Search

Background: Rubber accelerators are used in the production of rubber gloves and may cause contact allergy. Objectives: To estimate long‐term trend and prevalence of contact allergy to rubber accelerators for a 30‐year period in Denmark, high‐risk occupations, and exposures. Methods: Data from all patients with contact dermatitis consecutively patch tested at the department of Skin and Allergy Gentofte hospital with the rubber accelerators from the European baseline series (EBS) from 1990 to 2019, were analysed. Further, patients under suspicion of rubber accelerator contact allergy were additionally patch‐tested with rubber accelerators from the specialised rubber series from 2005 to 2019 and these were additional extracted. Results: The overall prevalence of contact allergy to one or more of the rubber accelerators from the EBS series was 2.7% with a significant decline in the first 12‐years, followed by a stable frequency in the past 18‐years. Associations with occupational contact dermatitis, hand dermatitis, and leg/foot dermatitis were found. Wet‐work occupations were most often affected and gloves the most frequent exposure. Conclusions: Contact allergy to one or more of the rubber accelerators from the EBS is frequent and has been unchanged for several decades, which calls for prevention. [ABSTRACT FROM AUTHOR]

Background: Allergic contact dermatitis (ACD) in the eye region caused by topical eye medications is difficult to diagnose and may be overlooked. Objective: To study the characteristics and causative agents in patients with ACD caused by topical eye medications in a Danish tertiary dermatology department. Methods: A retrospective study of 318 patients, patch tested between 2013 and 2021 due to suspected ACD to topical eye medications. All patients were tested with a locally developed eye medication series, some were additionally tested with suspected eye medications. Medical records were studied in patch test positive patients. Results: Contact allergy to a topical eye allergen/medication was found in 12.9% (n = 41) of 318 patients, and culprit allergens were phenylephrine (6.9%), timolol (2.5%) and ketotifen (1.6%). Patch test positive patients were often previously diagnosed with cataract (29.3%) or glaucoma (24.4%), and the majority reported more than one previous reaction. Initial symptoms were oedema (56.0%), erythema (48.8%) and dermatitis (31.7%) in the eye region, and facial dermatitis was also seen. Conclusions: Patients with symptoms from the eye region who have been using topical eye medications should be patch tested with ingredients from commonly used eye medications supplemented by the products tested 'as is'. [ABSTRACT FROM AUTHOR]

Background: Compliance with glove use and safe work practices are important factors in primary prevention of occupational hand eczema (OHE) in hairdressers. Objective: To assess the risk OHE and compliance with skin protective measures in hairdressers trained before and after implementation of a nationwide skin protection program in Danish hairdressing vocational schools in 2011. Methods: A repeated cross‐sectional study was performed. A questionnaire was sent in 2009 and 2020. The Danish Labour Market Supplementary Pension Scheme provided information on yearly payments from the hairdressing profession. Results: A response rate of 66.6% (305/460) was obtained in the 2009 survey and of 29.9% (363/1215) in the 2020 survey. The career time prevalence of OHE decreased from 42.8% to 29.0% (adjusted odds ratio 0.55 95% confidence interval [CI] 0.40‐0.77) and the incidence rate of OHE decreased from 57.5 (95%CI 48.4‐68.4) to 42.0 (95%CI 34.6‐50.9) per 1000 person years (incidence rate ratio 0.73 [95%CI 0.56‐0.95] between the two surveys). A statistically significant (P <.05) increase in glove use when doing wet‐work and when handling hair dyes, permanent wave solutions and bleaching products was observed in the 2020 compared to the 2009 survey. Conclusion: Our data suggest that skin protection training during apprenticeship reduces the risk of OHE in hairdressers. The lack of primary prevention of OHE in hairdressing vocational schools may be a missed opportunity in the prevention of the disease. [ABSTRACT FROM AUTHOR]

Background: We observed an increasing number of patients who presented with facial or retro‐auricular dermatitis after skin contact with plastic spectacles or plastic covered temples. Objectives: To identify the allergens in plastic spectacles that may cause allergic contact dermatitis. Methods: All patients with suspected allergic contact dermatitis to eyewear were tested with Solvent Orange 60 (SO60), four additionally with Solvent Yellow 14 (SY14), and five with scrapings from their own spectacles. In one case, a chemical analysis of the spectacles was performed to uncover the causative allergen. Results: Three patients were allergic to SO60, two patients to SY14, and two patients were allergic to both SO60 and SY14. Conclusion: Patients with suspected allergic contact dermatitis from spectacles should be tested with SO60 and SY14, and based on findings from previous reports, also with Solvent Red 179. [ABSTRACT FROM AUTHOR]

A recently used Plum hand disinfection gel declared THPE, but was not available for testing. Keywords: allergic contact dermatitis; CAS no. 102-60-3; case report; hand disinfection; tetrahydroxypropyl ethylenediamine EN allergic contact dermatitis CAS no. 102-60-3 case report hand disinfection tetrahydroxypropyl ethylenediamine 114 116 3 06/14/22 20220701 NES 220701 CASE 1 A 54-year-old man with a history of atopic dermatitis and mild interdigital hand eczema presented with erythematous swelling of the face and neck and aggravation of hand eczema during the coronavirus disease 2019 (COVID-19) pandemic (1½ years). [Extracted from the article]

Keywords: 2-hydroxyethyl methacrylate; artificial nail modelling systems; case report; dental plastic fillings; occupational contact dermatitis EN 2-hydroxyethyl methacrylate artificial nail modelling systems case report dental plastic fillings occupational contact dermatitis 106 108 3 06/14/22 20220701 NES 220701 2-Hydroxyethyl methacrylate (HEMA; CAS No. 868-77-9) is a plastic material used in printing industry, artificial nail modelling systems such as gel nails and long-lasting nail polish, and in dental plastic fillings. 2-hydroxyethyl methacrylate, case report, occupational contact dermatitis, artificial nail modelling systems, dental plastic fillings Local and systemic contact dermatitis elicited by dental plastic fillings in a patient allergic to 2-hydroxyethyl methacrylate. [Extracted from the article]

Background: In 2005, methylisothiazolinone (MI) was allowed as a stand‐alone preservative in cosmetics. This resulted in an epidemic of allergic contact dermatitis to MI, mainly affecting women exposed to leave‐on cosmetics. Consequently, a regulation of Annex V in the European Union in 2017 banned the use of MI in leave‐on cosmetics and reduced the allowed concentration in rinse‐off products. Objective: To analyze the temporal trends in contact allergy to MI in Danish patients in relation to key events including European regulations over time. Methods: A retrospective study of consecutive patients patch tested with methylisothiazolinone from 2005 to 2019. Demographics and clinical characteristics in terms of MOAHLFA (male, occupational, atopic dermatitis, hand dermatitis, leg dermatitis, facial dermatitis and age >40 years), sources of exposure, and clinical relevance were analyzed in relation to key historical events. Results: Three hundred eighty of 12 494 patients (3.0%, 95CI: 2.7–3.4%) tested from 2005 to 2019 were sensitized to MI. An increasing trend in the prevalence of MI contact allergy from 2005 to 2019 (P <.01) was observed, although a decline in the absolute number of patch‐test positive patients was seen from 2013 and onward. A reduction in leave‐on cosmetics as a source of exposure was observed following the legislative ban in 2017, from 24.8% from in 2010 to 2013 to 6.2% in 2017 to 2019 (P <.01). Conclusion: The epidemic of MI contact allergy is declining in absolute terms, although the prevalence in the patch‐tested population has not returned to its pre‐epidemic levels. The legislative regulation of MI in 2017 has been effective in terms of leave‐on cosmetics as a source of exposure in MI allergic patients. The process of post‐marketing risk assessment of contact allergens in the European Union needs improvement. [ABSTRACT FROM AUTHOR]

Background: During the first wave of the COVID‐19 pandemic of Spring 2020, Denmark was one of the first countries to introduce lockdown measures, including closing of all daycare centers. Following the reopening of daycare centers, Danish Health Authorities implemented a mandatory intensive hand hygiene regimen. Objectives: To examine the occurrence and point prevalence of hand eczema as a consequence of more intensive hand hygiene among Danish children attending daycare. Methods: The heads of 1667 daycare centers in Denmark were contacted and asked to forward a link to a questionnaire to parents of the children attending the daycare center. Results: Among 6858 children, 12.1% had hand eczema before reopening of daycare centers, whereas 38.3% reported hand eczema after the children returned to daycare. Of the children who never had hand eczema, 28.6% developed hand eczema after returning to daycare. The risk of hand eczema was significantly associated with atopic dermatitis, female gender, higher age, and frequency of handwashing. Conclusion: Following the implemented hygiene regimen, a high proportion of young children rapidly developed hand eczema. Well‐established prophylactic skin care might have spared a proportion of the children from developing hand eczema. [ABSTRACT FROM AUTHOR]

Background: The number of patients with contact dermatitis from glucose sensors and insulin infusion sets is increasing. Patch testing is challenging because of a lack of information concerning the constituent materials of medical devices. Objectives: To report on products and causes of allergic reactions to glucose sensors or insulin infusion sets over a 5‐year period and suggest a short screening series. Methods: Analysis of patch test data from consecutive patients suspected of allergic contact dermatitis (ACD) to glucose sensors and/or insulin infusion sets from 2015–2019. Results: Patient numbers increased from 4 to 15 per year; 30/38 (78.9%) were children. In 29 (76.3%), a diagnosis of allergic/probable ACD was established, mostly due to the tapes of the device or allergens in these tapes (n = 23) followed by allergens in the device housing (n = 10). Isobornyl acrylate, abitol, and colophonium were the most common allergens. Information from manufacturers was often difficult to obtain and, if accessible, inadequate. For this reason, the diagnosis was delayed for more than 1.5 years in 12 (31%) patients. Conclusions: The increasing number of patients, mostly children, with ACD from devices used in treatment of type 1 diabetes demonstrates the importance of this problem. Allergies can easily be overlooked, due to the lack of mandatory labeling of the constituent materials of the devices. [ABSTRACT FROM AUTHOR]

Background: Cobalt contact allergy is common, but clinical relevance is often difficult to determine. Objectives: To examine the aetiology, prevalence and clinical characteristics of cobalt‐allergic patients who were patch tested between 2002 and 2017 at the Department of Dermatology and Allergy, Herlev‐Gentofte Hospital. Methods: Patch test data, along with patient characteristics and causative exposures, from all adult dermatitis patients seen and tested between 2002 and 2017 were analysed. Associations were tested with the χ2 test and logistic regression. Results: A total of 13 475 adults aged 18 to 99 years were patch tested. The overall prevalence of cobalt allergy and the prevalence of isolated cobalt allergy were 3.3% and 1.5%, respectively. The prevalence of isolated cobalt allergy decreased from 2.4% in 2006 to 2009 to 1.1% in 2014 to 2017 (Ptrend = 0.00003). Leather exposure as a relevant cause of allergic cobalt dermatitis increased from 3.7% in 2002 to 2009 to 8.3% in 2010 to 2017 (P = 0.04). The current clinical relevance of positive patch test reactions, that is, a positive reaction to cobalt combined with a history of current skin exposure to a source of cobalt, was 20.1%. Conclusions: We conclude that cobalt allergy is relatively common, but causative exposures are largely unknown, and the proportion of positive patch test reactions with clinical relevance is low. It is therefore currently unclear how we can better protect consumers and workers from cobalt exposure. [ABSTRACT FROM AUTHOR]

Background: Contact allergy to oxidized limonene, with hydroperoxides of limonene (Lim‐OOHs) as the main allergens, is common. However, high proportions of weak positive and doubtful patch test reactions have been reported. Objectives: To determine the clinical relevance, elicitation threshold and dose‐response relationship of Lim‐OOHs in individuals with a positive or doubtful patch test reaction to standard Lim‐OOHs 0.3% pet. Methods: A multicentre 3‐week double‐blind vehicle‐controlled repeated open application test (ROAT) study with a simulated fine fragrance containing Lim‐OOHs at 1260, 420 and 140 ppm, equal to a dose/area per application of Lim‐OOHs of 3.0, 0.99 and 0.33 μg/cm2, was performed. Results: Among 11 subjects allergic to Lim‐OOHs, 11 (100%), 7 (64%), and 3 (27%), respectively, reacted to the applied doses. No reactions were seen in 17 healthy controls exposed to the highest dose. This difference in reactivity was statistically significant (P < 0.0001). Among 13 subjects with doubtful patch test reactions to Lim‐OOHs, two (15%) had positive ROAT reactions to the highest Lim‐OOH dose applied (P = 0.36 as compared with controls). Conclusions: Contact allergy to Lim‐OOHs is of clinical relevance in patients with positive patch test reactions. A doubtful patch test reaction to Lim‐OOHs 0.3% pet. can be of clinical relevance. [ABSTRACT FROM AUTHOR]

Background: In 2012, Danish authorities submitted a proposal to the European Chemical Agency restricting the content of hexavalent chromium to a maximum of 3 ppm in leather goods. Following its adoption, this proposal was implemented in 2015 as a directive in the EU. Objectives: To examine the temporal trend of chromium contact allergy in adult dermatitis patients patch tested between 2002 and 2017, and to determine clinical characteristics and causative exposures in these patients. Methods: All adult dermatitis patients patch tested between 2002 and 2017 were included. Patch test data were reviewed retrospectively. Comparisons were performed with the χ2 test and logistic regression analysis. Results: A total of 13 379 adults aged 18 to 99 years were patch tested between 2002 and 2017. The overall prevalence of chromium allergy was 2.2%. An overall decreasing trend was found for the prevalence of chromium allergy (Ptrend = 0.00002). Specifically, a significant difference was found for the study periods 2010 to 2013 (Ptrend = 0.002) and 2014 to 2017 (Ptrend < 0.0001) as compared with 2002 to 2005. Leather remained the most important single cause of allergic contact dermatitis caused by chromium. The proportion of clinically relevant leather exposures increased from 42.3% during 2002 to 2009 to 54.8% during 2010 to 2017 (P = 0.04). Conclusions: The prevalence of chromium allergy is decreasing. The EU Directive restricting the use of hexavalent chromium in leather goods is thought to be playing a central role in this change. [ABSTRACT FROM AUTHOR]

The article presents the study conducted on mice and nickel-allergic humans where IL-17+ cells have been found in positive patch test reactions indicating that IL- 17 may play a crucial role in allergic contact dermatitis (ACD). The trial was conducted to examine the effect of anti-IL-17 (secukinumab) in patients with contact allergy.

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]

Contact dermatitis in healthcare workers is a world wide problem. We conducted a retrospective observational study of the patch-test results of 1,402 healthcare workers and 1,402 matched controls with contact dermatitis who were treated at 3 hospitals departments in Denmark between 2007 and 2014. The primary objective was to determine whether healthcare work was associated with contact allergy to thiuram mix, used as a rubber accelerator ib rubber protective gloves. Unadjusted univariate analyses revealed that healthcare work was significantly associated with occupational contact dermatitis and hand dermatitis. Contact allergy to thiuram mix was more common in healthcare workers, and was significantly associated with having occupational contact dermatitis, hand dermatitis and older age. In conclusion, we report here a potential problem of contact allergy to thiurams in healthcare workers with contact dermatitis. Legislative authorities may in the future focus on the use of rubber accelerators in, for example, protective gloves, which are widely used by healthcare professionals. [ABSTRACT FROM AUTHOR]

Background Chlorhexidine is a widely used disinfectant in the healthcare setting and in cosmetic products. A high prevalence of chlorhexidine contact allergy was reported in Denmark in the 1980s (2.0-5.4% of patients patch tested). It is unknown whether the prevalence is still high, which products cause the contact allergy, and whether accidental re-exposure occurs in some patients. Objectives To estimate the prevalence of chlorhexidine contact allergy in a tertiary dermatology clinic in Denmark; to investigate whether patch testing with both chlorhexidine diacetate and chlorhexidine digluconate is necessary; to investigate how many patients have combined immediate-type allergy and contact allergy; and to identify which products cause chlorhexidine contact allergy, and whether patients are accidentally re-exposed. Methods This was a retrospective study including all patients patch tested with chlorhexidine during 2003-2013 at the Department of Dermato-Allergology at Copenhagen University Hospital Gentofte (n = 8497). All patients with a positive patch test reaction to chlorhexidine were sent a questionnaire comprising questions about the cause of the allergy and re-exposure. Results Overall, 1.0% (n = 82) of all patients patch tested with chlorhexidine were positive. A decrease in the prevalence was observed over time, most likely because of lowering of the test concentration from 1.0 to 0.5% in 2008. Of the 82 patients, 28 (0.3%) had positive test reactions to both chlorhexidine salts, 43 (0.5%) had a positive test reaction only to chlorhexidine diacetate, and 11 (0.1%) had a positive test reaction to chlorhexidine digluconate. Three patients were both patch test-positive and prick test-positive. A known cause of the allergy was reported by 19 patients (40%) in the questionnaire: the products used in the healthcare setting were mainly reported, but some reported cosmetic products. Accidental re-exposure was reported by 15 patients (32%), of whom 13 reported symptoms. Conclusions The prevalence of chlorhexidine contact allergy does not seem to be higher in Denmark than in other European countries. Patch testing with both chlorhexidine diacetate and chlorhexidine digluconate may be beneficial. Testing for immediate-type allergy in patients with a positive patch test reaction to chlorhexidine is recommended. Chlorhexidine-containing products used in the healthcare setting and in cosmetics are potential causes of sensitization and allergy. Re-exposure is common, highlighting the fact that patients and healthcare personnel need to be well informed about possible sources of exposure. [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]

This article discusses a case of occupational allergic contact dermatitis (OACD) caused by Tinuvin 770, a hindered amine light stabilizer (HALS) commonly used in grouting materials. The patient, a grout worker, presented with hyperkeratotic fissured eczema and pulpitis on his fingers. Patch testing revealed a positive reaction to Tinuvin 770. This case highlights the allergenic capacity of Tinuvin 770 and its importance in occupational settings. [Extracted from the article]

Atopic dermatitis, hand eczema and contact sensitization are prevalent disorders, and may, in many cases, be secondary to skin barrier abnormality. The aim of this study was to investigate the association between self-reported generalized xerosis, atopic dermatitis, hand eczema and contact sensitization, taking filaggrin gene mutations into account. Questionnaire data were collected from a cross-sectional study performed in a general population in Copenhagen. A total of 3,460 18-69-year-olds were patch-tested and 3,335 were genotyped for the 2282del4 and R501X mutations in the filaggrin gene. Atopic dermatitis and hand eczema were significantly associated with generalized xerosis, whereas contact sensitization (not nickel) showed only a borderline significant association. These results suggest that generalized xerosis may increase the risk of common skin disorders. [ABSTRACT FROM AUTHOR]

Background. Painters are among the occupational groups that most commonly experience occupational contact dermatitis, but few investigations exist concerning this occupation. Objectives. To characterize painters with contact dermatitis and identify the most common allergens associated with the occupation. Materials and methods. All patch test results of 219 painters and 1095 matched controls registered by the Danish Contact Dermatitis Group between 2001 and 2010 were analysed. Results. Hand eczema ( p < 0.0001) and occupational contact dermatitis ( p < 0.0001) were observed significantly more often in the painters than in the group of controls. Sensitizations to the following allergens from the European baseline series were associated with the occupation and were statistically significant: methylchloroisothiazolinone/methylisothiazolinone, epoxy resin, formaldehyde, and quaternium-15. Three different isothiazolinones emerged as the most frequent sensitizers of the allergens tested in addition to the baseline series. Conclusions. The results indicate that painters have an increased risk of developing occupational hand eczema. Isothiazolinones and epoxy resin proved to be the two most frequent sensitizers in painters. [ABSTRACT FROM AUTHOR]

Background. Despite the political intention to limit nickel allergy and dermatitis in Europeans, nickel allergy remains frequent. There are several explanations for the persistence of nickel allergy and dermatitis, including the increasing use of mobile phones. Before regulation of nickel release from mobile phones, we showed that eight (19.5%) of 41 mobile phones marketed in Denmark between 2003 and 2007 released nickel in concentrations that may result in nickel allergy and dermatitis. In 2009, the EU Nickel Directive was revised to include nickel-releasing mobile phones. Objectives. To investigate the proportion of mobile phones sold in Denmark that release nickel after regulation. Methods. Metallic parts from 50 randomly selected mobile phones currently for sale in Denmark were tested for nickel release by use of the dimethylglyoxime (DMG)-nickel spot test. Results. Nine (18%) phones showed at least one positive DMG test reaction and two phones had more than one DMG test-positive spot. Conclusions. Apparently, the proportion of mobile phones with significant nickel release remains unchanged, despite the 2009 revision of the EU Nickel Directive. We encourage manufacturers to measure nickel release from metallic components used in the assembly of mobile phones to ensure safe products. [ABSTRACT FROM AUTHOR]

Background: Nickel dermatitis may be caused by frequent and prolonged use of cell phones. Because little is known about the frequency of nickel release from cell phones, it is difficult to estimate the risk of nickel sensitization and dermatitis among their users. Objective: Inspired by a recent case of nickel dermatitis from prolonged cell phone use, the frequency of dimethylglyoxime (DMG)-positive cell phones on the Danish market was investigated. Methods: Five major cell phone companies were contacted. Two were visited, and the DMG test was performed on a sample of their products. Results: 5 of 15 (33.3%) phones from company A and 3 of 26 (11.5%) phones from company B showed at least 1 positive reaction. 3 phones had more than 1 positive DMG spots. Conclusions: This study documents that excessive nickel release (i.e. a positive DMG test) is relatively frequent in a sample of cell phones from the Danish market. Prolonged use of cell phones may in some cases fulfil the criteria for items included in the European Union Nickel Directive. We believe that this new cause of nickel dermatitis should be carefully followed and that regulatory steps may be necessary. [ABSTRACT FROM AUTHOR]

Methylchloroisothiazolinone and methylisothiazolinone (MCI/MI) contact allergy affects 1–3% of patch-tested patients in European centres. The aim of the present study was to evaluate the importance of the factors – time and concentration (dose/per unit area) – in the elicitation capacity by means of a repeated open application test (ROAT) experimental design. The study was designed as a double-blind, placebo-controlled, dose–response ROAT preceded by a diagnostic patch testing. 25 subjects with confirmed MCI/MI allergy and 10 healthy, non-MCI/MI allergic control subjects were exposed to 0.025 μg/cm2 (2 p.p.m.) of MCI/MI/unit area of the skin for 4 weeks. After a wash-out period of at least 4 weeks, the subjects were exposed to 0.094 μg/cm2 (7.5 p.p.m.) of MCI/MI/unit area of the skin for 4 weeks. The study showed the importance of both time and exposure in the elicitation process. It demonstrated that the elicitation threshold for MCI/MI is expected to be in the proximity of 0.025 μg/cm2 although it was not possible to establish a definitive elicitation threshold for MCI/MI in this study. [ABSTRACT FROM AUTHOR]

The elicitation potential of the cosmetic preservative diazolidinyl urea was studied in formaldehyde- and diazolidinyl urea-sensitized volunteer patients using a stepwise controlled exposure design. The test product was a facial moisturizer, preserved with varying concentrations of diazolidinyl urea, ranging from 0.05% to 0.6%. A repeated open application-like exposure test was performed on volunteers and a control group with the test product containing increasing preservative concentrations, on arm, neck and face, sequentially, for 2 weeks or until dermatitis developed. The preservative action in the cream at different test concentrations was tested in microbial challenge tests and was found effective at all concentrations tested. The study established a non-eliciting concentration of diazolidinyl urea of 0.05% in formaldehyde-sensitive patients and showed that the skin reactivity depends on the anatomical region, increasing from the upper arm to neck and, possibly, to the face. The study design, beginning on the upper arm and moving on to the neck and face seems to be relevant for the study of reactions to cosmetic products. A clear dose–response relationship was seen regarding preservative concentration in the product. [ABSTRACT FROM AUTHOR]

We have previously demonstrated that the epidermal content of the lymphocyte activating peptide ETAF/IL-l and lymphocyte chemotactic factor (ELCF) increases during the development of a cell-mediated immune reaction, represented either by the tuberculin skin reaction or by a positive patch test in patients with contact allergy. The present study describes the epidermal content of these mediators during an irritant patch test reaction. The results show that ELCF, but not ETAF/IL-1, is significantly increased in the epidermis of an irritant patch test with 3% SLS or 5% croton oil, irrespective of the intensity of the clinicai patch test reaction. We observed that simple occlusion of epidermis did not induce ELCF activity in healthy persons. whereas patients with previous or current eczema had a significant release of ELCF following such occlusion. These results seem to indicate that there exist important functional differences between allergic and irritant patch test reactions with respect to the presence of lymphocyte activating signals in epidermis. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 24-year-old woman who is suffering from atopic dermatitis that is presented with chronic hand eczema. It details the results of the patient's patch testing which revealed an allergic reaction to sorbitan sesquioleate that was found on the vinyl rubber gloves that the patient wore when doing tasks that involves prolonged contact with water. It offers information on sorbitan sesquioleate which is considered as a weak allergen.

The article discusses five cases of isothiazolinones-induced chronic dermatitis. The patients include a 47-year-old male who does not have a previous skin disease's history, a 35-year-old male whose patch test reaction to benzisothiazolinone (BIT) was positive, and a 42-year-old healthy female. It suggests that the cases reveal the increasing problem with isothiazolinones-induced contact allergy.

Primin was included in the European standard series (ESS) in 1984. In 2000, a primin-free variant of Primula obconica, the main source of contact allergy to primin, was introduced in the market. The aim of this study was to analyse the trends of primin allergy in 13 986 consecutively patch-tested eczema patients over a 20-year period from 1985 to 2004. 151 patients gave a positive patch test to primin. The majority were women, in two-third of patients the patch test was relevant and most presented with hand eczema. Only few of the cases (4.7%) were occupational. A significant decline of contact allergy to primin was seen ( P < 0.001) over the years affecting all age groups. The frequency was 0.5% during 2000–2004. Contact allergy has been rare since 2000. The low frequency of positive patch test to primin does not support inclusion in the ESS in our region. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 46-year-old otorhinolaryngologist who was detected with eczema on his right hand's second and third fingers. Topics include the disease caused by occupational exposure to tetracaine, the use of potent topical corticosteroids as treatment for the eczema and the routinary testing for contact allergy to local anaesthetics in patients tested with benzocaine.

The author focuses on allergenic reaction to skin due to Chemicals. Use of methyl¬isothiazolinone in cosmetics and paints has resulted in increase in allergic skin reac¬tions after airborne exposure to it. It also states that new regulation should be made on lowering the allowed concentration of compound in all products for the safety of consumer.