Prevalence Of Contact Sensitization Research Articles

Pattern of contact sensitization in patients with and without atopic dermatitis in an Asian dermatology center.

Although the traditional understanding is that contact sensitization is less frequent in patients with atopic dermatitis (AD), recent studies have shown similar or higher rates of positive patch-test results in AD patients. We sought to characterise the pattern of contact sensitization in patients with and without AD and evaluate the association between AD and contact sensitization. This was a single-center, 10-year retrospective review of patients who underwent patch testing between 2007 and 2017. There were 4903 patients (male-to-female ratio=1:1.4; mean age 40.1 years) included. About half (2499, 51.0%) of all patients developed at least one positive reaction. The top five frequent reactions were to nickel sulfate (45.4%), potassium dichromate (16.0%), p-phenylenediamine (13.4%), Myroxylon pereirae (11.8%), and fragrance mix I (11.2%). The overall prevalence of contact sensitization was not significantly different between patients with or without AD. Patients with AD were less likely to develop contact allergies to budesonide and thiuram mix, and more likely to develop contact allergies to potassium dichromate. Contact sensitization was detected in 50% of patients who were patch tested. Nickel sulfate was the most frequently sensitizing allergen. The prevalence of contact allergies in atopic patients is comparable to that in non-atopic patients.

The Effect of Atopy in the Prevalence of Contact Sensitization: The Experience of a Greek Referral Center.

Contact dermatitis is a well-known skin condition, which is related to stimuli and environmental exposure to chemicals, affecting all ages as well as both genders. In the present work, we attempt to investigate the patterns of contact sensitization, with respect to the personal history of atopy (AT), in Greece in a large number of allergens, using patch testing. The retrospective analysis included clinical routine data of 1978 patients collected from 2014 to 2016 in the Laboratory of Patch Testing, National Referral Centre of Occupational Dermatoses. Sensitization, in all cases, was tested with 28 allergens of the European baseline series as adjusted to our local circumstances and clinical experience. A total population of 1978 patients was evaluated, with a male-to-female ratio of 0.45 (1359 females/619 males). From our patient cohort, 693 (35%) patients were evaluated with a history of atopy, while 1285 (65%) were nonatopic. The five most prevalent allergens in the total population without AT were nickel sulphate 5% (15.47%), fragrance mix (I) 8% (9.10%), balsam of Peru (6.47%), cobalt chloride 1% (4.70%), and thiomersal 0.1% (4.10%). Respectively, in the total population with AT, the five most prevalent allergens were nickel sulphate 5% (10.36%), fragrance mix (I) 8% (5.11%), balsam of Peru (3.29%), thiomersal 0.1% (3.03%), and cobalt chloride 1% (2.78%). Contact dermatitis surveillance is of great importance towards the clinical and systematic understanding of the disease. Further studies should be directed towards that end, in order to facilitate more effective health policies.

Methylchloroisothiazolinone/methylisothiazolinone and methylisothiazolinone contact allergy: A 24-year, single-center, retrospective cohort study from Turkey.

Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI allergy caused a global epidemic during the period 2010 to 2015, reaching its peak in 2013/14. To investigate the characteristics of MCI/MI and MI allergy in Turkey over 24 years. A total of 2310 patients patch tested between 1996 and 2019 with MCI/MI 0.01% aq. or MCI/MI 0.02% aq., with or without MI 0.2% aq., were analyzed. The overall prevalence of contact sensitization was 3.3% (n = 77) with a peak level of 16.4% in 2015. The prevalence gradually decreased thereafter, but was still high (6.5%) in 2019. Seventy-three patients had clinically relevant sensitizations. MI could detect clinically relevant sensitizations in all seven patients with a negative patch test reaction to MCI/MI 0.02%. Non-occupational allergic contact dermatitis (ACD) was most frequently seen, mainly in women, with hand/face eczema from rinse-off or leave-on cosmetics, such as wet wipes. Occupational ACD was mainly seen among men with airborne eczema from wall paints in house painters, or with hand eczema from hair gel/wax in men's barbers. The prevalence of MCI/MI and MI sensitization in Turkey following the peak in 2015 is still high. This is probably due to the currently allowed level of 100 ppm for MI in rinse-off cosmetics. This needs to be urgently reduced.

The value of ongoing surveillance on the prevalence of contact sensitization.

Linked Article: Uter et al. Br J Dermatol 2020; 183:857–865.

Contact sensitization in patients with chronic venous insufficiency and the impact of the disease duration on the risk of occurrence of contact sensitization

Background/Aim. Development of allergic contact der-matitis as a complication of treatment of chronic venous insufficiency (CVI) is well known. The aim of this study was to determine the incidence and risk of eczematous contact sensitization in patients with CVI, as well as the correlation between disease duration and contact sensitization. Methods. The study involved 266 subjects examined during three-year-period who were divided into two groups: the study group included patients with CVI referred for allergy testing due to suspected contact dermatitis, and the control group included the ones without CVI patch tested for suspected contact dermatitis. The severity of CVI was assessed by Clinical Etiology-Anatomy-Pathophysiology (CEAP) classification. Thereafter, each patient underwent patch testing. Results. The incidence of contact sensitization among patients with CVI was 49.3%. In these patients, the incidence of contact sensitization to the European standard battery of allergens was 31.55%; to the battery specific for CVI it was 28.45%. Patients with CVI had a 2.45-fold higher risk for developing contact sensitization to two or more allergens, and a 3.69-fold higher risk for developing contact sensitization to five or more allergens compared to those without CVI. The prevalence of contact sensitization in patients with CVI was not significantly different from those without CVI. There was a positive correlation between the incidence of contact sensitization and the duration of the disease. Conclusion. Patients with CVI had no statistically significantly distinct contact sensitization prevalence and had 2.45 and 3.69 times higher risk to manifest contact sensitization to two and more allergens and five and more allergens, respectively, than patients with no CVI. The positive correlation between frequency of contact sensitization and disease duration was found.

Prevalence of contact sensitization in the general population and in patch tested patients

Contact sensitization is acommon condition. The spectrum of the most important allergens may change over the course of time owing to changes in exposure. Using the so-called baseline series, acollection of the most important and frequent allergens, both population-related and clinical epidemiological studies have been performed. Basic epidemiological concepts and special aspects regarding the epidemiology of contact allergies are presented. A concise adaptation of textbook knowledge and a selective literature search were performed. On the population level, about 25% of people are sensitized to at least one substance included in the baseline series, by far most often to nickel. In view of aprevalence of around 4%, fragrances are important contact allergens, too, along with preservatives. Among patients patch tested for suspected allergic contact dermatitis, the ranking of the most important allergen groups is similar, but the prevalences are (much) higher. Short-term changes in exposure and subsequently in the spectrum of major contact allergens can best be illustrated by clinical surveillance based on routinely collected data and, if needed, preventive measures can be initiated. In addition to time trend analyses, subgroup analyses may offer important clues regarding the identification of sensitizing and eliciting exposures, respectively.

Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review.

Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature. The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files. Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively). Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background.

The prevalence of contact sensitization to topical medicaments at Phramongkutklao Hospital

The prevalence of contact sensitization to topical medicaments at Phramongkutklao Hospital

Contact Sensitization in Children: A Retrospective Study of 2,614 Children from a Single Center.

Contact sensitization in children is more common than previously thought, but few studies have been performed on a large population assessed by the same team. The objective was to evaluate contact sensitization in children with suspected contact dermatitis, the relationship with atopic dermatitis (AD), and the most common allergens. The same team patch tested 2,614 children younger than 11 years old with a standard series of 30 allergens. A total of 1220 children (46.7%) developed at least one positive reaction, 606 of which were clinically relevant (49.7%). The most frequent reactions were to nickel sulfate (22.7%), cobalt chloride (11.1%), potassium dichromate (9.9%), neomycin sulfate (5.2%), thimerosal (4.2%), cocamidopropyl betaine (3.4%), and methylchloroisothiazolinone/methylisothiazolinone (3.2%). The prevalence of contact sensitization was similar in children with (47.3%) and without (46.1%) AD. Children with AD had a higher prevalence of positive reactions to potassium dichromate (p < 0.001), Compositae mix (p = 0.01), and disperse blue (p = 0.03). Contact sensitization is quite common in young children. This study adds some information on the most common contact allergens. A similar prevalence of positive patch test reactions was found in children with and without AD, but children with AD had a greater prevalence of positive patch test reactions to potassium dichromate, Compositae mix, and disperse blue.

Risk factors for common contact allergens and patch test results using a modified European baseline series in patients tested during between 2000 and 2009 at Siriraj Hospital

Surveillance of contact allergy using patch testing has demonstrated its value in detecting time trends. This study demonstrates the results of patch testing performed between 2000 and 2009 at the contact dermatitis clinic, Siriraj Hospital, Bangkok and risk factors for the top 5 common allergens. A retrospective review of medical records was conducted from January 2000 to December 2009. All Patients who were patch tested using a modified European baseline series were studied. There were 852 cases (206 males and 646 females; mean age 39.14 years). The top 5 most frequent allergens were gold sodium thiosulfate (30.7%), nickel sulfate (27.6%), potassium dichromate (20.8%), fragrance mix (18.3%) and cobalt chloride (16.0%), respectively. There was no statistically significant difference in the trends of positive patch test reactions for individual allergens during the 2000s. Gold sensitivity was found more common in females and in the head and neck regions. Nickel sensitivity was more common in females. Chromate sensitivity was more common in males and subjects aged = 40 years. Fragrance sensitivity was more common in females and subjects aged = 40 years. Among the patients with metal (chromate, nickel, cobalt and gold) allergy, the patient's recollection of a history of an allergic reaction to metal was significantly associated with a positive patch test reaction to either one of these metals, (P < 0.001; OR, 2.56; 95%CI, 1.87-3.50). The prevalence of contact sensitization appears to have not changed much during the decade. Further study, involving patients from all institutions in Bangkok, would provide a more comprehensive view of contact allergens in the region and lead to the creation of a local standard series.

Contact allergy and medicinal herbs

Herbal treatments are becoming increasingly popular, and are often used for internal as well as dermatological conditions, both externally as well as orally. The prevalence of contact sensitization against several plants especially of the Compositae family is quite high in Europe. Sensitization seems to occur relatively frequent with a few species such as arnica, elecampane and tea tree (oil), and occurs rarely with the majority. Testing for plant allergy is problematic because of the limited number of commercially available standardized patch test substances and the danger of active sensitization when testing with plants, parts thereof, or individual extracts. Knowledge about the allergic potential of plants is limited. Although plants are regarded as critical allergens by dermatologists, the number of reported cases of contact dermatitis is relatively small. Many widely used substances are not licensed as drugs or cosmetics. While the positive effects are frequently questionable or limited, the side effects are often more evident. Adverse effects of herbal medicines are an important albeit neglected subject in dermatology, which deserves further systematic investigation.

The prevalence of allergic contact sensitization in a general population in Tromso, Norway

Objectives. This study investigated the prevalence of contact sensitization in a general adult population and the relationship between the history of metal dermatitis and sensitization to metal allergens.Study Design. A cross-sectional population study using patch tests and a questionnaire was conducted among adults in Tromso, Northern Norway.Methods. A random sample of 830 participants aged 18–75 years were invited to participate in the patch testing and completed a 1-page self-administered questionnaire. Of the adults, 531 (64%) were actually TRUE tested (using a standardized, ready-to-apply patch test system) and completed the self-administered questionnaire about ear piercing, metal reactions, skin reactions to different allergens, atopic dermatitis, eczema, cooking equipment and diet.Results. The study showed that nickel (19.2%; women 31.1% and men 5.0%), fragrance mix (3.4%) and cobalt (1.7%) were the most prevalent allergens causing contact sensitization. For all other allergens, less than 1.1% tested positive. Eighty-four (45.2%) subjects with a positive history of metal dermatitis had negative patch tests.Conclusions. Contact sensitization was found frequently in this general adult population, especially to nickel and perfumes with a predominance among females. An eczematous reaction caused by cheap earrings seemed to be the best indicator for metal sensitivity.

FS05.4 Contact sensitization in Italian children over a 7 year period

Our aim was to investigate contact sensitization in children over a 7 year period and to compare these data to our previous findings. From January 1995 to December 2001, 1094 children with suspected allergic contact dermatitis were patch tested with our paediatric series of 30 substances. 404 were affected by atopic dermatitis. 570 children (52.1%), 300 girls and 270 boys, proved to be sensitized. Among them, 291 (51%) were polysensitized. Neomycin, nickel sulfate, wool alcohols, thimerosal, ammoniated mercury, and propolis gave the highest number of positive responses. No significant differences were observed in the prevalence of contact sensitization among the patients with atopic dermatitis and non atopics. However, in the latter the frequency of positive responses to nickel sulfate and Kathon CG was significantly lower than in the former. The face (25%), the hands (23%), and the flexural areas of the limbs (18%) were most frequently affected in children with positive patch tests. In this study population the frequency of sensitized children was significantly higher than the one found from 1988 to 1994, in particular for neomycin, nickel sulfate, wool alcohols, ammoniated mercury, propolis, potassium dichromate, mercaptobenzothiazole and thiuram mix. Our data demonstrate that contact sensitization is more and more frequent in children referring to our department and that the importance of some allergens, such as neomycin, wool alcohols, propolis and potassium dichromate, is increasing in the paediatric age with respect to previous results.

Patch testing reactions to a standard series in 608 patients tested from 1990 to 1997 at Massachusetts General Hospital

Background : Patch testing is a useful diagnostic tool when allergic contact dermatitis is suspected clinically. Objective : This study describes the results of patch testing performed from January 1, 1990 to June 1, 1997 at the Massachusetts General Hospital Contact Dermatitis Clinic. The findings are compared with those previously reported by the North American Contact Dermatitis Group (NACDG). Methods : Data were collected from chart review and analyzed. Patients included in the study underwent patch testing to the full European standard series of allergens. A standardized patch testing technique was used, and readings were performed by a single observer. Results : A total of 608 patients were patch tested to a screening tray of 24 allergens; 69.9% were women. At least one positive patch test reaction was observed in 60.0% of patients. The most common sensitizers were nickel sulfate, fragrance mix, potassium dichromate, cobalt chloride, balsam of Peru, quaternium-15, and neomycin sulfate. The sensitization rate to potassium dichromate (9.4%) was higher than has been reported by the NACDG. A statistically significant difference in the sensitization rate in men and women was observed for nickel, quinoline mix, epoxy resin, and formaldehyde. The prevalence of positive patch test reactions was not found to be influenced by testing during the summer months. Conclusions : In the authors' opinion, the prevalence of contact sensitization is generally comparable with the findings of the NACDG, with the exception of reactions to potassium dichromate. This difference in results probably reflects, in part, differences in methodology. The test concentration of potassium dichromate was 0.5%, commonly used in Europe, instead of the 0.25% concentration used by the NACDG. Further investigation is necessary to determine the optimal testing concentration of potassium dichromate.

Dermatoses in metal workers

In an epidemiological study of 286 metalworkers exposed to metalworking fluids (MWF), the prevalence of contact sensitization was investigated. In part I, irritant contact dermatitis in metal workers has been discussed. In 40 employees with dermatitis, patch tests were performed with a routine series, a series of common components of MWF, and a series of preservatives the employees worked with. Contact sensitization was established in 8 persons (2.8% of all workers), of whom 4 were allergic to biocides and/or corrosion inhibitors. Difficulties in interpretation of the relevance of positive reactions are discussed. Attention is paid to the use of biocides in MWF, their various types and their sensitizing capacities. Measures to reduce the induction of contact sensitization to preservatives in water-based fluids are discussed.