RESUMEN
Contact dermatitis (allergic and irritant) occurs when the skin encounters haptens that elicit a T cell-mediated hypersensitivity reaction (allergic) or a nonimmunologic, toxic reaction (irritant). Patch testing is the reference standard for diagnosing allergic contact dermatitis (ACD), although positive results are not always relevant. Therefore, the definitive diagnosis of ACD requires an astute clinician able to connect the results of patch testing appropriately with the clinical history and the cutaneous examination findings. Comorbid conditions such as atopic dermatitis can confound the accurate diagnosis of ACD because of the similarities in clinical presentation. Furthermore, both extremes of age can further challenge the diagnostic specificity of ACD owing to the maturing immune system and the space limitations present when the very young are patch tested. The goal of this Continuing Medical Education article is to discuss the challenges of diagnosing ACD in patients with unique comorbidities such as atopic dermatitis, given the morphologic similarities, and when to patch test these patients. Diagnosis of ACD will also be discussed in very young patients with a focus on patch test allergen selection despite the limited geographic space. The most common allergens reported in very young and old patients will also be discussed.
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Alérgenos , Comorbilidad , Dermatitis Alérgica por Contacto , Dermatitis Atópica , Dermatitis Irritante , Pruebas del Parche , Humanos , Dermatitis Atópica/epidemiología , Dermatitis Atópica/diagnóstico , Alérgenos/inmunología , Dermatitis Irritante/epidemiología , Dermatitis Irritante/diagnóstico , Dermatitis Irritante/inmunología , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/inmunología , Factores de EdadRESUMEN
Introduction: polysensitization is often defined as sensitization to three or more contact allergens. The objectives of our study were to determine the prevalence of polysensitization to allergens patch test and to analyze the factors associated with allergen polysensitization of the European Standard Battery in comparison with cases of oligosensitization. Methods: this is a retrospective descriptive cross-sectional study that included all patients who had undergone patch tests at the Department of Dermato-Allergology of the Department of Occupational Medicine of University Hospital Center Farhat Hached in Sousse spread over 10 years from January 1, 2009 to December 31, 2018. Results: in total, we collected 464 cases of contact dermatitis during the study period. The average age of patients was 38.93 ± 12.52 years with a slight female predominance (52.8% of cases). Among all the patients who consulted during the study period (832 patients), 133 patients had positive reactions to 3 or more allergens 16% of patients. Concerning, the associations of the most frequently noted allergens were those of triplet (chromium, cobalt, and nickel) in 15 patients and triplet (mercaptobenzothiazole, thiuram mix, and IPPD) in 7 cases. The predictive factors of polysensitivity were the personal history of leg ulcers; the site of the lesions in the thorax and the erythematous squamous and dyshidrotic appearance of the lesions. Conclusion: this phenomenon is frequent polysensitization, and close collaboration between dermatologists and occupational physicians to prevent this type of multiple allergies through better management of personal and also professional risk factors.
Asunto(s)
Alérgenos , Dermatitis Alérgica por Contacto , Hospitales Universitarios , Pruebas del Parche , Humanos , Femenino , Estudios Retrospectivos , Masculino , Estudios Transversales , Persona de Mediana Edad , Túnez/epidemiología , Adulto , Alérgenos/inmunología , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Prevalencia , Adulto Joven , Anciano , Adolescente , Dermatitis Profesional/epidemiología , Dermatitis Profesional/etiologíaRESUMEN
Eyelid dermatitis (ED) affects a cosmetically significant area and leads to patients' distress. Despite ongoing and recent research efforts, ED remains a multidisciplinary problem that needs further characterization. We aimed to evaluate the atopic eyelid dermatitis (AED) frequency in ED patients and to perform their clinical profiling. PubMed databases were searched from 01.01.1980 till 01.02.2024 to PRISMA guidelines using a search strategy: (eyelid OR periorbital OR periocular) AND (dermatitis or eczema). Studies with patch-tested ED patients were included. Proportional meta-analysis was performed using JBI SUMARI software. We included 65 studies across Europe, North America, Asia and Australia, with a total of 21,793 patch-tested ED patients. AED was reported in 27.5% (95% CI 0.177, 0.384) of patch-tested ED patients. Isolated ED was noted in 51.6% (95% CI 0.408, 0.623) of 8453 ED patients with reported lesion distribution, including 430 patients with isolated AED. Our meta-analysis demonstrated that the AED frequency in patch-tested ED patients exceeded the previous estimate of 10%. Isolated AED was noted in adult patients, attending contact allergy clinics. Future studies are needed to elucidate the global prevalence and natural history of isolated AED in adults.
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Pruebas del Parche , Humanos , Adulto , Prevalencia , Dermatitis Atópica/epidemiología , Dermatitis Alérgica por Contacto/epidemiología , Enfermedades de los Párpados/epidemiología , Enfermedades de los Párpados/etiología , Párpados/patología , Femenino , MasculinoAsunto(s)
Dermatitis Alérgica por Contacto , Liquen Plano , Lupus Eritematoso Cutáneo , Humanos , Liquen Plano/diagnóstico , Liquen Plano/epidemiología , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Femenino , Lupus Eritematoso Cutáneo/diagnóstico , Lupus Eritematoso Cutáneo/epidemiología , Masculino , Persona de Mediana Edad , Bases de Datos Factuales/estadística & datos numéricos , Adulto , Estados Unidos/epidemiología , Anciano , Factores de RiesgoRESUMEN
Background: There is controversy on whether allergic contact dermatitis (ACD) is associated with atopy. Research on eczema and the risk of ACD is mixed, and there is sparse literature on other atopic conditions. Objective: Our study examined the prevalence of several atopic conditions, including allergic rhinitis, eczema, asthma, and food allergies in patients with ACD, and compared these to patients without ACD. Methods: We retrospectively reviewed adult patients ages ≥ 18 years with ACD (n = 162) with positive patch testing results and documented any history of atopy, including childhood eczema, asthma, allergic rhinitis, and immunoglobulin E-mediated food allergy. The prevalence of atopic conditions was compared between our ACD cohort and controls without ACD (n = 163) from our electronic medical records system (age and gender matched). Results: Among our patients with ACD, 53 (33%) had allergic rhinitis, 22 (14%) had childhood eczema, 32 (20%) had asthma, and 8 (5%) had food allergies. We observed that the odds of atopy overall (n = 76) in the ACD group compared with the control group were increased (odds ratio [OR] 1.88; p = 0.007). Allergic rhinitis was the highest risk factor (n = 53) with an OR of 12.64 (p < 0.001). Childhood eczema (n = 22) was also increased in the ACD group (OR 2.4; p = 0.026). The odds of asthma and food allergy in the ACD group were also increased; however, the difference was not statistically significant from the control group (OR 1.76 [p = 0.071] and OR 2.76 [p = 0.139], respectively). Conclusion: Patients with ACD had increased odds of eczema, allergic rhinitis, and atopic conditions overall. Asthma and food allergies were not found to have a statistically significant correlation. Larger studies that delve into atopic risk factors in ACD would be important to confirm these findings.
Asunto(s)
Dermatitis Alérgica por Contacto , Humanos , Masculino , Femenino , Adulto , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/diagnóstico , Prevalencia , Estudios Retrospectivos , Persona de Mediana Edad , Hipersensibilidad a los Alimentos/epidemiología , Hipersensibilidad a los Alimentos/complicaciones , Adulto Joven , Factores de Riesgo , Asma/epidemiología , Asma/diagnóstico , Eccema/epidemiología , Rinitis Alérgica/epidemiología , Anciano , Oportunidad Relativa , Hipersensibilidad Inmediata/epidemiología , Adolescente , Pruebas del ParcheRESUMEN
BACKGROUND: Fragrance substances are a frequent cause of contact allergy worldwide. Fragrance exposure varies by sex, age and possibly country, influenced by cosmetic availability, environmental conditions and cultural practices. OBJECTIVES: To systematically review and gather prevalence of sensitization to fragrance mix I (FM I) and fragrance mix II (FM II) in consecutively patch tested European dermatitis patients. METHOD: A total of 4134 publications on patch test results of European dermatitis patients, published from 1981 to 2022, were systematically reviewed according to a previously registered and published PROSPERO protocol. RESULTS: Eighty-four eligible original articles were analysed. Overall prevalence of sensitization to fragrance mix I (FM I) was 6.81% (95% CI: 6.37-7.28), and FM II was 3.64% (95% CI: 3.3-4.01). Sensitization to FM I was most prevalent in Central and Eastern Europe and to FM II in Western Europe. No clear time trends were observed. Among paediatric dermatitis patients, sensitization prevalence for FM I and FM II was 4.09% (95% CI: 3.37-4.96) and 2.17% (95% CI: 1.53-3.07). CONCLUSION: The frequency of positive patch test results for both FMI and FMII remains high. Sensitization is also prevalent among children. Enhanced regulation and labelling of cosmetic products play a vital role in averting exposure and sensitization to fragrance allergens.
Asunto(s)
Dermatitis Alérgica por Contacto , Pruebas del Parche , Perfumes , Humanos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/diagnóstico , Europa (Continente)/epidemiología , Perfumes/efectos adversos , Prevalencia , Alérgenos/efectos adversos , Cosméticos/efectos adversosRESUMEN
Occupational dermatoses impose a significant socioeconomic burden. Allergic contact dermatitis related to occupation is prevalent among healthcare workers, cleaning service personnel, individuals in the beauty industry and industrial workers. Among risk factors, the exposure to preservatives is frequent, since they are extensively added in products for occupational use. The goal of this study is to investigate the contact allergy patterns in order to understand the linkage among hypersensitivity to preservatives, occupational profiles, patients' clinical and demographic characteristics. Patch test results were collected from monosensitized patients to Formaldehyde 2%, KATHON 0.02%, thimerosal 0.1%, and MDBGN 0.5%; information was also collected for an extended MOAHLFA (Male-Occupational-Atopic-Hand-Leg-Face-Age) index. To assess the relationship between allergen group and occupational-related ACD, the chi-square test for independence was utilized. To uncover underlying relationships in the data, multiple correspondence analysis (MCA) and categorical principal components analysis (CATPCA), which are machine learning approaches, were applied. Significant relationships were found between allergen group and: occupation class, atopy, hand, leg, facial, trunk, neck, head dermatitis, clinical characteristics, ICDRG 48 h and ICDRG 72 h clinical evaluation. MCA and CATPCA findings revealed a link among allergen group, occupation class, patients' demographic and clinical characteristics, the MOAHLFA index, and the ICDRG scores. Significant relationships were identified between the allergen group and various manifestations of dermatitis. The utilization of machine learning techniques facilitated the discernment of meaningful patterns in the data.
Asunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Profesional , Aprendizaje Automático , Pruebas del Parche , Conservadores Farmacéuticos , Humanos , Dermatitis Profesional/diagnóstico , Dermatitis Profesional/etiología , Dermatitis Profesional/epidemiología , Masculino , Femenino , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/inmunología , Dermatitis Alérgica por Contacto/etiología , Adulto , Persona de Mediana Edad , Conservadores Farmacéuticos/efectos adversos , Formaldehído/efectos adversos , Alérgenos/inmunología , Alérgenos/efectos adversos , Timerosal/efectos adversos , Adulto Joven , Exposición Profesional/efectos adversos , Exposición Profesional/estadística & datos numéricos , Factores de RiesgoRESUMEN
BACKGROUND: Mainly women work as foot care specialists (FCS). They are at risk to develop occupational dermatitis (OD). OBJECTIVES: The objective of this study is to describe the contact sensitisation pattern of female FCS with OD. METHODS: In a retrospective study, patch test and clinical data collected by the Network of Departments of Dermatology (IVDK) from 2008 to 2022 were analysed. Data of 116 female FCS with OD were compared with data of 13 930 female patients with OD working in other professions and 78 612 female patients without OD. RESULTS: Hand dermatitis (93.1%) was significantly more common and face dermatitis (0.9%) significantly less common in female FCS with OD compared to other female patients with or without OD. Frequent suspected allergen sources were disinfectants, gloves, leave-on and nail cosmetics. Occlusion and wetness were important co-factors. The most common diagnoses were irritant contact dermatitis (26.7%) and allergic contact dermatitis (21.6%). No sensitisation to any of the baseline series allergens was significantly more frequent in female FCS with OD than in the two control groups. However, sensitisations to allergens which FCS are abundantly exposed to, including fragrances, preservatives, rubber ingredients and disinfectants, were most common. CONCLUSIONS: FCS should be aware of the OD risk and prevention should be promoted.
Asunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Irritante , Dermatitis Profesional , Dermatosis de la Mano , Pruebas del Parche , Humanos , Femenino , Dermatitis Profesional/epidemiología , Dermatitis Profesional/etiología , Dermatitis Profesional/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/diagnóstico , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Estudios de Casos y Controles , Dermatosis de la Mano/epidemiología , Dermatosis de la Mano/etiología , Dermatitis Irritante/epidemiología , Dermatitis Irritante/etiología , Alérgenos/efectos adversos , Dermatosis Facial/epidemiología , Dermatosis Facial/etiología , Cosméticos/efectos adversos , Desinfectantes/efectos adversos , Guantes Protectores/efectos adversos , Dermatosis del Pie/epidemiologíaRESUMEN
BACKGROUND: Most studies investigating the prevalence of hand eczema (HE) in professional cleaners use self-reported questionnaire-based data. However, no validation studies of self-reporting of HE among professional cleaners have previously been conducted. OBJECTIVES: To investigate (1) the point prevalence of self-reported HE, (2) the point prevalence of HE estimated by physical examination of the hands and (3) the sensitivity and specificity of self-reporting of HE compared with the diagnosis based on physical examination among professional cleaners. METHODS: Professional cleaners at three different hospitals in Region Zealand were invited to fill out a questionnaire. The point prevalence of self-reported HE was estimated based on questions from the Nordic Occupational Skin Questionnaire. After completing the questionnaire, each cleaner underwent a physical examination of the hands by a dermatologist on the same day. RESULTS: In total, 234 cleaners were invited to participate in the study, and 224 (response rate = 96.0%) agreed to take part. Based on the self-reported questionnaires, 5.3% (n = 12) of the cleaners had current HE. Based on an examination by a physician, 19.2% (n = 43) of the cleaners had current HE. The sensitivity of self-reported HE was found to be 28.0%, while the specificity was found to be 100.0%. The positive predictive value was found to be 100.0%, while the negative predictive value was 85.0%. CONCLUSION: The true point prevalence of HE among professional cleaners is underestimated when based on self-reporting.
Asunto(s)
Dermatitis Profesional , Eccema , Dermatosis de la Mano , Autoinforme , Sensibilidad y Especificidad , Humanos , Dermatosis de la Mano/epidemiología , Dermatosis de la Mano/diagnóstico , Dermatitis Profesional/epidemiología , Dermatitis Profesional/diagnóstico , Masculino , Femenino , Adulto , Prevalencia , Eccema/epidemiología , Eccema/diagnóstico , Persona de Mediana Edad , Encuestas y Cuestionarios , Examen Físico , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/epidemiologíaRESUMEN
BACKGROUND/OBJECTIVES: In the last 10 years methylisothiazolinone (MI) emerged as a global cause of preservative-related ACD. New Zealand has liberal regulations for the MI concentration limit in cosmetic products compared to Europe and Australia. The aim of this study was to evaluate the prevalence of MI sensitisation in New Zealand, explore sources of MI exposure and make recommendations on New Zealand regulations for MI use. METHODS: This retrospective study included data from patients who underwent patch testing with MI from 2008 to 2021 in a tertiary hospital dermatology clinic and a private dermatology clinic in Auckland, New Zealand. Patient baseline characteristics were recorded along with results of patch testing. Sources of MI exposure were identified from medical records. RESULTS: Over the study period, 1049 patch tests were performed in 1044 patients. MI was only tested as a stand-alone allergen from 2015; positive reactions to MI increased from 5.3% in 2015 to a peak of 11.9% in 2017 and then decreased to 6.4% in 2021. The most common source of MI exposure was shampoo or conditioner (27.7% of all relevant reactions) followed by occupational exposures to paints, biocides or glue (19.1%). CONCLUSION: Both sensitisation and ACD to MI appear to be decreasing, likely secondary to changes in product compounding due to stricter concentration limits internationally. We recommend New Zealand adopt lower MI concentration limits for cosmetics to match the limits of Australia and Europe.
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Dermatitis Alérgica por Contacto , Pruebas del Parche , Tiazoles , Humanos , Nueva Zelanda , Estudios Retrospectivos , Tiazoles/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/epidemiología , Femenino , Masculino , Adulto , Persona de Mediana Edad , Cosméticos/efectos adversos , Conservadores Farmacéuticos/efectos adversos , Prevalencia , Exposición Profesional/efectos adversos , Dermatitis Profesional/etiología , Dermatitis Profesional/epidemiología , Adulto Joven , AncianoRESUMEN
BACKGROUND: Earlier studies suggested a potential association between tobacco smoking and nickel sensitization, but little is known about other contact allergens. OBJECTIVES: To investigate the association of smoking status and contact sensitizations as well as subtypes of dermatitis, and to analyse the sensitization profiles of tobacco smokers. PATIENTS AND METHODS: Within the Information Network of Departments of Dermatology (IVDK), we performed a cross-sectional multicentre pilot study comprising 1091 patch-tested patients from 9 departments, comparing 541 patients with a history of cigarette smoking (281 current and 260 former smokers) with 550 never-smokers. RESULTS: We could not confirm the previously reported association between nickel sensitization and tobacco smoking. Moreover, sensitizations to other allergens, including colophony, fragrance mix I, Myroxylon pereirae and formaldehyde, were not increased in cigarette smokers compared with never smokers. Hand dermatitis (50.6% vs. 33.6%) and occupational cause (36.2% vs. 22.5%) were significantly more frequent among cigarette smokers compared with never-smokers as shown by non-overlapping 95% confidence intervals. CONCLUSIONS: Although our study does not allow a firm conclusion on whether smoking status contributes to certain contact sensitizations, it confirms an association of smoking with hand dermatitis and occupational cause.
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Dermatitis Alérgica por Contacto , Dermatitis Profesional , Pruebas del Parche , Humanos , Estudios Transversales , Proyectos Piloto , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/diagnóstico , Masculino , Femenino , Persona de Mediana Edad , Adulto , Dermatitis Profesional/epidemiología , Dermatitis Profesional/etiología , Dermatosis de la Mano/epidemiología , Dermatosis de la Mano/etiología , Níquel/efectos adversos , Fumar Tabaco/efectos adversos , Fumar Tabaco/epidemiología , Alérgenos/efectos adversos , AncianoRESUMEN
BACKGROUND: Healthcare workers are at high risk of developing occupational hand dermatitis (HD) due to their frequent exposure to wet-work and use of gloves. Complaints of HD may interfere with work and cause loss of work productivity, or sick leave, and may have impact on job pleasure and performing daily activities. The prevalence of HD among intensive care unit (ICU) nurses is unknown. OBJECTIVES: To investigate the point prevalence and the 1-year prevalence of HD among ICU nurses, and to determine the impact of HD on work and daily activities. METHOD: A questionnaire-based cross-sectional study was performed among ICU nurses. Participants were recruited in the Amsterdam University Medical Centre. A symptom-based questionnaire was used to determine HD and atopic predisposition, and an additional questionnaire was used concerning the influence of HD. ICU nurses with an atopic predisposition or symptoms suiting HD were invited for the hand dermatitis consultation hour (HDCH). Data were analysed with logistic regression. RESULTS: A total of 184 ICU nurses were included. The point prevalence of HD was 9.8% (95% CI: 5.9-15.0) and the 1-year prevalence was 26.6% (95% CI: 20.4-33.6). Sick leave was reported by 0.5%. HD seemed to have more impact on job pleasure than on work productivity. CONCLUSION: The high prevalence rate of HD resulting from our study highlights the need for the prevention of occupational HD among healthcare workers.
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Dermatitis Profesional , Dermatosis de la Mano , Humanos , Dermatitis Profesional/epidemiología , Dermatitis Profesional/etiología , Dermatosis de la Mano/epidemiología , Femenino , Prevalencia , Estudios Transversales , Adulto , Masculino , Persona de Mediana Edad , Unidades de Cuidados Intensivos/estadística & datos numéricos , Países Bajos/epidemiología , Ausencia por Enfermedad/estadística & datos numéricos , Personal de Enfermería en Hospital/estadística & datos numéricos , Encuestas y Cuestionarios , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Enfermería de Cuidados CríticosAsunto(s)
Adhesivos , Alérgenos , Dermatitis Alérgica por Contacto , Pruebas del Parche , Humanos , Estudios Retrospectivos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/epidemiología , Alérgenos/efectos adversos , Estudios Transversales , Adhesivos/efectos adversos , Pruebas del Parche/estadística & datos numéricos , Femenino , Masculino , América del Norte/epidemiología , Adulto , Persona de Mediana EdadRESUMEN
BACKGROUND: The prevalence of contact allergy to various ophthalmic medications appears to be rare; however, data on culprits, clinical relevance of sensitizations, and changes in frequency within recent decades are limited. OBJECTIVE: This study aimed to investigate the clinical relevance, risk factors, and prevalence of contact allergy to topical ophthalmic medications in patients suspected of allergic contact dermatitis to ophthalmic medication. METHODS: We retrospectively analysed patch test results and clinical data for 754 patients patch-tested with an ophthalmic medication series at our tertiary referral centre between January 1992 and December 2022. RESULTS: In total, 37.5% (283/754) of patch-tested patients had a contact allergy to at least one ophthalmic allergen, with 87.3% (247) being clinically relevant sensitization. Phenylephrine (31.8%, 192/604), povidone-iodine (29%, 27/93), and tobramycin (23%, 46/200) were the most important sensitizers. The incidence of contact allergies increased significantly in a linear manner (p = 0.008) from 20% to 44.1% within the study period. Male sex and age above 40 were risk factors for contact allergy to ophthalmic medication. CONCLUSIONS: One third of patch tested patients had allergic contact dermatitis to ophthalmic medication, particularly phenylephrine. Male sex and age above 40 years were independent risk factors and drove the linear increase in contact allergy to ophthalmic medications within the past 31 years.
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Dermatitis Alérgica por Contacto , Soluciones Oftálmicas , Pruebas del Parche , Humanos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/epidemiología , Estudios Retrospectivos , Masculino , Femenino , Soluciones Oftálmicas/efectos adversos , Adulto , Persona de Mediana Edad , Factores de Riesgo , Prevalencia , Anciano , Fenilefrina/efectos adversos , Fenilefrina/administración & dosificación , Factores Sexuales , Adulto Joven , Adolescente , Factores de Edad , Tobramicina/efectos adversos , Tobramicina/administración & dosificaciónRESUMEN
BACKGROUND: Artificial nail modelling systems (ANMS) pose a significant risk for nail stylists and their clients regarding acrylate sensitization, which might jeopardize the use of acrylate-containing medical devices. OBJECTIVES: To evaluate the frequency of artificial nail practices among female healthcare workers (HCWs) compared with controls and assess ANMS-related side effects. METHODS: In this comparative, cross-sectional, single-centre study, a face-to-face interview with 200 female HCWs and 200 age-matched female dermatology patients (controls) was conducted regarding the use of ANMS between March and November 2023. RESULTS: Among 400 participants (median age: 25), 85 (21.3%) have applied ANMS at least once. The prevalence of ANMS application was significantly higher in HCWs (n = 54/200, 27%) compared with controls (n = 31/200, 15.5%) (p < 0.05). Long-lasting nail polish was the most commonly preferred technique (n = 82/85, 96.5%). ANMS were mainly performed in nail studios by nail stylists (n = 79/85, 92.9%), while three participants were using home kits. Nail brittleness was the most frequently reported side effect (n = 19/85, 22.4%). No case of allergic contact dermatitis (ACD) was detected. CONCLUSIONS: The popularity of ANMS among young female HCWs is growing. This striking trend might further put these individuals not only at risk of medical device-related adverse events but also occupational ACD.
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Acrilatos , Dermatitis Alérgica por Contacto , Dermatitis Profesional , Personal de Salud , Uñas , Humanos , Femenino , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/epidemiología , Adulto , Estudios Transversales , Personal de Salud/estadística & datos numéricos , Acrilatos/efectos adversos , Dermatitis Profesional/etiología , Dermatitis Profesional/epidemiología , Alérgenos/efectos adversos , Adulto Joven , Estudios de Casos y Controles , Persona de Mediana EdadRESUMEN
BACKGROUND: Allergic contact dermatitis is one of the most common forms of skin diseases that require medical intervention. Appropriate detection of allergens by patch test and accurate avoidance of them is the key to management. The objective of this study is to determine the types and frequency of allergens responsible for Allergic contact dermatitis in a tertiary hospital of Nepal. METHODS: Altogether 120 patients with Allergic contact dermatitis were enrolled in the study. Patch test was performed to find out the most common inciting allergen, utilizing the Indian Standard Series of allergens approved by The Contact and Occupational Dermatoses Forum of India. Results were read at 48 and 96 hours. Grading of the reactions was done based on the criteria of the International Contact Dermatitis Research Group. Pattern of reactivity of different allergens was assessed. RESULTS: Of all the patients, 63 (53%) showed positivity to at least one allergen. Nickel sulfate was the most frequent sensitizing agent in 22 (18%) cases, followed by Fragrance mix in 11(9%) and Paraphenylenediamine in 7 (6%) cases. Out of all positive results, Grade 1 positivity was seen in 44 (51%), Grade 2 positivity in 41(47%) and only 2 (2%) cases showed Grade 3 positivity. Mercaptobenzothiazole, Balsam of Peru, Nitrofurazone and Wool Alcohol did not show positive results in any of our patients. CONCLUSIONS: Patch testing helps in the treatment, long term remission, and patient counseling for prevention. Larger scale studies are required to know the sensitivity to allergens in Nepalese population.
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Dermatitis Alérgica por Contacto , Humanos , Alérgenos/efectos adversos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Nepal/epidemiología , Pruebas del Parche , Personas del Sur de AsiaRESUMEN
BACKGROUND: Professional ice hockey players may contract irritant and allergic contact dermatitis. AIMS: To investigate the presence of contact allergy (CA) in professional ice hockey players in Sweden. METHODS: Ten teams from the two top leagues were assessed for potential occupational exposure to sensitizers. Exactly 107 players were patch tested with an extended baseline series and a working series, in total 74 test preparations. The CA rates were compared between the ice hockey players and controls from the general population and dermatitis patients. RESULTS: One out of 4 players had at least one contact allergy. The most common sensitizers were Amerchol L 101, nickel and oxidized limonene. CA was as common in the ice hockey players as in dermatitis patients and significantly more common than in the general population. Fragrances and combined sensitizers in cosmetic products (fragrances + preservatives + emulsifier) were significantly more common in ice hockey players compared with the general population. CONCLUSION: The possible relationship between CA to fragrances and cosmetic products on the one hand and the presence of dermatitis on the other should be explored further.
Asunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Profesional , Hockey , Pruebas del Parche , Humanos , Suecia/epidemiología , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/diagnóstico , Adulto , Masculino , Dermatitis Profesional/etiología , Dermatitis Profesional/epidemiología , Níquel/efectos adversos , Adulto Joven , Exposición Profesional/efectos adversos , Cosméticos/efectos adversos , Perfumes/efectos adversos , Estudios de Casos y Controles , Persona de Mediana Edad , Limoneno/efectos adversosRESUMEN
Allergic contact dermatitis is reported among individuals using continuous glucose monitoring systems and insulin pumps. The aim of this study was to describe contact allergy patterns for allergens in the Swedish baseline series and medical device-related allergens among users. Contact allergy to baseline series allergens and isobornyl acrylate was compared between diabetes patients and dermatitis patients patch-tested at the Department of Occupational and Environmental Dermatology during 2017 to 2020. Fifty- four diabetes patients and 2,567 dermatitis patients were included. The prevalence of contact allergy to fragrance mix II and sesquiterpene lactone mix was significantly higher in diabetes patients compared with dermatitis patients. Of the diabetes patients 13.0% and of the dermatitis patients 0.5% tested positive to sesquiterpene lactone mix (p < 0.001). Of the diabetes patients 7.4% and of the dermatitis patients 2.3% tested positive to fragrance mix II (p = 0.041). Of the diabetes patients 70.4% tested positive to medical device-related allergens. Of the diabetes patients 63.0% and of the dermatitis patients 0.2% were allergic to isobornyl acrylate (p < 0.001). In conclusion, not only medical device-related contact allergies, but also contact allergy to baseline series allergens (fragrance mix II and sesquiterpene lactone mix), is overrepresented in diabetes patients who use medical devices.
Asunto(s)
Acrilatos , Canfanos , Dermatitis Alérgica por Contacto , Diabetes Mellitus , Sesquiterpenos , Humanos , Alérgenos/efectos adversos , Estudios Retrospectivos , Suecia/epidemiología , Automonitorización de la Glucosa Sanguínea , Glucemia , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Diabetes Mellitus/inducido químicamente , Pruebas del Parche , LactonasRESUMEN
BACKGROUND: The baseline series includes common allergens, evolves over time, and differs by location. Our study aims to characterize allergen sensitization trends among the Israeli population during the last two decades, compare our results to American and European registries, as well as to highlight significant allergens in additional series outside the European baseline series (OEBS). METHODS: We analysed patch test results of 2086 patients from a designated contact dermatitis clinic in Tel Aviv between 2019 and 2022, compared them to European and North American registries and to 2156 patch test results conducted in Israel two decades ago. RESULTS: 38.6% of patients had at least one positive reaction to an allergen in the European baseline series (EBS), nickel sulphate (14.6%), fragrance mix I (4.6%), and Methylchloroisothiazolinone methylisothiazolinone (MCI/MI; 3.7%) were the most common among them. N-Isopropyl N-Phenyl-4-Phenylenediamine (NIPPD; 0%), Propolis (0.1%), Sesquiterpene lactone mix (0.1%), and Budesonide (0.1%) elicited a sensitization frequency significantly lower than the proposed threshold for baseline inclusion. Chi-square test revealed a statistically significant decrease (p < 0.05) in the sensitization frequency of fragrance mix I, Formaldehyde, Potassium dichromate, Neomycin sulphate, Myroxylon pereirae, Sesquiterpene lactone, and NIPPD during the last two decades. The overall sensitization frequency to the majority of allergens was lower in our cohort in comparison to the North American and European registries. CONCLUSIONS: MCI/MI and 2-hydroxyethyl methacrylate-2 (HEMA) are common, relevant allergens, with high SPIN (significance and prevalence index number) and should be better regulated by the authorities. While among the EBS, NIPPD, Propolis, Sesquiterpene lactone, and Budesonide usually do not elicit a positive reaction and therefore should be reconsidered in baseline series, among the OEBS, Chloramphenicol, Quaternium 15, Propyl gallate, and Amerchol L101 have elicited high SPIN values and should be vigilantly examined in the suitable clinical scenario. Significantly lower sensitization frequency to propolis raises the possibility of a protective effect due to early oral exposure among the Israeli population.
Asunto(s)
Alérgenos , Dermatitis Alérgica por Contacto , Pruebas del Parche , Humanos , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/diagnóstico , Israel/epidemiología , Alérgenos/efectos adversos , Femenino , Masculino , Persona de Mediana Edad , Adulto , Sistema de Registros , Própolis/efectos adversos , Europa (Continente)/epidemiología , Fenilendiaminas/efectos adversos , Níquel/efectos adversos , Tiazoles/efectos adversos , Myroxylon/efectos adversosRESUMEN
Use of medical devices (MDs), that is, glucose sensors and insulin pumps, in patients with Type 1 diabetes mellitus (T1D) has proven an enormous advantage for disease control. Adverse skin reactions from these MDs may however hamper compliance. The objective of this study was to systematically review and analyse studies assessing the prevalence and incidence of dermatitis, including allergic contact dermatitis (ACD) related to MDs used in patients with T1D and to compare referral routes and the clinical investigation routines between clinics being part of the European Environmental and Contact Dermatitis Research Group (EECDRG). A systematic search of PubMed, EMBASE, CINAHL and Cochrane databases of full-text studies reporting incidence and prevalence of dermatitis in persons with T1D using MDs was conducted until December 2021. The Newcastle-Ottawa Scale was used to assess study quality. The inventory performed at EECRDG clinics focused on referral routes, patient numbers and the diagnostic process. Among the 3145 screened abstracts, 39 studies fulfilled the inclusion criteria. Sixteen studies included data on children only, 14 studies were on adults and nine studies reported data on both children and adults. Participants were exposed to a broad range of devices. Skin reactions were rarely specified. It was found that both the diagnostic process and referral routes differ in different centres. Further data on the prevalence of skin reactions related to MDs in individuals with T1D is needed and particularly studies where the skin reactions are correctly diagnosed. A correct diagnosis is delayed or hampered by the fact that, at present, the actual substances within the MDs are not declared, are changed without notice and the commercially available test materials are not adequately updated. Within Europe, routines for referral should be made more standardized to improve the diagnostic procedure when investigating patients with possible ACD from MDs.