Distribution characteristics and clinical significance of exposed allergens in different age groups

Allergic skin diseases

Epidemiological survey of contact dermatitis in Italy (1984–1993) by GIRDCA (Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali)

Objective: Allergic contact dermatitis (ACD) is a hypersensitivity reaction which develops against substances contacting the skin. Patch tests are used for the detection the allergens that cause ACD. The most common substances that cause ACD vary based on geographic regions. In this study, detection of the most common allergens in patients who underwent patch testing with the diagnosis of ACD and comparison of the results with literature were aimed.Mateials and Methods: One hundred forty-eight patients, who underwent European standard patch test with the diagnosis of ACD in our clinic between January 2010 and June 2013, were enrolled in our study. The data about age, sex, duration of disease, occupation, the presence of atopy, localization of the lesion of the patients and patch test results were recorded retrospectively.Results: Eighty-nine females and 59 males, a total of 148 patients, were included in the study. The mean age of the patients was 35.3 ± 14.8. Positive reactions to one or more allergens were observed in forty-five (30.4%) of 148 patients who underwent patch test. The allergens that were the most common cause of positive reactions were nickel sulfate (11.5%), potassium dichromate (6.1%), cobalt chloride (4.7%), paraben mix (4.1%), thiuram mix (2.7%), neomycin sulfate (2.7%) and fragrance mix (2.7%), respectively. Conclusion: We believe that our study will contribute to the determination of contact allergens which is the most common cause of sensitization in our country

Epidemiological Survey of Contact Dermatitis in Italy (1984-1993) by GIRDCA (Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali)

This study presents a comprehensive analysis of patch test results in a cohort of 716 pediatric patients diagnosed with type IV hypersensitivity dermatosis. The aim is to provide valuable insights for the prevention and treatment of type IV hypersensitivity dermatosis in the pediatric population. A prospective study was conducted from August 2021 to October 2023, enrolling pediatric patients with type IV hypersensitivity dermatosis attending the Department of Dermatology at the prestigious Air Force Medical Center. The patients were categorized into four distinct age groups based on World Health Organization guidelines: infants and young children (under 3 years), preschoolers (ages 3 to 5), school-age children (ages 6 to 11), and adolescents (ages 12 to 14). Patch testing was performed using a pediatric series of allergens, and the distribution patterns of allergens were meticulously analyzed based on the test results. Furthermore, variations in patch test positivity rates and allergen positivity rates were evaluated across different genders and age groups. Out of the 716 patients included in the study, the overall patch test positivity rate was found to be 86.87%. The top five allergens identified were textile dye mix, limonene hydroperoxide, nickel sulfate, cobalt chloride, and benzoyl peroxide. A comparative analysis of patch test positivity rates between males and females revealed no significant difference (87.85% vs. 86.19%, χ2 = 0.439, P > 0.05). Similarly, there was no statistically significant variation observed in the patch test positivity rates among the top three dermatoses, including eczema, facial dermatitis, and allergic contact dermatitis (ACD) (χ2 = 6.39, P > 0.05). Notably, within the top 10 allergens, textile dye mix, benzoyl peroxide, disperse blue 106/124, and potassium dichromate exhibited higher positivity rates in males (38.14%, 25.99%, 25.14%, and 13.56%, respectively) compared to females (29.56%, 18.23%, 17.40%, and 7.18%, respectively). Conversely, the positivity rate of cobalt chloride was higher in females (28.18%) than in males (19.49%). These gender-based differences were statistically significant (P < 0.05). In terms of age groups, there was no significant disparity observed in the overall patch test positivity rates (χ2 = 3.26, P > 0.05). However, when analyzing the top five allergens, namely textile dye mix, nickel sulfate, and cobalt chloride, distinct variations in positivity rates were discerned among different age groups (P < 0.05). For the specific case of ACD, sensitivity: 82.6%, specificity: 57.1%, false positive rate (FPR): 42.9% . This study elucidates the primary allergens implicated in type IV hypersensitivity dermatosis among pediatric patients visiting our dermatology outpatient clinic, namely textile dye mix, limonene hydroperoxide, nickel sulfate, cobalt chloride, and benzoyl peroxide. Additionally, it highlights the influence of gender on the positivity rates of common allergens, such as textile dye mix, benzoyl peroxide, disperse blue 106/124, potassium dichromate, and cobalt chloride. Furthermore, age-related variations were noted in the positivity rates of textile dye mix, nickel sulfate, and cobalt chloride.

BACKGROUND AND OBJECTIVESContact allergy is associated with a significant morbidity all over the world. This study was performed to investigate the pattern of sensitization by contact allergens in the local population.DESIGN AND SETTINGRetrospective study to investigate patch test reactivity among patients with clinical diagnosis of contact dermatitis who were referred to the allergy clinic at the King Khalid University Hospital, Riyadh, between April 2008 and March 2010.PATIENTS AND METHODSOf the 196 patients referred to the allergy clinic over the 2-year period, 91 (46.4%) patients reacted to one or more patch test allergens, and these patients were included in this study. The study group included 82 (91.1%) of Saudi nationality and 9 (8.9%) patients of other nationalities. The patch test was performed using the T.R.U.E TEST, containing 24 allergens/allergen mixes.RESULTSOf the 91 cases who reacted positively to one or more allergens, 67 (73.6%) were females with a mean age of 37 (8.3 years) and 24 (26.4%) were males with a mean age of 34 (11.6 years). Thirty-three (36.2%) patients reacted to nickel sulfate, 14 (15.3%) to p-phenylenediamine, 13 (14.2%) to p-tert-butylphenol-formaldehyde resin, 13 (14.2%) to thimerosal, and 9 (9.8%) to colophony. Reactivity against the rest of the allergens was not remarkable. A significantly higher percentage of females reacted to nickel sulfate (84.8% vs 15.2% in males; P=.0001), p-tert-butylphenol-formaldehyde resin (92.3% vs 7.7%; P=.0001), and thimerosal (76.9% vs 23.1%; P=.03).CONCLUSIONSPatch test reactivity to nickel sulfate was high. The pattern of contact allergy observed in this study indicates the need for large-scale investigations to identify local allergens responsible for contact allergy and for formulation of policies directed towards avoidance of exposure.

The results of a 7-year retrospective study (1998-2004) from patch testing with the European Standard Series (ESS) establishing the frequency of sensitization in a contact dermatitis clinic in Israel are presented. 23 allergens were patch tested on 2156 patients, 1462 females (67.8%) and 694 males (32.2%). Atopy and asthma were present in 21.9% of the patients. One or more allergic reactions were observed in 937 patients (43.5%). The highest yield of patch test positives from the 1076 positive reactions were obtained from nickel sulfate (13.9%), fragrance mix (7.1%), potassium dichromate (3.8%), Balsam of Peru (3.6%), CL+Me-isothiazolinone (3.4%) and cobalt chloride (3.4%). Allergens which produced the least amount of positive results were primin and clioquinol. Allergic contact dermatitis (ACD) was established in 32.8%, whereas occupationally related allergic (8.0) and irritant contact dermatitis (5.6%) affected a total of 13.6% of the cases studied. The most common clinical forms of dermatitis were chronic dermatitis (47.7%) followed by acute dermatitis (22.8%), and lichenification and hyperkeratosis (7.9%). The hands (30.7%), face and neck (23.9%) and extremities (11.3%) were the most frequently affected areas. Four allergens in our study differed from the top 10 allergens in Europe namely: Cl+Me-isothiazolinone, formaldehyde, 4-tert-butylphenol formaldehyde resin and sesquiterpene lactone mix reflecting an existing difference in environmental exposure. Our study is the first to provide data on the frequency of sensitization and important allergens in the aetiology of ACD in Israel. In spite of the existing differences with Europe, we conclude that ESS is an appropriate screening system for the diagnosis of ACD in Israel.

Contact allergy: The impact of gender and occupation

Nickel allergy in the United States: A public health issue in need of a “nickel directive”

Numerous studies have focused attention on the influence of various biological and environmental factors on contact hypersensitivity. In order to evaluate the persistence and/or modification of allergic contact sensitivity to a number of common contact sensitizers, the same standardized patch tests were repeated on 174 subjects with contact sensitivity after a time lapse of 5 years (1987-1992). In 18.4% of the cases, 1 or more sensitivities were lost; 28.7% of the patients had a higher number of positive patch tests after 5 years, while the remaining 52.9% of the patients showed no change in the number of positive patch tests. In 88%, the positive allergens were unchanged, whereas in the remaining 12% of the subjects, they showed 1 or more variations. The association between the allergens most often positive was calculated for both the 1st and the 2nd patch test results. Moreover, to evaluate the frequency of an allergen's positivity, we studied the disappearance of old sensitivities and the appearance of new sensitivities by the McNemar test. Cobalt chloride was the only allergen with a significant frequency of new positivities over the period of observation (p < 0.01). Logistic regression analysis was performed to evaluate the possible influence of positive tests to other allergens, and of some clinical findings associated with contact dermatitis, on the sensitivity to cobalt chloride in 1987 and in 1992.

North American Contact Dermatitis Group standard tray patch test results (1992 to 1994)

Introduction: Allergic Contact Dermatitis is a form of eczema or dermatitis on the skin which appears as a delayed-type IV hypersensitivity reaction that manifests 48-72 hours after exposure to the allergen (low molecular weight chemical) with social, psychological, occupational, and familial by having an impact on the patient’s quality of life. Objectives: The purpose of the study is to show the epidemiological and clinical situation of Allergic Contact Dermatitis in Kosovo by identifying the most at-risk patients. Patients and Methods: The study is of a retrospective cohort, clinical-analytical type. The study population consists of 1201 pediatric, adult, and elderly patients who presented to the Allergy Clinic, University Hospital Center (UHCK), and the AllergyAsthma Specialist Office in Prishtina, Kosovo with suspicion of Contact Dermatitis and from which 536 were diagnosed with ACD during 2010-2020. Results: Of the 355 cases, 59 patients were male (11.03%) and 477 were female (88.97%). The youngest patient in the study was 1 year old and the oldest was 85 years of age. The most common allergens from our study are Nickel sulphate 5% in 404 cases (57.7%), P-phenyl diamine 1% in 97 cases (13.86%), Cobalt chloride 1% in 46 cases (6.57%), Potassio Bicromato 0.5% in 23 cases (3.29%), Thiuram-mix in 19 cases (2.7%), Paraben mix 16% in 13 cases (1.86%). Conclusion: 12% of patients who come to the Allergy Clinic for skin problems have Allergic Dermatitis Contact and Prevalence to have a positive result in at least one allergen is high 44.6%. The most affected age group is 25-29 years (102 cases or 19.3% of cases with Allergic Contact Dermatitis). For each year of increasing age, the likelihood of Allergic Contact Dermatitis increases by a factor of 1.01; the presence of allergic diseases increases the likelihood by a factor of 0.511, the female gender has a 3,084 times greater risk of contracting Allergic Contact Dermatitis in a lifetime.

Objective To assess the environmental contact allergens in patients with allergic contact dermatitis (ACD).Methods Totally,167 patients with ACD were included in this study.All the patients underwent patch test.Results Of these patients,92 (55.1％) were diagnosed as facial ACD,and 148 showed positive patch test results (88.6％).The six most common allergens in a decreasing order were nickel sulfate,fragrance mix,paraphenylenediamine,thimerosal,octanoates and amerchol L 101.Conclusion Patch test may be an efficient way to confirm the cause of ACD.

Patch testing is an essential procedure in the investigation of eczema in children. To analyse the frequency of contact hypersensitivity and allergic contact dermatitis among Polish children with eczema. During an allergy screening programme involving 9320 children aged 7 and 16 years, 12.6% reported symptoms of chronic/recurrent eczema. From this group, a representative sample of 229 eczema children underwent patch testing: 96 children aged 7 years and 133 teenagers aged 16 years. Patch testing was with 10 allergens: methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), nickel sulfate, mercury ammonium chloride, thimerosal, cobalt chloride, potassium dichromate, lanolin, fragrance mix I, Myroxylon pereirae (balsam of Peru), and colophonium. 49.4% tested children were found patch test (PT) positive. 43.8% of 7 year olds with eczema were PT positive, with sensitization to nickel sulfate (30.2%), thimerosal (10.4%), cobalt chloride (8.3%), fragrance mix I (7.3%), MCI/MI (6.3%), potassium dichromate (6.3%), M. pereirae (3.1%), mercury ammonium chloride (2.3%), and colophonium (1.0%). 52.6% teenagers were PT positive, with sensitization to nickel sulfate (23.3%), thimerosal (27.8%), cobalt chloride (10.5%), potassium dichromate (6.0%), mercury ammonium chloride (2.3%), M. pereirae (1.5%), and MCI/MI (0.8%). The final diagnosis of allergic contact dermatitis was confirmed in 36% of 7 year olds and 26% of 16 year olds. Every second child with eczema is PT positive, whereas every third child is finally diagnosed with allergic contact dermatitis.

Prevalence of Allergic Contact Dermatitis in Thailand