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ABSTRACT Objective Design Data Sources Eligibility Criteria for Selected Trials Results Conclusion Eczema is the most burdensome skin condition worldwide and topical anti‐inflammatory treatments are commonly used to control symptoms. The relative effectiveness and safety of different topical anti‐inflammatory treatments is uncertain.Network meta‐analysis performed within a Cochrane systematic review to compare and statistically rank efficacy and safety of topical anti‐inflammatory eczema treatments.Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase and trial registries to June 2023.Included trials were within‐participant or between‐participant randomised controlled trials. Participants had eczema that was not clinically infected and was not contact dermatitis, seborrheic eczema or hand eczema. Interventions were topical anti‐inflammatory treatments but not complementary treatments, antibiotics alone, wet wraps, phototherapy or systemic treatments. Comparators were no treatment/vehicle or another topical anti‐inflammatory.We identified 291 trials (45,846 participants), mainly in high‐income countries. Most were industry‐funded with median 3 weeks treatment duration. Risk of bias assessed using the Cochrane Risk of Bias 2.0 tool was high in 89% of trials, mainly due to risk of selective reporting. Network meta‐analysis of binary outcomes ranked potent and/or very potent topical steroids, tacrolimus 0.1% and ruxolitinib 1.5% among the most effective treatments for improving patient‐reported symptoms (40 trials, all low confidence) and clinician‐reported signs (32 trials, all moderate confidence). For investigator global assessment, the Janus kinas inhibitors ruxolitinib 1.5%, delgocitinib 0.5% or 0.25%, very potent/potent topical steroids and tacrolimus 0.1% were ranked as most effective (140 trials, all moderate confidence). Continuous outcome data were mixed. Local application site reactions were most common with tacrolimus 0.1% (moderate confidence) and crisaborole 2% (high confidence) and least common with topical steroids (moderate confidence). Skin thinning was not increased with short‐term use of any topical steroid potency (low confidence) but skin thinning was reported in 6/2044 (0.3%) participants treated with longer‐term (6–60 months) topical steroids.Potent topical steroids, Janus kinase inhibitors and tacrolimus 0.1% were consistently ranked as among the most effective topical anti‐inflammatory treatments for eczema. [ABSTRACT FROM AUTHOR]

Background: Budesonide and tixocortol pivalate as markers of contact allergy to corticosteroids have been questioned, as they are not able to detect a significant percentage of allergic patients. Objectives: To investigate the potential role of clobetasol propionate in enhancing corticosteroid sensitisation detection. Methods: Between January 2022 and December 2023, patients who attended centres involved in the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy were tested with an extended baseline series that included budesonide, tixocortol pivalate, clobetasol propionate 0.1% in ethanol and 1% in petrolatum. Results: A total of 4338 patients were tested. Twenty‐four patients were allergic to budesonide (0.55%, 95% CI: 0.37–0.82); nine patients were allergic to tixocortol pivalate (0.21%, 95% CI: 0.11–0.39); and 23 patients were allergic to clobetasol (0.53%, 95% CI: 0.35–0.79). Only four of those patients allergic to clobetasol were detected by budesonide and one by tixocortol pivalate. No significant differences in the number of positive tests were found between clobetasol in petrolatum or ethanol. Conclusions: In Spain budesonide remains the main corticosteroid allergy marker whereas the role of tixocortol pivalate is questionable. The addition of clobetasol propionate to the Spanish baseline series would improve the ability to detect patients allergic to corticosteroids. [ABSTRACT FROM AUTHOR]

Background: Isocyanates are used as starting materials of polyurethane (PU) products. They are relatively important occupational skin sensitizers. Objectives: To analyse results of a large isocyanate patch test series of 19 isocyanate test substances and 4,4′‐diaminodiphenylmethane (MDA), a marker of 4,4′‐diphenylmethane diisocyanate (MDI) hypersensitivity. Methods: Test files were screened for positive reactions in the isocyanate series. Patients with positive reactions were analysed for occupation, exposure and diagnosis. Results: In 2010–2019, 53 patients had positive reactions in the series (16% of 338 patients tested). MDA, the well‐established screening substance for MDI allergy, was positive in 30 patients, an in‐house monomeric MDI test substance in 23 patients and 3 different polymeric MDI test substances in 19–21 patients. We diagnosed 16 cases of occupational allergic contact dermatitis (OACD) from MDI including 3 pipe reliners. Hexamethylene‐1,6‐diisocyanate (HDI) oligomers in paint hardeners caused 5 cases of OACD, more cases than 2,4‐toluene diisocyanate (TDI; n = 3) and isophorone diisocyanate (IPDI; n = 1) put together. Conclusions: In contrast to previous studies, polymeric MDI test substances were not superior to a monomeric MDI. Pipe reliners may get sensitised not only by epoxy products and acrylates but also by MDI in hardeners of PU pipe coatings. HDI oligomers were the second most important causes of OACD after MDI. In contrast to previous studies, polymeric MDI patch test substances were not superior to a monomeric MDI. Pipe reliners may get sensitised by MDI in hardeners of polyurethane pipe coatings. HDI oligomers were the second most important causes of occupational allergic contact dermatitis after MDI. [ABSTRACT FROM AUTHOR]

Background: Tefillin are a religious article worn by Jewish men during daily prayer. Tefillin dermatitis secondary to potassium dichromate sensitivity is recognised, but data remain sparse. Objective: To investigate the prevalence and clinical characteristics of tefillin dermatitis. Methods: Patients who underwent patch testing with the European baseline series in a tertiary dermatology clinic in 2009–2023 and were diagnosed with tefillin dermatitis were identified by file review and their clinical data recorded. Results: Of 1679 consecutive male patients tested, 25 (1.49%) were diagnosed with tefillin dermatitis, accounting for 15.34% of all potassium‐dichromate‐positive patients (163/1679). Mean pre‐symptomatic duration of tefillin use was 38 ± 16.9 years, and mean follow‐up time, 3.1 ± 2.9 years. Patients presented with an eczematous rash on body areas in direct contact with the leather box or straps of the tefillin. An id reaction was noted in 32%, and sensitivity to other leather accessories, in 44%. Fourteen patients (56%) switched to chromate‐free tefillin: symptoms resolved completely in 11 (79%) and partially in 2. Limitations: Retrospective cohort design. Conclusion: This is the largest study to date of tefillin dermatitis caused by sensitivity to potassium dichromate used in leather production. Prognosis after switching to chromate‐free tefillin was good‐to‐excellent. Tefillin dermatitis may be more prevalent than previously thought. [ABSTRACT FROM AUTHOR]

Background: Fragrance substances are a frequent cause of contact allergy worldwide. Fragrance exposure varies by sex, age and possibly country, influenced by cosmetic availability, environmental conditions and cultural practices. Objectives: To systematically review and gather prevalence of sensitization to fragrance mix I (FM I) and fragrance mix II (FM II) in consecutively patch tested European dermatitis patients. Method: A total of 4134 publications on patch test results of European dermatitis patients, published from 1981 to 2022, were systematically reviewed according to a previously registered and published PROSPERO protocol. Results: Eighty‐four eligible original articles were analysed. Overall prevalence of sensitization to fragrance mix I (FM I) was 6.81% (95% CI: 6.37–7.28), and FM II was 3.64% (95% CI: 3.3–4.01). Sensitization to FM I was most prevalent in Central and Eastern Europe and to FM II in Western Europe. No clear time trends were observed. Among paediatric dermatitis patients, sensitization prevalence for FM I and FM II was 4.09% (95% CI: 3.37–4.96) and 2.17% (95% CI: 1.53–3.07). Conclusion: The frequency of positive patch test results for both FMI and FMII remains high. Sensitization is also prevalent among children. Enhanced regulation and labelling of cosmetic products play a vital role in averting exposure and sensitization to fragrance allergens. [ABSTRACT FROM AUTHOR]

Background: Earlier studies suggested a potential association between tobacco smoking and nickel sensitization, but little is known about other contact allergens. Objectives: To investigate the association of smoking status and contact sensitizations as well as subtypes of dermatitis, and to analyse the sensitization profiles of tobacco smokers. Patients and Methods: Within the Information Network of Departments of Dermatology (IVDK), we performed a cross‐sectional multicentre pilot study comprising 1091 patch‐tested patients from 9 departments, comparing 541 patients with a history of cigarette smoking (281 current and 260 former smokers) with 550 never‐smokers. Results: We could not confirm the previously reported association between nickel sensitization and tobacco smoking. Moreover, sensitizations to other allergens, including colophony, fragrance mix I, Myroxylon pereirae and formaldehyde, were not increased in cigarette smokers compared with never smokers. Hand dermatitis (50.6% vs. 33.6%) and occupational cause (36.2% vs. 22.5%) were significantly more frequent among cigarette smokers compared with never‐smokers as shown by non‐overlapping 95% confidence intervals. Conclusions: Although our study does not allow a firm conclusion on whether smoking status contributes to certain contact sensitizations, it confirms an association of smoking with hand dermatitis and occupational cause. [ABSTRACT FROM AUTHOR]

Background: Machine learning (ML) offers an opportunity in contact dermatitis (CD) research, where with full clinical picture, may support diagnosis and patch test accuracy. Objective: This review aims to summarise the existing literature on how ML can be applied to CD in its entirety. Methods: Embase, Medline, IEEE Xplore, and ACM Digital Library were searched from inception to February 7, 2024, for primary literature reporting on ML models in CD. Results: 7834 articles were identified in the search, with 110 moving to full‐text review, and six articles included. Two used ML to identify key biomarkers to help distinguish between allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD), three used image data to distinguish between ACD and ICD, and one used clinical and demographical data to predict the risk of positive patch tests. All studies used supervision in their ML model training with a total of 49 704 patients across all data sets. There was sparse reporting of the accuracy of these models. Conclusions: Although the available research is still limited, there is evidence to suggest that ML has potential to support diagnostic outcomes in a clinical setting. Further research on the use of ML in clinical practice is recommended. [ABSTRACT FROM AUTHOR]

This article discusses a case of severe bullous hand eczema in an 8-year-old child caused by an allergy to nail (meth)acrylates. The child's mother, who was training as a nail technician, had been applying gel varnish to the child's nails. Patch testing confirmed the diagnosis of hand eczema due to nail (meth)acrylate allergy. The article emphasizes the importance of caution when using cosmetics on children and highlights the potential for serious consequences for one's professional prospects if sensitization occurs. [Extracted from the article]

The diagnosis of eczema ('dermatitis') is mostly clinical and depends on the clinical history and exploratory objective findings (primary lesions, patterns). Contact dermatitis remains as an important condition in the group of eczematous disorders, with important socioeconomic and occupational relevance. Although irritant and allergic contact dermatitis have a different pathogenesis, both are characterized by a rather typical morphology, are triggered by external factors and tend to occur primarily in the area of contact with the exogenous agent. In addition, allergic and irritant dermatitis may also co‐exist. The importance of diagnosing contact dermatitis, especially when allergic in nature, is both due to the possibility of avoiding the trigger, and due to its role in aggravating other skin conditions. Nevertheless, the heterogeneity of clinical presentations in daily practice may pose an important challenge for the suspicion and correct diagnosis of contact dermatitis. Furthermore, other conditions, with different pathogenesis and treatment, may clinically simulate contact dermatitis. The Task Force aims to conduct a review of the unifying clinical features of contact dermatitis and characterize its main clinical phenotypes, and its simulators, in order to contribute to an early suspicion or recognition of contact dermatitis and enable a correct differential diagnosis. [ABSTRACT FROM AUTHOR]

Abandoning a brood to maximize lifetime reproductive success may result from the current costs affecting future reproductive opportunities. In certain contexts, clutch abandonment can be an evolved breeding strategy rather than a generalized response to stressors such as inclement weather and predation. Obligate brood parasitism, a reproductive strategy in which a parasitic species relies solely on other species to raise its young, imposes fitness costs to hosts and could serve as a trigger for clutch abandonment. This cost, and the resulting clutch abandonment strategy, may vary according to contact with the parasite, sensitivity to parasitism and the value of the current reproductive effort (i.e. brood value). We conducted a phylogenetically controlled meta-analysis covering 85 host species of the three generalist cowbird species (Molothrus sp.) in which we examined the following effects on the abandonment (nest desertion and egg burial) of parasitized versus unparasitized clutches: habitat at a small scale (higher host–parasite encounter frequency in open versus forested habitats) and at a large scale (longer interaction between parasites and hosts in prairie versus nonprairie regions), brood value (relative value of a clutch) and host species sensitivity to brood parasitism (relative body mass). Parasitism increased clutch abandonment overall. This increase was strongest in open nonforested habitats, with smaller, more sensitive hosts being more likely to abandon their clutch. Brood value and occurrence in prairie regions did not affect clutch abandonment, indicating that recent, more fine-scale host–parasite interactions were more important than coevolutionary history. Therefore, the abandonment of a brood can be used in diverse parental care strategies, including antiparasitic defences of brood-parasitic hosts. • We examined responses of hosts to parasitism by cowbirds (Molothrus sp.). • Parasitism increased clutch abandonment overall. • Abandonment strongly affected host sensitivity and current exposure to parasitism. • We found no effect of brood value or coevolutionary history. • Host behavioural plasticity may modulate host defences more than previously thought. [ABSTRACT FROM AUTHOR]

Introduction: The growing presence of allergens in materials and scarce data on allergic contact dermatitis in children has increased our need to refine its diagnosis in this population. We aimed to analyze children's specific responsivity to highly reactive subcomponents of Fragrance mix I, Fragrance mix II, and Textile dye mix from the European baseline series. Methods: We retrospectively analyzed patch test records of children aged 2 to 18 who underwent patch testing with the European baseline series between 2014 and 2022 in Israel. Results: A total of 367 children were included in the study. In all, 160 children had positive results; 43 patients reacted to one of the mixes, and 20 performed further testing. Eleven of them completed the extended series at the exact same times as the regular European series, which benefited children. Farnesol was the most reactive compound (30.8%). Conclusions: Performing the extended European series provides a more accurate and time‐efficient allergic contact dermatitis diagnosis. Farnesol reactivity appears prominent in children and may justify tighter product regulations. [ABSTRACT FROM AUTHOR]

Decorative tattoos are known to contain ingredients that may elicit allergic contact dermatitis; it is less well-known if permanent makeup pigments carry the same risk. Identify pigments used in permanent makeup inks sold in the United States and review cases of allergic contact dermatitis to these pigments. Using internet searches, permanent makeup inks sold in the United States were identified. Safety data sheets were used to catalog pigments used in permanent makeup. A subsequent literature search was performed to identify cases of allergic contact dermatitis to these pigments. A total of 974 permanent makeup inks were reviewed, and 79 unique pigments were identified. The average product contained 4 pigments. Twenty of the pigments were inorganic metals, including carbon, iron, chromium, manganese, and molybdenum. Fifty-nine pigments were organic, of which most were azo, quinacridone, or anthraquinone dyes. A literature search revealed that 10 of the 79 pigments were associated with allergic contact dermatitis. Permanent makeup primarily uses organic pigments, although some metallic pigments are still used. Physicians should also be aware that some of these pigments—both organic and inorganic—are known causes of allergic contact dermatitis. Of note, patch testing to these ingredients can be negative. [ABSTRACT FROM AUTHOR]

Photoallergic contact dermatitis is a skin disease caused by combined exposure to photoreactive chemicals and sunlight. Exposure to allergens and the risk of skin sensitization is an essential regulatory issue within the industry. Yet, only few non‐validated assays for photoallergy assessment exist as the pathogenesis is not fully deciphered. Improving such assays and/or developing new ones require an understanding of the chemical mechanisms involved. The first key event in the photosensitization process, namely chemical binding of the photoallergen to endogenous proteins, is thought to proceed via photo‐mediated radicals arising from the photoallergen. Moreover, the mechanism of action of these radicals if formed in the epidermis is not known and far from being unraveled. We present here an original proof‐of‐concept methodology to probe radical generation from allergens in contact with photoexposed skin, using electron paramagnetic resonance and spin trapping in a reconstructed human epidermis model mimicking real‐life exposure scenarios. [ABSTRACT FROM AUTHOR]

This study evaluated the therapeutic efficacy and underlying mechanisms of crisaborole combined with vitamin D in the treatment of allergic contact dermatitis. While crisaborole, a phosphodiesterase 4 inhibitor, and vitamin D analogs are commonly used in the treatment of atopic dermatitis, their combined therapeutic potential in allergic contact dermatitis (ACD) remains unexplored. Given their anti-inflammatory properties, we hypothesized that the combination of crisaborole and vitamin D could offer superior efficacy in mitigating the symptoms and underlying mechanisms of allergic contact dermatitis. In vitro, HaCaT cells stimulated with tumor necrosis factor-α and interferon-γ were treated with a combination of crisaborole and vitamin D, followed by cytokine expression analysis. In vivo, male C57BL/6 mice were divided into five groups and treated accordingly: blank control, dinitrochlorobenzene-induced model, crisaborole alone, vitamin D alone, and a combination of crisaborole and vitamin D. On day 14, dorsal skin and ear thickness were measured, followed by comprehensive pathological evaluations. In vivo and in vitro experiments showed that the expression levels of inflammatory factors were significantly lower in the DNCB + VD + Cri group than in the DNCB group. Histological analyses revealed that, compared with the DNCB group, the combined treatment group significantly reduced epidermal hyperkeratosis, improved epidermal transdermal water loss, decreased dermatitis scores, and diminished mast cell infiltration. Moreover, it lowered the expression levels of IL-6, IL-4, TNF-α, iNOS, IL-17, CC chemokine ligand 2 (CCL2), and CC chemokine receptor 2 (CCR2). CCL2 recognizes CCR2 and stimulates inflammatory cells, enhancing the inflammatory response. Increased CCL2 expression correlates with heightened inflammation and dendritic cell infiltration in ACD, while downregulation of CCL2 attenuates inflammation. Thus, the combined use of crisaborole and vitamin D demonstrates superior therapeutic efficacy over monotherapy in a mouse model of ACD. The combination of vitamin D and crisaborole significantly reduces inflammation and epidermal hyperkeratosis in a mouse model of allergic contact dermatitis, demonstrating superior therapeutic efficacy compared to either treatment alone. This suggests that the combined therapy could be a promising approach for the prevention and treatment of allergic contact dermatitis. [ABSTRACT FROM AUTHOR]

Background Objectives Materials and Methods Results Conclusions Acrylate polymers and cross‐polymers (ACPs) are frequently used cosmetic ingredients. The British Society for Cutaneous Allergy (BSCA) and the UK Cosmetic, Toiletry and Perfumery Association (CTPA) collaborated to investigate the allergenic potential of three commonly‐used ACPs.The objective of this study is to determine the prevalence of allergic contact dermatitis (ACD) to three ACPs: glyceryl acrylate/acrylic acid co‐polymer, sodium polyacrylate, and acrylates/C10‐30 alkyl acrylate cross‐polymer (Carbopol®).The BSCA prospectively audited data collected from 20 centres in the UK and Ireland between 1st September 2021 and 1st September 2022. Patients with suspected ACD to (meth)acrylates, with facial dermatitis, or consecutive patients, were patch tested to glyceryl acrylate/acrylic acid co‐polymer 10% aqueous (aq.) sodium polyacrylate 2% aq., and to acrylates/C10‐30 alkyl acrylate cross‐polymer 2% aq. (Carbopol®). The frequencies of positive, irritant, and doubtful reactions were recorded.In total, 1302 patients were patch tested. To glyceryl acrylate/acrylic acid co‐polymer, there was one doubtful reaction in a patient allergic to multiple (meth)acrylates, and one irritant. To sodium polyacrylate, there were four irritant reactions, one doubtful, and one positive reaction; in all cases, relevance was unknown and there was no demonstrable (meth)acrylate allergy. There were no reactions to Carbopol®.Sensitisation to these concentrations of the three tested ACPs is rare. Elicitation of dermatitis in (meth)acrylate‐sensitised patients by exposure to these three ACPs appears unlikely. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Hand eczema (HE) is a common skin disease with a negative impact on patients' quality of life in occupational and non‐occupational settings. Up‐to‐date, data on HE in Italian patients referred for patch testing are lacking.To characterise the profile in terms of demographics, aetiology and patch test results of Italian patients affected by HE referred for patch testing.A retrospective descriptive study on consecutive patients affected by HE who underwent patch testing from 2016 to 2023 in eight dermatology clinics was performed. HE patients were divided into two groups according to the exclusive (HE‐only group) and not‐exclusive (HE+ group) hand involvement, and compared to patients with eczema localised in body areas other than hands (NHE group).One thousand five hundred and ninety‐seven patients were affected by HE (35.3% males; mean age 42.7 years), 60.2% belonging to the HE‐only group and 39.8% to the HE+ group. Occupational dermatitis was diagnosed in 33.2% of HE‐only patients, 25.0% of HE+ patients and 5.2% of NHE patients (p < 0.001). HE‐only patients presented: Allergic Contact Dermatitis (ACD), Irritant Contact Dermatitis (ICD), atopic HE in 48.1%, 47.5% and 7.1%, respectively; hyperkeratotic palmar, acute recurrent vesicular and nummular clinical subtypes in 52.2%, 43.9% and 11.9%, respectively; relevant positive patch test reactions in 48.1% (nickel sulphate 18.9%, methylchloroisothiazolinone/methylisothiazolinone 10.6%, methylisothiazolinone 8.6%, p‐phenylenediamine 6.0% and potassium dichromate 4.7%).HE patients, and particularly those with exclusive hand involvement, show a particular profile in terms of demographic and clinical characteristics, etiologies and relevant positive patch test reactions. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Allergic contact dermatitis (ACD) from protective gloves is often caused by rubber additives, such as accelerators. However, while accelerator‐free rubber gloves are available, they still cause ACD in some individuals.A new allergen, 2‐cyаnоethyl dimethyldithiocarbamate, (CEDMC), has recently been identified in accelerator‐free gloves, and we here provide a first in vitro characterisation of CEDMC in a dendritic cell (DC)‐like cell model along with three reference sensitizer rubber chemicals, consisting of tetraethylthiuram disulfide (TETD) and two xanthogenates.Cellular responses after the exposure to the rubber chemicals were assessed using a transcriptomic approach, multiplex cytokine secretion profiling, and flow cytometry to determine DC model activation marker expression and apoptosis induction.CEDMC and all other sensitizers were classified as strong skin sensitizers with the transcriptomic approach. They all significantly increased IL‐8 secretion and exposure to all except one increased CD86 DC activation marker expression. When tested, CEDMC induced apoptosis, however, delayed compared to TETD.The in vitro data corroborate CEDMC, TETD, and investigated xanthogenates as skin sensitizers. Transcriptomic analyses further reveal unique cellular responses induced by CEDMC, which together with future study can contribute to better understanding of cellular mechanisms underlying the sensitising capacity of rubber chemicals. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusion 2‐Hydroxyethyl methacrylate (HEMA) was added into the European baseline series (EBS) in 2019. There is limited data regarding the frequency, relevance, and sources of exposure to HEMA.To investigate the frequency and clinical relevance of positive reactions to HEMA in the EBS in Israel, and explore sources of exposure.Retrospective cohort study that included all patients who underwent patch testing with the EBS in a tertiary center in Israel between 2020 and 2023. Positive reactions to HEMA were stratified by sex, six age groups, and year of study. Sources of exposure to HEMA as well as occupational data were recorded.A total of 1671 consecutive patients underwent HEMA patch testing, with 135 (8.1%) showing positive reactions to HEMA (130 females, 5 males). The prevalence in women (11.0%) was significantly higher compared to men (1.0%) (p < 0.001). Stratification by age and sex revealed the highest frequency of HEMA sensitivity of 16.7% among women younger than 30 years of age, with odds ratio of 2.3 (95%CI: 1.6–3.3, p < 0.001) compared to older women. There was an increase in frequency among women between the years 2022 and 2023 when compared to 2020–2021 (OR 1.7, 95%CI: 1.5–2.1, p < 0.01) attributable to COVID‐19 pandemic and social restrictions. Among men the frequency fluctuations over the study period and age categories were nonsignificant. 111 (84%) were judged to be of clinical relevance and nail cosmetics was responsible for 95% of them. Of 111 patients with relevant reaction (110 females, 1 males), 20 (18%) had occupational contact dermatitis (18 nails stylists, 2 dentists). Other culprit products included sanitary pads (n = 4), medical adhesives (n = 3), and paints (n = 2).We report the highest frequency of HEMA sensitivity to date of 8.1%, that was most common among young women and in vast majority of cases was attributable to nail cosmetics. Our findings reflect the popularity of nail cosmetics in Israel as well as the global trend of increasing sensitivity to (meth)acrylates. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusions Photoallergic contact dermatitis (PACD) is a delayed hypersensitivity reaction to allergens only in the presence of ultraviolet radiation in sunlight. Photopatch testing (PhotoPT) is necessary to confirm the diagnosis of PACD. There are few published studies of PhotoPT in North America.To summarise the results of patients photopatch tested by members of the North American Contact Dermatitis Group (NACDG), 2009–2020.Retrospective analysis of patient characteristics and PhotoPT results to 32 allergens on the NACDG Photopatch Test Series.Most of the 454 tested patients were female (70.3%), 21–60 years old (66.7%) and White (66.7%). There were a total of 119 positive photopatch tests. Sunscreen agents comprised 88.2% of those, with benzophenones responsible for over half of them. Final diagnoses included PACD in 17.2%, allergic contact dermatitis (ACD) in 44.5%, polymorphous light eruption (PMLE) in 18.9% and chronic actinic dermatitis (CAD) in 9.0% of patients.In 454 patients with suspected photosensitivity referred for photopatch testing in North America, approximately one‐fifth had PACD. Sunscreen agents, especially benzophenones, were the most common photoallergens. Other common diagnoses included ACD, PMLE and CAD. Photopatch testing is an important tool for differentiating these conditions. [ABSTRACT FROM AUTHOR]

Background Objectives Patients and Methods Results Conclusions Propolis was added to the European baseline series (EBS) in 2019.To investigate the frequency and relevance of positive patch tests to propolis in the EBS and to study co‐reactivities.Retrospective study in patients patch tested between June 2019 and November 2023 in a university hospital in Amsterdam, The Netherlands.Of 3134 consecutive patients, 299 (9.5%) had a positive reaction to propolis 10% pet. Only nine reactions (3%) were judged to be clinically relevant. There were significant co‐reactivities to Myroxylon pereirae resin (balsam of Peru), colophonium, fragrance mixes 1 and 2, and to limonene and linalool hydroperoxides. A steep increase in rates of positive reactions to propolis was observed from 2020 to 2023. This was highly likely the result of the replacement of Chinese propolis with Brazilian propolis by the manufacturer.Positive patch tests for propolis are very frequent in Amsterdam, but only a few of these reactions are relevant. Most are probably (pseudo‐)cross‐reactions in patients with fragrance allergies. Propolis in the EBS has very limited value for dermatologists and patients in The Netherlands. Changes in patch test materials should be provided to all users to avoid misinterpretation of patch test results. [ABSTRACT FROM AUTHOR]

Introduction Objectives Methods Results Conclusion Tert‐butylphenol (TBP) derivatives, antioxidants in adhesives and diabetes devices, may provoke allergic contact dermatitis (ACD).The objective of this study is to report sensitization to TBP derivatives in medical devices and to highlight that tert‐butylhydroquinone (BHQ) and tert‐butylcatechol (TBC) are potential screeners in this regard.Fifteen patients with ACD from adhesives and diabetes devices were patch tested to different TBPs: BHQ 1% pet., TBC 0.25% pet., BHA 2% pet., BHT 2% pet., 4‐tert‐butylphenol (TBP) 1% pet. and 2,4‐di‐tert‐butylphenol (di TBP) 1% pet. The culprit devices (medical adhesives, sanitary pads, diabetes devices) and TBP patch preparations were analysed using gas chromatography‐mass spectrometry (GC–MS).BHQ (9/13), TBC (7/13), and to a lesser extent BHT (3/15), BHA (2/15) and TBP (2/13) gave positive reactions. Seven patients had developed ACD from adhesives and diabetes devices, respectively, and one patient from sanitary pads. GC–MS analyses of the medical devices and patch test materials confirmed the presence of the patch‐test positive TBPs, or chemically related derivatives, or, interestingly, tert‐butylbenzoquinones (BBQ) were found, that is, spontaneously formed, highly reactive TBP metabolites, likely (pseudo‐) cross reacting with the patch tested TBPs.TBPs might be overlooked sensitizers in medical devices, and BHQ and TBC are potential screeners in this regard. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusion Reports of allergic contact dermatitis (ACD) to phytonadione epoxide (PE) in cosmetics suggest that PE is as powerful a sensitiser as its parent compound phytonadione.To evaluate a case series of ACD to PE in Spain.We reviewed the records of 20 patients with ACD to cosmetics containing PE diagnosed across Spain between January 2019 and June 2023.All 20 patients developed patch test (PT) or repeated open application test (ROAT) reactions to cosmetics containing PE. All involved women with eyelid eczema. PT or ROAT with PE preparations were positive in 17/20 (85%). PE at 1%, 5%, 10% and 20% in pet. was patch‐tested in 8/17, 14/17, 11/17 and 8/17 patients; being positive in 6/8 (75%), 13/14 (92.85%), 11/11 (100%) and 8/8 (100%), respectively.Regulators should, not only ban the specific dangerous cosmetic ingredients, but also consider to ban or keep under close surveillance those closely related products or derivatives that might potentially cause similar harmful effects. PTs with PE are suggested to be performed at a 5% concentration in pet. Higher concentrations (10% pet.) should be tested whenever PTs with 5% pet. PE are negative. [ABSTRACT FROM AUTHOR]

The present study aims to investigate the current trends in replacing conventional preservatives with multifunctional ingredients with antimicrobial properties for preservation of cosmetics for infants or sensitive population, to decrease their potential for contact dermatitis. We first reviewed the labels of cosmetics purchased from the Chinese market for conventional preservatives and multifunctional ingredients with antimicrobial properties, of which the actual contents were further quantified by chromatographic methods. We identified 7 traditional preservatives (phenoxyethanol, benzoic acid (salts), methylparaben, benzyl alcohol, sorbic acid (salts), propylparaben, and methylisothiazolinone), and 11 alternative ingredients with antimicrobial activities (ethylhexylglycerin, butylene glycol, caprylyl glycol, propylene glycol, 1,2-hexanediol, p-anisic acid, hydroxyacetophenone, pentylene glycol, decylene glycol, caprylhydroxamic acid, and aminomethyl propanol) in descending order of prevalence. The contents of all identified preservatives and ingredients were either below regulatory limits or in the range that is generally regarded to be safe. Further challenge with microorganisms indicated irrespective of the composition of preservation systems, product preservation could be compromised under test conditions. We conclude that multifunctional ingredients with antimicrobial properties in cosmetics have the potential to completely replace or significantly reduce the use of traditional preservatives while retaining comparative preservative efficacy. Future attentions may need to be shifted to the safety of those multifunctional ingredients with antimicrobial properties. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Formaldehyde is a common cause of contact allergy. Hidden formaldehyde, that is, formaldehyde in products without formaldehyde releasers, has previously been detected in cosmetic products.The objective of this study was to investigate the content and causes of hidden formaldehyde in leave‐on cosmetic products.The formaldehyde release from 142 cosmetic products, primarily creams, was analysed using the chromotropic acid (CA) method. The study included 130 products with no formaldehyde releasers on the ingredient list and 12 products with formaldehyde releasers. Products without formaldehyde releasers positive to CA, that is, with formaldehyde ≥2.5 ppm, were additionally analysed using high‐performance liquid chromatography (HPLC). Formaldehyde release from selected raw materials and packaging were also investigated.Hidden formaldehyde was found in 23 of the 130 products (18%) without formaldehyde releasers on the ingredient list. The average formaldehyde content was 105 ppm (range: 0.5–507 ppm) in products with hidden formaldehyde and 355 ppm (range: 75–637 ppm) in eight products with formaldehyde releasers, selected for HPLC analysis. Impurities of formaldehyde in dihydroxyacetone may be a cause of hidden formaldehyde in self‐tanners. No clear pattern was found for the other products with hidden formaldehyde.Changes in regulation are needed to prevent allergic contact dermatitis from hidden formaldehyde in cosmetic products. [ABSTRACT FROM AUTHOR]

This article discusses a case of allergic contact dermatitis (ACD) and delayed wound healing caused by the use of cosmetic creams containing panthenol. Panthenol is commonly found in hypoallergenic cosmetics, including moisturizers and wound-healing creams. The patient experienced eczema and delayed wound healing after using several creams on her face and for aftercare treatment of her wounds. Patch testing confirmed a diagnosis of ACD from panthenol contact allergy. The article highlights the importance of being aware of the presence of panthenol in cosmetic products and its potential to cause allergic reactions. [Extracted from the article]

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Background Objectives Results Conclusions The woods of trees of the genus Dalbergia are a frequent cause of allergic contact dermatitis.To describe the different patterns of symptoms and sensitisation to woods of the genus Dalbergia in four patients whose regular work is linked to music, either as performers (two patients) or instrument makers.The patients showed extensive cross‐reactivity between the different Dalbergia woods. The two musicians exhibited symptoms exclusively in the contact areas, while the instrument makers showed a pattern of airborne symptoms. The period from sensitisation to the development of symptoms varied greatly among the patients.The symptoms of allergic contact dermatitis to Dalbergia woods differ markedly depending on the route of contact. Cross‐reactivity between the woods of this genus is very wide. The sensitising potential varies between the various Dalbergia woods, which require different contact periods depending on their sensitising power. [ABSTRACT FROM AUTHOR]

Allergic diseases like asthma, allergic rhinitis and dermatitis pose a significant global health burden, driving the search for novel therapies. The NLRP3 inflammasome, a key component of the innate immune system, is implicated in various inflammatory diseases. Upon exposure to allergens, NLRP3 undergoes a two-step activation process (priming and assembly) to form active inflammasomes. These inflammasomes trigger caspase-1 activation, leading to the cleavage of pro-inflammatory cytokines (IL-1β and IL-18) and GSDMD. This process induces pyroptosis and amplifies inflammation. Recent studies in humans and mice strongly suggest a link between the NLRP3 inflammasome, IL-1β, and IL-18, and the development of allergic diseases. However, further research is needed to fully understand NLRP3's specific mechanisms in allergies. This review aims to summarize the latest advances in NLRP3 activation and regulation. We will discuss small molecule drugs and natural products targeting NLRP3 as potential therapeutic strategies for allergic diseases. [ABSTRACT FROM AUTHOR]

Objective: This scoping review aimed to map the adverse reactions in the oral mucosa and face caused by the use of natural products. Methodology: This review was performed according to the Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with a protocol registered in the Open Science Framework (DOI 10.17605/OSF.IO/R57D8). The search was carried out systematically using PubMed, Scopus, Web of Science, Embase, LILACS, and LIVIVO databases, as well as gray literature through Google Scholar and OpenGrey. Reports of clinical cases on the adverse effects of natural products on the oral mucosa or perioral region of the face resulted from inappropriate use or self-medication were included. Data from the included studies were described in a narrative form. Results: Seven hundred and six studies were identified, and after removing duplicates and applying the eligibility criteria, 28 studies were included. The year of publication ranged from 1976 to 2022. The studies were conducted in 19 countries. Fifty patients were mentioned in the included studies and 34 were female (68%). The natural products most related to adverse reactions were propolis (n = 17), with manifestations such as perioral eczema, edema, erosions, erythema, allergic contact dermatitis, and garlic (n = 9), with manifestations such as chemical burn, burning sensation, vesicles and blisters, crusts, and ulcerations. Conclusion: Propolis and garlic were the natural products with the most reported adverse effects on the oral mucosa and perioral region. [ABSTRACT FROM AUTHOR]

Background/Objectives: In the last 10 years methylisothiazolinone (MI) emerged as a global cause of preservative‐related ACD. New Zealand has liberal regulations for the MI concentration limit in cosmetic products compared to Europe and Australia. The aim of this study was to evaluate the prevalence of MI sensitisation in New Zealand, explore sources of MI exposure and make recommendations on New Zealand regulations for MI use. Methods: This retrospective study included data from patients who underwent patch testing with MI from 2008 to 2021 in a tertiary hospital dermatology clinic and a private dermatology clinic in Auckland, New Zealand. Patient baseline characteristics were recorded along with results of patch testing. Sources of MI exposure were identified from medical records. Results: Over the study period, 1049 patch tests were performed in 1044 patients. MI was only tested as a stand‐alone allergen from 2015; positive reactions to MI increased from 5.3% in 2015 to a peak of 11.9% in 2017 and then decreased to 6.4% in 2021. The most common source of MI exposure was shampoo or conditioner (27.7% of all relevant reactions) followed by occupational exposures to paints, biocides or glue (19.1%). Conclusion: Both sensitisation and ACD to MI appear to be decreasing, likely secondary to changes in product compounding due to stricter concentration limits internationally. We recommend New Zealand adopt lower MI concentration limits for cosmetics to match the limits of Australia and Europe. [ABSTRACT FROM AUTHOR]

Introduction Materials and methods Results Conclusion Chronic actinic dermatitis (CAD) is an immunologically mediated photodermatosis that has been effectively treated with azathioprine and mycophenolate mofetil (MMF) in uncontrolled studies. We conducted a prospective randomized controlled trial to compare the efficacy and safety of azathioprine and MMF in CAD treatment, aiming to address existing evidence gaps.Consecutive CAD patients were randomized into two groups: azathioprine (Group A) or MMF (Group B) for 12 weeks. Primary outcomes included Eczema Area and Severity Index (EASI) and Dermatology Life Quality Index (DLQI) at baseline and Week 12. Secondary outcomes included various clinicodemographic factors predictive of treatment response, defined at least a 75% reduction in EASI score (EASI75) by Week 12.The median (IQR) percentage reduction in EASI at 12 weeks was higher in Group B than in Group A [78.3% (75.0–83.30%) vs. 68.3% (31.2–80.10%), P = 0.034]. Baseline DLQI scores indicated a moderate impact on quality of life, with significant reductions by Week 12 in both groups and no intergroup differences at baseline (P = 0.291) or Week 12 (P = 0.599). Overall, 23 patients were classified as non‐responders, with more extended illness duration (P = 0.026) and outdoor occupations (P = 0.042) associated with poorer responses. Adverse effects were consistent with known profiles, with one patient discontinuing azathioprine due to hypersensitivity.Our study highlights the efficacy and safety of azathioprine and MMF in CAD treatment, with MMF showing superior outcomes. However, further research is warranted to explore emerging therapies and prognostic factors in CAD management. [ABSTRACT FROM AUTHOR]

Background: Animal and owner quality‐of‐life (QoL) is pivotal in treatment decisions. Accurate measurement of owner‐reported QoL and treatment satisfaction (TS) supports disease burden and treatment benefit evaluation. Objectives: Develop and evaluate an owner‐completed canine dermatitis QoL and TS questionnaire (CDQoL‐TSQ) in allergic dogs. Materials and Methods: The CDQoL‐TSQ was drafted following review of existing measures and expert input. Content validity was assessed through interviews with owners of allergic dogs. Psychometric properties of the QoL domains (Canine QoL, Owner QoL) were evaluated. Score interpretation was derived. Results: Twenty dog owners were interviewed. Item wording was amended following the first 10 interviews. Data from 211 owners were used in the psychometric evaluation. The Canine QoL domain demonstrated strong internal consistency (α = 0.89), test–retest reliability (ICC2,1 = 0.844), moderate convergent validity (r = 0.41) and moderate‐high known‐groups validity (effect size 0.37–0.64). The Owner QoL domain demonstrated strong internal consistency (α = 0.73), high convergent validity (r = 0.63) and moderate‐high known‐groups validity (0.43–0.63). Test–retest reliability approached moderate strength (ICC2,1 = 0.490). Group‐level interpretation analysis showed minimal important difference of 7.0–13.6 points for dogs and 13.0–13.6 for owners. For individual dogs a change of 6.3 or 12.5 points for dogs, and 12.5 or 18.8 for owners indicates a response. Conclusions and Clinical Relevance: The CDQOL‐TSQ is a two‐part assessment to evaluate QoL and TS in canine allergic dermatitis. The QoL questionnaire demonstrated validity and reliability, and interpretation of scores was derived, making it suitable for use in research and practice. The TS module is suitable for clinical setting use to improve owner–veterinarian communication. [ABSTRACT FROM AUTHOR]

Background: Direct skin contact with items containing lanolin can induce sensitization and development of contact dermatitis (CD). This multi-centric study investigated prevalence of lanolin sensitization among 30,269 outpatients from North-Eastern Italy patch tested during 1997–2021. Methods: European baseline and extended Triveneto series were applied on the upper part of patients' back and removed after 48 h. Risk factors for lanolin sensitization were investigated by multiple logistic regression analysis, reporting adjusted odds ratios (aOR) with 95% confidence interval (95%CI). Results. Overall lanolin patch test positive ratio (PTPR) was 1.64% (=501/30,629), with variability over time and by research center. The body area most frequently affected by CD were hands (36.32%), followed by face (19.52%) and legs (8.09%), with a lanolin PTPR of 1.68%, 1.37% and 3.07%, respectively. Prevalence of occupational CD was 8.24%, and 1.83% patients with occupational CD patch tested positive against lanolin. Lanolin sensitization was significantly higher in males (aOR = 1.34; 95%CI: 1.08; 1.65) and among patients with leg CD aged 49–60 years (aOR = 2.34; 95%CI: 1.20; 4.57) or older than 60 (aOR = 4.21; 95%CI: 2.59; 6.85). Sub-group analysis confirmed the significantly higher sensitization rate of older patients with leg CD, with much stronger effect size in females 61+ years old (aOR = 5.33; 95%CI 2.87; 9.89) than males in the same age group (aOR = 2.92; 95%CI: 1.34; 6.39). Moreover, female house painters were more likely to test positive to lanolin. Conclusions: The variability of lanolin PTPR over time and by research center endorsed the ongoing debate on the relevance of the respective skin reaction. Clinicians assessing patients with dermatitis should collect information on potential risk factors for lanolin sensitization, particularly use of skin care products containing the hapten. Occupational exposure to lanolin-containing varnishes should also be considered. [ABSTRACT FROM AUTHOR]

The anti-inflammatory, antiviral, and anti-cancer properties, as well as the mechanism of action of cyclo-[Pro-Pro-β3-HoPhe-Phe-] tetrapeptide (denoted as 4B8M), were recently described. The aim of this work was to synthesize and evaluate the immunosuppressive actions of the stereochemical variants of 4B8M by sequential substitution of L-amino acids by D-amino acids (a series of peptides denoted as P01–P07) using parent 4B8M as a reference compound. In addition, diverse available bioinformatics tools using machine learning and artificial intelligence were tested to find the bio-pharmacokinetic and polypharmacological attributes of analyzed stereomers. All peptides were non-toxic to human peripheral blood mononuclear cells (PBMCs) and only cyclo-[D-Pro-Pro-β3-HoPhe-Phe-] peptide (P03) was capable of inhibiting mitogen-induced PBMC proliferation. The peptides inhibited the lipopolysaccharide (LPS)-induced production of tumor necrosis factor-alpha (TNF-α) to various degrees, with P04 (cyclo-[Pro-Pro-D-β3-HoPhe-Phe-]) and P03 being the most potent. For further in vivo studies, P03 was selected because it had the combined properties of inhibiting cell proliferation and TNF-α production. P03 demonstrated a comparable ability to 4B8M in the inhibition of auricle edema and lymph node cell number and in the normalization of a distorted blood cell composition in contact sensitivity to the oxazolone mouse model. In the mouse model of carrageenan-induced inflammation of the air pouch, P03 exhibited a similar inhibition of the cell number in the air pouches as 4B8M, but its inhibitory effects on the percentage of neutrophils and eosinophils in the air pouches and blood, as well as on mastocyte degranulation in the air pouches, were stronger in comparison to 4B8M. Lastly, in a mouse model of dextran sulfate-induced colitis, similar effects to 4B8M regarding thymocyte number restoration and normalization of the blood cell pictures by P03 were observed. In summary, depending on either experimental findings or in silico predictions, P03 demonstrated comparable, or even better, anti-inflammatory and bio-pharmacokinetic properties to 4B8M and may be considered as a potential therapeutic. The possibility of P00 and P03 identification by circular dichroism measurements was tested by quantum-chemical calculations. [ABSTRACT FROM AUTHOR]

Cotton is used for the production of textiles, hygiene and cosmetic materials. During cultivation and technological processes, various types of substances (surfactants, softeners, lubricants, etc.) penetrate cotton, which can have a harmful effect on both the human body and the environment. The aim of this study was to analyze selected cotton products in order to identify the substances contained and to describe the potential possibilities of inducing textile contact dermatitis (CD). The impact of the identified compounds on the aquatic environment was also taken into account. Nine samples of cotton clothing and seven samples of cotton pads from various manufacturers were tested. Samples after extraction using the FUSLE (Focused Ultrasonic Liquid Extraction) technique were analyzed with GC/MS. Qualitative analysis was based on comparing mass spectra with library spectra using the following mass spectra deconvolution programs: MassHunter (Agilent), AMDIS (NIST), and PARADISE (University of Copenhagen). The parameter confirming the identification of the substance was the retention index. Through the non-target screening process, a total of 36 substances were identified, with an average AMDIS match factor of approximately 900 ("excellent match"). Analyzing the properties of the identified compounds, it can be concluded that most of them have potential properties that can cause CD, also due to the relatively high content in samples. This applies primarily to long-chain alkanes (C25–C31), saturated fatty acids, fatty alcohols (e.g., oleyl alcohol), and fatty acid amides (e.g., oleamide). However, there are not many reports describing cases of cotton CD. Information on the identified groups of compounds may be helpful in the case of unexplained sources of sensitization when the skin comes into contact with cotton materials. Some of the identified compounds are also classified as dangerous for aquatic organisms, especially if they can be released during laundering. [ABSTRACT FROM AUTHOR]

Background: Mainly women work as foot care specialists (FCS). They are at risk to develop occupational dermatitis (OD). Objectives: The objective of this study is to describe the contact sensitisation pattern of female FCS with OD. Methods: In a retrospective study, patch test and clinical data collected by the Network of Departments of Dermatology (IVDK) from 2008 to 2022 were analysed. Data of 116 female FCS with OD were compared with data of 13 930 female patients with OD working in other professions and 78 612 female patients without OD. Results: Hand dermatitis (93.1%) was significantly more common and face dermatitis (0.9%) significantly less common in female FCS with OD compared to other female patients with or without OD. Frequent suspected allergen sources were disinfectants, gloves, leave‐on and nail cosmetics. Occlusion and wetness were important co‐factors. The most common diagnoses were irritant contact dermatitis (26.7%) and allergic contact dermatitis (21.6%). No sensitisation to any of the baseline series allergens was significantly more frequent in female FCS with OD than in the two control groups. However, sensitisations to allergens which FCS are abundantly exposed to, including fragrances, preservatives, rubber ingredients and disinfectants, were most common. Conclusions: FCS should be aware of the OD risk and prevention should be promoted. [ABSTRACT FROM AUTHOR]

Background: Chemical hair relaxers are widely utilized by black women, yet little research exists on the allergens present in these products. Objective: This study aims to investigate allergen prevalence in the most popular chemical hair relaxers. Methods: We analysed 41 products from five major retailers, identifying allergens through ingredient lists and comparing them to the 2020 American Contact Dermatitis Group Core allergen series. Results: The most common contact allergens in chemical relaxers include propylene glycol, cetyl steryl alcohol, fragrance, D/L‐a‐tocopherol, tea tree oil and cocamidopropyl betaine. Conclusion: Understanding allergen exposure in products used by individuals with textured hair is needed for managing contact dermatitis in diverse populations. This analysis underscores the presence of potential allergens in hair relaxers, emphasizing the importance of dermatologists' awareness and patient scrutiny of ingredient lists. [ABSTRACT FROM AUTHOR]

Introduction: Allergic contact dermatitis (ACD) to salicylic acid (SA) is widely unreported. Furthermore, cross‐reactivity between SA and other salicylates has not been reported despite well‐documented in‐group salicylate cross‐reactivity. Objective: To describe our clinic's experience patch testing to SA, highlighting seven cases of relevant reactions and concomitant reactivity with other salicylates. Methods: Results of patch testing to 5% SA in petrolatum between 1 January 2020, and 9 February 2024, are reported. Seven cases of relevant reactions to SA are detailed. Results: A total of 489 patients (27.5%) were tested to SA, 21 of which were positive: 7 doubtful (+/−), 14 weak positive (+), and no strong/extreme positive reactions. Four irritant reactions were documented. Of the 14 weak positive (+) reactions, 7 had definite or probable clinical relevance, 5 of which also reacted to other salicylates. Conclusions: ACD to SA is likely underreported due to a lack of testing. In our experience, testing SA 5% petrolatum is tolerable without significant irritation. Cross‐reactivity between SA and other salicylates is probable. Though SA appears to be the primary sensitizer in some cases, more studies are needed to understand its possible role as a marker for salicylate allergy. [ABSTRACT FROM AUTHOR]

Patch testing is the only clinically applicable diagnostic method for Type IV allergy. The availability of Type IV patch test (PT) allergens in Europe, however, is currently scarce. This severely compromises adequate diagnostics of contact allergy, leading to serious consequences for the affected patients. Against this background, the European Society of Contact Dermatitis (ESCD) has created a task force (TF) (i) to explore the current availability of PT substances in different member states, (ii) to highlight some of the unique characteristics of Type IV vs. other allergens and (iii) to suggest ways forward to promote and ensure availability of high‐quality patch testing substances for the diagnosis of Type IV allergies throughout Europe. The suggestions of the TF on how to improve the availability of PT allergens are supported by the ESCD, the European Academy of Allergy and Clinical Immunology, and the European Academy of Dermatology and Venereology and intend to provide potential means to resolve the present medical crisis. [ABSTRACT FROM AUTHOR]

Background: Due to an increasing occupational usage of isothiazolinone (IT)‐containing preservatives, and their potential to cause skin sensitization and allergic contact dermatitis, that is, chronic disease, there is a need for more knowledge on how highly exposed workers are affected. Objectives: The overall objective was to explore dermatological symptoms of potentially long‐lasting or chronic character in Swedish painters. Methods: Building painters from western and southern Sweden were initially invited to perform a questionnaire on occurrence of skin symptoms. Participants with affirmative responses, and the right inclusion criteria, were further invited to patch testing with four different ITs: benzisothiazolinone (BIT), methylisothiazolinone, methylchloroisothiazolinone and octylisothiazolinone. Results: There was a tendency towards higher occurrence of positive patch test reactions among the painters compared with occupationally unexposed registry patients; however, not statistically significant differences. BIT was the substance most frequently causing positive test results in both groups. The occurrence of adult‐onset eczema was higher in painters than in the control group of electricians, and just shy of statistical significance concerning any of several skin locations (face/legs/arms/hands). Conclusion: Building painters present with positive patch test reactions to common paint preservatives (ITs), and they report adult‐onset eczema more often than do less occupationally exposed groups. [ABSTRACT FROM AUTHOR]

Background: The prevalence of contact allergy to various ophthalmic medications appears to be rare; however, data on culprits, clinical relevance of sensitizations, and changes in frequency within recent decades are limited. Objective: This study aimed to investigate the clinical relevance, risk factors, and prevalence of contact allergy to topical ophthalmic medications in patients suspected of allergic contact dermatitis to ophthalmic medication. Methods: We retrospectively analysed patch test results and clinical data for 754 patients patch‐tested with an ophthalmic medication series at our tertiary referral centre between January 1992 and December 2022. Results: In total, 37.5% (283/754) of patch‐tested patients had a contact allergy to at least one ophthalmic allergen, with 87.3% (247) being clinically relevant sensitization. Phenylephrine (31.8%, 192/604), povidone‐iodine (29%, 27/93), and tobramycin (23%, 46/200) were the most important sensitizers. The incidence of contact allergies increased significantly in a linear manner (p = 0.008) from 20% to 44.1% within the study period. Male sex and age above 40 were risk factors for contact allergy to ophthalmic medication. Conclusions: One third of patch tested patients had allergic contact dermatitis to ophthalmic medication, particularly phenylephrine. Male sex and age above 40 years were independent risk factors and drove the linear increase in contact allergy to ophthalmic medications within the past 31 years. [ABSTRACT FROM AUTHOR]

Background: This study aims to assess the impact of safety footwear (SF) on workers concerning foot-related problems, especially regarding discomfort, foot pain, and skin lesions. Methods: A literature search of PubMed, Embase, Scopus, and Cochrane databases was performed according to PRISMA guidelines. Studies reporting foot-related problems in workers wearing SF were included. Exclusion criteria included non-English papers, reviews, laboratory and animal studies, expert opinions, letters to the editor, and grey literature. The quality assessment was performed using the Newcastle–Ottawa Scale. Descriptive statistic was used to present data. Result: The initial search results yielded 483 articles; 7 articles were included in the review process. Despite the extensive variety of SF, all studies consistently reported symptomatic discomfort and pain. The discomfort factors included heat, sweating, heaviness, and footwear flexibility, with primary issues in the toes, toecaps, or metatarsal–toe crease region. The pain prevalence ranged from 42.3% to 60.8% in various anatomical regions. Irritant Contact Dermatitis was the most common (97.9%) foot dermatosis, but other foot lesions were reported: dry skin (30.2%), calluses (30%), hard nails (28%), corns (27%), and blisters. Conclusions: Current SFs are designed to comply with safety regulations but are influenced by the frequent occurrence of discomfort and foot problems. The literature review identified weaknesses in certain design features. Recommendations have been proposed to improve SF development. These include addressing issues such as the selection of specific types and designs of SF based on task performance and the working environment, footwear weight, and breathable materials for moisture permeation. Considerations should also encompass distinct sizing for an optimal fit, insole application, especially for prolonged standing users, and education programs to prevent foot-related issues. [ABSTRACT FROM AUTHOR]

Contact dermatitis is a common inflammatory skin disease that often requires prescription therapy and is associated with adverse reactions. Omega fatty acids have been recognized for their anti-inflammatory effect and could serve as a safer option in contact dermatitis treatment. Therefore, the aim of this randomized controlled study, conducted at the University of Split School of Medicine, was to evaluate the efficacy and safety of omega fatty acids containing topical products in an experimental model of irritant contact dermatitis. This study was registered with ClinicalTrials (NCT06189144) and is closed. The primary outcomes were levels of transepidermal water loss, skin hydration, and skin erythema, all measured using an MPA6 device in 25 healthy participants. A significant difference was observed between the hydration values of the intervention (45.7 ± 12.4) and control groups (31.6 ± 12.3) (p < 0.05) on final measurements (day 10). Moreover, higher erythema levels were observed in participants who were smokers, compared to non-smokers. No adverse drug reactions were observed during the study period. In conclusion, omega fatty acids topical product use shows promise in the treatment of irritant contact dermatitis, and further studies are needed to evaluate efficacy in a larger sample of patients. [ABSTRACT FROM AUTHOR]

Acrylates and methacrylates, though common in a wide variety of products, especially in the dental industry, can cause adverse skin reactions. These compounds, including 2-hydroxyethyl methacrylate, triethylene glycol dimethacrylate, and bisphenol A-glycidyl methacrylate, are strong contact irritants or allergens. Found in dental prostheses, composite resins, dentin bonding materials, and glass ionomers, they pose a higher risk of exposure for dental personnel. Clinically, acrylate allergies manifest as facial rashes, eczema with cracked skin on fingers (pulpitis), nail dystrophy, and periungual dermatitis. Recently, however, the highest frequency of allergic reactions to acrylates has been observed in the beauty industry due to increased use in artificial nails, eyelashes, and hair extensions. This has led to greater sensitization. Acrylates are also used in medical applications such as bone cement for orthopedic endoprostheses, soft contact lenses, hearing aids, histological preparations, and wound dressings, which can also cause allergic reactions. For example, acrylates in surgical glue can cause severe dermatitis, and diabetic medical devices are also potential sources of allergic contact dermatitis. Given the extensive use and prolonged skin contact of products containing acrylates and methacrylates, this review aims to present current knowledge from the literature on reactions to these compounds across different industries. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusion Neomycin is an aminoglycoside antibiotic that may cause contact allergy. It was withdrawn as a medicine for human use in Denmark in October 2009 but is still found in some vaccines.To identify time trends in contact allergy to neomycin in the period from 2000 to 2023.A cross‐section study of patients ≥18 years consecutively patch‐tested with neomycin sulfate (20% in pet.) at Gentofte Hospital, Denmark, during the period 2000–2023 was conducted.The overall prevalence of contact allergy to neomycin was 1.4%. The prevalence was significantly lower in the period ‘2010–2023’ (1.2%) than in ‘2000–2009’ (1.8%) (p < 0.005). Contact allergy to neomycin was significantly positively associated with facial dermatitis and age >40 years, and significantly negatively associated with occupational dermatitis and hand dermatitis. No changes in sex, occupational dermatitis, atopic dermatitis, hand dermatitis, leg dermatitis, facial dermatitis, or age > 40/≤40 (the MOAHLFA‐index) were identified when comparing neomycin contact allergic‐patients in the two periods ‘2010–2023’ and ‘2001–2009’.Neomycin is a rare cause of contact allergy in Denmark with a significantly lower prevalence following its withdrawal as a medicinal product for human use in Denmark in 2009. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Regulatory actions significantly reduced methyldibromo glutaronitrile (MDBGN)‐induced allergic contact dermatitis (ACD) from cosmetics in Europe. Turkey banned MDBGN in 2015.To assess sensitization and ACD rates to MDBGN before and after its ban in Turkey.Data from 2653 consecutively patch tested patients between 1996 and 2023 with MDBGN 0.1% pet. (n = 573) or 0.2%–0.3% pet. (n = 1310) or 0.5% pet. (n = 770) were analysed. MDBGN was tested as MDBGN/phenoxyethanol (PE) in 1434 patients.The sensitization prevalence was 1.7% (45/2653), peaking at 5.3% in 2018 and 2023 with MDBGN 0.3% pet. There was a two‐fold male predominance, with patients exclusively ≥20 years old. None of the patients reacted to PE. ACD occurred in 0.7% (19/2653), mainly affecting hands and linked to non‐occupational exposure (78.9%), particularly from rinse‐off/leave‐on cosmetics. The pattern of ‘middle‐aged men with hand eczema and fragrance allergy' was particularly notable. Occupational ACD was rare (21.1%), occurring mainly in hairdressers from hair gel. Positive reactions with current clinical relevance dropped from 48.3% (1996–2014) to zero after 2015 (p < 0.001).The ban effectively reduced MDBGN‐induced ACD in Turkey, yet the prevalence of positive patch test reactions remains high, likely due to past exposures or other undisclosed sources. We suggest continued testing of MDBGN in the EBS in Turkey. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusion The use of methylisothiazolinone (MI) as a preservative in cosmetic products caused an alarming increase in MI contact allergy across Europe in the 2010s. This was followed by regulations of use with a total ban on leave‐on (implemented in 2017) and reduced use concentrations in rinse‐off cosmetics (2018).To follow‐up on the prevalence of contact allergy to MI and the related benzisothiazolinone (BIT) and octylisothiazolinone (OIT) in consecutively patch‐tested patients in Europe.A cross‐sectional audit following the design of two previous audits on MI contact allergy from 1 May 2022 to 31 October 2022 included all patients patch tested with the European baseline series, including or supplemented with MI, BIT and OIT across 10 departments in eight European countries.A total of 2554 patients were consecutively patch tested with the three isothiazolinones during the study period. The prevalence of MI and BIT contact allergy was 2.9% (95% confidence interval [CI]: 2.3%–3.7%; range 1.1%–5.8%) and 3.1% (95% CI: 2.4%–3.9%; range 0.0%–6.6%), respectively; that of OIT was 0.7% (95% CI: 0.4%–1.1%; range 0%–3.2%). Rinse‐off cosmetic (73.3%) and leave‐on cosmetic products (13.3%) were still associated with eliciting allergic contact dermatitis to MI.We confirmed a positive impact of regulatory measures on the prevalence of MI contact allergy in Europe, which halved compared to 2015. However, our data suggest that consumers may still be exposed to older cosmetic products containing MI. BIT has superseded MI in causing contact allergy, despite not being allowed for use in cosmetic products. [ABSTRACT FROM AUTHOR]