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Background: Iodopropynyl butylcarbamate (IPBC) is a broad‐spectrum preservative for use in several product types, including cosmetics, in which its concentrations have been limited by EU legislation because of concerns related to its iodine content and release, and the risk of subsequent iodine overdose. Objectives: To report on concomitant patch test reactions observed with iodine and IPBC in patients sensitized to iodine‐containing antiseptics. Patients Between 2012 and 2018, seven patients, six from Belgium and one from France, two suffering from acute dermatitis during surgical interventions, four from dermatitis caused by wound treatment, and one from occupational dermatitis, were shown to be sensitized to iodine and/or povidone‐iodine (PVP‐I), which was considered to be relevant for their dermatitis. All patients were coincidentally also patch tested with IPBC. Results: All patients showed positive patch test reactions to several other allergens, including IPBC. No relevance could be detected for IPBC. Conclusions: We suspect that, notwithstanding the absence of firm evidence for IPBC being dehalogenated to produce free iodine in animals or in humans, the patch test reactions to IPBC in iodine‐allergic subjects were possibly caused by free iodine released from this preservative agent, thus underlining the EU restrictions regarding the use of this preservative in cosmetics. [ABSTRACT FROM AUTHOR]

Background: In the 2010s an epidemic of allergic contact dermatitis to methylisothiazolinone (MI) occurred in Europe. European authorities banned the use of methylisothiazolinone in leave-on cosmetics in 2017 and limited its use in rinse-off products in 2018., Objectives: To investigate the sensitization rate to MI in Belgium between January 2014 and December 2019, and to assess cosensitizations to octylisothiazolinone (OIT) and benzisothiazolinone (BIT) in MI-sensitized patients., Methods: A retrospective study of patch test results with MI, OIT, and BIT observed in patients attending five Belgian hospitals., Results: Overall, 560 of 10 029 patients (5.58%) had a positive patch test reaction to MI, and its sensitization rate decreased from 7.9% in 2014 to 3.1% in 2019. Rinse-off cosmetics, paints, and detergents were the most prevalent sensitization sources in recent years. Simultaneous reactions readily occurred to OIT, and, surprisingly, and increasingly, also to BIT., Conclusions: Contact allergy to MI in Belgium has reached a pre-epidemic level, reflecting the impact of recent regulatory measures. Leave-on cosmetics, in contrast to rinse-off products, have almost disappeared as sensitization sources in Europe. Paints and detergents also remain problematic. The remarkably high number of patients (co)sensitized to BIT should be a focus of future research., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The chemical Kathon CG(®), a mixture of the preservatives methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI), was the leading cause of a worldwide epidemic of contact-allergic reactions in the eighties. From 2000 on, MI alone became allowed in industrial products and in 2005 authorities gave a green light for its use in leave-on and rinse-off cosmetics up to a maximum concentration of 100 ppm (0.01%). Following initial occupational cases, a continuously increasing number of consumers sensitized to MI have been reported and both Belgian and French allergy groups decided to routinely test MI in their baseline series from 2010 onwards. Two multicenter studies, comprising 8,680 and 7,874 patients in Belgium and France respectively, both clearly show the rise in contact allergy caused by MI, with a spectacular sensitization rate of ∼ 6.0% in 2012, even increasing to 7.0% in 2013. Mostly middle-aged women, presenting with facial-and/or hand dermatitis, were affected, although very young children were reported as well. Furthermore, the data confirmed that sensitization is primarily caused by cosmetics (mostly leave-on, but also rinse-off), household detergents and water-based paint. This unprecedented outbreak of contact sensitization to a preservative agent in Europe, and beyond, should have alerted the authorities much sooner and meanwhile the need for safer use concentrations of MI in cosmetics, detergents and industrial products is becoming more urgent every day.

Disperse dyes are the most common contact sensitizers among textile dyes. The main aim of this study was to investigate the outcome of patch testing with a textile dye mix 6.6%. A total of 2,049 patients from Sweden and 497 from Belgium were tested with the mix, consisting of Disperse (D) Blue 35, D Yellow 3, D Orange 1 and 3, D Red 1 and 17, 1.0% each, and D Blue 106 and D Blue 124, 0.3% each. Of the total number, 65 patients, 2.6%, tested positively to the mix, 4.2% of the Belgian patients and 2.1% of the Swedish patients. Patch testing with the mix 6.6% revealed significantly more patients with contact allergy compared with testing with a previous mix 3.2% (p < 0.01). Contact allergy to the mix was significantly more common in the Belgian than in the Swedish patients.

Background: The widespread use of fragrance-containing products is probably the most important reason for its high impact in allergic contact dermatitis., Objectives: To describe the frequency of contact allergy to fragrance allergens as tested in the standard series, in relation to age, sex and lesion locations. To determine trends in frequency over the years and to study the association between positive tests observed with the different fragrance-allergy markers as well as between specific fragrance allergens and locations of the lesions., Patients/methods: 10 128 patients underwent patch testing between January 1990 and December 2005 at the Dermatology department in Leuven., Results: 1463 (14.5%), that is, 380 (26%) males and 1083 (74%) females, reacted positively to at least 1 fragrance-allergy marker in the standard series: 9% to fragrance mix I, 6% to Myroxylon pereirae, and 4.8% to colophonium (often in association), 2.1% to hydroxyisohexyl 3-cyclohexene carboxaldehyde and 2.1% to fragrance mix II, the latter 2 allergens having been introduced more recently. Over the years, fragrance contact allergy has shown a fluctuating trend. Hands and face were the most commonly affected body sites. Moreover, a significant association was found between specific fragrance allergens and certain locations., Conclusions: This study illustrates that fragrance contact allergy is common in patients suffering from contact dermatitis.

Background: Photoallergic contact dermatitis from topical ketoprofen (KP), a nonsteroidal anti-inflammatory agent, is a well-known side effect., Objectives: To investigate photo-contact allergic reactions to KP and other nonsteroidal anti-inflammatory drugs (NSAIDs), sunscreens, and fragrance components as well as the presence of prolonged photosensitivity related to it., Patients/methods: From June 1993 to June 2007, 42 patients were patch tested and photopatch tested with the ingredients of a KP preparation and other relevant substances. A questionnaire was performed in order to determine the importance of prolonged photosensitivity; 40/42 did respond., Results: 38 patients showed photo-contact reaction, 1 photoaggravated reaction, and 3 contact allergic (CA) reaction to KP. Simultaneous photo-contact allergic reactions were frequently observed not only to structurally related but also to non-structurally related NSAIDs and sunscreens. Simultaneous CA to fragrance components was common. 1/3 of the patients reported prolonged photosensitivity, i.e. from 1 up to 14 years after having stopped KP application., Conclusions: The history is often not a good guidance to determine KP-related (photo) allergic contact dermatitis and the severe clinical symptoms sometimes require hospitalization, and/or systemic corticosteroids. As for the association between KP and sunscreen intolerance (being 1 of the possible causal factors for recurrent dermatitis), routine standard photopatch testing with KP might be indicated.

Topical ketoprofen (KP) is widely used because of its anti-inflammatory effect. However, photocontact dermatitis is a side-effect. Between May 2001 and June 2002, the Belgian Contact & Environmental Dermatitis Group conducted a prospective, open patch and photopatch test study in 20 patients suspected of KP dermatitis. Severe skin symptoms requiring systemic corticotherapy occurred in 47%. 5 patients were hospitalized. 1 patient showed prolonged photosensitivity. All patients were tested with KP and the other constituents of KP gel. Attribution to KP was demonstrated in all cases. Patch and photopatch tests with KP 2% in petrolatum showed contact photoallergy in 17 patients, contact allergy in 1 patient and photoaggravated contact allergy in 2 patients. 5 patients also reacted to the fragrance components lavender (Lavandula augustifolia) oil and/or neroli (Citrus aurantium dulcis) oil 5% in alcohol. However, in 4 of these, irritant reactions to the ethanolic dilutions could not be ruled out. Additional tests with 3 non-steroidal anti-inflammatory drugs without benzophenone structure ibuprofen, naproxen and diclofenac identified only 1 contact allergic reaction to diclofenac. Cross-reactivity to the substituted benzophenones, oxybenzone and sulisobenzone occurred only to the first in less than 30% of the patients. A high frequency (69%) of contact allergy to fragrance mix was found. Dermatologists should be aware of the severity of photoallergic reactions to KP and the risk of cross-sensitization.

Purpose: To determine the release of nickel from 1- and 2-euro coins and the ability to produce allergic contact dermatitis from the application of coins to the palmar skin of nickel-sensitized individuals., Methods: Three experiments were conducted. Experiments 1 and 2 checked the release of nickel from 1- and 2-euro coins by using the dimethylglyoxime test. In experiment 3, the elicitation of positive reactions was checked by applying coins to the palmar skin for 48 h under occlusion in nickel-sensitized and non-sensitized individuals., Results: The dimethylglyoxime test for release of nickel was positive in all cases. Positive patch test reactions to euro coins applied to the palmar skin of nickel-sensitized individuals were observed at 48 and 96 h., Conclusion: The results show that positive patch test reactions to euro coins can be obtained from nickel-sensitized individuals after 48 h of application to the palmar skin under occlusion. These results do not contradict other experiments in which repeated handling of coins was unable to provoke fingertip allergic contact dermatitis. A dose-response relationship is a credible explanation to support such potential discrepancies., (Copyright (c) 2004 S. Karger AG, Basel.)

Since November 1997, 14 successive cases of occupational contact dermatitis were observed in 13 laboratory technicians and 1 physician, working in a genetics laboratory in Leuven (Belgium) in 3 laboratories of bacteriology in Strasbourg, Montbeliard and Angers, and in the laboratory of hematology in Bordeaux (France). The dermatitis, located on the hands, forearms and face, relapsed after each exposure to an immersion oil for microscopy. Patch tests performed in 10 patients were positive to epoxy resin (ER) in the European standard series (10/10 patients) and to newly formulated Leica immersion oil (7/7), 1 patient testing negatively with the former oil. A breakdown performed in 2 patients with the oil's ingredients confirmed sensitization to liquid modified ER components, contained at >80% concentration in the oil. The presence of DGEBA was demonstrated by HPLC analysis at a +/-30% rate. Although the safety data sheet indicated a revision of the formula, nobody was alerted to the risk of sensitization and the need for skin protection. ERs, as a source of occupational allergy, can provoke epidemics of contact dermatitis in industry. This report of epidemic contact dermatitis from ERs, used for their optical properties in an immersion oil for microscopy, emphasizes the need for perpetual vigilance in occupational medicine and the usefulness of multicentre contacts in dermato-allergology.

We performed patch tests with Dermatophagoides pteronyssinus (Dp) antigens from 2 different sources in 355 non-randomly selected patients with atopic dermatitis (AD) and 398 subjects of a control group. The study demonstrated that contact sensitization to mites occurred in an appreciable % of AD cases (20.8%), using commonly available assay products. The differences recorded between the 2 materials tested were related to the concentration of P1 antigen. Non-atopic patients rarely showed positive reactions to Dp (0.75%), when strict criteria for readings were applied and if 2 readings were performed. Patients with positive patch tests did not necessarily show positive immediate skin tests. It would be useful to carry out tests systematically in atopic patients, even if it is not yet known what modern treatment would be best for the patient. Laboratories still do not provide standardized house dust mite preparations--measuring and codifying their biological activity--for use in patch tests. It is to be hoped that the extension of this type of test will lead to the production of better test materials, in syringes with homogeneous dispersion and concentration.

No seasonal influence of UV sunlight on patch test reactions in humans over a period of 9 years of clinical practice was found in this retrospective study of almost 8000 patients. Although the mean UV monthly dose varies seasonally, up in the summer and down in the winter, no significant differences could be identified for patch test reactions, either for the mean number of positive test reactions or for the intensity of the skin reaction or for the id-like spread reactions seen in summer or winter. Furthermore, no short-term influences of UV exposure during the weekend preceding patch testing could be demonstrated. Therefore, reliable patch-test results can be expected at any season of the year from a general population, at least in Belgian-type climates.

A multicentric study concerning the frequency of positive allergic patch test reactions to mercury and to thiomersal has been conducted in France and in Belgium among 2,000 adult patients submitted to routine patch testing. 73 (3.6 p. 100) patients had a positive patch test to mercury and 47 (2.3 p. 100) to thiomersal, 22 (1.1 p. 100) reacted positively to both mercurials. These high figures are most probably in relation with a broad use of mercurials in both countries, as antiseptics as well as preservative agents in topical drugs. They lead to a careful use of mercurials, which have to be avoided when they can be advantageously replaced by other antiseptics or preservative agents. As far as cosmetics are concerned, the use of mercurials (chemical nature and concentration) is restricted by a Recommendation of the European Council.

Patch test results from 163 patients with leg ulcers and/or chronic venous insufficiency, tested with a modified ICDRG standard test battery and a pharmaceutical test series, are analyzed and compared with the results obtained from a randomly selected control group of patients with eczematous conditions. A sensitization index for the most common contact allergens present in this test series is calculated, and the relevancy of hypersensitivity to specific topical agents is determined.