental medicine, students from dental technician school, dental professionals and patients. Material and Methods: A total of 128 participants were included in the study. All of them were patch-tested with nickel, cobalt, copper, potassium dichromate, palladium, aluminium, gold and tin. The results were subject to statistical analysis (p < 0.05). Results: For the whole studied population, potassium dichromate exhibited concomitant reactivity most often; copper and tin also often manifested co-reactivity. For the groups, exposed in dental practice, potassium dichromate and tin were outlined as the most often co-reacting metal allergens, but statistical significance concerning the co-sensitization to copper and the other metals was established only for aluminium. An increased incidence and OR for concomitant sensitization to cobalt and nickel was established in the group of dental students; to copper and nickel - in the control group; to palladium and nickel - in the group of dental professionals, the group of students of dental medicine and in the control group; to potassium dichromate and cobalt - in the group of dental students; to copper and palladium - in the control group of dental patients; to potassium dichromate and copper - in the group of dental professionals; to copper and aluminum - in the groups of students from dental technician school and of dental professionals; to copper and gold - in the groups of dental professionals and in the group of dental patients; to potassium dichromate and aluminum - in the group of dental professionals; to potassium dichromate and gold - in the group of dental professionals, and to aluminium and tin - in the groups of dental professionals and in the group of dental patients. Conclusions: Our data indicate a high risk of concurrent contact sensitization to the studied relevant for dental practice metals. Since the role of occupational exposures can’t be excluded, adequate preventive measures and information should be provided. General population also need to be well informed and the European Union regulations to be properly applied.

Background Dental technicians (DTs) are at increased risk for allergic contact sensitization. Objectives To assess the current spectrum of occupational sensitization in DTs with occupational contact dermatitis (OCD). Methods A retrospective analysis of Information Network of Departments of Dermatology patch test data from the years 2001-2015 concerning DTs with OCD was performed. Results Patients of the study group (226 DTs with OCD) were significantly more often diagnosed with allergic contact dermatitis (37.6% versus 18.5%; p = 0.0002) than patients of the control group (124 DTs without OCD). In the study group, positive reactions were most frequently observed to methacrylates and/or acrylates (n = 67). Of these, 61 patients showed positive reactions to at least one of the five most frequent allergens in this group, namely 2-hydroxyethyl methacrylate, 2-hydroxypropyl methacrylate, methyl methacrylate, ethyl methacrylate, and/or ethylene glycol dimethacrylate. In contrast, no positive reactions to diurethane dimethacrylate (DUDMA) occurred. Among allergens of the German Contact Dermatitis Research Group series 'dental metals', positive reactions were less frequent and were mainly to palladium chloride (n = 6). Conclusions The present data analysis showed that the sensitization spectrum and spectrum of cross-reactivity are largely unchanged as compared with the 1990s. It can be concluded that test recommendations are still valid and useful, except for the methacrylate DUDMA, which could be omitted.

Objectives: To assess the irritation and contact sensitization potential of a 200 mg ibuprofen medicated plaster.Methods: This double-blind, phase-1 placebo controlled study had two phases; the induction phase to evaluate the irritant potential of continuous application of the plaster, and the challenge phase to assess contact sensitivity (allergy). The cumulative irritancy potential was evaluated using an adaptation of the Shelanski method. Healthy adults (18 years of age) (N = 210) were treated simultaneously with one ibuprofen medicated and one placebo plaster applied in a randomized fashion to either the left or right side of the lower back. During the induction phase, plasters were applied on Days 1, 3, 5, 8, 10, 12, 15, 17, and 19 and the final plaster removed on Day 22. At each scheduled visit plasters and applications sites were assessed for degree of adhesion and skin irritation (score of 1 = no irritation to 7 = strong reaction spreading beyond test sites), respectively. The challenge phase followed a two-week washout period. A plaster was applied on Day 36 for 48 h and assessment occurred on Days 38, 39, and 40.Results: The mean cumulative irritation score during the induction phase was lower for the ibuprofen medicated plaster than the placebo plaster (0.32 vs. 1.23, respectively). Three (1.4%) subjects experience a dermal reaction of grade >= 3 for the ibuprofen medicated plaster compared with 27 (12.7%) for the placebo plaster. Following challenge with ibuprofen or placebo plasters, 12 subjects (6.2%) with the ibuprofen medicated plaster and four (2.2%) with the placebo plaster had skin reaction of assessment grade higher than the induction phase. One subject for the ibuprofen and two for the placebo plaster had reactions with grade >2. No subjects showed an increase in sensitization on Day 39 or 40 compared with Day 38.Conclusions: The findings indicate that the both the irritancy and contact sensitization of the ibuprofen medicated plaster is acceptable.

Background Occupational exposure of bricklayers, construction workers, tile setters etc. has changed during the last years. For some years now, all manually handled cement in the European Union and in Switzerland is chromate-reduced. Epoxy resin systems are being used in more and more fields of application. Improved worker's protection, especially wearing protective gloves, is promoted. These changes influence the spectrum of occupational contact sensitization. Objective Description of the current allergen spectrum in patients working in the building trade who suffer from occupational contact dermatitis. Material and methods Retrospective analysis of data of the Information Network of Departments of Dermatology (IVDK), 2009 - 2011. Results During the study period, 245 bricklayers, construction workers, tile setters etc. with occupational dermatitis have been patch tested. Potassium dichromate was the most frequent allergen, yielding 15.1% positive reactions, followed by epoxy resin with 13.7% positive reactions. Beyond that, there were 8 additional components of epoxy resin systems (5 reactive diluents and 3 amine hardeners), as well as 9 rubber ingredients, mainly thiurams, among the 30 most frequent allergens. In the course of time, a decline of chromate sensitization could be noted, paralleled by a decline of cobalt sensitization. In contrast, sensitization to epoxy resin has increased. Conclusion Thanks to the usage of chromate-reduced cement, chromate sensitization continues to decline in the building trade. The increase of epoxy resin sensitization must prompt intensified prevention efforts. When recommending protective gloves, thiuram-free products should be preferred. The most important allergens are covered by the following test series recommended by the German Contact Dermatitis Research Group (DKG): DKG baseline series, DKG test series "building trade", DKG rubber series.

Objectives: The aim of this study has been to evaluate the rate of contact sensitization to some rubber allergens and to bisphenol A (BPA) amongst students of dental medicine and dental patients. Material and Methods: A total of 50 participants were included in the study: 40 students of dental medicine exposed to the studied rubber allergens and BPA-based dental materials during the course of their education; 10 dental patients without occupational exposure to the latter substances served as a control group. All of them were patch-tested with the studied rubber allergens and bisphenol A. Results: Highest was the sensitizing action of carba mix, followed by benzoyl peroxide and mercapto mix. The sensitization rate for carba mix was significantly higher for dental students as well as for the whole studied population, if compared to the one for thiuram mix (Chi2 = 12.9, p < 0.001; Chi2 = 13.9, p < 0.001), bisphenol A (Chi2 = 8.9, p < 0.001; Chi2 = 11.9, p < 0.001), toluenesulfonamide formaldehyde resin (Chi2 = 10.7, p < 0.001; Chi2 = 13.9, p < 0.001) and benzoyl peroxide (Chi2 = 4.7, p = 0.03; Chi2 = 5.8, p = 0.016), and for dental patients, if compared to the one for mercapto mix (Chi2 = 7.07, p = 0.008). Concomitant positive skin patch-test reactions to carba mix and to benzoyl peroxide, and to all the studied allergens were established. Conclusions: Carba mix could be outlined as a sensitizer of paramount importance for dental students as well as for dental patients. Benzoyl peroxide was the second ranked sensitizer for dental students. Positive skin patch-test reactions to bisphenol A and toluenesulfonamide formaldehyde resin were established only among the group of dental students. Int J Occup Med Environ Health 2017;30(3):397–405

SummaryBackground Textile dyes, rubber, elements or textile resins carry the risk of inducing allergic contact sensitization. Objectives To assess clinical data and patch test results for dermatitis patients with suspected textile allergy. Methods A retrospective analysis of Information Network of Departments of Dermatology data of the years 2007–2014 of patients patch tested because of suspected textile allergy was performed. Results Patients of the study group (n = 3207) suffered more frequently from leg, trunk and generalized dermatitis than patients of the control group (n = 95210). Among the allergens of the textile dye series, the highest frequency of positive reactions was observed for p-aminoazobenzene (5.1%) and p-phenylenediamine (PPD) (4.5%), followed by Disperse Orange 3 (3.1%), Disperse Blue 124 (2.3%), Disperse Blue 106 (2.0%), Disperse Red 17 (1.1%), and Disperse Yellow 3 (1.1%), partly with concomitant reactions. Patch testing with the patients' own textiles was performed in 315 patients, with positive reactions in 18 patients. These were mostly elicited by blue or black textiles with tight skin contact. Only 2 of these patients also reacted to textile dyes from the German Contact Dermatitis Research Group series. Conclusions For the comprehensive diagnosis of contact sensitization in patients with suspected textile dermatitis, combined patch testing is indicated, with (i) PPD and a textile dye series and (ii) patients' own clothing.

Background Previous studies have documented the cosmetic allergic contact dermatitis due to common cosmetic allergens in standard series and various cosmetic products used in rosacea patients; however, the prevalence of contact sensitization to other cosmetic allergens other than those in standard series is largely unknown. Aims To assess the prevalence of contact sensitization to a European cosmetic series of allergens (Chemotechnique Diagnostics AB, Malmo, Sweden) in rosacea patients and to compare this with the prevalence observed in general population. Methods In this prospective monocenter study, 103 patients with rosacea and 104 control subjects were investigated for contact sensitizations via patch testing the cosmetic series including 49 allergens. Results At least one positive allergic reaction was observed in 62 (60.2%) rosacea patients, and in 25 (24.0%) control subjects. Compared with control subjects, rosacea patients were statistically more likely to have positive patch tests. The most common allergens giving positive results were octyl gallate (10.68%), dodecyl gallate (8.74%), tert-Butylhydroquinone (7.77%), thimerosal (6.80%), euxyl K400 (6.80%), cocamidopropyl betaine (5.83%), and 2,6-Di-tert-butyl-4-cresol (4.85%). Conclusions This study shows that rosacea patients show a strikingly high prevalence of contact sensitization to cosmetic allergens. We recommend the additional use of cosmetic series for patch testing, and the careful use of cosmetics in rosacea patients if cosmetic contact sensitivity is suspected.

Contact dermatitis is a well-known skin condition, which is related to stimuli and environmental exposure to chemicals, affecting all ages as well as both genders. In the present work, we attempt to investigate the patterns of contact sensitization, with respect to the personal history of atopy (AT), in Greece in a large number of allergens, using patch testing. The retrospective analysis included clinical routine data of 1978 patients collected from 2014 to 2016 in the Laboratory of Patch Testing, National Referral Centre of Occupational Dermatoses. Sensitization, in all cases, was tested with 28 allergens of the European baseline series as adjusted to our local circumstances and clinical experience. A total population of 1978 patients was evaluated, with a male-to-female ratio of 0.45 (1359 females/619 males). From our patient cohort, 693 (35%) patients were evaluated with a history of atopy, while 1285 (65%) were nonatopic. The five most prevalent allergens in the total population without AT were nickel sulphate 5% (15.47%), fragrance mix (I) 8% (9.10%), balsam of Peru (6.47%), cobalt chloride 1% (4.70%), and thiomersal 0.1% (4.10%). Respectively, in the total population with AT, the five most prevalent allergens were nickel sulphate 5% (10.36%), fragrance mix (I) 8% (5.11%), balsam of Peru (3.29%), thiomersal 0.1% (3.03%), and cobalt chloride 1% (2.78%). Contact dermatitis surveillance is of great importance towards the clinical and systematic understanding of the disease. Further studies should be directed towards that end, in order to facilitate more effective health policies.

Background: Compositae contact sensitization may be difficult to diagnose, because of a lack of reliable screening allergens. Objectives: To assess the suitability of Compositae mix II 2.5% pet. (CM2.5) as a screening mix in the baseline series combined with sesquiterpene lactone (SL) mix and parthenolide (PTH). Methods: CM2.5 was added to the baseline series, which included SL mix and PTH 0.1% pet., in January 2015, and PTH was included in TRUE Test Panel 3 in October 2015. All Compositae-sensitive patients diagnosed or tested in the next 4 years were assessed. Results: Altogether, 57 patients (2.7%) presented with Compositae allergy. On primary testing in 53 newly diagnosed patients, SL mix elicited positive reactions most frequently (53% positive), followed by CM2.5 (47% positive), and PTH (45% positive). CM2.5 and PTH pet. elicited a few irritant reactions. Three patients had late reactions. Altogether, 16 patients (28%) were not detected by any of the three screening agents. Conclusions: SL mix is an indispensable, although insufficient, screening mixture in Denmark. It may be relatively safely supplemented with CM2.5 and PTH in the TRUE Test system for screening, but, when Compositae sensitization is suspected, further extracts should be tested on the basis of the history.

SCOPUS: le.j, info:eu-repo/semantics/published

BACKGROUND Hand eczema is a common problem with multifactorial etiology. Both endogenous factors like atopy, stress and exogenous factors like contact with irritants and allergens have been incriminated in its causation and aggravation. OBJECTIVES To study the contact sensitization and its pattern in patients of hand eczema and association of contact sensitivity with severity of hand eczema. METHODOLOGY This study was conducted among 80 patients of hand eczema, from 1 st January 2015 to 31 st December 2015 in the Department of Dermatology, Venereology and Leprosy, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun. Patients were patch tested with Standard Indian patch test battery as approved by the Contact and Occupational Dermatoses Forum of India (CODFI). RESULTS Of the 80 patients, 43 (53.8%) were males and 37 (46.2%) females, with a male to female ratio of 1.16:1. Most of our patients (56.2%) belonged to 21-40 years of age group. Hyperkeratotic eczema (36.3%) was the most common type of HE followed by housewife eczema (26.3%), pompholyx (12.5%), fingertip eczema (8.8%), patchy vesiculosquamous and unspecified eczema (6.2%) each, recurrent focal palmar peeling (2.5%), and ring eczema (1.2%). Patch test to one or more allergen was positive in 42 patients (52.5%). Potassium dichromate was the most common sensitizer in our study, followed by nickel, fragrance mix, PPD, wool alcohol and balsum of Peru, parthenium, cobalt. CONCLUSION Contact sensitivity was found to be present in 52.5% of cases of hand eczema in our study. However, no significant association was observed between contact sensitivity and severity of the disease.

SummaryBackground Allergic contact dermatitis is known to occur in children with and without atopic dermatitis, but more data are needed on contact sensitization profiles in these two groups. Objectives To identify frequent allergens in children with and without atopic dermatitis suspected of having allergic contact dermatitis. Methods A retrospective analysis of children aged 0–17 years patch tested between 1996 and 2013 was performed. Results Of all 1012 children tested because of suspected contact dermatitis, 46% developed one or more positive reactions, the proportions for children with (n = 526) and without (n = 395) atopic dermatitis being 48% and 47%, respectively. Children with atopic dermatitis reacted more often to lanolin alcohols (30% pet., p = 0.030), Amerchol L-101 (p = 0.030), and fragrances [fragrance mix I (p = 0.048) and Myroxylon pereirae (p = 0.005)]. Allergens outside the European baseline series that frequently gave positive reactions in these groups included cocamidopropyl betaine and Amerchol L-101. Reactivity to these allergens was significantly more frequently found in atopic dermatitis children. Conclusion Sensitization prevalences in children with and without atopic dermatitis were similar, but children with atopic dermatitis reacted significantly more often to lanolin alcohols and fragrances. Testing with additional series besides the European baseline series may be necessary, as reactions to, for example, cocamidopropyl betaine and Amerchol L-101 may otherwise be missed.

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

Background The evidence on the safety of topical preparations containing emulsifiers is limited. Objectives The aims of the study were to assess (1) the prevalence of sensitization to some emulsifiers commonly found in topical products, (2) the sensitization to emulsifiers in relation to sex, age, and predisposing factors, and (3) the frequency of concomitant sensitization to other common allergens. Methods All consecutive patients presenting to the Allergy Unit of our Dermatological Department for allergological investigation were enrolled. All patients were patch tested with the Italian Societa Italiana di Dermatologia Allergologica Professionale ed Ambientale baseline series and an additional emulsifiers series. Doubtful patch test reactions were not considered. Results Of 310 patients, 50 (16%) were sensitized to emulsifiers with 72 positive reactions. Lauryl polyethylene glycol/polypropylene glycol-18/18 methicone gave 26 positive reactions, glyceryl oleate 19, myristyl alcohol, and Amerchol L101 11. Concomitant sensitization to emulsifiers was found in 16 patients. Patients allergic to emulsifiers showed concomitant allergic reactions to allergens commonly found in cosmetics. No significant differences by sex, age, atopic diathesis, and clinical pattern at presentation were noticed. Conclusions Contact allergy to emulsifiers is more frequent than reported. Patients allergic to emulsifiers show frequent positive patch tests to other constituents of cosmetics and topical products.

Background: Neomycin contact sensitization rates in North America range from 7% to 13%, whereas in Europe they average approximately 1.9%. Objectives: Given that topical neomycin products are no longer readily available in Canada, the aim of this study was to examine what influence this may have had on neomycin sensitization rates in the 3 western provinces. Methods: On the basis of an observation originally communicated by L. M. Parsons and C. Zhang of the University of Calgary, which suggested significantly reduced rates of neomycin sensitization in Calgary, Alberta, Canada, a multicenter study of patch test results from 5690 patient charts was undertaken. Data from 3 other western Canadian Universities (the University of Saskatchewan, the University of Alberta, and the University of British Colombia) were analyzed. Data were available from 2001 to 2013 for the University of Saskatchewan (except 2006), whereas the University of Alberta and the University of British Columbia had data from 2009 to 2013. Descriptive statistics, trend analysis, and risk estimates were determined using SPSS version 20. Results: Sensitization rates for neomycin have decreased in western Canada and are now similar to those of Europe. Conclusions: This trend is likely influenced by the reduced availability of over-the-counter and prescription neomycin products in Canada.

BACKGROUND: Chronic urticaria (CU) can be provoked by a wide variety of causes. Some studies suggest contact sensitization may play a role in the disease. OBJECTIVE: To investigate the incidence and distribution characteristics of allergic contact sensitization in central Chinese subjects with CU, and assess contact allergen avoidance measures in managing CU. METHODS: Patch tests were performed, following the recommended standard procedure, with 20 selected allergens, in line with the European baseline series. All subjects with positive results were prescribed appropriate avoidance measures for the sensitizing substances, while subjects with negative results served as the control group. CU severity was assessed daily from week1 to week4 and for each subject, applying the Urticaria Activity Score. RESULTS: 42.9% (233/543) of subjects with CU showed positive reactions to one or more contact allergen(s). Potassium dichromate, benzene mix and carba mix were more common in male patients, while nickel sulfate was more frequent in females. The positive rates for different allergens varied with age and occupation. The median (interquartile range) severity scores at week 1 were 20 (14-21) and 15 (14-27) for the allergen avoidance group and control group, respectively (P>0.05); and 12 (7-15) and 14 (12-17) at week 4 (P

Background Atopic dermatitis is a common illness in childhood. Children with atopic dermatitis are prone to develop cutaneous sensitization due to skin barrier dysfunction. Aim The aim of this study was to evaluate the frequency of cutaneous sensitizations in patients with atopic dermatitis and to identify the most frequent causative allergens. Study design The study group consisted of 112 children with atopic dermatitis, aged 1–18 years (median 88.5 months) and 39 healthy controls, aged 1–8 years (median 88.48 months). Methods The diagnosis of atopic dermatitis was established by modified Hanifin and Rajka criteria; severity of the disease was assessed by scoring of atopic dermatitis. Serum blood eosinophil count, total IgE and skin prick tests for common aeroallergens and food allergens were performed. Patch tests with cosmetic series and European standard patch test series (Stallegenes© Ltd, Paris, France) were applied. Results Of the children with atopic dermatitis, 17% (n = 19) were sensitized to either cosmetic or standard series or both of them; no children in the control group had a positive patch test (p = 0.001). Atopy and severity of atopic dermatitis was not a significant risk factor for cutaneous sensitization. The most common allergens were Nickel sulphate and Methychloroisothiazinolone (4.5% and 4.5%) in the European standard patch test and cocamidoproplybetaine (12.5%) in the cosmetic series patch test. Conclusion Cutaneous sensitization can develop in children with atopic dermatitis, therefore allergic contact dermatitis should be kept in mind.

The following chapter describes different aspects of occupational contact dermatitis of dental personnel. In particular, occupational skin problems of dentists, dental assistants, dental technicians and orthodontists will be discussed.

Background The number of patients affected by allergies is increasing worldwide. The resulting allergic diseases are leading to significant costs for health care and social systems. Integrated care pathways are needed to enable comprehensive care within the national health systems. The ARIA (Allergic Rhinitis and its Impact on Asthma) initiative develops internationally applicable guidelines for allergic respiratory diseases. Methods ARIA serves to improve the care of patients with allergies and chronic respiratory diseases. In collaboration with other international initiatives, national associations and patient organizations in the field of allergies and respiratory diseases, real-life integrated care pathways have been developed for a digitally assisted, integrative, individualized treatment of allergic rhinitis (AR) with comorbid asthma. In the present work, these integrated care pathways have been adapted to the German situation and health system. Results The present ICP (integrated care pathways) guideline covers key areas of the care of AR patients with and without asthma. It includes the views of patients and other healthcare providers. Discussion A comprehensive ICP guideline can reflect real-life care better than traditional guideline models.

Background Peristomal allergic contact dermatitis is an emerging problem and contact sensitization is probably more common than previously thought. Our objective was to identify sensitization to the most common topical equipment for ostomy in patients with history of peristomal dermatitis. Methods Twenty-six patients with suspected peristomal contact dermatitis were patch tested with our standard series and with products for stoma care (adhesive pastes, powders, adhesive skin barriers). Thirteen patients and 20 volunteers were also patch tested with Gantrez ES-425, which is a common component of adhesive pastes. Results Eighteen patients showed one or more positive reactions, 12 to one or more of the most commonly used adhesive pastes. Ten out of 13 patients tested to Gantrez ES-425 had a positive reaction. Conclusions Allergic contact dermatitis of the peristomal area is probably more common than previously reported. Patch testing is the method of choice to determine sensitization to products for stoma care, and Gantrez ES-425 should be considered for patch testing.

Wound care products are emerging as causes of allergic contact dermatitis (ACD). There are increasing reports of ACD to certain medical adhesives; however, there are no published reports of contact sensitization solely due to wound closure tape such as Steri-Strips™. Herein, we present the first confirmed case of ACD in a child caused by wound closure tape.

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