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The safety assessment of cosmetics considers the exposure of a ‘common consumer’, not the occupational exposure of hairdressers. This review aims to compile and appraise evidence regarding the skin toxicity of cysteamine hydrochloride (cysteamine HCl; CAS no. 156-57-0), polyvinylpyrrolidone (PVP; CAS no. 9003-39-8), PVP copolymers (CAS no. 28211-18-9), sodium laureth sulfate (SLES; CAS no. 9004-82-4), cocamide diethanolamine (cocamide DEA; CAS no. 68603-42-9), and cocamidopropyl betaine (CAPB; CAS no. 61789-40-0). A total of 298 articles were identified, of which 70 were included. Meta-analysis revealed that hairdressers have a 1.7-fold increased risk of developing a contact allergy to CAPB compared to controls who are not hairdressers. Hairdressers might have a higher risk of acquiring quantum sensitization against cysteamine HCl compared to a consumer because of their job responsibilities. Regarding cocamide DEA, the irritant potential of this surfactant should not be overlooked. Original articles for PVP, PVP copolymers, and SLES are lacking. This systematic review indicates that the current standards do not effectively address the occupational risks associated with hairdressers’ usage of hair cosmetics. The considerable irritant and/or allergenic potential of substances used in hair cosmetics should prompt a reassessment of current risk assessment practices.

The dysfunctionality of the protective skin barrier in psoriasis allows easier cutaneous penetration of various contact haptens; thus, such patients can develop allergic contact hypersensitivity as a comorbidity. Both skin conditions involve T-cell-mediated mechanisms. Dermatologists and allergists should consider assessing allergic contact cell-mediated hypersensitivity in selected psoriasis patients, especially those with palmoplantar psoriasis and who are refractory to topical treatments, and in patients with psoriasis, with or without arthritis, treated with biologics that present skin lesions clinically suggestive of contact dermatitis.

Allergic contact dermatitis (ACD) to cobalt is more common in children and adolescents than adults. However, detailed information on sites and sources of cobalt ACD is limited.To assess trends in positive and clinically relevant patch test reactions to cobalt in children and associated patient characteristics, common sources and body sites affected.A retrospective analysis of children (18 years) patch tested to cobalt by the North American Contact Dermatitis Group between 2001 and 2018.Of 1919 children patch tested, 228 (11.9%) and 127 (6.6%) had a positive/allergic or currently relevant patch test reaction to cobalt, respectively. The most common primary body sites affected were scattered generalized (30.0%), face, not otherwise specified (10.6%) and trunk (10.1%). Patients with allergic and currently relevant allergic patch test reactions were more likely to have a primary site of trunk (p = 0.0160 and p = 0.0008) and ears (p = 0.0005 and p 0.0001). Affected body site(s) varied by cobalt source among patients with currently relevant reactions, especially for less common sources. The most commonly identified sources of cobalt included jewellery, belts and clothing.Positive patch test reactions to cobalt were common in children. The most common body site was scattered generalized and the sources of cobalt varied by body site.

Ten percent efinaconazole nail solution (EFCZ solution) is a new topical triazole antifungal drug, and we sometimes encounter patients with allergic contact dermatitis (ACD) caused by EFCZ solution in our outpatient clinic. However, no previous reports have summarized the patch test (PT) results obtained for individual ingredients in several patients with EFCZ solution-induced ACD.This study aimed to 1) confirm the causative agent of EFCZ solution-induced ACD based on PT of individual ingredients and 2) analyze the optimal concentration and vehicle for such PT on the basis of previous studies.We clinically diagnosed eight patients with EFCZ solution-induced ACD from Sep. 2014 to Aug. 2021, and performed 48-hour closed PT using EFCZ solution and its ingredients. Readings were done on days (D) 2, 3, and 7 according to the International Contact Dermatitis Research Group criteria.Six of the 8 patients underwent PT with EFCZ solution, and all showed + to +++ reactions on D3. The results for the main component, EFCZ, were + to +++ on D3 in all patients. Two patients were patch tested with both 10% EFCZ in ethanol and 10% EFCZ in petrolatum, which produced similar reactions. One patient had an allergic reaction to ethanol.The causative agent of EFCZ solution-induced ACD was EFCZ in all patients. For PT, we recommend EFCZ solution as is, its 10-fold dilution and 1% and 0.1% EFCZ in petrolatum.

We recently identified an outbreak of occupational allergic contact dermatitis (ACD) involving workers of a Spanish company selling smartphone protective cases from a glue product. A chemical analysis of one glue sample revealed the presence of 4-acryloylmorpholine among other allergens.The same glue is also used to attach tempered glass protective cases to Apple smartwatches.Our objective was to describe a case series of nonoccupational consumer ACD from the previously mentioned Apple smartwatch protective case glue.We evaluated epidemiological and clinical data, as well as patch tests results.Three women were diagnosed with nonoccupational ACD from the adhesive. An annular vesicular inflammatory plaque involving the dorsal aspect of the wrist was initially observed in all. Two of the 3 patients were patch tested with 4-acryloylmorpholine 0.5% with positive strong reactions. Both also strongly reacted to a sample of the glue semiopen tested in a drop of petrolatum. One of them was also positive for various acrylates.4-Acryloylmorpholine has been identified in an adhesive used to attach protective cases to smartwatches. Nonoccupational ACD have been described to involve consumers of smartwatches. A UV-curable adhesive used to attach protective cases to smartwatches has been considered to be the culprit.

The only official method that can detect the skin sensitizing potential of chemicals, including the elicitation response, is the OECD test guideline (TG) 406. However, this guideline uses guinea pigs, which requires complex procedures. Since a simple and complete test method for evaluating skin sensitization is needed, especially for mechanistic studies of skin sensitization, this study confirmed the reactivity of mice to skin sensitizing substances. We set up a protocol involving one induction exposure of the test substance to the back skin, followed by three challenge exposures to the auricle (Protocol 2), and compared their skin sensitization responses with the results of two exposures to the auricle and back skin every 2 weeks (Protocol 1) and a local lymph node assay (TG442B). A hapten 2,4-dinitrofluorobenzene caused significant auricular thickening, skin inflammation, and enlarged auricular lymph nodes in Protocols 1 and 2. These changes were more pronounced in Protocol 2. Plasma IgE and IgG1 and gene expression of IL4, IFNγ, and perforin were significantly increased in Protocol 2. Cell proliferation in the auricular lymph nodes was observed in both protocols as in TG442B. These results indicate that Protocol 2 can be a good candidate for a relatively simple skin sensitization test.

Introduction: Propolis is a resinous substance collected by bees. Its use is widespread in cosmetics and natural medi-cine because of variable beneficial effects. Local application and consumption may cause hypersensitivity.Objective: Aim of this study was to analyze the 30-year data of patients with propolis hypersensitivity.Method: 17 784 patients were patch tested between 1992 and 2021 in the Allergology Outpatient Unit of the De-partment of Dermatology, Venereology and Dermatooncology of the Semmelweis University. 464 patients (2.6%) had propolis sensibility. We present the annual changes in the frequency of propolis sensibility, the typical diagnoses, age groups, localizations most affected by clinical symptoms and the co-hypersensitivities according to propolis sen-sibility.Results: In the 30-year period, the sensitization frequency of propolis was on average 2.6%; in 2019-2021, we de-tected a sudden increase (6.2%, 8.4%, 6.9%). Female predominance was typical (70.7%). Most patients belonged to the age group 51-60 years (24.6%), the mean age was 52.5 years. Most skin symptoms appeared on hands (34.2%), legs (18.4%), and face (17.5%). Regarding co-hypersensitivities, fragrance mix I (27.7%), balsam of Peru (26.8%) and wood tar (23.0%) can be mentioned.Conclusion: The general need for biocosmetics, complementary and alternative medicine raises the exposure of propolis. The risk of contact hypersensitivity is increased because propolis products are used mostly on inflamed skin with higher allergen penetration. According to our results, propolis - beside its advantageous properties - is an important environ-mental allergen, especially among elderly women. Propolis sensibility, the possible cross-and co-hypersensitivities can cause contact dermatitis or may worsen different skin diseases. Propolis sensibility can be verified by patch testing.Bevezetés: A propolisz méhek által gyűjtött gyantás anyag, melynek különféle termékekben történő külső és belső alkalmazása jótékony hatásai miatt széles körben elterjedt. Ismert allergén, a növekvő expozíciós lehetőségek szenzibilizáló hatását is előtérbe hozták. Célkitűzés: A szerzők 30 éves periódusban epicutan tesztelt, propoliszérzékeny betegek adatait dolgozták fel az irodalmi adatok tükrében. Módszer: A Semmelweis Egyetem Bőr-, Nemikórtani és Bőronkológiai Klinikájának Allergológiai Laboratóriumában 1992 és 2021 között epicutan tesztelt 17 784 beteg közül annak a 464 betegnek az eredményeit elemeztük retrospektíven, akiknél propolisz-túlérzékenység igazolódott. Vizsgáltuk a szenzibilizációs gyakoriságok változását, a jellemző diagnózisokat, a betegek életkori megoszlását, a klinikai tünetek leggyakoribb lokalizációit és a társult allergénérzékenységeket. Eredmények: A 30 éves periódusban a propolisz szenzibilizációs gyakorisága átlagosan 2,6% volt, 2019–2021-ben a vizsgált periódusban korábban nem észlelt jelentős emelkedés mutatkozott (6,2%, 8,4%, 6,9%). Jellemző volt a női dominancia (70,7%). A propolisz-túlérzékenység az 51–60 évesek körében fordult elő a leggyakrabban (24,6%), a betegek átlagéletkora 52,5 év volt. A legtöbb tünet kezeken (34,2%), lábakon (18,4%), arcon (17,5%) jelent meg. A társult érzékenységek közül az illatanyagok, a fragrance mix I (27,7%), a perubalzsam (26,8%) és a fakátrány (23,0%) emelhető ki. Következtetés: Az alternatív gyógyászati antibakteriális és antivirális készítmények, valamint a biotermékek iránti nagy kereslet növeli a propoliszexpozíciós lehetőségek számát. A szenzibilizáció esélyét fokozza, hogy a propolisztartalmú termékeket sokszor ellenőrizetlen mennyiségben és formában, a bőrön gyulladt, fokozott allergénpenetrációt biztosító területeken alkalmazzák. Eredményeink alapján a propolisz – jótékony hatásai mellett – jelentős környezeti allergén, elsősorban az idősebb nők körében. Expozícióinak ismerete hasznos, szenzibilizációja és társult allergénjei epicutan tesztsor segítségével kimutathatók. Orv Hetil. 2022; 163(39): 1559–1567.

Allergic contact dermatitis (ACD) to Compositae is caused by sensitisation to sesquiterpene lactones (SQLs) and subsequent exposure can occur from direct handling or from airborne transmission. Plants from the Compositae family are ubiquitous globally and their plant extracts are also used in various products.Investigation of contact allergy (CA) and allergic contact dermatitis (ACD) to Compositae at a single dermatology centre.A retrospective case review was performed on patients undergoing patch testing to Compositae between January 2011 and December 2020 in Melbourne, Australia.Of 3679 patients, 44 (1.2%) patch tested positive to Compositae and 19 (43.2%) reactions were deemed relevant. Thirteen cases (68.4%) were from direct contact with Compositae plants, mostly in gardeners. Six cases (31.6%) were from personal products and all these patients were female. Involvement of the face was significant (p = 0.007). Simultaneous allergic reactions included SQL mix in eight (42.1%), fragrance mix in seven (36.8%), potassium dichromate in three (15.8%) and colophonium in two (10.5%) cases.Contact with Compositae from gardening contributed most cases of ACD; however, personal products accounted almost one-third of cases. Treatment options remain limited and avoidance is the most important aspect of management.

Veterinary assistants and veterinarians are at an increased risk of developing an occupational skin disease, for example, irritant/allergic contact dermatitis, contact urticaria and hand eczema (HE).We aimed to investigate the prevalence of skin problems and the influence of predisposing factors especially among veterinary assistants.We conducted a cross-sectional study among veterinary assistant staff (n = 103) and veterinarians (n = 19). A questionnaire, specific IgE determination and photographs of hands were evaluated for skin symptoms. Logistic regression models assessed predisposing factors.Over 50% (n = 62/122) of our study population reported hand eczema (HE) in the last 12 months (1-year prevalence). Twenty-seven subjects reported redness and contact urticaria directly after animal contact, 35 had a positive history of allergic contact dermatitis. HE was associated with (i) increased frequency of hand washing (11-15 times per day; OR 4.15, confidence interval [CI] 95% 1.18-14.6, p = 0.027, univariate model) and (ii) unprotected contact to fluids and tensides5 times per day (OR 4.56, CI 95% 1.53-13.6, multivariate model).We observed a high prevalence of self-reported HE among staff in veterinary practices. Excessive hand washing, unprotected contact with irritants and long-term glove use should be avoided.

Azobenzene disperse dyes (azo DDs) are well-known as textile allergens, but the knowledge of their occurrence in garments is low. The numerous azo DDs and dye components found in textiles constitute a potential health risk, but only seven azo DDs are included in the European baseline patch test series (EBS).To investigate non-regulated azo DDs and dye components in synthetic garments on the Swedish market.High-performance liquid chromatography/mass spectrometry, gas chromatography/mass spectrometry and computerized data mining.Sixty-two azo DDs were detected, with Disperse Red 167:1 occurring in 67%, and 14 other DDs each found in20% of the garments. Notably, the EBS dyes were less common, three even not detected, while arylamines were frequently detected and exceeded 1 mg/g in several garments. Also, halogenated dinitrobenzenes were identified in 25% of the textiles.Azo DDs and dye components, in complex compositions and with large variations, occurred frequently in the synthetic garments. The arylamines were shown to occur at much higher levels compared to the azo DDs, suggesting the former constitute a potentially higher health risk. The role of arylamines and halogenated dinitrobenzenes in textile allergy has to be further investigated.

Background: Patch testing with the fragrance allergy markers in the European baseline series (EBS) does not identify all patients with fragrance allergy. Hydroperoxides of linalool and limonene have been shown to be useful allergens in detecting fragrance sensitization. Objectives: To evaluate the added value of testing with 30 fragrance allergens in addition to the EBS. Methods: All patients with suspected fragrance allergy who underwent patch testing at the Amsterdam University Medical Centers between November 2019 and January 2021 to the EBS and fragrance series were included. Results: Of 323 patients tested, 162 (50.2%) were found to be fragrance sensitized. The most sensitizing single allergens were the hydroperoxides of linalool (1.0 and 0.5% pet.) and limonene (0.3 and 0.2% pet.). Testing with the hydroperoxides of linalool and limonene identified 62 fragrance-sensitized patients (38.3%) who could not be detected by the common fragrance markers. Of all fragrance-sensitized patients, 21 (13.0%) would have been missed when not testing with the fragrance series. Conclusions: Patch testing with the fragrance series in addition to the EBS is valuable. To reduce the risk of false-negative reactions, it is advisable to test the hydroperoxides of linalool and limonene.

Allergic contact dermatitis (ACD) has been estimated to affect up to 20% of the general population. Patch testing is the gold standard for identification of causative allergens. When allergen avoidance fails, current treatment options include topical and oral corticosteroids, systemic immunosuppressants, and phototherapy. Dupilumab, a monoclonal antibody targeting IL-4/IL-13, is approved by the US Food and Drug Administration for the treatment of moderate to severe atopic dermatitis. It also has been used off label with some success in the treatment of ACD. This article discusses the evidence for using dupilumab to treat ACD as well as considerations for patch testing in patients who are taking this medication.

Consort allergic contact dermatitis (CACD) develops following exposure to an allergen originating from another individual. The diagnosis is often not straightforward. We conducted a systematic review to characterize patient demographics, clinical features, consort types, responsible products, and associated allergens in CACD. A literature search was conducted in PubMed, EMBASE, Web of Science, and CINAHL Complete from inception to July 2020. In total, 183 articles describing 261 patients with CACD were included. Mean age was 40.9 years with female predominance (62.8%). The most common body sites involved were the face (48.6%), hand (30.4%), arm (20.9%), neck (17.8%), and genitals (11.5%). The most common consorts were partners/spouses (50.0%, of which 29.9% were related to sexual activity), children (19.4%), and healthcare providers (7.8%). Allergens were mainly encountered via direct contact with consorts (80.5% of cases). A caregiver relationship was involved in 27.6% of cases, and the consort's occupation in 14.6%. The most frequently implicated products were medications (35.6%), plants/botanicals (11.7%), and fragrances (8.7%). Patch testing identified 125 unique allergens in CACD. CACD can occur in relation to many individuals encountered throughout life. Caregivers may represent a high-risk group for developing CACD. Obtaining a holistic history encompassing social, sexual, and occupational factors can aid in the diagnosis.

Lanolin is an important cause of allergic contact dermatitis.The aims of this study were to describe the epidemiology of lanolin allergy and to assess trends in patch test reactions to lanolin over time.This study used a retrospective analysis of patients patch tested with lanolin alcohol 30% or Amerchol L-101 50% in petrolatum by the North American Contact Dermatitis Group between 2001 and 2018 (n = 43,691).Overall, 1431 (3.3%) had a positive reaction, and 1238 (2.8%) were currently relevant. Prevalence of lanolin allergy was 4.63% between 2011 and 2018 (P0.0001). Most lanolin-allergic patients had + (52%) reactions; 18%, and 6% had ++ and +++ reactions, respectively. Common primary anatomic sites of dermatitis were the hands (20.7%), scattered/generalized distribution (19.6%), and face (17.0%). Allergic reactions to lanolin were more common in children (4.5%) than in adults (3.2%, P = 0.0018). Compared with nonallergic patients, lanolin-allergic patients were more likely to have history of eczema or hay fever, male sex, older than 40 years, or Black race (P0.05). Common lanolin sources were personal care products and drugs/medications. Only 2.24% of the positive reactions were linked to occupation.Lanolin sensitivity was common. Reactions were often clinically relevant and linked to personal care products and medications.

The patch test is the standard for diagnosing allergic contact dermatitis. Standardized trays allow the examination of the most prevalent allergens, whereas customized trays are more appropriate for addressing specific allergens and require expertise. They are therefore usually performed in specialized clinics.We assessed the results of 4355 patch tests performed between 2012 and 2020 in a contact dermatitis clinic located in a large tertiary medical center. All patients were tested using the European baseline series and additional trays as clinically indicated. We assessed the frequency of relevant positive reactions outside the European baseline series. We then examined the added value and number of tests (NNTs) that need to be performed to elicit one relevant positive reaction per tray and common allergens.Nine hundred fifty-four patients (21.9%) had 1 or more positive relevant reactions; 43.3% tested positive for an allergen outside the European baseline series (OEBS). The acrylate and fragrance trays were highly represented among the positive and relevant reactions OEBS with NNTs of 4.4 and 6.8, respectively. 2-Hydroxyethyl methacrylate is the most prevalent allergen OEBS and is considered a marker for acrylate sensitivity with a high rate of cross-reactions and concordance rate of 85%, justifying its addition to the EBS in 2018. Other highly represented allergens include chloramphenicol, 2-hydroxyethyl acrylate, and Amerchol L-101, a lanolin derivative. The cosmetics and textile trays, although often tested, have relatively low added values of 3.7% and 2.3%, respectively. Surprisingly, the cutaneous adverse drug reaction series tray (CAD-1000) yielded no positive reactions, whereas testing the patients' medication yielded positive results in 10.9% of the cases.Expanded patch testing is crucial to accurately diagnose allergic contact dermatitis and almost doubles the number of patients with relevant positive reactions. Acrylate sensitivity is an emerging epidemic with a high positive reaction rate and low NNT, as is sensitivity to the allergens in the fragrance tray. 2-Hydroxyethyl methacrylate is a reliable marker for acrylate sensitivity with a concordance rate of 85%. Chloramphenicol is a common culprit and should be added to the standard tray in countries with a high usage rate. A low NNT was also observed when testing the patients' own cosmetics and medications; this should, therefore, be encouraged. The textile tray yielded a relatively high NNT; however, it should be performed when clinically indicated in the absence of a reliable marker in the EBS.

The aim of this study was to establish the diagnoses of patients with disseminated eczema and analyze the allergens involved in disseminated eczema due to allergic contact dermatitis. We analyzed the data from patients with a diagnosis of disseminated / generalized eczema who had undergone anamnesis, physical examination and patch tests in a Contact Dermatitis consultation from 2003 to 2019. Allergic contact dermatitis was the most frequent diagnosis, folowed by atopic dermatitis, asteatotic eczema, and gravitational eczema. The allergens most frequently involved in allergic contact dermatitis were isothiazolinones, topical medications, paraphenylenediamine, and fragrances. Allergic contact dermatitis caused almost half of the cases of disseminated eczema. It would be therefore advisable for patients with disseminated eczema to be assessed at a Contact Dermatitis unit and undergo patch tests.

Textile production forms one of the most polluting industries worldwide. However, other than damaging environmental effects, chemical waste products, such as formaldehyde or thiazolinone, are problematic for human health, as allergic potential is present in these compounds. Mostly, contact dermatitis occurs when human skin is exposed to textiles. Moreover, non-eczemous variants are mainly associated to textiles. In order to diagnose the possible allergy of the patient towards these compounds, in vivo and in vitro methods ca be performed, such as patch testing or cytokine detection assays, respectively. Newest research focuses on medical textiles such as garments or sutures to help in diagnosis, therapy and recovery of the patients. Sutures and dressings with antimicrobial properties, with the release of oxygen and growth factors offer greater properties. In this review, state of the art in the field as well as future perspectives will be discussed, which are based on the smart textiles that are going to become more important and probably widespread after the current limits exceeded.

Contact allergy to cardiac implantable electronic devices is a rare problem in patients. Clinical evaluation and patch tests have an important place in its diagnosis. Also in this case, the diagnosis is supported by ultrasonography. It has been reported in the literature that allergic dermatitis developed after permanent pacemaker implantation in the first few days until the current year. In our case report, we showed that the allergic reaction in the patient was too late. In this article, we present a 94-year-old male patient with a permanent pacemaker who came to us with the complaint of redness and itching in the left chest area and was diagnosed with contact allergy.

Skin reactions to the glucose monitoring systems Dexcom G5 and G6 have been rare. In 2019, the components of the adhesive were exchanged for better skin fixation. Since then, more and more patients experienced severe skin reactions. A few months ago, 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate (MBPA) was identified as a new component in the adhesive of the G6 model. Furthermore, it was suspected that isobornyl acrylate (IBOA) was also a component of the exchanged adhesive.Our objective was to investigate if MBPA plays a major role in the increasing skin problems of patients without a history of IBOA-sensitization. Furthermore, our aim was to examine whether IBOA is contained in the newer model adhesive and may also contribute to allergic contact dermatitis (ACD).Five patients with a newly occurred ACD caused by the glucose monitoring system Dexcom G6 were investigated. Patch testing including MBPA in three different concentrations, as well as IBOA, were performed. Gas chromatography-mass spectrometry of the newer system Dexcom G6 was carried out.All patients were shown to be sensitized to MBPA, while MBPA 0,5% showed the strongest reaction. On the other hand, IBOA was tested negative.In our study group, MBPA was observed to be the triggering allergen of the recently changed adhesive.

Skin sensitization resulting in allergic contact dermatitis represents an important toxicological endpoint as part of safety assessments. When available substance-specific sensitization data are inadequate, the dermal sensitization threshold (DST) concept has been proposed to set a skin exposure threshold to provide no appreciable risk of skin sensitization. Structure-based DSTs, which include non-reactive, reactive, and high potency category (HPC) DSTs, can be applied to substances with an identified chemical structures. An

The assessment of skin sensitisation is a key requirement in all regulated sectors, with the European Union's regulation of cosmetic ingredients being most challenging, since it requires quantitative skin sensitisation assessment based on new approach methodologies (NAMs). To address this challenge, an in-depth and harmonised understanding of NAMs is fundamental to inform the assessment. Therefore, we compiled a database of NAMs, and in vivo (human and local lymph node assay) reference data. Here, we expanded this database with 41 substances highly relevant for cosmetic industry. These structurally different substances were tested in six NAMs (Direct Peptide Reactivity Assay, KeratinoSens™, human Cell Line Activation Test, U-SENS™, SENS-IS, Peroxidase Peptide Reactivity Assay). Our analysis revealed that the substances could be tested without technical limitations, but were generally overpredicted when compared to reference results. Reasons for this reduced predictivity were explored through pairwise NAM comparisons and association of overprediction with hydrophobicity. We conclude that more detailed understanding of how NAMs apply to a wider range of substances is needed. This would support a flexible and informed choice of NAMs to be optimally applied in the context of a next generation risk assessment framework, ultimately contributing to the characterisation and reduction of uncertainty.

Hairdressers are at high risk of developing occupational hand eczema. Opinions on the health and safety concerns of nonfood consumer products, such as cosmetics and their ingredients, consider the exposure of a “common consumer,” which may not account for occupational exposure of hairdressers. As a result, there is a parlous scenario in which serious safety concerns about occupational exposures are present. The purpose of this review is to compare the frequency of exposure to various types of hair cosmetic products among hairdressers and consumers. Database searches for this review yielded a total of 229 articles; 7 publications were ultimately included. The analysis showed that—dependent on the task—hairdressers were exposed 4 to 78 times more than consumers to a wide spectrum of hair cosmetic products used in their daily working life, ranging from shampoos, conditioners, oxidative and nonoxidative hair colors, to bleaching agents. The highest frequency was found for coloring hair with oxidative hair color. Consumer use frequency does not appear to be appropriate for representing hairdresser exposure. The current standards do not effectively address the occupational risks associated with hairdressers' use of cosmetics. The findings of this study should cause current risk‐assessment procedures to be reconsidered.

Allergic contact dermatitis to corticosteroids can be a challenging diagnosis as corticosteroids are used in the treatment of dermatitis. The prevalence of contact allergy to corticosteroid varies between previous studies.To study the prevalence of sensitization to budesonide, tixocortol-21-pivalate and hydrocortisone-17-butyrate in a Danish patient population from 2006-2020, cross-sensitization, risk factors and clinical relevance.A retrospective analysis of patch test data and MOAHLFA index was performed among 6823 patients consecutively patch tested with TRUE test as part of the baseline series.A positive patch test for corticosteroids was found in 185 patients (1.2% budesonide, 1.6% tixocortol-21-pivalate, 1.0% hydrocortisone-17-butyrate) without gender difference. For women, the prevalence of tixocortol-21-pivalate sensitization increased significantly from 1.3% in 2006-2008 to 2.9% in 2018-2020. Tixocortol-21-pivalate sensitization had more frequently clinical relevance in women (61.3%) compared to men (34.5%). Age above 40 years was positively associated to corticosteroid sensitization. Budesonide and hydrocortisone-17-butyrate accounted for 67.7% of co-sensitizations.The prevalence of corticosteroid sensitization was 2.7%. Age was the only risk factor for corticosteroid sensitization. The frequency of corticosteroid sensitization was stabile over time except for tixocortol-21-pivalate sensitization for women. About one third of sensitized patients had co-sensitizations to other corticosteroid groups.

The filaggrin gene (FLG) plays a role in skin diseases, with the skin barrier function being impaired in FLG null carriers. The role of FLG status in relation to nickel penetration into the skin remains unclear.To elucidate the association between FLG status and nickel penetration into stratum corneum (SC) in individuals without self-reported history of nickel allergy.Forty participants (23 FLG wt and 17 FLG null) were exposed to a nickel solution (80 μg/cmThe average recovered nickel dose was 35%-48%. A tendency towards lower recovery was seen in FLG null carriers compared to FLG wt carriers, and lower recovery in those with history of skin and/or respiratory symptoms compared to those without such history. This was however not statistically significant.FLG null carriers had less nickel recovered by tape strips compared with FLG wt carriers and, compared with individuals without a history of skin and/or respiratory symptoms, indicating higher nickel penetration into SC for FLG null carriers, but further studies are needed.