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- Agner, Tove, et al.
(författare)
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Contact sensitisation in hand eczema patients-relation to subdiagnosis, severity and quality of life: a multi-centre study
- 2009
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Ingår i: Contact Dermatitis. - 0105-1873. ; 61:5, s. 291-296
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Tidskriftsartikel (refereegranskat)abstract
- Background Contact sensitisation has been identified as a factor associated with poor prognosis for patients with hand eczema. Objectives To study implications of contact sensitisation with respect to severity, quality of life (QoL) and subdiagnosis of hand eczema. Methods The study was performed as a multi-centre, cross-sectional study from 10 European clinics. All patients were patch tested, and severity of hand eczema assessed by Hand Eczema Severity Index. A multi-variate analysis was performed to explore which factors influenced severity, QoL and sick leave. Results A total 416 patients were included, and 63% had contact sensitisation to one or more of the tested allergens. More women (66%) than men (51%) were sensitized. No significant association was found between sensitisation to specific allergens, disease severity, QoL or diagnostic subgroups. High age, male sex, atopic eczema and presence of contact sensitisation were independent risk factors for increased severity as measured by Hand Eczema Severity Index. Furthermore, the severity of hand eczema increased by the number of contact sensitisations detected (P = 0.023). High age and personal history of atopic eczema were independent risk factors for low QoL, as measured by Dermatology Life Quality Index, and atopic eczema as well as allergic contact dermatitis as subdiagnosis was associated with increased sick leave. Conclusion Diagnostic subgroups were not found to be related to specific allergens. Contact sensitisation was found to be a risk factor for increased severity of hand eczema, as did high age, male sex and atopic eczema.
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| 2. |
- Agner, Tove, et al.
(författare)
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Hand eczema severity and quality of life: a cross-sectional, multicentre study of hand eczema patients
- 2008
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 59:1, s. 43-47
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives: Hand eczema is a chronic disease with negative impact on quality of life (QoL). In this study, QoL in hand eczema patients is assessed and related to age, sex, severity, and diagnostic subgroups. Methods: A total of 416 patients with hand eczema from 10 European patch test clinics participated in the study. Data on QoL were obtained from a self-administered questionnaire using the Dermatology Life Quality Index (DLQI). Severity was assessed by a scoring system (Hand Eczema Severity Index, HECSI) as well as frequency of eruptions and sick leave due to hand eczema. Results: No significant difference was found between males and females with respect to QoL [DLQI median values and 25/75 percentiles for males and females being 7.0 (3-14) and 8.0 (3-13), respectively], although males were more severely affected than females (P < 0.025). A significant positive correlation was found for hand eczema severity and age (P < 0.001), while no significant correlation was found for QoL and age. QoL was found increasingly reduced when sick leave was getting higher (P < 0.001). A statistically significant correlation between QoL (as measured by DLQI) and hand eczema severity as measured by HECSI was found (P < 0.001). No significant difference in QoL was found between diagnostic subgroups. Conclusions: QoL was found markedly negatively affected in hand eczema patients and was significantly correlated to disease severity. No significant difference in QoL was found between males and females, in spite of significantly more severe eczema in males, indicating that QoL in female patients is more easily affected.
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| 5. |
- Johansen, Jeanne D., et al.
(författare)
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European Society of Contact Dermatitis guideline for diagnostic patch testing : recommendations on best practice
- 2015
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 73:4, s. 195-221
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Forskningsöversikt (refereegranskat)abstract
- The present guideline summarizes all aspects of patch testing for the diagnosis of contact allergy in patients suspected of suffering, or having been suffering, from allergic contact dermatitis or other delayed-type hypersensitivity skin and mucosal conditions. Sections with brief descriptions and discussions of different pertinent topics are followed by a highlighted short practical recommendation. Topics comprise, after an introduction with important definitions, materials, technique, modifications of epicutaneous testing, individual factors influencing the patch test outcome or necessitating special considerations, children, patients with occupational contact dermatitis and drug eruptions as special groups, patch testing of materials brought in by the patient, adverse effects of patch testing, and the final evaluation and patient counselling based on this judgement. Finally, short reference is made to aspects of (continuing) medical education and to electronic collection of data for epidemiological surveillance.
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| 6. |
- Muris, Joris, et al.
(författare)
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Sensitization to palladium in Europe
- 2015
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 72:1, s. 11-19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundRecently, sodium tetrachloropalladate (Na2PdCl4) was found to be a more sensitive palladium patch test allergen than palladium dichloride (PdCl2). ObjectivesTo determine the optimal test concentration of Na2PdCl4, to evaluate the prevalence of palladium sensitization with Na2PdCl4 and PdCl2, and to compare the results with nickel sensitization in a European multicentre study. Materials and methodsIn addition to the European or national baseline series including NiSO(4)6H(2)0 5% pet., consecutive patients were tested with PdCl2 and Na2PdCl4 2%, 3% and 4% pet. in eight European dermatology clinics. The age and sex distributions were also evaluated in patients sensitized to nickel and palladium. ResultsIn total, 1651 patients were tested. Relative to 3% Na2PdCl4, 4% Na2PdCl4 did not add any information. Two per cent Na2PdCl4 resulted in more doubtful reactions and showed suboptimal reactivity. The prevalence of palladium sensitization doubled with Na2PdCl4 and was similar to that of nickel. Interestingly, in contrast to nickel sensitization, palladium sensitization was not related to female sex. ConclusionsThree per cent Na2PdCl4 pet. is the most suitable patch test concentration. Sensitization to palladium is almost as prevalent as sensitization to nickel. The sex distribution is different between nickel-sensitized and palladium-sensitized patients, suggesting different sources of exposure.
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| 7. |
- Pontén, Ann, et al.
(författare)
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Patch testing with 2.0% (0.60 mg/cm(2) ) formaldehyde instead of 1.0% (0.30 mg/cm(2) ) detects significantly more contact allergy.
- 2013
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 68:1, s. 50-53
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Tidskriftsartikel (refereegranskat)abstract
- Background.The currently used patch test concentration for formaldehyde is 1.0% (wt/vol) in water. However, clinical experience and previous studies suggest that 1.0% might be insufficient for detecting an optimized number of clinically relevant cases of contact allergy to formaldehyde. Objectives.To validate earlier patch test results for comparison of 1% (wt/vol) and 2% (wt/vol) formaldehyde in water, and to investigate co-reactivity with quaternium-15. Materials and methods.In 12 dermatology clinics, 3591 patients were routinely patch tested simultaneously with 2.0% (wt/vol) (0.60 mg/cm(2) ) and 1.0% (wt/vol) (0.30 mg/cm(2) ) formaldehyde. Micropipettes were used for delivering the exact dosage of the allergen. Results.Significantly more patients reacted to 2.0% formaldehyde than to 1.0% (3.4% versus 1.8%, p < 0.001). Overall, there were no sex differences between those reacting positively to 2.0% and 1.0%. Of 25 quaternium-15-positive patients, 4 (0.1%) reacted positively without reacting to formaldehyde. Conclusion.On the basis of the results of this multicentre study, as well as of previous studies, it can be suggested that 2.0% (wt/vol) in water formaldehyde should be used in routine patch testing in the baseline series.
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| 8. |
- Sosted, Heidi, et al.
(författare)
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Contact allergy to common ingredients in hair dyes
- 2013
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 69:1, s. 32-39
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Tidskriftsartikel (refereegranskat)abstract
- Background p-Phenylenediamine (PPD) is the primary patch test screening agent for hair dye contact allergy, and approximately 100 different hair dye chemicals are allowed. Objectives To examine whether PPD is an optimal screening agent for diagnosing hair dye allergy or whether other clinically important sensitizers exist. Methods Two thousand nine hundred and thirty-nine consecutive patients in 12 dermatology clinics were patch tested with five hair dyes available from patch test suppliers. Furthermore, 22 frequently used hair dye ingredients not available from patch test suppliers were tested in subgroups of approximate to 500 patients each. Results A positive reaction to PPD was found in 4.5% of patients, and 2.8% reacted to toluene-2,5-diamine (PTD), 1.8% to p-aminophenol, 1% to m-aminophenol, and 0.1% to resorcinol; all together, 5.3% (n=156). Dying hair was the most frequently reported cause of the allergy (55.4%); so-called temporary henna' tattoos were the cause in 8.5% of the cases. p-Methylaminophenol gave a reaction in 20 patients (2.2%), 3 of them with clinical relevance, and no co-reaction with the above five well-known hair dyes. Conclusions Hair dyes are the prime cause of PPD allergy. PPD identifies the majority of positive reactions to PTD, p-aminophenol and m-aminophenol, but not all, which justifies additional testing with hair dye ingredients from the used product.
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| 9. |
- Sukakul, Thanisorn, et al.
(författare)
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Results of patch testing with five fragrance materials hitherto not tested : A dose-finding study in the clinical population
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Ingår i: Contact Dermatitis. - 0105-1873.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Quantitative risk assessment (QRA) for skin sensitization is used to derive safe use levels of sensitising fragrance ingredients in products. Post-marketing surveillance of the prevalence of contact allergy to these ingredients provides relevant data to help evaluate the performance of these measures. Objectives: To determine a suitable patch test concentration for five fragrance materials that had hitherto not been tested on a regular basis. These concentrations are then to be used in a surveillance study with patch testing consecutive patients over an extended monitoring period. Materials and Methods: Furaneol, CAS.3658-77-3; trans-2-hexenal, CAS.6728-26-3; 4,8-dimethyl-4,9-decadienal, CAS.71077-31-1; longifolene, CAS.475-20-7; benzaldehyde, CAS.10052-7, were patch tested with other fragrance allergens in four clinics. Patch testing was conducted in three rounds, starting with the lowest concentrations of the five ingredients. The doses were increased in the subsequent rounds if no late-appearing positive reactions and virtually no irritant reactions were reported. Results: Overall, 373 patients were tested. No positive allergic reaction was reported to the five ingredients. Patch test results of other fragrance allergens are reported. Conclusions: The highest test concentrations are each considered safe for patch testing consecutive patients. Further surveillance based on these preparations will evaluate the hypothesis that QRA-driven consumer product levels of these fragrances can prevent sensitization.
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