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Hall's Journal of Health Oct 1886
PubMed: 36491596
DOI: No ID Found -
Anais Brasileiros de Dermatologia 2016The number of studies on patch-test results in children and adolescents has gradually increased in recent years, thus stimulating reviews. This paper is a systematic... (Review)
Review
The number of studies on patch-test results in children and adolescents has gradually increased in recent years, thus stimulating reviews. This paper is a systematic review of a 15-year period devoted to studying the issue. Variations pertaining to the number and age groups of tested children and/or adolescents, the number of subjects with atopy/atopic dermatitis history, the quantity, type and concentrations of the tested substances, the test technique and type of data regarding clinical relevance, must all be considered in evaluating these studies, as they make it harder to formulate conclusions. The most common allergens in children were nickel, thimerosal, cobalt, fragrance, lanolin and neomycin. In adolescents, they were nickel, thimerosal, cobalt, fragrance, potassium dichromate, and Myroxylon pereirae. Knowledge of this matter aids health professionals in planning preventive programs aimed at improving children's quality of life and ensuring that their future prospects are not undermined.
Topics: Adolescent; Age Factors; Allergens; Child; Dermatitis, Allergic Contact; Dermatitis, Atopic; Female; Humans; Male; Patch Tests; Sex Factors; Time Factors
PubMed: 26982781
DOI: 10.1590/abd1806-4841.20163927 -
American Journal of Clinical Dermatology Jun 2018Patients with atopic dermatitis (AD) have increased penetration of allergens, immune dysregulation (including shared cytokine pathways), and frequent use of emollients... (Review)
Review
Patients with atopic dermatitis (AD) have increased penetration of allergens, immune dysregulation (including shared cytokine pathways), and frequent use of emollients and topical medications, all of which may predispose toward developing allergic contact dermatitis (ACD). Recent systematic reviews have suggested that ACD is a significant clinical problem in both children and adults with AD. While this remains controversial, ACD remains an important comorbidity and potential exacerbant of AD in clinical practice. Common relevant allergens, include lanolin, neomycin, formaldehyde, sesquiterpene lactone mix, compositae mix, and fragrances that are commonly found in AD patients' personal care products. We herein review the clinical scenarios where patch testing is indicated in AD. In addition, we review the contraindications, preferred patch-testing series, pitfalls, and challenges determining the relevance of positive patch-test reactions in AD patients.
Topics: Adult; Allergens; Child; Comorbidity; Dermatitis, Allergic Contact; Dermatitis, Atopic; Disease Progression; Emollients; Humans; Incidence; Patch Tests; Skin
PubMed: 29305764
DOI: 10.1007/s40257-017-0340-7 -
Contact Dermatitis Jan 2021Lanolin is often included when patch testing for common contact allergens. The clinical relevance of a positive patch test reaction to lanolin markers is, however, still... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Lanolin is often included when patch testing for common contact allergens. The clinical relevance of a positive patch test reaction to lanolin markers is, however, still a subject for debate.
OBJECTIVES
To evaluate Amerchol L101 as a marker of lanolin allergy and investigate the clinical impact of lanolin-containing moisturizers on healthy and damaged skin using the repeated open application test (ROAT).
METHODS
Twelve test subjects and 14 controls were patch tested with Amerchol L 101 and additional lanolin markers. Subsequently, a blinded ROAT was performed on the arms of the study participants for 4 weeks. Each participant applied a lanolin-free cream base and two different lanolin-containing test creams twice daily on one arm with intact skin and on the other arm with irritant dermatitis, induced by sodium lauryl sulfate (SLS).
RESULTS
Eleven test subjects (92%) had positive patch test reactions to Amerchol L 101 when retested and one test subject (8%) had a doubtful reaction. None of the study participants had any skin reactions to the ROAT on intact skin and all participants healed during the ROAT on damaged skin.
CONCLUSIONS
Lanolin-containing emollients do not cause or worsen existing dermatitis when performing ROAT in volunteers patch test positive to Amerchol L101.
Topics: Case-Control Studies; Dermatitis, Allergic Contact; Dermatitis, Irritant; Double-Blind Method; Humans; Lanolin; Patch Tests; Skin Cream
PubMed: 32844454
DOI: 10.1111/cod.13689 -
Life (Basel, Switzerland) May 2022Atopic dermatitis (AD) is a chronic inflammatory disease characterised by an impaired skin barrier. The prolonged use of topical preparations containing medications,...
Atopic dermatitis (AD) is a chronic inflammatory disease characterised by an impaired skin barrier. The prolonged use of topical preparations containing medications, emollients, fragrances and preservatives may increase the risk of contact hypersensitivity (CHS). In the Allergy Outpatient Unit of the Department of Dermatology, Venereology and Dermatooncology of Semmelweis University, 5790 adult patients were patch tested between 2007-2021 with the European Environmental Baseline Series according to international standards. Among all the tested adult patients, 723 had preservative CHS (PCHS) and 639 had AD. Among the 723 PCHS patients, 68 (9.4%) had AD; the female to male ratio was 3:1 in this group. Out of 639 AD patients, 68 had PCHS (10.6%). In the AD-PCHS group, 83.8% had CHS to methylisothiazolinone (MI) (tested from 2014), 36.8% to Kathon CG, 16.2% to methyldibromo-glutaronitrile, 11.8% to paraben, 7.4% to formaldehyde, 4.4% to para-tert-butylphenol-formaldehyde resin and 1.5% to Quaternium-15. The most common concomitant PCHS combination was Kathon CG + MI. Most patients (32.4%) belonged to the age group of 21-30, and skin symptoms affected mostly the limbs and face. The most common other concomitant allergens were nickel, lanolin alcohol and balsam of Peru. Preservatives (especially MI and Kathon CG) are important contact allergens in adult AD, mostly among young women. The rate of AD in the PCHS group and the rate of PCHS in the AD group is remarkable; thus, the role of PCHS should be highlighted in the topical therapy and in the prevention of possible AD exacerbations.
PubMed: 35629382
DOI: 10.3390/life12050715 -
BMC Chemistry Feb 2023Topical lanolin is commonly used on nipples to aid breastfeeding success. The raw material undergoes refinement to remove contaminants such as pesticides, which may...
BACKGROUND
Topical lanolin is commonly used on nipples to aid breastfeeding success. The raw material undergoes refinement to remove contaminants such as pesticides, which may accumulate from exogenous environmental sources. The level of refinement influences final lanolin purity. For use in nipple creams, a lanolin which complies with a published monograph (either USP or Ph. Eur.) is desirable to ensure a non-toxic product with neutral taste and smell, and low allergenicity.
METHODS
The aim of this study was to determine the residual trace pesticide levels and quantify the Free Lanolin Alcohols (FLA) levels in two commercially available lanolin products (HPA LANOLIN (Lansinoh Laboratories Inc.); PURELAN (Medela AG)) and two lanolin ingredients (PHARMALAN PH EU-SO-(RB) and CORONA-8 SO-(RB) (Croda, Goole, UK)) using established validated methods. Test samples were subjected to Gas-Chromatographic and Liquid-Chromatographic analysis to quantify and identify a panel of 178 pesticide residues. FLA levels and the presence of oxidative metabolites were also determined.
RESULTS
The purity of the lanolin ingredients was consistent with expectations based on their level of refinement; lanolin in compliance with the Ph. Eur. monograph demonstrated the highest level of purity. Differences were seen between the lanolin nipple creams tested, in terms of FLA levels and pesticide residue levels. Specifically, the HPA LANOLIN contained an extremely low level of FLA (0.61%), which was fourfold less than in the PURELAN (2.76%). Additionally, the HPA LANOLIN did not contain any detectable pesticide residues. The PURELAN was found to contain a number of pesticide residues, however the detected levels were low and within the permitted limits and so despite their presence, the PURELAN was still compliant with the relevant monographs.
CONCLUSIONS
This data reinforces that the purity of monograph compliant Lanolin makes it suitable for use on the nipples of breastfeeding mothers. A higher level of refinement leads to a reduction in pesticide contaminants also reduces FLA levels in the final material, minimizing the risk of allergenicity.
PubMed: 36849952
DOI: 10.1186/s13065-023-00919-0 -
Acta Dermato-venereologica Aug 2017Although wool is commonly believed to cause irritant (non-immune) and hypersensitivity (immune) cutaneous reactions, the evidence basis for this belief and its validity... (Review)
Review
Although wool is commonly believed to cause irritant (non-immune) and hypersensitivity (immune) cutaneous reactions, the evidence basis for this belief and its validity for modern garments have not been critically examined. Publications from the last 100 years, using MEDLINE and Google Scholar, were analysed for evidence that wool causes cutaneous reactions, both immune-mediated (atopic dermatitis exacerbation, contact urticaria, allergic contact dermatitis) and non-immune-mediated (irritant contact dermatitis, itch). Secondary aims of this paper were to examine evidence that lanolin and textile-processing additives (formaldehyde, chromium) cause cutaneous reactions in the context of modern wool-processing techniques. Current evidence does not suggest that wool-fibre is a cutaneous allergen. Furthermore, contact allergy from lanolin, chromium and formaldehyde is highly unlikely with modern wool garments. Cutaneous irritation from wool relates to high fibre diameters (≥ 30-32 µm). Superfine and ultrafine Merino wool do not activate sufficient c-fibres to cause itch, are well tolerated and may benefit eczema management.
Topics: Allergens; Animals; Chromium Compounds; Dermatitis, Atopic; Dermatitis, Contact; Dermatitis, Irritant; Evidence-Based Medicine; Formaldehyde; Humans; Lanolin; Risk Factors; Skin; Wool
PubMed: 28350041
DOI: 10.2340/00015555-2655 -
The Cochrane Database of Systematic... Dec 2014Leading health authorities all recommend exclusive breastfeeding to six months' postpartum. While most women initiate breastfeeding, many discontinue due to difficulties... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Leading health authorities all recommend exclusive breastfeeding to six months' postpartum. While most women initiate breastfeeding, many discontinue due to difficulties encountered rather than maternal choice. One common breastfeeding difficulty is painful nipples. Research has identified poor infant positioning or latch as a common cause of painful nipples. While many different interventions designed to reduce nipple pain in breastfeeding women have been evaluated, it is unclear which intervention is the most effective treatment. An understanding of nipple pain and treatment options are needed to improve breastfeeding duration and exclusivity rates and to address systematically one of the most frequent difficulties encountered by breastfeeding women.
OBJECTIVES
To assess the effects of all interventions in the resolution or reduction of nipple pain and the impact of the interventions on other outcomes such as nipple trauma, nipple infections, breast mastitis, breastfeeding duration, breastfeeding exclusivity, and maternal satisfaction.
SEARCH METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2014) and scanned secondary references.
SELECTION CRITERIA
All randomised or quasi-randomised controlled trials designed to evaluate any intervention for treating nipple pain among breastfeeding women. Trials using a cluster-randomised design were eligible for inclusion. Cross-over trials were not eligible for inclusion. The following interventions were eligible for inclusion compared with each other or usual care (i.e. education only): pharmacological (e.g. antifungal creams); non-pharmacological topical treatments (e.g. lanolin); dressings (e.g. hydrogel dressings); nipple protection devices (e.g. breast shells), phototherapy, and expressed breast milk. Nipple pain in women who are feeding with expressed breast milk (i.e. women of infants in neonatal units) is associated with other methods of removing milk from the mother's breast such as manual expression and various types of breast pumps. Nipple pain and subsequent treatment is different in this unique maternal population and thus we excluded women solely feeding with expressed breast milk from this review.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trials for inclusion, extracted data, evaluated methodological quality, and checked data for accuracy. We sought additional information from several trial researchers.
MAIN RESULTS
We included four trials of good methodological quality involving 656 women in the review. The four included trials evaluated five different interventions including glycerine pads, lanolin with breast shells, lanolin alone, expressed breast milk, and an all-purpose nipple ointment. All studies included education to position the infant at the breast correctly as part of routine postpartum care to both treatment and control groups.Pooled data existed only for the comparison of lanolin versus usual care. We did not pool data for other outcomes due to either heterogeneity in outcome measures or differing interventions.There was no evidence that glycerine gel dressings or breast shells with lanolin significantly improved nipple pain. One trial found no clear differences in nipple pain (at one to three days, four to five days, or six to seven days' post-treatment) between women who applied lanolin or nothing to their nipples. In contrast, the same trial found that women who applied expressed breast milk had significantly lower perceptions of nipple pain following four to five days of treatment than women who applied lanolin. However, this beneficial effect was not maintained after six to seven days of treatment. There were no group differences in nipple pain perceptions at any assessment between women who applied expressed breast milk and women who applied nothing. Women who applied an "all-purpose nipple ointment", in comparison to women who applied lanolin, had no improvement in nipple pain after seven days of treatment. There was insufficient evidence that glycerine gel dressings, lanolin with breast shells, lanolin alone, expressed breast milk, or all-purpose nipple ointment improved maternal perceptions of nipple pain.Overall, there was insufficient evidence to recommend any intervention for the treatment of nipple pain. However, one important finding was that regardless of the treatment used, for most women nipple pain reduced to mild levels after approximately seven to 10 days' postpartum. The provision of anticipatory guidance regarding usual time to pain reduction may be a useful strategy in assisting women to continue to breastfeed and to do so exclusively. The overall quality of the evidence for the primary outcome of nipple pain as assessed using GRADE was of low quality, mainly because single studies with few participants contributed data for analysis.
AUTHORS' CONCLUSIONS
There was insufficient evidence that glycerine gel dressings, breast shells with lanolin, lanolin alone, or the all-purpose nipple ointment significantly improved maternal perceptions of nipple pain. The results from these four trials of good methodological quality suggested that applying nothing or just expressed breast milk may be equally or more beneficial in the short-term experience of nipple pain than the application of an ointment such as lanolin.The quality of the evidence for this review did not lead to robust conclusions regarding the objectives assessed. We included only four trials, incorporating 656 women, in the review and all four trials compared varying interventions, participants, study outcome measures, and standards of usual care. The methodological quality of the included studies was good but the overall quality of the evidence for the primary outcome of nipple pain was of low quality, mainly because single studies with few participants contributed data for analysis.
Topics: Bandages; Breast Diseases; Breast Feeding; Female; Gels; Glycerol; Humans; Lanolin; Milk, Human; Nipples; Ointments; Pain Management; Protective Devices; Randomized Controlled Trials as Topic
PubMed: 25506813
DOI: 10.1002/14651858.CD007366.pub2 -
Molecules (Basel, Switzerland) Feb 2016Oil-in-water nanoemulsions are stable systems with droplet sizes in the 20-200 nm range. The physicochemical properties of these systems may be influenced by the...
Oil-in-water nanoemulsions are stable systems with droplet sizes in the 20-200 nm range. The physicochemical properties of these systems may be influenced by the addition of additives. Thus, the influence of ethoxylated (EL) and acetylated lanolin (AL) addition on the droplet size, pH values, electrical conductivity and stability of nanoemulsions was investigated. Then, effect of nano-emulsions additives with EL (NE-EL) or AL (NE-AL) in hydration, oiliness and pH of the skin were evaluated. Nanoemulsion safety was evaluated through the observation of no undesirable effects after skin formulation application. Both additives caused changes in droplet size and electrical conductivity, but not in pH values. Nanoemulsions containing up to 6.0% ethoxylated lanolin and 2.0% acetylated lanolin remained stable after centrifugation tests. Higher concentrations of the additives made the nanoemulsions unstable. Stability tests showed that ethoxylated lanolin produced more stable nanoemulsions then acetylated lanolin and that the major instability phenomenon occurring in these systems is coalescence at elevated temperatures. Nanoemulsion-based lanolin derivatives increased skin hydration and oiliness and did not change cutaneous pH values. These formulations are non-toxic since they did not cause any irritation on the skin surface after nanoemulsion application, showing potential as carriers for pharmaceuticals and cosmetic applications.
Topics: Acetylation; Adult; Biological Transport; Cosmetics; Drug Stability; Electric Conductivity; Emulsions; Female; Hot Temperature; Humans; Hydrogen-Ion Concentration; Lanolin; Nanostructures; Particle Size; Plant Oils; Polyethylene Glycols; Skin; Skin Absorption; Viscosity; Water
PubMed: 26927034
DOI: 10.3390/molecules21030248 -
Revista Brasileira de Ginecologia E... Nov 2018To compare two different treatments-the use of highly purified anhydrous (HPA) lanolin and expressed breast milk-for women with pain and nipple trauma during the... (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVE
To compare two different treatments-the use of highly purified anhydrous (HPA) lanolin and expressed breast milk-for women with pain and nipple trauma during the breastfeeding process.
METHOD
A total of 180 puerperal women were randomly assigned to 2 groups: one was treated with HPA lanolin and the other with their own expressed breast milk. All of the participants received the same breastfeeding technique instructions and therapeutic care standard. Three assessments were performed: at the time of inclusion in the study (after randomization); after 48 hours; and after 7 days. At each interval, data was collected in relation to pain and trauma. A numerical/verbal category scale was used for the pain variable, and the nipple trauma score for the trauma variable. The results were subjected to statistical analysis using the chi-squared test, the Fisher exact test, the student -test, and the Kolmogorov-Smirnov test. Generalized estimating equations were calculated using the STATA 12 statistical software package (StataCorp LLC, College Station, TX, USA) and IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp, Armonk, NY, USA).
RESULTS
There was pain improvement from the second to the third assessment in the group that used HPA lanolin, while the pain remained unchanged between these two periods ( < 0.001) in the breast milk group. In terms of trauma, improvement was identified in its extension and depth from the first to the third assessment, and it was higher in the HPA lanolin group than in the breast milk group ( = 0.025).
CONCLUSION
The treatment of pain and nipple trauma with HPA lanolin achieved better results than the one with breast milk, based on a 7-day treatment period.
Topics: Adolescent; Adult; Breast Feeding; Female; Humans; Lanolin; Middle Aged; Milk, Human; Nipples; Pain; Pain Management; Young Adult
PubMed: 30372779
DOI: 10.1055/s-0038-1675180