Frequency Of Positive Patch Tests Research Articles

2-Hydroxyethyl methacrylate (HEMA): A clinical review of contact allergy and allergic contact dermatitis. Part 2. Cross- and co-sensitization, other skin reactions to HEMA, position of HEMA among (meth)acrylates, sensitivity as screening agent, presence of HEMA in commercial products and practical information on patch test procedures.

This is the second part of a literature review of the clinical aspects of contact allergy to and allergic contact dermatitis from 2-hydroxyethyl methacrylate (HEMA). Topics include cross- and co-sensitization, atypical manifestations of contact allergy, frequency of positive patch tests to HEMA compared with other (meth)acrylates, sensitivity of HEMA as a screening agent, the presence of HEMA in commercial products, and practical information on patch testing procedures. Primary sensitization to methacrylates including HEMA may result in methacrylate and acrylate cross-sensitization. There is a strong cross-allergy between HEMA, ethylene glycol dimethacrylate (EGDMA), and hydroxypropyl methacrylate; many reactions to EGDMA are cross-reactions to primary HEMA sensitization. Rare atypical manifestations of HEMA-allergy include lichen planus, lymphomatoid papulosis, systemic contact dermatitis, leukoderma after positive patch tests, and systemic side effects such as nausea, diarrhoea, malaise, and palpitations. The occurrence of respiratory disease caused by methacrylates such as asthma is not infrequent. HEMA is the most frequently patch test-positive methacrylate. It is a good screening agent for allergy to other (meth)acrylates. Patch test sensitization to HEMA 2% pet. is extremely rare. There are (some) indications that HEMA is frequently used in dental products and nail cosmetics.

Is Patch Test Necessary in Children to Solve the Clinical Conundrum of Foot Eczema.

Foot eczema in children is a commonly encountered condition but is associated with diverse etiology, thereby posing a diagnostic challenge. These include atopic eczema, juvenile plantar dermatoses, irritant contact dermatitis, and allergic contact dermatitis. Because of the diverse etiology, it is often difficult to distinguish between the conditions clinically, thereby warranting patch testing for the correct diagnosis. The study was conducted to determine the frequency of positive patch tests among children with foot eczema and to compare them with children with and without atopy. This was a prospective observational study done on 86 children aged 4 to 17 years presenting with foot eczema in whom patch testing was done using Indian standard series and footwear series and patients' own footwear. The clinical diagnosis of foot eczema in our study was allergic contact dermatitis (37%), followed by atopic eczema (30%), juvenile plantar dermatoses (17%), and lichen simplex chronicus (15%). Patch test positivity was present in 36% of the cases with clinical relevance in 65% of the cases. The common allergens were rubber allergens and disperse dyes. Of the children who were patch tested, highest patch test positivity rates were seen in allergic contact dermatitis (50%) and juvenile plantar dermatoses (53%). No significant differences were observed with regard to patch test positivity or relevance between children with and without atopy. The diagnosis of foot eczema in children cannot be made on clinical grounds alone, and patch testing should be recommended in children with any morphological pattern of foot eczema irrespective of presence or absence of atopy, especially in those with long-standing and recalcitrant disease with frequent exacerbations.

Patch Testing With Methylchloroisothiazolinone/Methylisothiazolinone Using a New Diagnostic Mix-A Multicenter Study From the International Contact Dermatitis Research Group.

In the early 1980s, a preservative containing a mixture of methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) in a ratio of 3:1 was introduced. This mixture (mix) has been patch tested at 100 ppm (0.01%) worldwide and at 200 ppm (0.02%) in Sweden since 1986 and also in the European baseline series since 2014. A new aqueous mix of MCI 0.015% and MI 0.2% was compared with patch testing with the 2 aqueous baseline preparations of MCI/MI 0.02% and MI 0.2%. Four thousand three hundred ninety-seven patients with dermatitis in 12 International Contact Dermatitis Research Group dermatology departments from 3 continents were patch tested simultaneously with the 3 preparations. The frequency of positive patch tests to the allergens varied between 0% and 26.7% in the 12 test centers. The new mixture MCI/MI 0.215% in aqua (aq) detected significantly more patients with MCI/MI allergy than both MCI/MI 0.02% aq (P < 0.001) and MI 0.2% aq (P < 0.001) alone and combined. The results favor replacing the preparations MCI/MI 0.02% aq and MI 0.2% aq with the mixture MCI/MI 0.215% aq in the International Contact Dermatitis Research Group baseline series.

Frequency Of Positive Patch Tests To Common Allergens By Age Groups

Contact Dermatitis (CD) is a common skin disorder. Patch testing is the gold standard for evaluation of allergen sensitizations in CD. We sought to identify the most common allergens identified by patch testing based on age groups in our academic allergy clinic. We performed an IRB-approved retrospective chart review of 100 patients patch tested with the North American Contact Dermatitis Group Standard (NACDG) and T.R.U.E. test panels from 2008-2015. Data collected included results of patch testing, age, and sex. 100 patients, aged 4-89 years (mean age 47.1), were included in this study. 81% were female. The five most common sensitizers across all age groups were Iodopropynyl Butylcarbamate, Fragrance Mix 1, Nickel, Neomycin, and Cobalt. Patients were assigned to groups: Pediatric (0-21 years), Middle Age (22-65), and Elderly (66+). The most common allergens in the pediatric group were Nickel and Neomycin (4/22 each, 19%). The most common allergen in both the middle aged and elderly groups was Iodopropynyl Butylcarbamate (15/56, 27%, and 10/23, 43% respectively). Fragrance Mix 1 and Iodopropynyl Butylcarbamate sensitization became increasingly common with age. Nickel, Neomycin, and Cobalt sensitizations were equally distributed across age groups. There was no difference in frequency of sensitizers noted between the middle age and elderly population. In our patient sample, the prevalence of sensitization to certain allergens varied by age. Fragrance and Iodopropynyl Butylcarbamate were infrequent sensitizers in children, potentially related to exposure. Nickel, Neomycin and Cobalt were common allergens in all age groups.

Frontal fibrosing alopecia: possible association with leave-on facial skin care products and sunscreens; a questionnaire study.

Since its first description in 1994, frontal fibrosing alopecia (FFA) has become increasingly common, suggesting that environmental factors are involved in the aetiology. To identify possible causative environmental factors in FFA. A questionnaire enquiring about exposure to a wide range of lifestyle, social and medical factors was completed by 105 women with FFA and 100 age- and sex-matched control subjects. A subcohort of women with FFA was patch tested to an extended British standard series of allergens. The use of sunscreens was significantly greater in the FFA group compared with controls. Subjects with FFA also showed a trend towards more frequent use of facial moisturizers and foundations but, compared with controls, the difference in frequencies just failed to reach statistical significance. The frequency of hair shampooing, oral contraceptive use, hair colouring and facial hair removal were significantly lower in the FFA group than in controls. Thyroid disease was more common in subjects with FFA than controls and there was a high frequency of positive patch tests in women with FFA, mainly to fragrances. Our findings suggest an association between FFA and the use of facial skin care products. The high frequency of sunscreen use in patients with FFA, and the fact that many facial skin care products now contain sunscreens, raises the possibility of a causative role for sunscreen chemicals. The high frequency of positive patch tests in women with FFA and the association with thyroid disease may indicate a predisposition to immune-mediated disease.

Contact Allergy in Children Referred for Patch Testing

To determine the frequency of positive and relevant patch tests in children referred for patch testing in North America; to compare results of patch testing children and adults; and to compare our results with international data on contact allergy in children. Retrospective cross-sectional analyses of North American Contact Dermatitis Group (NACDG) data from January 1, 2001, through December 31, 2004. Patch test reactions for allergens that were positive and considered of clinical importance to the patient's eczematous problem were defined as being of current or past relevance. Clinical patch test data from 13 NACDG members, primarily a referral population. The pediatric population (hereafter referred to as "children") was defined as patients aged 0 to 18 years (n = 391). Patients 19 years and older constituted the comparison adult group (n = 9670). The frequency of positive patch test reactions and number of relevant ones. Secondary measures included the association of atopic markers, frequency of irritant reactions, and sources of relevant supplementary allergens. No significant difference in the overall frequency of at least 1 relevant positive patch test reaction was noted in children (51.2%) compared with adults (54.1%). The most frequent positive reactions in children were to nickel (28.3%), cobalt chloride (17.9%), thimerosal (15.3%), neomycin sulfate (8.0%), gold sodium thiosulfate (7.7%), and fragrance mix (5.1%). For children aged 0 to 18 the most frequent relevant positive reactions were to nickel sulfate (26.0%), cobalt (12.4%), neomycin (4.4%), fragrance mix (4.1%), gold (3.6%), and quaternium 15 (3.6%). The frequency of irritant reactions in adults and children was similar. Of the children with a relevant positive reaction, 34.0% had atopic dermatitis included as one of their final diagnoses, compared with 11.2% of adults (P < .001). Fifteen percent and 39% of children had relevant allergens not included in the NACDG series and a commercially available skin patch test (T.R.U.E. TEST [thin-layer rapid use epicutaneous test], panel 1.1 and 2.1; Allerderm, Phoenix, Arizona), respectively. Adults and children in this group are equally likely to have allergic contact dermatitis; frequency of relevant allergen reactions differs.

Decreasing trends in methyldibromo glutaronitrile contact allergy – following regulatory intervention

The preservative methyldibromo glutaronitrile (MDBGN) has been banned, first from stay-on, and later from rinse-off cosmetics, in the EU countries because of increasing rates of contact allergy. To evaluate the frequency of contact allergy to MDBGN among patients patch tested by the Danish Contact Dermatitis Group just before and following regulatory decisions. The data set comprised 19 279 consecutive eczema patients patch tested from 2003-2007 with MDBGN 0.3% in petrolatum (pet.) or, in a minority of patients, with Euxyl K 400 1.5% in pet. A significantly decreasing trend in the frequency of positive patch tests to MDBGN was found from 4.6% in 2003 to 2.6% in 2007 (P < 0.001). The decreasing trend was seen for both men and women. A significantly decreasing proportion of cases with a current relevance of contact allergy to MDBGN was also seen from 51.3% in 2003 to 29% in 2007 (P < 0.001). Regulatory interventions have already had a major effect on allergic disease due to MDBGN in Denmark. The same trends are likely to be seen in other EU countries.

Metal allergy in Singapore

This is a clinical epidemiologic study to determine the frequency of metal allergy among patch-tested patients in the years 2001-2003. The results are compared with those of previous studies. All patients diagnosed as having allergic contact dermatitis in the National Skin Centre, Singapore, from January 2001 to December 2003 were studied retrospectively. The frequency of positive patch tests to the following metals were nickel 19.9%, chromate 5.6%, cobalt 8.2% and gold 8.3%. The frequency of nickel allergy has been steadily rising over the last 20 years. The most common sources of nickel allergy are costume jewelry, belt buckles, wrist watches and spectacle frames. After declining from 1984 to 1990, chromate and cobalt allergies have also been steadily increasing subsequently. The most common sources of chromate allergy were cement, leather and metal objects. Most positive patch tests to cobalt are regarded as co-sensitization due to primary nickel or chromate allergies. There has been a steep increase in positive patch tests to gold from 2001 to 2003, which is difficult to explain because the relevance and sources of such positive patch tests can rarely be determined with certainty. There has been an overall rise in the frequency of metal allergy in the last 20 years.

Results of patch testing with lavender oil in Japan.

We report the annual results of patch testing with lavender oil for a 9-year period from 1990 to 1998 in Japan. Using Finn Chambers and Scanpor tape, we performed 2-day closed patch testing with lavender oil 20% pet. on the upper back of each patient suspected of having cosmetic contact dermatitis. We compared the frequency of positive patch tests to lavender oil each year with those to other fragrances. We diagnosed contact allergy when patch test reactions were + or <+ at 1 day after removal. The positivity rate of lavender oil was 3.7% (0-13.9%) during the 9-year period from 1990 to 1998. The positivity rate of lavender oil increased suddenly in 1997. Recently, in Japan, there has been a trend for aromatherapy using lavender oil. With this trend, placing dried lavender flowers in pillows, drawers, cabinets, or rooms has become a new fashion. We asked patients who showed a positive reaction to lavender oil about their use of dried lavender flowers. We confirmed the use of dried lavender flowers in 5 cases out of 11 positive cases in 1997 and 8 out of 15 positive cases in 1998. We concluded that the increase in patch test positivity rates to lavender oil in 1997 and 1998 was due to the above fashion, rather than due to fragrances in cosmetic products.

Contact sensitization in fruit farmers

The aim of the study was to determine the prevalence of sensitization and contact dermatitis in a population of Italian farmers and the importance of pesticides as skin sensitizers. Sixty-four female worker (mean age 35) employed in the harvesting of cherries, peaches, olives and grapes were studied. Skin diseases were assessed with a questionnaire and physical examination. The farm workers were patch tested with the GIRDCA standard series containing 30 allergens and six pesticides currently used on the farm. 18 workers (28%) were sensitized to one or more allergens. 36 subjects (52%) were found to be atopic and three (4.7%) had dermatitis of the hands with positive reactions to the GIRDCA standard series. Differences in contact sensitization betweeen atopic and non atopic patients were not statistically significant (χ2 test). One worker had contact urticaria to peaches and 36 farmers (52%) referred to itching and skin rashes in summer, during the harvesting of peaches. Only 18 workers reported that they almost always wore protective clothing. Despite the high frequency of positive patch tests, contact sensitization to pesticides was unusual in our group. No cases of allergic contact dermatitis to pesticides were found and only one patient who was symptomless (1.5%) had an allergic reaction to pesticides (azinphos-methyl). Copyright © 1999 John Wiley & Sons, Ltd.

Contact sensitization in fruit farmers

The aim of the study was to determine the prevalence of sensitization and contact dermatitis in a population of Italian farmers and the importance of pesticides as skin sensitizers. Sixty-four female worker (mean age 35) employed in the harvesting of cherries, peaches, olives and grapes were studied. Skin diseases were assessed with a questionnaire and physical examination. The farm workers were patch tested with the GIRDCA standard series containing 30 allergens and six pesticides currently used on the farm. 18 workers (28%) were sensitized to one or more allergens. 36 subjects (52%) were found to be atopic and three (4.7%) had dermatitis of the hands with positive reactions to the GIRDCA standard series. Differences in contact sensitization betweeen atopic and non atopic patients were not statistically significant (χ2 test). One worker had contact urticaria to peaches and 36 farmers (52%) referred to itching and skin rashes in summer, during the harvesting of peaches. Only 18 workers reported that they almost always wore protective clothing. Despite the high frequency of positive patch tests, contact sensitization to pesticides was unusual in our group. No cases of allergic contact dermatitis to pesticides were found and only one patient who was symptomless (1.5%) had an allergic reaction to pesticides (azinphos-methyl). Copyright © 1999 John Wiley & Sons, Ltd.

Contact Sensitivity to Rubber Additives in Belgium

The frequency of positive patch tests to rubber additives in Belgium is recorded. Allergy due to rubber protective gloves represents 41% of the overall sensitivity to rubber.

Trichophytin Contact Sensitivity in Patients With Dermatophytosis

Trichophytin contact sensitivity was investigated in patients with dermatophytosis by patch testing with highly concentrated purified trichophytin on partially stripped skin. The lack of primary irritant reactions was confirmed on the skin of children. Positive patch tests were noted in 113 of 178 patients (63.5%). However, there was a great difference in the incidence of trichophytin contact sensitivity between cases with different clinical types. The highest frequency of positive patch tests was obtained in patients with the vesiculobullous type of tinea pedis (83.3%). In contrast, a very low incidence was noted in patients with tinea corporis (37%) and the squamous hyperkeratotic type of tinea pedis (36%). Causative organisms and the age and sex of the patients did not show a relationship with the reactivity. A diminished incidence of positive reactions was noted in atopic individuals and in patients seen in winter. Patients who had persistent or recurrent infections for a long period of time, especially those having inflammatory lesions, had a higher frequency of positive patch tests.

Sensitivity to some rubber additives.

The frequency of positive patch tests to 13 rubber accelerators in Poland was recorded. Of particular interest was the relatively large group of patients positive to several, mostly chemically unrelated, accelerators. The mechanism of this multiple sensitivity is discussed. Positive tests to N-isopropyl-N-phenyl-p-phenylenediamine were observed in more than half of the patients reacting to several aromatic amines. Anamnesis indicated that in the case of cross-reactions to many aromatic amines, none of the patients positive to N-isopropyl-N-phenyl-p-phenylenediamine had complained of a reaction to rubber products.