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Contact Dermatitis May 2021Polyaminopropyl biguanide (INCI name) and polyhexamethylene biguanide (PHMB) are polymeric biguanides. PHMB is a broad-spectrum antimicrobial substance used as a...
BACKGROUND
Polyaminopropyl biguanide (INCI name) and polyhexamethylene biguanide (PHMB) are polymeric biguanides. PHMB is a broad-spectrum antimicrobial substance used as a preservative in many products. Due to our limited knowledge on PHMB contact allergy frequency and the fact that cases of allergic contact dermatitis to PHMB might be missed, we have included PHMB as a screening allergen since 2016.
OBJECTIVE
To report the prevalence of positive patch test reactions to PHMB as a screening allergen in patients with suspected allergic contact dermatitis.
METHODS
A retrospective analysis of 1760 patch tested patients from July 2016 to December 2018 was performed. Polyaminopropyl biguanide 2.0% aqua was included in the extended Malmö baseline series during the study period.
RESULTS
Of all patients, 1204 (68.4%) were female. Positive patch test reactions were reported in 19 patients (1.1%). The most common sites of lesions were face, head, and neck (52.6%). There was a significant correlation between concomitant reactions to PHMB and other cosmetic-related allergens.
CONCLUSION
The prevalence of positive reactions to PHMB was higher than that previously reported. Patch testing with PHMB should be performed in patients with dermatitis who have lesions on the face, head, and neck.
Topics: Adult; Aged; Biguanides; Cosmetics; Dermatitis, Allergic Contact; Female; Humans; Middle Aged; Molecular Structure; Patch Tests; Preservatives, Pharmaceutical; Prevalence; Retrospective Studies; Sweden
PubMed: 33098110
DOI: 10.1111/cod.13728 -
Nutrients May 2023The clinical examination of patients often includes the observation of the existence of a close relationship between the ingestion of certain foods and the appearance of...
The clinical examination of patients often includes the observation of the existence of a close relationship between the ingestion of certain foods and the appearance of various symptoms. Until now, the occurrence of these events has been loosely defined as food intolerance. Instead, these conditions should be more properly defined as adverse food reactions (AFRs), which can consist of the presentation of a wide variety of symptoms which are commonly identified as irritable bowel syndrome (IBS). In addition, systemic manifestations such as neurological, dermatological, joint, and respiratory disorders may also occur in affected patients. Although the etiology and pathogenesis of some of them are already known, others, such as non-celiac gluten sensitivity and adverse reactions to nickel-containing foods, are not yet fully defined. The study aimed to evaluate the relationship between the ingestion of some foods and the appearance of some symptoms and clinical improvements and detectable immunohistochemical alterations after a specific exclusion diet. One hundred and six consecutive patients suffering from meteorism, dyspepsia, and nausea following the ingestion of foods containing gluten or nickel were subjected to the GSRS questionnaire which was modified according to the "Salerno experts' criteria". All patients underwent detection of IgA antibodies to tissue transglutaminase, oral mucosal patch tests with gluten and nickel (OMPT), and EGDS, including biopsies. Our data show that GSRS and OMPT, the use of APERIO CS2 software, and the endothelial marker CD34 could be suggested as useful tools in the diagnostic procedure of these new pathologies. Larger, multi-center clinical trials could be helpful in defining these emerging clinical problems.
Topics: Humans; Food Intolerance; Nickel; Mucositis; Malabsorption Syndromes; Glutens; Hypersensitivity; Irritable Bowel Syndrome; Celiac Disease; Diet, Gluten-Free
PubMed: 37242236
DOI: 10.3390/nu15102353 -
Dermatitis : Contact, Atopic,...Patch testing is a vital component of the workup for allergic contact dermatitis. There are limited data on changes of patch testing use among Medicare providers, as...
BACKGROUND
Patch testing is a vital component of the workup for allergic contact dermatitis. There are limited data on changes of patch testing use among Medicare providers, as well as patch testing reimbursement rates.
OBJECTIVE
The aim of the study was to evaluate trends in the use of patch testing among various Medicare providers and Medicare patch testing reimbursement.
DESIGN
A longitudinal analysis of patch testing claims was performed with the Medicare Part B Physician/Supplier Procedure Summary files from 2010 to 2018. The primary outcomes were the total number and change in the number of submitted patch testing services from 2010 to 2018 by 3 provider groups: dermatology physicians, nondermatology physicians, and nonphysician providers. Secondary outcome measures included Medicare reimbursement amounts and changes in reimbursement amounts for patch test services (total and per 1000 enrollees) from 2010 to 2018 for the 3 provider groups, as well as per patch test service.
RESULTS
From 2010 to 2018, submitted patch testing services per 1000 enrollees grew by 89.0%. The annual trend estimate for submitted services relative to 2010 was +10.1% (95% confidence interval [CI] = 8.1 to 12.0) for physicians and +34.1% (95% CI = 32.1 to 36.0) for nonphysician providers (physician assistants and nurse practitioners). Among physicians, the annual trend estimate for submitted services was +5.1% (95% CI = -11.3 to 21.5) for dermatologists and +31.40% (95% CI = 15.00 to 47.81) for allergists.
CONCLUSIONS
Patch testing increased in the US Medicare population from 2010 to 2018, and this increase was largely driven by nonphysician providers and allergists.
Topics: Aged; Dermatitis, Allergic Contact; Humans; Medicare Part B; Patch Tests; United States
PubMed: 34115665
DOI: 10.1097/DER.0000000000000754 -
JAMA Dermatology Nov 2022Individuals with allergic contact dermatitis to one topical corticosteroid may also react to other corticosteroids. Corticosteroid classification models have been...
IMPORTANCE
Individuals with allergic contact dermatitis to one topical corticosteroid may also react to other corticosteroids. Corticosteroid classification models have been proposed to predict such copositivity, recommend representative screening corticosteroids, and guide allergen avoidance.
OBJECTIVE
To use patient data to determine copositivity patterns between corticosteroids and evaluate against previous corticosteroid classification models.
DESIGN, SETTING, AND PARTICIPANTS
This qualitative study included a retrospective analysis of the Mayo Clinic Contact Dermatitis Group corticosteroid patch test data from 2010 to 2019. Among patients undergoing patch testing with the Mayo Clinic's standard or steroid series who consented to research participation, 5637 patients were included in the analysis. Copositivity rates were determined between corticosteroids and analyzed by hierarchical clustering for comparison to previous classification models.
MAIN OUTCOMES AND MEASURES
The frequency of patch test positivity to each of the analyzed corticosteroids was noted and compared with previously published patch test positivity rates. Copositivity rates between each pair of corticosteroids were determined, and overall copositivity patterns were analyzed and evaluated against known steroid classes.
RESULTS
A total of 49 472 individual patches were applied to 5637 patients, testing 18 corticosteroids. Patch test positivity rates ranged between 0.3% and 4.7%. The fluocinonide positivity rate corresponded to the highest copositivity rate with other corticosteroids (mean [SD], 50.7% [26.1%]). Tixocortol-21-pivalate, 0.1%, and tixocortol-21-pivalate, 1%, positivity rates corresponded to the lowest copositivity rates (mean [SD], 4.1% [1.7%] and 3.6% [1.4%], respectively). Hierarchical clustering elucidated patterns that did not support previous corticosteroid classification models.
CONCLUSIONS AND RELEVANCE
In this qualitative study, copositivity rates were variable between corticosteroids, and overall patch test positivity for allergy to topical corticosteroids was rare. Previously published corticosteroid classifications are not supported by real patient-derived data and may not be accurate in predicting corticosteroid copositivity.
Topics: Humans; Patch Tests; Retrospective Studies; Adrenal Cortex Hormones; Dermatitis, Allergic Contact; Glucocorticoids
PubMed: 36169950
DOI: 10.1001/jamadermatol.2022.3774 -
Immunology and Allergy Clinics of North... Aug 2021This article reviews the laboratory's role in identifying causes of chemical-induced allergic dermatitis. Several topics will be discussed. Allergen hazard... (Review)
Review
This article reviews the laboratory's role in identifying causes of chemical-induced allergic dermatitis. Several topics will be discussed. Allergen hazard identification refers to testing of chemicals for their sensitization potential. Animal-based, in silico, in chemico, and in vitro tests have been developed to identify the skin sensitization hazard of potential chemical allergens, but only a few of these are accepted by regulatory agencies. Laboratory investigations have also evaluated the stability of several commercially available allergic contact dermatitis patch tests. Such studies are considered product testing and are usually conducted in analytical chemistry laboratories.
Topics: Allergens; Animals; Dermatitis, Allergic Contact; Humans; Laboratories; Patch Tests; Skin
PubMed: 34225898
DOI: 10.1016/j.iac.2021.04.003 -
Contact Dermatitis Feb 2023Sorbitan sesquioleate (SSO) is a sorbitan fatty acid ester, an emulsifier used in topical products and certain patch test preparations. SSO may affect the patch test...
BACKGROUND
Sorbitan sesquioleate (SSO) is a sorbitan fatty acid ester, an emulsifier used in topical products and certain patch test preparations. SSO may affect the patch test results. It has been debated whether to include the substance in the baseline series to avoid misinterpretation of the results.
OBJECTIVES
To report the prevalence and simultaneous reactions of SSO with other patch test preparations containing SSO as an emulsifier.
MATERIALS AND METHODS
A retrospective analysis of 3539 dermatitis patients who underwent patch testing from 2016 to 2020 was performed.
RESULTS
The 5-year SSO contact allergy prevalence was 0.48%, and 1.3% had a doubtful reaction. Patients with a stronger positive reaction (2+, 3+) were more likely to react simultaneously to other allergen preparations containing SSO (p value = 0.018). One patient with a strong reaction to SSO reacted positively to all SSO-containing patch test preparations. Definite fragrance allergens could not be identified in the patients who had simultaneous reactions to SSO and fragrance mix (FM) I.
CONCLUSIONS
Patch testing with allergen preparations containing SSO affected the patch test interpretation. Fragrance contact allergy could not be ruled out when a patient simultaneously reacted to SSO and FM I. Changing emulsifiers in patch test preparations would be advantageous.
Topics: Humans; Dermatitis, Allergic Contact; Patch Tests; Retrospective Studies; Test Taking Skills; Allergens; Perfume; Emulsifying Agents
PubMed: 36305668
DOI: 10.1111/cod.14239 -
Turkish Archives of Pediatrics Jan 2021Irritant contact dermatitis and Allergic contact dermatitis are two distinct forms of contact dermatitis. Allergic contact dermatitis is a Type 4 (delayed-type)...
OBJECTIVE
Irritant contact dermatitis and Allergic contact dermatitis are two distinct forms of contact dermatitis. Allergic contact dermatitis is a Type 4 (delayed-type) hypersensitivity reaction that occurs during subsequent contact with an allergen to a previously sensitized person. The number of allergens that cause allergic contact dermatitis is increasing day by day. Although it is not the gold standard for the detection of these allergens, skin patch testing is a very helpful method. This study aimed to determine the most common contact allergens in the pediatric age group.
MATERIAL AND METHODS
All patients with the diagnosis of contact dermatitis who underwent a skin patch test (TRUE TEST) in the department of Pediatric Allergy and Immunology between March 2017-February 2018 were enrolled in this study. The patch test was evaluated 72 hours later by the same physician and interpreted as recommended by the American Academy of Dermatology. In addition to the patient files, demographic and clinical characteristics, localization of lesions, and itch score according to visual analog scale were recorded.
RESULTS
A total of 80 children enrolled in the study; 45 (56.3%) were girls and 35 (43.7%) were boys. The mean age of the children was 7.37±3.84 years and 57.5% of the patients who underwent skin patch testing had a positive response to at least one or more allergens. The most common allergens were Nickel sulfate, CI + Me-Isothiazolinone, Thiuram Mix, Formaldehyde, and P-tert-butylphenol formaldehyde resin (14.8%, 10%, 6.3%). There was no difference in terms of age, sex, duration of complaints, and pruritus score according to nickel sensitization.
CONCLUSION
In the presence of chronic dermatitis in children, allergic contact dermatitis should be considered in the differential diagnosis. The culprit allergen should be determined. Also, the most common contact allergen is Nickel Sulphate in the world and the increased sensitization to other allergens is due to the increased contact of children with cosmetics and different contact allergens.
PubMed: 34013230
DOI: 10.14744/TurkPediatriArs.2020.79577 -
Revista Paulista de Pediatria : Orgao... 2022The aim of this study was to identify which types of skin reactions are associated with slime toys and which of their ingredients are most frequently involved in cases... (Review)
Review
OBJECTIVE
The aim of this study was to identify which types of skin reactions are associated with slime toys and which of their ingredients are most frequently involved in cases of poisoning.
DATA SOURCE
Between January and July 2021, articles were selected using PubMed, SciELO, and LILACS databases. The following descriptors were used: (dermatitis OR rash OR eczema OR inflammation) AND slime. Inclusion criteria were articles available in full, in either Portuguese, English, or Spanish, published between January 2000 and July 31, 2021, and articles reporting cases of contact dermatitis or eczema potentially or directly attributed to slime toys. Articles not meeting these criteria and duplicate texts in the databases were excluded.
DATA SYNTHESIS
In total, 65 publications were identified, of which 16 were included in this review. This resulted in a total of 22 children (2 males, 20 females), aged between 4 and 13 years, who were reportedly intoxicated by slime toys, most of these being linked to homemade preparations. Studies reported the occurrence of contact or allergic dermatitis on hands, fingers, nails, forearms, and cheeks. The most allergenic and/or irritant ingredients included liquid detergent and soap. Additionally, patch tests identified positive reactions to methylisothiazolinone and methylchloroisothiazolinone, the preservatives used by chemical industries on preparation of glue, soap, detergents, etc.
CONCLUSIONS
Although slime toys might be important for improving motor development and parental relationships, homemade slime toy recipes include several allergenic and irritant ingredients which might be exposed to vulnerable children and cause intoxications. Therefore, homemade slime toys preparations should be used cautiously and under the supervision of adults.
Topics: Child; Male; Adult; Female; Adolescent; Humans; Child, Preschool; Dermatitis, Allergic Contact; Irritants; Soaps; Patch Tests; Eczema; Allergens
PubMed: 36383795
DOI: 10.1590/1984-0462/2023/41/2021357 -
Contact Dermatitis Sep 2021Because Myroxylon pereirae (MP), or balsam of Peru, is nowadays almost not used "as such," and fragrance mix 1 (FM1) apparently is more sensitive in detecting fragrance...
BACKGROUND
Because Myroxylon pereirae (MP), or balsam of Peru, is nowadays almost not used "as such," and fragrance mix 1 (FM1) apparently is more sensitive in detecting fragrance allergy, the usefulness of testing MP in baseline series was recently questioned.
OBJECTIVES
Identification of the number of clinically relevant patch test reactions to MP not detected by FM1.
METHODS
Retrospective analysis of 12 030 patients patch tested with MP and FM1 for contact dermatitis between January 2018 and December 2019 in 13 Italian dermatology clinics.
RESULTS
Four hundred thirty-nine patients (3.6%) had a positive patch test reaction to MP; 437 (3.6%) had a positive patch test reaction to FM1. Positive reactions to both MP and FM1 were observed in 119 subjects (1.0%), 310 (2.6%) reacted to MP only, 304 (2.5%) to FM1 only, 5 to MP and sorbitan sesquioleate (SSO), 9 to FM1 and SSO, and 5 to MP, FM1, and SSO. Single sensitizations were clinically relevant in 75.2% of cases for MP (62.9% current, 12.3% past) and 76.3% for FM1 (70.1% current, 6.2% past).
CONCLUSIONS
Based on our results, MP appears to be still worth testing along with FM1 in baseline series, because it allows detection of a remarkable number of fragrance allergies, often relevant, which would be otherwise missed.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Balsams; Dermatitis, Allergic Contact; Female; Hexoses; Humans; Male; Middle Aged; Odorants; Patch Tests; Retrospective Studies; Young Adult
PubMed: 33748955
DOI: 10.1111/cod.13839 -
Contact Dermatitis Feb 2022Apprentice nurses are considered at high risk to developing occupational skin diseases.
BACKGROUND
Apprentice nurses are considered at high risk to developing occupational skin diseases.
OBJECTIVES
This study assessed the frequency and origin of hand eczema, and work-related risk factors in apprentice nurses.
METHODS
The study involved 240 final-year apprentice nurses (females 75%, median age 19 years) from vocational schools in Zagreb, Croatia. The study was performed in 2020/2021 and included a questionnaire and clinical examination by means of the Osnabrück Hand Eczema Severity Index (OHSI). Skin prick test (SPT) with natural rubber latex (NRL) allergen, and patch test with the basic series of allergens, and disinfectants, were performed in 42 apprentice nurses with hand eczema that lasted more than 3 months.
RESULTS
Clinically observed and self-reported hand eczema were found in 49% and 46% of apprentice nurses, respectively. Those with observed changes were older and reported more days per month spent on practical work than those with healthy skin (P = .001). Median OHSI was 4 (interquartile range 2-6). There were no positive SPTs to latex, and 11 (26%) apprentice nurses had positive patch test reactions to one or more tested allergens, mostly nickel.
CONCLUSIONS
Hand eczema was common in final-year apprentice nurses during the COVID-19 pandemic. It was mostly of irritative origin, associated with the duration of practical training, confirming cumulative effect of hazards on skin barrier.
Topics: COVID-19; Croatia; Dermatitis, Occupational; Eczema; Female; Hand Dermatoses; Humans; Male; Pandemics; Patch Tests; Risk Factors; SARS-CoV-2; Severity of Illness Index; Students, Nursing; Young Adult
PubMed: 34773266
DOI: 10.1111/cod.14006