International Contact Dermatitis Research Group Research Articles

Three-part scoring system (tripartite) for teledermatology versus International Contact Dermatitis Research Group criteria to interpret patch test readings: A comparative, observational study.

Background The International Contact Dermatitis Research Group (ICDRG) grading is the gold standard and is used to interpret patch test results in allergic contact dermatitis (ACD). The ICDRG readings include a combination of visual and palpation findings. Digital photography limits palpation. An alternative scoring system exists to analyse 2D images and interpret patch test readings in teledermatology (TD). Aims To compare tri-partite scoring system (TPSS) (TD) with ICDRG (face-to-face) and to assess the feasibility of TPSS by TD. Methods In this observational study, two investigators each scored the patch test readings for 78 patients at the 48th h, 96th h and on the 7th day. Results The TPSS has a sensitivity of 100%, specificity of 93.34%, positive predictive value of 91.67% and negative predictive value of 100%. At a confidence interval of 95%, Cohen's kappa (0.90) indicated excellent agreement between both investigators. The concordance between both scoring systems was at 93.2% for agreement and 6.82% for disagreement. Polysensitisation (6 patients with 16 allergens) was detected equally in both methods. Limitations A single centre study. Conclusion The readings obtained by TPSS were in agreement with ICDRG. TPSS can reduce the number of patient visits by 50% and may be used during COVID-19 times and beyond.

A Dermatological Safety Test of a Face Serum Formulation Derived from Honey and Propolis of Stingless Bee from East Kalimantan

Skincare, which is a type of cosmetics, is an essential component in the process of maintaining and caring for the skin. It is known that the skin quickly absorbs the tiny molecular structure of serum. Stingless bees, widespread in East Kalimantan and Indonesia, benefit the skin's health by producing honey and propolis. This research aims to demonstrate that a face serum derived from honey and propolis of stingless bees from East Kalimantan is safe for use on the skin using dermatological standards. Here we will see whether there are allergic reactions and irritation from using facial serum. Using the Repeated Open Application Test (ROPT) technique, 20 volunteers were subjected to applying a face serum containing honey and stingless bee propolis. The serum was given to the upper arm twice daily for seven days. As part of the test, allergic reactions were evaluated using the system developed by the International Contact Dermatitis Research Group (ICDRG), and irritating reactions were evaluated using the Primary Irritation Index (PII). The results showed that on the first day, four of the volunteers reported moderate irritation reactions. Consequently, they scored 0.7, indicating they suffered minor irritation. On the other hand, the reactions of the remaining 16 volunteers were typical. Twenty participants had normal skin from the second treatment until the seventh day. The overall findings show that the facial serum based on honey and kelulut propolis from stingless bees from East Kalimantan showed a mild irritation reaction at the beginning of use and was safe to use in subsequent uses.

Patch Test in Chronic Urticaria as a Diagnostic Investigative Tool – A Study in a Tertiary Care Center

Abstract Background: Chronic urticaria (CU) is associated with diverse clinical presentations and varied etiology. Contact allergy plays a critical role in the etiopathogenesis of CU; thus, a patch test can be helpful in identifying potential contact allergens. Aims and Objectives: The aim and objective of this study were to study the causative contact allergen in CU using the Indian Standard Battery allergens approved by the Contact and Occupational Dermatoses Forum of India and to establish the use of patch test in CU. Materials and Methods: One hundred clinically diagnosed cases of CU patients attended to the dermatology department for 2 years were evaluated with detailed history and clinical examination and a patch test was done using the Indian standard series. The patches were removed after 48 h and a reading was taken after 30 min. Observations were graded according to the International Contact Dermatitis Research Group recommendations. Results: Hospital-based prevalence of CU among patients attending the dermatology outpatient department was 3%. A positive patch test was observed in 30% of our study cases. Nickel sulfate was the most common allergen followed by fragrance mix. Patch test positivity was more in housewives, followed by farmers, teachers, and construction workers. Conclusion: The patch test can be used as a diagnostic investigative tool for the etiological diagnosis of CU.

Nickel Sensitivity in Patients With Irritable Bowel Syndrome.

Nickel (Ni) is the most common contact allergen in the population. We aimed to investigate whether there is a relationship between Ni sensitivity and irritable bowel syndrome (IBS) in our study. This study was conducted in 50 patients with IBS who were followed up between March 2018 and July 2018, and 40 healthy people as a control group in a single center with a dermatology department. European standard contact allergen series Ni preparate and corticosteroid pomace were applied to the back region of the study subjects. The evaluation was performed at 48, 72, and 96 hours according to the scheme proposed by the International Contact Dermatitis Research Group (ICDRG). Those who reacted at 72 hours were considered to have Ni allergy. Results: The female/male ratio was 24/26 and 18/22 in the patient and control groups, respectively. The mean ages of the patient and control groups were 42.82 (±10.65) and 39.77 (±11.21) years, respectively. Ni sensitivity was present in 40% of the patient group and 17.5% of the control group (p=0.03). We believe that the presence of Ni sensitivity is important in the pathogenesis of IBS disease. In our study, Ni sensitivity was found to be quite high in IBS patients compared to the normal population.

The Preparation and Sensory Evaluation of Post-waxing Aftercare Lotion

In this study, we prepared a lotion containing <i>Gymnema sylvestre Leaf</i> Extract (GSLE) and evaluated its stability, safety, and usability. To assess stability, a series of scientific evaluations were conducted, including centrifugation testing and heat-cool cycling. Following the application of the Lycon, 5% GSLE lotion on the skin, a skin patch test was conducted to detect the presence of erythema in the designated patch area, in accordance with the established guidelines provided by the International Contact Dermatitis Research Group (ICDRG). Using a 10-point scale, the level of satisfaction resulting from actual usage was assessed. The stability of both the vehicle and the 5% GSLE lotion was found to be intact in terms of their physical and chemical properties. No adverse skin reactions were observed in any of the groups tested, which included the vehicle, Lycon lotion, and 5% GSLE lotion. Furthermore, when considering efficacy, functionality, and usability, the 5% GSLE lotion demonstrated the highest value. In terms of absorption, moisturization, smoothness, and calming effects, the Lycon lotion exhibited relatively lower performance compared to both the vehicle and the 5% GSLE lotion. Across all evaluation criteria, the 5% GSLE lotion was found to provide an excellent user experience.

Analysis of Hexavalent Chromium in Cement Samples From Countries Within and Outside the EU: A Study From the International Contact Dermatitis Research Group.

Background: Allergic contact dermatitis (ACD) caused by hexavalent chromium (Cr(VI)) is often severe and difficult to treat. The content of Cr(VI) in cement can be reduced by, for example, addition of iron(II) sulfate. Since 2005 the content of Cr(VI) in cement is regulated in the EU Directive 2003/53/EC and must not exceed 2 ppm. Since this regulation came into force, ACD caused by cement has markedly been reduced. Objective: To investigate Cr(VI) and total chromium content in samples of cement from countries within and outside the EU. Methods: The members of the International Contact Dermatitis Research Group (ICDRG) were invited to participate in the study with the aim to collect cement samples from geographically different areas. The content of Cr(VI) in the samples was estimated by the diphenyl carbazide spot test, atomic absorption spectroscopy was used to assess the total chromium content. Results: Forty-five cement samples were analyzed, containing amounts of Cr(VI) from <0.1 to >70 ppm. Twenty-one samples contained >2 ppm Cr(VI), 24 contained less. Four of 17 samples from within the EU contained >2 ppm Cr(VI), that is, higher amounts than stipulated in the EU directive, as compared with 17 samples from countries outside the EU. Conclusion: In countries outside the EU, significantly more cement samples contained >2 ppm Cr(VI).

Allergic contact dermatitis to chlorhexidine-containing antiseptics in infants and children: the origin of sensitization and the role of the excipients in this sensitization (a series of ten cases).

The recent COVID-19 pandemic provoked an outstanding increase of infection-control measures, with chlorhexidine becoming an extensively used antiseptic. Allergic contact dermatitis to chlorhexidine is considered as a rare event in children, is often difficult to identify, and its diagnosis is often misdiagnosed as other skin diseases. We aimed to explore the sensitization to chlorhexidine-containing antiseptics in infants and children to determine the origin of their sensitization and the role of the excipients in their dermatosis. We performed patch tests with chlorhexidine digluconate 0.5%, benzalkonium chloride 0.1%, benzyl alcohol 10%, 5% and 1% in ten children (1-16.5-year-old) with severe contact reactions to chlorhexidine-based antiseptics (Biseptine®) and cosmetics. We also performed patch tests with sodium benzoate 5% in four of the children. Results were measured according to criteria recommended by the International Contact Dermatitis Research Group. Patch test reactions revealed that most children were sensitized to at least two components of chlorhexidine-containing antiseptics (chlorhexidine, benzyl alcohol and/or benzalkonium chloride). To explore the origin of the sensitization, we searched for umbilical cord care with chlorhexidine- containing antiseptics and the use of cosmetics and drugs containing chlorhexidine and excipients of chlorhexidine-containing antiseptics. Most parents reported prior disinfection of umbilical cord with chlorhexidine-containing antiseptics, but this was not always the case. Allergic contact dermatitis to chlorhexidine, benzyl alcohol and benzalkonium chloride should be considered in infants and children with severe eczema and concomitant allergies. The regular use of cosmetics and drugs containing chlorhexidine, benzyl alcohol, benzalkonium chloride or sodium benzoate should be cautioned or avoided in children with severe eczema or pre-existing allergies. Early suspicion and allergology exploration of allergic contact dermatitis to chlorhexidine-containing antiseptics and their excipients is of paramount importance to help prevent severe allergic reactions to topical antiseptics and numerous cosmetics.

Patch Testing With Nickel Sulfate 5.0% Traces Significantly More Contact Allergy Than 2.5%: A Prospective Study Within the International Contact Dermatitis Research Group.

Nickel allergy is the most common contact allergy, and a nickel salt is, therefore, included in most baseline patch test series. In the baseline series of the International Contact Dermatitis Research Group and the American Contact Dermatitis Society, nickel sulfate hexahydrate (NSH) in petrolatum at 2.5% is included, whereas NSH at 5.0% is included in many other baseline series, such as the European and Swedish ones. The aim of the study is to investigate whether NSH at 5.0% detects significantly more contact allergy than NSH 2.5% when both preparations are tested simultaneously in consecutive dermatitis patients. Two thousand two hundred eighty-seven consecutive dermatitis patients were patch tested simultaneously with NSH in petrolatum at 2.5% and 5.0%. The allergy rates were compared for all clinics individually and combined using McNemar test, 2-sided. Contact allergy to NSH 5.0% and 2.5% was found in 20.3% and 16.8%, respectively ( P < 0.0001). In 6 of 11 clinics, significantly more patients tested positive to the higher NSH concentration. For the 2 clinics in North America combined, significantly more patients tested positive to NSH 5.0%. The NSH preparation in the International Contact Dermatitis Research Group baseline patch test series should be considered to be changed from NSH 2.5% (1 mg NSH/cm 2 ) to 5.0% (2 mg NSH/cm 2 ).

Relevance of patch testing in allergic contact dermatitis to cosmetics among patients attending outpatient department at a tertiary care center in North Kerala

Purpose: The incidence of dermatitis due to cosmetics is increasing because of the greater product use. Identification of causative allergen(s) in patients with cosmetic dermatitis is important. It can lead to patient awareness in cosmetic product selection and decrease in the incidences of allergic contact dermatitis. Theaim of the study was to assess the clinical profile of allergic contact dermatitisto cosmetics and investigate the role of patch testing in evaluation of allergic contact dermatitis to cosmetics. Patients and method: It was a prospective, interventional study, which included40 patients with a suspected allergic contact dermatitis to cosmetics. Patch testing was performed utilizing the ‘Indian Standard Series and Standard Cosmetic and Fragrance Series’ approved by ‘Contact and Occupational Dermatoses Forum of India’.The reactions were recorded according to International Contact Dermatitis Research Group recommendations. Result: Out of total 40 cases that were recruited in the study with a provisional diagnosis of ACD to various cosmetic ingredients, 67.5% tested positive for one or more allergens. The clinical relevance of patch testing in suspected cases of cosmetic sensitivity was found to be statistically significant (p&lt;0.027). Conclusion: The study found clinical relevance of patch testing in suspected cases of cosmetic sensitivity to be statistically significant (p&lt;0.027).

ANALYSIS OF PATCH TEST RESULTS FOR INDIVIDUAL INGREDIENTS IN PATIENTS WITH ALLERGIC CONTACT DERMATITIS CAUSED BY 10% EFINACONAZOLE NAIL SOLUTION

Ten percent efinaconazole nail solution (EFCZ solution) is a new topical triazole antifungal drug, and we sometimes encounter patients with allergic contact dermatitis (ACD) caused by EFCZ solution in our outpatient clinic. However, no previous reports have summarized the patch test (PT) results obtained for individual ingredients in several patients with EFCZ solution-induced ACD. This study aimed to 1) confirm the causative agent of EFCZ solution-induced ACD based on PT of individual ingredients and 2) analyze the optimal concentration and vehicle for such PT on the basis of previous studies. We clinically diagnosed eight patients with EFCZ solution-induced ACD from Sep. 2014 to Aug. 2021, and performed 48-hour closed PT using EFCZ solution and its ingredients. Readings were done on days (D) 2, 3, and 7 according to the International Contact Dermatitis Research Group criteria. Six of the 8 patients underwent PT with EFCZ solution, and all showed + to +++ reactions on D3. The results for the main component, EFCZ, were + to +++ on D3 in all patients. Two patients were patch tested with both 10% EFCZ in ethanol and 10% EFCZ in petrolatum, which produced similar reactions. One patient had an allergic reaction to ethanol. The causative agent of EFCZ solution-induced ACD was EFCZ in all patients. For PT, we recommend EFCZ solution as is, its 10-fold dilution and 1% and 0.1% EFCZ in petrolatum.

Evaluation of skin irritation and skin sensitization potential of Venusia max lotion (paraben-free, alcohol-free, mineral oil-free, animal origin free) using human repeat insult patch test

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Topical exposure to chemicals from cosmetics can lead to adverse skin effects or skin irritation. This study aimed to investigate the skin irritation and sensitizing potential of a moisturizer Venusia max lotion (paraben-free, alcohol-free, mineral oil-free, animal origin free (PAMA) free).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; In this single-center, non-randomized, observational study, skin irritation, and skin sensitization potential of a test product was assessed using the human repeat insult patch test (HRIPT) technique. Approximately 0.04 g of the test product and filter papers dipped in 0.9% isotonic saline solution (~0.04 ml of solution) were filled in different wells of patch chambers and applied occlusively, on the back of each participant. Scoring of the skin reactions in the induction phase and challenge phase was done using Draize and international contact dermatitis research group (ICDRG) scales respectively. Scores were compared to the baseline and the negative control (isotonic saline).&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In total 234 participants (50 with sensitive skin), 224 and 221 participants completed the induction phase and challenge phase respectively. Scores for the induction phase for Venusia max lotion (PAMA free) and isotonic saline were 0.46 and 0.06 respectively. The mean cumulative score of erythema and oedema for Venusia max lotion (PAMA free) was below 2. For the challenge phase, none of the participants showed any positive reactions at any time point for test product and isotonic saline.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Test product Venusia max lotion (PAMA free) found to be non-irritant and hypoallergenic. Thus, it can be used without fear of skin irritation or sensitization.&lt;/p&gt;

Effectiveness of knee acupressure along with herbal knee poultice for knee osteoarthritis treatment: A pilot pre-post clinical study

Background & objectiveAccording to the clinical practice guideline of the Traditional Thai Medicine hospital, the therapeutic procedure of knee osteoarthritis (KOA) has been improved. The purpose of this study was aimed to assess the effectiveness of the procedure for the relief of knee pain in KOA patients. MethodsA multi-center, open-label, pre-post clinical trial was performed in 39 patients with KOA. Patients were treated with seven points of knee acupressure for 14 min. along with 30 min. of herbal knee poultice (Zingiber cassumunar, Gloriosa superba, Aloe vera, and Cinnamomum camphora). The clinical assessments including WOMAC score, visual analog scale (VAS) for pain as well as knee physical examination were carried out to compare between day 0 and day 3 after the treatment. ResultsA total of 36 patients were analyzed at the end of the study. The result revealed that WOMAC and VAS significantly reduced (p < 0.05) after three times of the treatment with the KOA guideline when compared with day 0. Moreover, the physical examination of the knee was improved. Based on the criteria of the International Contact Dermatitis Research Group (ICDRG), there was no skin irritation observed in all patients. ConclusionThis study proved that the KOA guideline from Traditional Thai Medicine hospital could potentially be applied to relieve pain in KOA.

Multiyear Group and Medical Center Patch Test Frequency Data: Confounding Variables.

Patch test frequency data have been extensively published by research groups, such as the International Contact Dermatitis Research Group, North American Contact Dermatitis Group, Dermato-Allergology Study and Research Group, and European Environmental Contact Dermatitis Research Group. As this knowledge accumulation is widely applied in clinical and public health settings, we describe confounding factors to consider when using such data for medical policy considerations. These concepts can also be used in individual reports of new allergens or series of cases. Some of these confounders may have been reported in current literature (until October 2020), whereas others have not been mentioned/considered in most group publications.

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.

Preventive effect of a heparinoid-containing product on the application site reaction of the rotigotine transdermal patch in Parkinson’s disease: A pilot randomized clinical trial (the SkinHeRo study)

IntroductionThe rotigotine transdermal patch (RTP) is a dopamine agonist used to treat Parkinson’s disease (PD) but is sometimes discontinued because of application site reactions (ASRs). We aimed to investigate the effect of a heparinoid-containing product (HCP) for preventing ASRs due to the RTP by conducting a randomized controlled pilot trial. MethodsTwenty patients with idiopathic non-demented PD were randomized to the skin care group using a HCP (group H) and the non-skin care group (group N). The primary outcome was the change in the baseline Skindex-16 score (ΔSkindex-16) at week 4. In addition, skin symptoms were also evaluated using the Dermatology Life Quality Index (DLQI) and International Contact Dermatitis Research Group (ICDRG) system for clinical scoring allergic patch test reactions up to week 8. ResultsThe ΔSkindex-16 score at week 4 tended to be lower in group H than in group N, although the difference was not statistically significant (−1.5 ± 2.0 vs 1.3 ± 10.9, p = 0.53). When the patients with baseline Skindex-16 scores ≥ 7 were excluded, the ΔSkindex-16 at week 4 was significantly lower in group H (−1.5 ± 2.0 vs 6.1 ± 8.6, p = 0.042). The DLQI also tended to be lower in group H at weeks 4 and 8, but not significantly (p = 0.066 and p = 0.077, respectively). The ICDRG score at week 4 was significantly lower in group H (p = 0.044). ConclusionWe suggest that the HCP has a preventive effect against ASRs cause by the RTP.

The Role of Patch Testing with Indian Cosmetic Series in Patients with Facial Pigmented Contact Dermatitis in India.

Background:Pigmented contact dermatitis (PCD) is a non-eczematoid variant of contact dermatitis, mainly characterised by hyperpigmentation. It occurs due to contact with a low amount of allergen over a long duration of time. PCD is frequently seen in Indians but is often misdiagnosed or underdiagnosed because of the asymptomatic nature of the entity. The aetiology and the allergens implicated in PCD in the Indian subcontinent is still an enigma because of the limited studies done.Materials and Methods:This was an institution-based cross-sectional study, done at a tertiary hospital. Patch testing with Indian Cosmetic Series was conducted in a standardised method. Readings were taken at 48 hrs/72 hrs and on the 7th day [Figure 2a and b]. The International Contact Dermatitis Research Group (ICDRG) scoring system was used to grade the readings.Results:Out of the 38 biopsy proven cases of PCD, 18 (47%) showed lichenoid features, 17 (45%) showed spongiotic features, 3 (8%) showed a mixed lichenoid and spongiotic pattern. Among total 1216 (32 patches × 38 patients) patch applied, 42 (3.4%) showed positivity in 30 patients. Among allergen categories, colorant (PPD) was found to be most common (37%) followed by fragrances (18%), preservatives (15%), anti-microbial (11%) and emulsifier and anti-oxidants (each 8%).Conclusion:It is important to identify the allergens implicated in PCD to help in better management of the condition. Patch testing proves to be a non invasive, low cost method and its role is indispensable in identifying the correct allergen.

Comparative evaluation of steroid sensitivity in various dermatoses with control group through histopathological examination and patch testing

Background: Topical corticosteroids are widely used for treating various dermatoses. People have been self-medicating them for fungal infections, pigmentary disorders, and for many other dermatoses. This overzealous and irrational use of corticosteroid makes individuals susceptible for its adverse effects. Aim: The aim of this study was to evaluate steroid sensitivity in various dermatoses. Materials and Methods: Patch testing with Indian standard series and corticosteroid series was performed in sixty subjects where thirty patients were cases and thirty were controls. Histopathological examination and As it is (ASIS) were done only for the case group. Patches were applied on the back for 48 h and reading was done on day 2, day 4, and day 7 according to the International Contact Dermatitis Research group grading. Results: The maximum cases were in the age group of 20–30 years (33.3%) while 31–40 years was the most common age range (50%) among controls. Among the case group, 60% were male and 40% were female. Maximum patients affected in the case group were homemakers (36.7%) followed by laborers (13.3%). The case group showed 16.7% positive patch test reactions while none were positive in the control group. Thiomersal was positive in 13.3% of cases and neomycin in 3.3% of cases. ASIS was negative in all cases. Thiomersal is commonly used as a preservative in topical medicaments, cosmetics, and vaccines. Conclusions: Steroid sensitivity is hard to diagnose clinically, thereby causing difficulty in managing such cases. Patch test is a noninvasive gold standard procedure without major adverse effects and helps in treating the dermatoses with appropriate class of corticosteroid by avoiding the suspected allergen.

Contact Allergy to Fragrance Mix II and Hydroxyisohexyl 3-Cyclohexene Carboxaldehyde: A Retrospective Study by International Contact Dermatitis Research Group.

Fragrance mix II (FM II) is included in the baseline patch test series recommended by the International Contact Dermatitis Research Group (ICDRG). Hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) is the most important sensitizer of the 6 fragrance materials included in FM II. Besides being a part of FM II, HICC is also tested separately in the ICDRG baseline series. The aim of the study was to investigate the prevalence of contact allergy to FM II and HICC in 2012-2016 with a focus on simultaneous reactions and the percentage of missed contact allergy to HICC provided that only FM II had been tested. A total of 25,019 consecutive dermatitis patients in 13 dermatology clinics representing 12 countries in 5 continents were patch tested with FM II and HICC in the baseline series. Contact allergy to FM II and HICC was found in 3.9% and 1.6%, respectively. For FM II, the frequency varied from 1.5% to 7.6% in different centers. The corresponding range for HICC was 0.2% to 3.6%. Simultaneous contact allergy to FM II and HICC was noted in 1.4% with the range 0.2% to 2.6%. Seventy-seven patients (0.31%) with contact allergy to HICC did not test positively to FM II. The range for missed HICC allergy by testing only FM II in the different centers would be 0.04% to 0.74%. The ratio between the contact allergy rates for FM II and HICC was similar for all centers, except for Montreal having significantly more contact allergy to FM II than to HICC. The frequency of missed contact allergy to HICC when testing only with FM II was less than 0.5%, therefore questioning the need to test HICC separately in the ICDRG baseline series.

Patch Testing With Formaldehyde 2.0% (0.60 mg/cm2) Detects More Contact Allergy to Formaldehyde Than 1.0.

The International Contact Dermatitis Research Group increased the patch test concentration of formaldehyde from 1.0% aqueous (aq) to 2.0% aq (in 2011). This study was designed to investigate the outcome of the decision. Consecutive dermatitis patients in 8 different clinics were patch tested with formaldehyde 1.0% aq and 2.0% aq. The test solutions were applied with a micropipette to the filter paper discs in the respective chamber. A total of 2778 patients were tested with 1.0% aq and 2766 to 2.0% aq. Sixty-five patients (2.3%, calculated from 2766 tested, to 2.0% aq) had positive patch test reactions interpreted as contact allergy to formaldehyde. This is a rather low frequency. Of these 65, 46 were women (46/1703 [2.7%]) and 19 were men (19/1063 [1.8%]). Thirty-six reacted only to 2.0% aq, 21 patients reacted to both concentrations, and 8 patients reacted only to 1.0% aq. Significantly, more patients reacted to 2.0% aq compared with 1.0% aq (P < 0.001). There was no significant sex difference. A total of 0.8% irritant reactions were recorded to formaldehyde 2.0% aq and 0.1% to 1.0% aq. The increased formaldehyde patch test concentration to 2.0% aq revealed more formaldehyde contact allergy.

Relevance of patch testing and its correlation with clinical patterns of contact dermatitis of hand

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Contact dermatitis of hand is a common dermatoses with different aetiological conditions and different morphologies. The aim of our study is to identify the clinical patterns, causative allergens and the relevance of patch testing for contact dermatitis of hand.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 74 patients with hand eczema were included in our study after getting informed and written consent to do patch tests during December 2016 to May 2017 in our dermatology OPD. Patch test was done by using Indian standard series battery and the readings were taken at 48 hrs and 72 hrs. The results were interpreted according to International Contact Dermatitis Research Group (ICDRG) criteria.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The incidence of hand eczema was 3.2 percent with male: female ratio of 1.55:1. The most common age group affected was 31-40 years. The most common morphological pattern observed in our study was fissured pattern (43%) followed by unspecified pattern (23%), hyperkeratotic (12%), lichenoid (10%), pompholyx (4%), fingertip eczema (1%), ring pattern (1%) and mixed morphology (6%). In our study, current relevance of 79% (31 allergens), doubtful relevance of 15% (6 allergens), and old relevance of 3% (one allergen) was noted. Cross sensitization was observed with one allergen (3%).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Patch testing is a very useful scientific diagnostic tool that unravels the cause of contact dermatitis of hand. Avoidance of the substances responsible for allergy can be advised to the patient.&lt;/p&gt;