Cause Of Allergic Contact Dermatitis Research Articles

Étude rétrospective (2007–2022) des causes de dermatites allergiques de contact en Algérie identifiées par la batterie standard européenne : à propos de 202 cas

The European Baseline Series (EBS) of patch tests is the essential tool for allergological exploration of patients suspected of allergic contact dermatitis. The main objective of our study was to define the epidemiological, clinical characteristics, and sensitization profile to contact allergens of the EBS among all patients who underwent contact allergological exploration in an allergology clinic in Algeria over a 15-year period (from 2007 to 2022). Our aim was to generate a map of allergic contact dermatitis in Eastern Algeria to support prevention efforts on a national scale. MethodsOur study was a retrospective descriptive monocentric study conducted in an allergology and contact allergen exploration medical office in Constantine, Algeria. It included all EBS performed between March 2007 and February 2022 on patients who were either first-time visitors or referred for patch testing. ResultsA total of 202 patients suspected of contact dermatitis were tested, with ages ranging from 3 to 75 years. Among them, 125 were female (61.9%) and 77 were male (38.1%). Of these, 138 patients (68.8%) (45 males, 93 females) tested positive for one or more allergens. Fifty-eight patients (42%) had a positive reaction to more than two contact allergens. The most common positive reactions were observed with nickel (30.2%), cobalt (28.2%), potassium dichromate (27.2%), myroxylon pereirae (9.9%), and fragrance mix I (8.4%). Sensitivity to nickel was more frequent among females (P < 0.0001), while sensitivity to potassium dichromate was more frequent among males (P = 0.01). ConclusionsThe distribution of different causes of contact allergy identified through EBS was similar to what is observed in Europe. It allowed us to define, based on the sensitization profile of the patients included in our study, the most frequent causes of allergic contact dermatitis within our population. However, the emergence of new contact allergens can only be identified if Algeria establishes an allergo-vigilance network, similar to that in Europe, enabling both the evolution of patch test compositions and the detection of new allergic risks within the population.

New device, 'old' allergens. Allergic contact dermatitis caused by the Dexcom G7 glucose sensor.

Allergic contact dermatitis (ACD) has been reported as an adverse effect from the use of several glucose sensors and insulin pumps from different manufacturers. Isobornyl acrylate (IBOA) has been identified as a major culprit sensitizer, but also other acrylates and (modified) colophonium have been reported as causes of ACD. To report the two first cases diagnosed with ACD caused by the Dexcom G7 (DG7) glucose sensor. Two children with suspected ACD from DG7 were patch tested with our medical device series with an addition of selected test preparations including two variants of modified colophonium - methyl hydrogenated rosinate (MHR) and glyceryl hydrogenated rosinate (GHR). Both patients were also tested with acetone extracts made from different parts of the DG7 sensor. The extracts were analysed by gas chromatography-mass spectrometry (GC-MS). Both patients tested positive to IBOA, hydroabietyl alcohol and GHR. In addition, patient 1 had a positive reaction to MHR and patient 2 had a positive reaction to colophonium. The GC-MS analyses showed the presence of IBOA and colophonium-related substances in the DG7 extracts. Both patients were diagnosed with contact allergy to well-known medical device-related sensitizers. The presence of IBOA and (modified) colophonium in a newly introduced (on the Swedish market in 2023) glucose sensor is remarkable and indicates an inadequate toxicological assessment of the materials used in the sensor.

More than just methylisothiazolinone: Retrospective analysis of patients with isothiazolinone allergy in North America, 2017-2020

Isothiazolinones are a common cause of allergic contact dermatitis. To examine the prevalence of positive patch test reactions to isothiazolinones from 2017-2020 and characterize isothiazolinone-allergic (Is+) patients compared with isothiazolinone nonallergic (Is-) patients. Retrospective cross-sectional analysis of 9028 patients patch tested to methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) 0.02% aqueous, MI 0.2% aqueous, benzisothiazolinone (BIT) 0.1% petrolatum, and/or octylisothiazolinone (OIT) 0.025% petrolatum. Prevalence, reaction strength, concurrent reactions, clinical relevance, and source of allergens were tabulated. In total, 21.9% (1976/9028) of patients had a positive reaction to 1 or more isothiazolinones. Positivity to MI was 14.4% (1296/9012), MCI/MI was 10.0% (903/9017), BIT was 8.6% (777/9018), and OIT was 05% (49/9028). Compared with Is-, Is+patients were more likely to have occupational skin disease (16.5% vs 10.3%, P <.001), primary hand dermatitis (30.2% vs 19.7%, P <.001), and be >40years (73.1% vs 61.9%, P<.001). Positive patch test reactions to >1 isothiazolinone occurred in 44.1% (871/1976) of Is+patients. Testing solely to MCI/MI would miss 47.3% (611/1292) of MI and 60.1% (466/776) of BIT allergic reactions. Retrospective cross-sectional study design and lack of follow-up data. Sensitization to isothiazolinones is high and concurrent sensitization to multiple isothiazolinone allergens is common.

Increased rates of contact allergy to selected preservatives in patients with allergic contact dermatitis in Turkey.

Preservatives are a frequent cause of allergic contact dermatitis (ACD) and have caused numerous epidemics. The objective of this study is to determine the prevalence of preservative sensitivity, assess the change in the frequency of sensitivity, identify new preservatives with increased sensitivity rates, and evaluate the situation in Turkey by comparing our findings with current literature. A total of 201 patients diagnosed with ACD between 2018 and 2020, were patch tested with the European baseline series and additional seven preservative haptens. The change in the prevalence of sensitivity to each preservative hapten was investigated by comparing the data from the study conducted in our department between 2000 and 2004. Results showed that 17.4% (n = 35) of the patients were positive to preservatives. Comparison with previous data from 2000 to 2004 revealed an increase in the frequency of sensitization. The most prevalent allergen was methyldibromo glutaronitrile (9.5%), followed by methylchloroisothiazolinone/methylisothiazolinone (6.5%), and methylisothiazolinone (5%). The increase in preservative sensitivity in Turkey is the most remarkable finding. Although MDBGN was prohibited in cosmetic products, MCI/MI and MI are still widely used. Our findings suggest that awareness of preservative sensitivity should be increased and additional precautions should be taken, also in Turkey, regarding the use of preservatives.

Role of acrylates in the development of contact dermatitis in diabetic patients-A Polish dermatology tertiary centre experience.

In recent years, an increasing number of contact dermatitis cases triggered by acrylates contained in diabetes medical devices have been reported. Acrylates seem to play a major role in the development of irritant contact dermatitis and allergic contact dermatitis (ACD) in diabetic patients. To study a group of patients with contact dermatitis caused by diabetes medical devices with a focus on acrylates as possible allergens responsible for contact dermatitis. Fifteen patients with diabetes mellitus type 1 and contact dermatitis from diabetic devices were patch tested to 25 acrylate allergens. Three patients (20%) reacted to the following allergens: three patients reacted to isobornyl acrylate (IBOA) and one of them additionally to 2-hydroxyethyl acrylate (2-HEA); results were of clinical relevance. All three patients were using insulin pumps and glucose sensors (GS)-in one patient contact dermatitis was towards the insulin pump and the GS, in one patient only towards the insulin pump and in one patient only towards the GS. Twelve patients (80%) did not show any skin reaction towards the allergens tested. A majority of diabetic patients showed no reactions towards any acrylate allergen tested; yet, the presence of untested allergens must be kept in mind. IBOA proved to be a cause of ACD in diabetes patients. 2-HEA might be another culprit allergen, but its presence in the devices must first be confirmed.

Negative formaldehyde release from textiles washed with a formaldehyde-containing laundry soap according to manufacturer instructions: An application of chromotropic acid testing.

Formaldehyde is a common preservative used to prevent microbial growth in water. It can be found in personal care products and household cleaning products, including laundry detergents. Formaldehyde has frequently been recognised as a cause of allergic contact dermatitis, but whether it remains present in textiles washed with formaldehyde-containing laundry detergents is unknown. This study aimed to utilise the chromotropic acid method (CAM) to assess formaldehyde release from textiles washed with a laundry detergent known to contain formaldehyde. Textiles were laundered with a detergent containing calcium formate at four concentrations (0×, 0.5×, 1× and 5× the recommended amount per manufacturer label) and kept wet or allowed to dry. Select textiles were subjected to an additional rinse cycle. Textiles were then tested utilising the CAM. A sample of the pure laundry detergent was also tested using the CAM. The CAM was positive only for wet textiles washed at 5× the recommended concentration of detergent and pure detergent. All dry textiles were negative. Formaldehyde release was not detected from any textiles washed following the manufacturer's recommendations. Once dry, it is likely safe for formaldehyde-allergic patients to wear textiles washed with formaldehyde-containing detergents.

It is not always chlorhexidine: Identification of benzoxonium chloride and lauramine oxide as culprit allergens in a popular antiseptic in Switzerland.

A popular antiseptic spray in Switzerland (Merfen spray), containing chlorhexidine digluconate, benzoxonium chloride and lauramine oxide, is frequently used to treat skin wounds. However, it is also increasingly reported as a major cause of adverse skin reactions, including allergic contact dermatitis (ACD). To investigate the contact allergens responsible for ACD from this antiseptic. Patch tests were performed on seven patients with a clinical history compatible with contact dermatitis from this antiseptic mixture. All patients presented with acute eczematous reactions following contact with either Merfen spray alone, or with multiple products including this spray. Patients showed positive reactions to this product in both patch tests and repeated open application tests (ROATs). Four patients showed dose-dependent reactions to both benzoxonium chloride and lauramine oxide. One patient showed a dose-dependent reaction to the former and a non-dose-dependent reaction to the latter. Finally, two subjects showed responses only to lauramine oxide. One patient reacted to chlorhexidine digluconate 0.5% aq. in addition to both other allergens. Two commercially unavailable allergens, that is, benzoxonium chloride and/or lauramine oxide were identified as major causes of ACD from Merfen antiseptic spray, whereas chlorhexidine digluconate was a contributing culprit in only one patient.

Patch Testing With Cobalt in Adults: A North American Contact Dermatitis Group Experience, 2001-2018.

Background: Cobalt is a recognized cause of allergic contact dermatitis (ACD); however, detailed information on patient characteristics, sites, and sources is lacking. Objective: The aim of the study is to assess trends in patch test reactions to cobalt and associated patient characteristics, common sources, and body sites affected. Methods: The study used a retrospective analysis of adult patients who were patch tested to cobalt by the North American Contact Dermatitis Group between 2001 and 2018 (n = 41,730). Results: Overall, 2986 (7.2%) and 1362 (3.3%) had allergic or currently relevant patch test reaction to cobalt, respectively. Patients with versus without an allergic patch test reaction to cobalt were more likely to be female, employed, have a history of eczema or asthma, be Black, Hispanic, or Asian, and have occupational-related dermatitis. The most commonly identified sources of cobalt in allergic patients included jewelry, belts, and cement, concrete, and mortar. Affected body site(s) varied by cobalt source among patients with currently relevant reactions. Occupational relevance was found in 16.9% of patients with positive reactions. Conclusions: Positive patch test reactions to cobalt were common. The most common body sites were the hands, and affected site varied by the source of cobalt.

Methyl(chloro)isothiazolinone contact allergy: a monocentric experience from Turkey

Introduction Due to their ubiquitous use, isothiazolinones caused allergic contact dermatitis epidemics and their use was restricted by legal regulations. Objectives We aimed to evaluate demographic data, clinical findings, and patch test features of patients with methylisothiazolinone (MI) and/or methylchloroisothiazolinone(MCI) sensitivity in our study. Methods This study is a bidirectional and cross-sectional study, between July 2020 and September 2021. A total of 616 patients, including prospective and retrospective populations, demographic data, clinical findings, and patch test results were reviewed. Patients’ demographics, patch test results, allergen sources, presence of occupational contact, and the characteristics of dermatitis attacks were recorded. Results A total of 50 patients with MI and MCI/MI sensitivity, 36 male (72%) and 14 female (28%), were included in our study. The overall prevalence of MI and MCI/MI between 2014 and 2021 was 8.4% (52/616) with two peak levels in 2015(21%) and 2021 (20%). A statistically significant relationship was found between shampoo use and facial involvement (p = 0.031), shower gel use and arm involvement (p = 0.027), wet wipe use and hand involvement (p = 0.049), detergent use and the pulps (p = 0.026) and the lateral aspects of fingers involvement (p = 0.048), water-based dye use and periungual involvement (p = 0.047). Conclusion Although legal regulations related to MI and MCI/MI cause a decrease in the frequency of their sensitivities were still common causes of allergic contact dermatitis.

Tobramycin and antiglaucoma agents as increasing culprits of periorbital allergic contact dermatitis from topical ophthalmic medications: A 24-year study from Turkey.

Allergic contact dermatitis (ACD) from topical ophthalmic medications (TOMs) poses an additional disease burden to patients who already suffer from eye problems. To investigate the epidemiological/clinical profile of patients with periorbital ACD from TOMs in Turkey. This was a retrospective, cross-sectional, single tertiary centre study based on files of 75 patch tested patients with suspected periorbital ACD from TOMs among a total of 2801 consecutively patch tested patients with suspected ACD of any origin between 1996 and 2019. Periorbital ACD was diagnosed in 25 of 75 (33.3%) patients (female:male=1.8:1; age range: 6-85 years) with suspected ACD from TOMs showing an overall prevalence of 0.9% (25/2801) among the whole patch test population. Atopy was not present. Tobramycin-containing TOMs were the most frequent culprits, followed by antiglaucoma preparations. Their frequency increased, whereas no new cases of neomycin-induced ACD were observed after 2011. Positivities with thimerosal were of unknown clinical relevance, while benzalkonium chloride (BAC) caused ACD in two patients. The diagnosis would be missed in each 20% of patients without performing day (D) 4 and D7 readings and strip-patch testing. Ten culprits were identified only by testing with patients' own TOMs in eight (32%) patients. Aminoglycosides, particularly tobramycin, were the leading cause of ACD from TOMs. The frequency of ACD from tobramycin and antiglaucoma medications increased after 2011. BAC was a rare but important allergen. Additional D4 and D7 readings, strip-patch testing, and testing with patients' own TOMs seem essential when patch testing with eye medications.

Trends in the Prevalence of Methylchloroisothiazolinone/Methylisothiazolinone Contact Allergy in North America and Europe

The common use of isothiazolinones as preservatives is a global cause of allergic contact dermatitis. Differences in allowable concentrations of methylisothiazolinone (MI) exist in Europe, Canada, and the US. To compare the prevalence of positive patch test reactions to the methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) combination and MI alone in North America and Europe from 2009 to 2018. This retrospective analysis of North American Contact Dermatitis Group, European Surveillance System on Contact Allergies (ESSCA), and the Information Network of Departments of Dermatology (IVDK) databases included data from patients presenting for patch testing at referral patch test clinics in North America and Europe. Patch tests to MCI/MI and MI. Prevalence of allergic contact dermatitis to MCI/MI and MI. From 2009 to 2018, participating sites in North America and Europe patch tested a total of 226 161 individuals to MCI/MI and 118 779 to MI. In Europe, positivity to MCI/MI peaked during 2013 and 2014 at 7.6% (ESSCA) and 5.4% (IVDK) before decreasing to 4.4% (ESSCA) and 3.2% (IVDK) during 2017 and 2018. Positive reactions to MI were 5.5% (ESSCA) and 3.4% (IVDK) during 2017 and 2018. In North America, the frequency of positivity to MCI/MI increased steadily through the study period, reaching 10.8% for MCI/MI during 2017 and 2018. Positive reactions to MI were 15.0% during 2017 and 2018. The study results suggest that in contrast to the continued increase in North America, isothiazolinone allergy is decreasing in Europe. This trend may coincide with earlier and more stringent government regulation of MI in Europe.

Allergic Contact Dermatitis: Sensitization to 2-Hydroxyethyl Methacrylate

Acrylate polymers are an important cause of allergic contact dermatitis. Over the last decades, the vector of allergy to methacrylic acid esters has shifted from industrial products to the beauty and medical industries. In the described clinical case, the potential risk of sensitization to 2-hydroxyethyl methacrylate, a component of medical products, is emphasized, particularly in patients working in the cosmetology field. The authors present a clinical case of allergic contact dermatitis caused by 2-hydroxyethyl methacrylate, a component of the adhesive in a medical plaster. Basic diagnostic measures, including allergodiagnostics using a patch test, were conducted. Based on the collected data, the diagnosis was verified, and therapy for allergic contact dermatitis was prescribed according to the international clinical treatment protocol. The increasing number of cases of allergic contact dermatitis caused by acrylate compounds in medical materials requires further investigation and the implementation of effective preventive measures to ensure patient safety.

REFLECTANCE CONFOCAL MICROSCOPY OF ALLERGIC CONTACT DERMATITIS TO MANGO SAP (MANGIFERA INDICA)

<h3>Introduction</h3> The mango fruit is a rare cause of allergic contact dermatitis (ACD) with less than forty instances reported since the first published case in 1939. Reflectance confocal microscopy (RCM) is a non-invasive imaging technique that enables dynamic, high-resolution assessment of ACD <i>in vivo.</i> <h3>Case Description</h3> A 39-year-old non-atopic woman presented to the clinic with a pruritic, vesicular eruption on the leg following exposure to mango sap within seven days of exposure. The patient reports a prior history of similar pruritic eruptions after exposure to mango sap but denies reactions from ingestion of the fruit. She also endorses a history of exuberant reactions to poison ivy, although the timeframe of exposure order during childhood is unclear. RCM was used to image the affected skin in real-time and revealed dark spongiotic vesicles containing bright cells representative of an inflammatory infiltrate. The patient was recommended to apply clobetasol 0.05% cream to the affected area which showed improvement within 10 days. <h3>Discussion</h3> We present a unique case of mango sap-induced ACD evaluated <i>in vivo</i> using RCM. Poison ivy and mangos are both members of the Anacardiaceae family and it is hypothesized that cross-sensitization occurs between the urushiol antigen and 5-resorcinol found in mango sap. RCM has been used in diagnosing ACD and some features may be useful tool to rule out alternative diagnoses. Due its' ability to provide non-invasive <i>in vivo</i> visualization of affected skin, RCM possesses promising diagnostic potential in evaluating inflammatory skin diseases in real-time.

ALLERGIC CONTACT DERMATITIS TO 2-OCTYL CYANOACRYLATE CONFIRMED BY PATCH TESTING: A PEDIATRIC CASE SERIES

<h3>Introduction</h3> 2-octyl cyanoacrylate is a tissue adhesive commonly used to close wounds. While there have been multiple case reports regarding allergic contact dermatitis (ACD) to 2-octyl cyanoacrylate in the adult population, there is little in the literature regarding ACD to 2-octyl cyanoacrylate in the pediatric population. <h3>Methods</h3> A retrospective chart review was completed to identify patients who underwent patch testing to 2-octyl cyanoacrylate at a pediatric tertiary care center within the past 5 years. <h3>Results</h3> A total of 5 pediatric patients met inclusion criteria. All patients had a history of atopy. Four patients used 2-octyl cyanoacrylate previously without documented adverse reaction. Two patients had open patch testing and 3 had traditional occlusive patch testing. All patients were tested to multiple substances, and 3 of the 5 patients had reactions to other allergens in addition to 2-octyl cyanoacrylate. Four of five patients had reactions consisting of either erythema, pruritus, or pain within 24 hours of 2-octyl cyanoacrylate placement. All patients had positive reactions at 48 hours and strong or extreme positive reactions on subsequent readings. One patient required oral steroids for relief and the other 4 were treated with topical steroids. <h3>Conclusion</h3> 2-octyl cyanoacrylate can be a cause of ACD in pediatric patients. While reactions concerning for ACD can occur with many surgical products, a thorough history and patch testing can aid in identifying specific causative agents.

Comparison between patch test results of natural dyes and standard allergens in batik workers with occupational contact dermatitis

Background Occupational contact dermatitis (OCD) is a skin disorder caused by contact with any substances found in the workplace. Occupational contact dermatitis is second most common occupational disease (15% of all cases of occupational disease). Occupational contact dermatitis is divided into allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) which is 80% of cases that affects hands. Batik is an art that is painted on cloth, it is one of Indonesian cultural heritage. Batik workers have a higher risk of obtaining OCD due to exposure to chemicals and fluids used during work. Natural dyes used in the dyeing process are less likely to cause ACD than standard allergens. Some of the natural dyes used in the dyeing process in batik industries are Indigofera tinctoria, sappan wood (Caesalpinia sappan), and Mahagony (Swietenia mahagoni) cause skin sensitisation. Objective To compare the results of patch testing between natural dyes (Indigofera tinctoria, sappan wood (Caesalpinia sappan), and Mahagony (Swietenia mahagoni) with standard allergens (p-phneyldiamine 0.1%, potassium dichromate 0.5% and formaldehyde 0.1%) as a cause of ACD in batik workers in Surakarta, East Java, Indonesia. Method A cross-sectional study was conducted on 63 subjects batik workers with OCD in Surakarta, East Java, Indonesia. Subjects were patch tested with three standard allergens (p-phenylenediamine 0.1%, potassium dichromate 0.5%, and formaldehyde 1%) and natural dyes (Indigofera tinctoria, sappan wood (Caesalpinia sappan), and Mahagony (Swietenia mahagoni). A closed patch test was evaluated 48 and 96 hour later. Screening of OCD in batik workers in Surakarta, East Java, Indonesia was based on Nordic Occupational Skin Questionnaire NOSQ-2002, and diagnosis of OCD was based on Mathias criteria (at least 4 out of 7 criteria were met). Data were analysed using a non-parametric Chi-square test with SPSS 21 with a significant difference if the p-value < 0.05. Result Natural dyes significantly caused allergic contact dermatitis in batik workers in Surakarta, East Java, Indonesia than standard allergens (p = 0.016). A positive patch test was found in 11 patients, standard allergen p-phenylenediamine (PPD) 0.1% was seen on one patient, potassium dichromate 0.5% on two patients, and formaldehyde 1% on two patients. A positive patch test using Indigofera tinctoria was found at one patient, sappan wood (Caesalpinia sappan) in three patients, and Mahagony (Swietenia mahagoni) in five patients. Conclusion Natural dyes cause more positive patch test results in batik workers.

Lanolin Allergic Reactions: North American Contact Dermatitis Group Experience, 2001 to 2018.

Lanolin is an important cause of allergic contact dermatitis. The aims of this study were to describe the epidemiology of lanolin allergy and to assess trends in patch test reactions to lanolin over time. This study used a retrospective analysis of patients patch tested with lanolin alcohol 30% or Amerchol L-101 50% in petrolatum by the North American Contact Dermatitis Group between 2001 and 2018 (n = 43,691). Overall, 1431 (3.3%) had a positive reaction, and 1238 (2.8%) were currently relevant. Prevalence of lanolin allergy was 4.63% between 2011 and 2018 (P < 0.0001). Most lanolin-allergic patients had + (52%) reactions; 18%, and 6% had ++ and +++ reactions, respectively. Common primary anatomic sites of dermatitis were the hands (20.7%), scattered/generalized distribution (19.6%), and face (17.0%). Allergic reactions to lanolin were more common in children (4.5%) than in adults (3.2%, P = 0.0018). Compared with nonallergic patients, lanolin-allergic patients were more likely to have history of eczema or hay fever, male sex, older than 40 years, or Black race (P < 0.05). Common lanolin sources were personal care products and drugs/medications. Only 2.24% of the positive reactions were linked to occupation. Lanolin sensitivity was common. Reactions were often clinically relevant and linked to personal care products and medications.

Multiple cases of sensitization to an antiseptic containing chlorhexidine digluconate/benzalkonium chloride/benzyl alcohol with different profiles of sensitization in adults and children.

An aqueous antiseptic containing "chlorhexidine digluconate/benzalkonium chloride/benzyl alcohol" (CBB) is widely used in France. The only previous documented study dealing with allergic contact dermatitis (ACD) to this antiseptic is one small case series in children. The French Vigilance Network for Dermatology and Allergy (REVIDAL-GERDA) has collected many cases in the last few years. To evaluate the clinical and sensitization profiles of patients diagnosed with ACD to CBB. We performed a retrospective study of patients with contact dermatitis to CBB and positive tests to CBB and/or at least one of its components. All patients had to be tested with all components of CBB. A total of 102 patients (71 adults and 31 children) were included. The lesions were extensive in 63% of patients and 55% had delayed time to diagnosis. CBB patch tests were positive in 93.8% of cases. The allergen was identified in 97% of patients, mainly benzyl alcohol in adults (81.7%) and chlorhexidine digluconate in children (54.8%). About 32.4% of the patients were sensitized to several components. CBB is a cause of ACD at all ages. The components of the antiseptic should be tested. The sensitization profile seems to be different between adults and children.

Novel insights into contact dermatitis

Contact dermatitis is a common disease that is caused by repeated skin contact with contact allergens or irritants, resulting in allergic contact dermatitis (ACD) and/or irritant contact dermatitis. Attempts have been made to identify biomarkers to distinguish irritant and allergic patch test reactions, which could aid diagnosis. Some promising candidates have recently been identified, but verification and validation in clinical cases still need to be done. New causes of ACD are constantly being recognized. In this review, 10 new contact allergens from recent years, several relating to anti-aging products, have been identified. Frequent allergens causing considerable morbidity in the population, such as the preservative methylisothiazolinone, have been regulated in the European Union. Asignificant drop in the number of cases has been seen, whereas high rates are still occurring in other areas such as North America. Other frequent causes are fragrance allergens, especially the widely used terpenes and acrylates found in medical devices for control of diabetes. These represent unsolved problems. Recent advances in immunology have opened the way for a better understanding of the complexity of contact dermatitis, especially ACD-a disease that may be more heterogenous that previous understood, with several subtypes. With the rapidly evolving molecular understanding of ACD, the potential for development of new drugs for personalized treatment of contact dermatitis is considerable.

Nickel dust-induced occupational contact dermatitis by welding and grinding work in shipyard workers: a report of nine cases

BackgroundOccupational skin diseases are skin conditions that occur or worsen in relation to work and known to be the second most common type of occupational disease affecting individuals in the United States. In Korea, epidemiological reports related to occupational skin diseases are rare. But, no cases of occupational contact dermatitis caused by welding and grinding work have been reported previously.Case presentationNine male workers working in the production department for liquefied natural gas (LNG) ships in Ulsan complained of erythematous papules/patches and itching in various areas of the body after welding and grinding work. The work environment monitoring report revealed that the amount of nickel dust exceeded the time weighted average (TWA) and poor local ventilation status. Based on the symptoms and the overall results of surveys, several tests, and work environment monitoring report, the 2 workers who had positive patch-test reactions to nickel were diagnosed with nickel dust-induced allergic contact dermatitis. The other 7 workers were diagnosed that there was a high probability that they had nickel dust-induced irritant contact dermatitis. The 2 workers who had nickel dust-induced allergic contact dermatitis were recommended to switch their jobs.ConclusionsNickel is one of the most common cause of allergic contact dermatitis. In this case, the dust was assumed to be created by welding work with a high nickel content new welding rod and subsequent grinding work, and the concentration of this dust exceeded the time weighted average. Thus, it is thought that the nickel dust may have caused contact dermatitis through continuous contact with the workers' exposed skin in a poorly ventilated space. Currently, several domestic shipbuilding companies are manufacturing LNG tankers using a new construction method. Consequently, it is highly likely that similar cases will occur in the future, which makes this case report meaningful.

Occupational Allergic Contact Dermatitis in Wind Turbine Blades Production

Introduction: Epoxy resins, widely used in several industrial sectors, are among the main causes of allergic contact dermatitis. The wind turbine production industry is one of the sectors that uses these products widely. This study aimed to assess the prevalence of contact allergy to epoxy resin and its components among wind turbine blades production workers with suspected contact dermatitis.&#x0D; Methods: We performed a retrospective analysis of the patch test results performed between 2012 and 2019 in wind turbine blades production workers with dermatitis and characterized their demographic and clinical data, patch test results and the occupational impact of allergic contact dermatitis on these workers.&#x0D; Results: Out of the 3049 patients patch tested in the period 2012-2019, we identified thirteen wind turbine blades production workers, predominantly male (69.2%). All of them handled glues, resins and/or paints in their daily work activities. Seven (53.8%) had a combination of hand dermatitis and airborne dermatitis, two (15.4%) had exclusively hand dermatitis and four (30.8%) had predominantly airborne dermatitis. All patients had positive patch test for epoxy resin and ten patients (76.9%) had also reaction for 1,6-hexanediol diglycidylether. Two patients (15.4%) also had a reaction to the already hardened resin powder. Four (30.8%) patients had to quit their jobs due to allergic contact dermatitis and three (23.1%) were transferred to another workstation without exposure to epoxy resin. Avoidance of exposure resulted in a significant improvement.&#x0D; Conclusion: With this study, we confirmed that epoxy resin and its components are the main cause of dermatitis among wind turbine blades production workers, that eczema occurs by direct contact and by airborne exposure.