Search

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 Irritant contact dermatitis ( ICD) is a common diagnosis in patients with occupational contact dermatitis ( OCD). Studies are lacking on the usefulness of material safety data sheets ( MSDSs) in making the diagnosis of ICD. Objective To characterize irritant exposures leading to the diagnosis of occupational ICD ( OICD), and to evaluate the occurrence of concomitant exposures to contact allergens. Methods We included 316 patients with suspected occupational hand dermatitis, referred to the Department of Dermato- Allergology, Copenhagen University Hospital Gentofte, Denmark during January 2010- August 2011, in a programme consisting of a clinical examination, exposure assessment, and extensive patch/prick testing. Results OCD was diagnosed in 228 patients. Of these patients, 118 were diagnosed with OICD. The main irritant exposures identified were wet work (n = 64), gloves (n = 45), mechanical traumas (n = 19), and oils (n = 15). Exposure to specific irritant chemicals was found in 9 patients, and was identified from MSDSs/ingredients labelling in 8 of these patients. Review of MSDSs and ingredients labelling showed that 41 patients were exposed to 41 moderate to potent contact allergens, and 18 patients were exposed to 25 weak workplace contact allergens. Conclusion In the present study, the systematic exposure assessment did not reveal any new irritants. MSDSs have a limited role in the investigation of ICD. [ABSTRACT FROM AUTHOR]

Background The diagnosis of combined allergic and irritant contact dermatitis is an accepted subdiagnosis for hand dermatitis, and it is often considered in a patient with contact dermatitis, a positive and relevant patch test result, and wet work exposure. We therefore hypothesize that it is arbitrary for wet work exposure to be taken into consideration in a patient with newly diagnosed relevant contact allergy. Furthermore, an overestimation of the diagnosis will probably occur if the criteria for wet work exposure are applied correctly, as many occupations have an element of wet work. Objectives To find the statistically expected number of combined allergic and irritant contact dermatitis cases in 1000 patients, and to evaluate the diagnostic criteria for the diagnosis. Methods One thousand consecutive patients with occupational contact dermatitis from a hospital unit in Denmark were assessed. Results The expected number of cases with the diagnosis of combined allergic and irritant contact dermatitis was 0.33%, as compared with the observed number of 6.4%. Females occupied in wet occupations were often diagnosed with combined allergic and irritant contact dermatitis ( p < 0.005). Conclusion The diagnosis of combined allergic and irritant contact dermatitis should be used critically to avoid misclassification, and possible criteria for the diagnosis are proposed. [ABSTRACT FROM AUTHOR]

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

Background Methylchloroisothiazolinone ( MCI) and methylisothiazolinone ( MI) are the active ingredients in commonly used preservative systems (e.g. Kathon CG®). MCI/ MI is present in the European baseline patch test series at 100 ppm aq. Since 1986, 200 ppm (dose 0.006 mg/cm2) has been used in Sweden without causing skin irritation. Centres in Spain, the United Kingdom and Ireland have also used 200 ppm in their baseline series. Objectives To find the optimal patch test concentration for MCI/ MI. Materials and methods MCI/ MI 100 ppm aq. and MCI/ MI 200 ppm aq. were simultaneously patch tested in 3300 consecutively tested dermatitis patients at eight European patch test clinics and one US patch test clinic. With the Finn Chambers® technique (diameter 8 mm), 15 µl was micropipetted on to the filter paper in the chamber. The corresponding volume for Van der Bend® chambers was 20 µl, and that for IQ Chambers® was 25 µl. Results Contact allergy to MCI/ MI at 100 and 200 ppm was found in 1.2% and 2.1% of patients, respectively ( p < 0.001). Conclusions MCI/ MI 200 ppm aq. (dose 0.006 mg/cm2) diagnoses significantly more contact allergy than the presently used concentration of 100 ppm (dose 0.003 mg/cm2), without resulting in more adverse reactions. MCI/ MI at 200 ppm should therefore be considered for inclusion in the European baseline test series. [ABSTRACT FROM AUTHOR]

Background. Although heterozygous filaggrin gene ( FLG) mutation carriers seem to have an increased risk of atopic, irritant and allergic nickel dermatitis, it remains unclear whether the risk of contact sensitization to allergens other than nickel is also elevated in FLG mutation carriers. Objectives. We hypothesized that heterozygous FLG mutation carriers who suffer from dermatitis will have strongly reduced or even absent filaggrin levels during episodes of inflammation, potentially increasing the penetration of contact allergens, and hence the risk of becoming sensitized. Materials and methods. During 2006-2008, 3335 randomly invited 18-69-year-old adult Danes participated in a general health examination, filled out a questionnaire, and were genotyped for the R501X and 2282del4 mutations in FLG. Results. A logistic regression analysis restricted to individuals who reported atopic dermatitis and frequent episodes of hand eczema showed a strong association between FLG mutations and contact sensitization to allergens other than nickel (odds ratio 5.71; 95% confidence interval 1.31-24.94). In participants without dermatitis, no association was found between contact sensitization and FLG mutations. Conclusion. FLG mutation carriers with self-reported dermatitis have an increased risk of contact sensitization to substances other than nickel, whereas FLG mutations alone may not, or may only slightly, increase the risk of sensitization. [ABSTRACT FROM AUTHOR]

Background. Cobalt allergy is prevalent in dermatitis patients. Very little documentation exists about current sources of cobalt exposure. Objectives. To investigate and discuss putative sources of cobalt exposure and to present selected epidemiological data on cobalt allergy from patch-tested dermatitis patients in an attempt to better understand cobalt allergy. Materials and methods. 19 780 dermatitis patients aged 4-99 years were patch tested with nickel, chromium or cobalt between 1985 and 2010. The cobalt spot test was used to test for cobalt ion release from mobile phones as well as cobalt-containing dental alloys and revised hip implant components. Results. Six of eight dental alloys and 10 of 98 revised hip implant components released cobalt in the cobalt spot test, whereas none of 50 mobile phones gave positive reactions. The clinical relevance of positive cobalt test reactions was difficult to determine in the majority of patients. Isolated patch test reactivity to cobalt was less associated with occupational dermatitis and hand eczema than patch test reactivity to cobalt in combination with other contact allergies. Conclusions. It is often difficult to interpret the relevance of a positive patch test reaction to cobalt, and there is a need for further studies to determine sources of cobalt exposure. [ABSTRACT FROM AUTHOR]

Background. Fragrance ingredients are a frequent cause of allergic contact dermatitis. The EU Cosmetics Directive states that 26 specific fragrance ingredients, known to cause allergic contact dermatitis, must be declared on the ingredient lists of cosmetic products. Objectives. To investigate frequencies of sensitization to the 26 individual fragrances and evaluate their importance as screening markers of fragrance allergy. Method. This was a retrospective study based on data from the Department of Dermato-Allergology, Copenhagen University Hospital Gentofte. Eczema patients (n = 1508) were patch tested (January 2008 to July 2010) with the 26 fragrance ingredients. Results. Sensitization to the 26 fragrances was identified in 115 (7.6%) subjects. The most frequent allergens were Evernia furfuracea (n = 50), Evernia prunastri (n = 31), and hydroxyisohexyl 3-cyclohexene carboxaldehyde (n = 24). Including fragrance mix I, fragrance mix II and Myroxylon pereirae, 196 (13.0%) had a fragrance allergy. Testing with the 26 fragrances additionally identified 23 subjects who would otherwise have gone undetected. The majority (75.7%) of positive reactions to the 26 fragrances were of clinical relevance. Conclusions. Sensitization to the 26 individual fragrance ingredients was identified in 7.6% of the subjects patch tested. Most reactions were of clinical relevance. Fragrance-allergic subjects would be missed if testing with the individual fragrance ingredients was not performed. [ABSTRACT FROM AUTHOR]

Background. Allergens included in the European baseline series should result in positive patch test reactions in at least 1% of a patch test population. Inclusion of local anaesthetics other than benzocaine in the baseline series has previously been debated. Objectives. To investigate temporal trends of benzocaine and lidocaine allergy in dermatitis patients who underwent routine patch testing in a tertiary referral patch test centre, and to clarify and discuss whether lidocaine and benzocaine should be included in routine series. Methods. Dermatitis patients who underwent routine patch testing with benzocaine as a part of the European baseline series between 1985 and 2010 (n = 19 347) and dermatitis patients who underwent routine patch testing with lidocaine between 1994 and 2001 (n = 6265) and between 2007 and 2009 (n = 1360) were included. Results. The overall prevalences of contact allergy were 0.5% (benzocaine), 0.3% (lidocaine for the period 1994-2001), and 0.14% (lidocaine for the period 2007-2009). Current relevance was observed in 10% of those with benzocaine allergy and in 5% of those with lidocaine allergy. Conclusions. Benzocaine and lidocaine allergy is infrequent in Danish dermatitis patients. Lidocaine should only be used for aimed testing, and benzocaine should be removed from the baseline series used in Denmark. [ABSTRACT FROM AUTHOR]

Fragrances frequently cause contact allergy, and cosmetic products are the main causes of fragrance contact allergy. As the various products have distinctive forms of application and composition of ingredients, some product groups are potentially more likely to play a part in allergic reactions than others. To determine which cosmetic product groups cause fragrance allergy among Danish eczema patients. This was a retrospective study based on data collected by members of the Danish Contact Dermatitis Group. Participants ( N = 17716) were consecutively patch tested with fragrance markers from the European baseline series (2005-2009). Of the participants, 10.1% had fragrance allergy, of which 42.1% was caused by a cosmetic product: deodorants accounted for 25%, and scented lotions 24.4%. A sex difference was apparent, as deodorants were significantly more likely to be listed as the cause of fragrance allergy in men (odds ratio 2.2) than in women. Correlation was observed between deodorants listed as the cause of allergy and allergy detected with fragrance mix II (FM II) and hydroxyisohexyl 3-cyclohexene carboxaldehyde. Deodorants were the leading causes of fragrance allergy, especially among men. Seemingly, deodorants have an 'unhealthy' composition of the fragrance chemicals present in FM II. [ABSTRACT FROM AUTHOR]

Percutaneous coronary intervention (PCI) with implantation of a metal stent is a common procedure performed in patients with symptomatic ischaemic heart disease. Intracoronary stents typically have a backbone of stainless steel, which contains nickel, chromium, and molybdenum, and it remains unclear whether individuals who are allergic to these metals have an increased risk of restenosis after PCI with stent implantation. To further evaluate whether dermatitis patients with nickel and/or chromium allergy had an increased risk of developing cardiac in-stent restenosis with stainless steel stents. An individual-level linkage study was performed to identify dermatitis patients who had been patch tested with the European baseline series between 1979 and 2007 at Gentofte University Hospital ( N = 18794) and who had also undergone PCI at some point in a Danish hospital. One hundred and forty-nine (0.8%) dermatitis patients who had undergone PCI with a metal stent were included. One hundred and forty-seven were patch-tested before undergoing PCI. Of the patients, 14.1% (21/149) had cardiac in-stent restenosis. Among patients with metal allergy, 2 (11.8%) had restenosis. Nickel and/or chromium allergy in dermatitis patients does not appear to increase the overall risk of in-stent restenosis after PCI. [ABSTRACT FROM AUTHOR]

The article presents a study that evaluates whether an increase in contact allergy to para group chemicals are associated to the prevalence of p-phenylenediamine (PPD) allergy in Danish dermatitis patients between 1989 to 2007. The study is investigated through patch testing with the use of 5% benzocaine, 1% PPD free base, and 16% paraben mix in petrolatum. The results of the study indicate that the prevalence of PPD is not associated with the increase in contact allergy to para group chemicals.

Background: Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) has been one of the most frequent sensitizers since the 1980s. In 2005, the use of MI alone was approved for the preservation of cosmetic and household products in the EU. Before that, MI was used in industrial products, and the first cases of isolated MI contact allergy were published. Objectives: To present the prevalence and causes of MI contact allergy. Materials and methods: Patch test results from 2536 dermatitis patients tested with MI at Gentofte University Hospital between May 2006 and February 2010 were analysed. A retrospective investigation of medical records from MI-allergic patients was performed to reveal the causes of their MI contact allergy. Results: Of patch-tested patients, 1.5% had MI contact allergy. It was associated with occupational dermatitis, hand eczema and age above 40 years. Exposure to MI in cosmetic products was found in 12 (32%) cases, and exposure to MI in occupational products was found in 11 (30%) cases; 5 of the 11 were painters. Conclusions: The prevalence of MI contact allergy is already at the same level as that of other sensitizing preservatives, which have been on the market for several years, but no rising trend was identified. MI contact allergy was associated with both occupational and consumer products. [ABSTRACT FROM AUTHOR]

Background: Most cosmetics and industrial products contain preservatives. Preservative allergy is common and, historically, changing contact allergy epidemics caused by preservatives have been observed. In 1997, Alan Dillarstone predicted a stable development of preservative allergy following mandatory ingredient labelling on cosmetic products. Objectives: To investigate the development in the prevalence of preservative allergy in Denmark over a 24-year period (1985–2008) and to challenge the prediction made by Dillarstone. Patients/Methods: A retrospective analysis of patch test data was performed ( n = 18179). Comparisons were made using a χ2 test. Logistic regression analyses were used to test for associations. Results: The development of preservative allergy mirrored those of other European patch test centres. The development was not dependent on sex or age group. The prevalence was higher among women and those aged 41–60 years. Formaldehyde allergy was persistently prevalent over the study years. The overall prevalence of preservative allergy increased significantly ( Ptrend = 0.001), mainly because of patch testing with additional preservatives in recent years. Conclusions: Dillarstone's prediction was confirmed as the prevalence of contact allergy to individual preservatives remained relatively stable. However, the overall burden of preservative allergy seemed to increase. Introduction of new preservatives may add to the burden of contact allergy. [ABSTRACT FROM AUTHOR]

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

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

The article presents a study which focuses on the investigation of the occurrence of contact allergy to hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) among eczema patients. It says that the evaluation and recording of the clinical relevance were according to the standardized guidelines set by the Danish Contact Dermatitis Group (DCDG). Results show that the positive patch test reaction to HICC is more significant in women than in men.

The article presents a case study of a 37-year old woman with localized dermatitis due to jewelry exposure. It says that the jewelries to which the patient reacted was collected to examine through chemical analysis and microstructural surface characterization with the use of scanning electron microscope. Moreover, nickel and cobalt release testing shows that the patient was allergic to nickel.

The article presents a research study on the prevalence of allergic nickel dermatitis disorder in nickel-allergic patients in Denmark and also describes the consumer behaviour of these patients with regard to metallic items. Topics discussed include the regulations passed by the European Union (EU) regarding nickel release from metallic items, the methods and results of the study and a detailed discussion regarding allergic nickel dermatitis.

The article presents a case study of a 28-year-old woman with a history of atopic dermatitis presented with a one-year history of hand eczema involving the second to fourth fingers on both hands. Topics discussed include occupational exposure to methylisothiazolinone in adhesive labels; diagnostic patch testing for allergens; and exposure assessment of methylisothiazolinone in consumer products.

The article discusses the findings of a study to assess the release of chromium (VI) in 848 jewellery items using the diphenylcarbazide (DPC) spot test. It notes that the jewellery items were purchased from different locations including Denmark, Poland, and Great Britain. The results of the DPC spot test confirm that the jewellery items failed to release more than 0.5 parts per million (ppm) of chromium (VI) which is less than the amount needed to elicit dermatitis in allergic patients.

The article presents a case study of a 46-year-old atopic woman with chronic dermatitis on her left planar on both feet. The patient underwent patch testing which reveals reactivity to chromium. The study showed the need for dermatologists to examine the validity of chromium-free footwear in patient with foot dermatitis and chromium allergy.

The article presents a research study which examines the correlation between contact allergy (CA) and rheumatoid arthritis (RA). The findings of the study reveal that CA and RA are inversely correlated with one another. It was also found out that patients with RA exhibit impaired cell-mediated immunity which might contribute to a reduction in skin reactivity. The study suggests that the immunological background of the two diseases may be useful in the development of future treatments.

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