Abstract
BackgroundKathon CG, a combination of methylchloroisothiazolinone and methylisothiazolinone, is widely used as preservative in cosmetics, as well in household cleaning products, industrial products such as paints and glues. It has emerged as an important sensitizing agent in allergic contact dermatitis. ObjectivesThis study evaluated the reactivity to this substance in patients subjected to patch tests at the Dermatology Institute in Bauru, São Paulo from 2015 to 2017 and its correlation with other preservatives, the professional activity and location of the lesions. MethodsThe patients were submitted to standard series of epicutaneous tests, standardized by the Brazilian Group Studies on Contact Dermatitis. ResultsOut the 267 patients tested, 192 presented positivity to at least one substance and 29 of the patients (15.10%) presented reaction to Kathon CG, with predominance of the female gender (n=27); main professional activity associated with Kathon CG sensibilization was cleaning (17.24%), followed by aesthetic areas (13.79%) and health care (10.34%). The most prevalent sensitizations among the substances tested were nickel sulphate (56.3%), followed by cobalt chloride (23.4%), neomycin (18.2%), potassium dichromate (17.7%), thimerosal (14.5%), formaldehyde (13.2%), paraphenylenediamine (9.3%), and fragrance mix (8.3%). Study limitationsWe do not have data from patients that were submitted to patch test a decade ago in order to confront to current data and establish whether or no sensitization to Kathon CG has increased. ConclusionHigh positivity to Kathon CG corroborates the recent findings in the literature, suggesting more attention to concentration of this substance, used in cosmetics and products for domestic use.
Highlights
Allergic Contact Dermatitis (ACD) is an inflammatory process mediated by immunological mechanisms that has a significant socioeconomic impact,[1] since it constitutes an important cause of dermatology appointments and even removal of patients from their activities, with great repercussion on the quality of life and occupational commitment
Nonparametric statistical calculations using the chi-square test were used to compare proportions with regard to the studies of the Brazilian Group of Contact Dermatitis[4] and the one accomplished at Santa Casa de São Paulo during 2006---2011.12 A binary logistic regression model was used to assess the association of sensitivity to Kathon CG with sex and occupation
When comparing the positivity rates to allergic substances between the groups of patients evaluated in our study and those studied by the Brazilian Group of Contact Dermatitis (2000) and the Santa Casa de São Paulo group (2006---2011), we found a concomitant significant difference of increased positivity for eight substances, with those presenting with the highest positivity being nickel sulfate and cobalt chloride (Table 3)
Summary
Allergic Contact Dermatitis (ACD) is an inflammatory process mediated by immunological mechanisms that has a significant socioeconomic impact,[1] since it constitutes an important cause of dermatology appointments and even removal of patients from their activities, with great repercussion on the quality of life and occupational commitment.The range of clinically relevant allergens, which may be organic and inorganic substances, natural or synthetic, has increased, especially in the more industrialized countries. The prevalence of ACD by a given antigen depends on its sensitizing potential, as well as the frequency and time of exposure. Kathon CG, a combination of methylchloroisothiazolinone and methylisothiazolinone, is widely used as preservative in cosmetics, as well in household cleaning products, industrial products such as paints and glues. It has emerged as an important sensitizing agent in allergic contact dermatitis. Objectives: This study evaluated the reactivity to this substance in patients subjected to patch tests at the Dermatology Institute in Bauru, São Paulo from 2015 to 2017 and its correlation with other preservatives, the professional activity and location of the lesions. Study limitations: We do not have data from patients that were submitted to patch test a decade ago in order to confront to current data and establish whether or no sensitization to Kathon CG has increased
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