| 1. |
- Dubnika Hauksson, Inese, et al.
(författare)
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Clinically relevant contact allergy to formaldehyde may be missed by testing with formaldehyde 1.0%.
- 2011
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 164:3, s. 568-572
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Tidskriftsartikel (refereegranskat)abstract
- Background: It has been found that patch testing with 15μl formaldehyde 2.0% aq detects twice more allergies than testing with 1.0%. The clinical relevance of positive patch test reactions is often difficult to determine. Use tests are simple to do and help to evaluate the significance of patch test results. Objectives: To study the clinical relevance of contact allergy to formaldehyde detected by 2.0% (0.60 mg/cm²) but not by 1.0%. Patients/Methods: 18 patients positive to formaldehyde 2.0% but negative to 1.0% and a control group of 19 dermatitis patients without allergy to parabens, formaldehyde and formaldehyde releasers were included in the study. Formaldehyde 2000 ppm, the maximum concentration permitted in leave-on cosmetics according to the EU Cosmetics Directive, was added to a batch of a moisturiser preserved with parabens. The same batch without formaldehyde served as control. The study was double-blinded and randomised. The patients were provided with both moisturisers and instructed to apply one of them twice a day on a marked-out 5×5 cm area on the inside of one upper arm and the other moisturiser on the other arm. Reading of the test sites was done once a week for a maximum of 4 weeks. Results: In the control group there were no allergic reactions to any of the moisturisers. 9 of the 17 formaldehyde-allergic patients reacted with an allergic reaction to the moisturiser which contained formaldehyde (p<0.001). No positive reactions were observed to the moisturiser without formaldehyde. Conclusions: Our results demonstrate that contact allergy to formaldehyde 2.0% may be clinically relevant.
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| 2. |
- Dubnika Hauksson, Inese
(författare)
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Contact allergy to formaldehyde. Diagnosis and clinical relevance.
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Preservatives are biologically active substances mainly used in water-based products to prevent the growth of microorganisms. Most people are exposed to them on a daily basis. Formaldehyde is one of the oldest and most commonly used preservatives. However, it is a well-known contact sensitiser in dermatitis patients. The aims of this work were: i) to investigate the prevalence of contact allergy to formaldehyde using the baseline patch test series; ii) to determine the optimal patch test concentration and dose for formaldehyde; iii) to study the clinical relevance of contact allergy to formaldehyde detected by formaldehyde 2.0% (0.60 mg/cm2) but not by formaldehyde 1.0% (0.30 mg/cm2); iv) to study the effects of low concentrations of formaldehyde on irritant contact dermatitis in formaldehyde-allergic patients; v) to semi-quantify the formaldehyde content in skin care products used by patients with suspected allergic contact dermatitis, and compare this with the declaration of contents; vi) to determine whether formaldehyde-allergic patients are more exposed to formaldehyde in skin care products than dermatitis patients without contact allergy to formaldehyde; vii) to investigate the patterns of concomitant contact allergy to formaldehyde and formaldehyde releasers. The findings were as follows: i) patch testing with 15 μl formaldehyde 2.0% (0.60 mg/cm2) using a micropipette detects significantly more reacting individuals than 1.0% (0.30 mg/cm2), without a high frequency of irritant reactions. ii) individuals who react to formaldehyde 2.0% (0.60 mg/cm2) but not to 1.0% (0.30 mg/cm2) have a significant risk of developing an eczematous reaction when exposed to concentrations of formaldehyde allowed by the EU Cosmetic Directive. iii) daily exposure to low concentrations of formaldehyde is sufficient to exacerbate existing dermatitis in patients with contact allergy to formaldehyde. iv) to assess exposure and clinical relevance in formaldehyde-allergic patients, the patients’ skin care products should be analysed, especially when the labelling of the products does not include formaldehyde or formaldehyde-releasing preservatives.
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| 3. |
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| 4. |
- Dubnika Hauksson, Inese, et al.
(författare)
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Routine diagnostic patch-testing with formaldehyde 2.0% (0.6 mg/cm2) may be an advantage compared to 1.0%.
- 2010
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 90:5, s. 480-484
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Tidskriftsartikel (refereegranskat)abstract
- Our clinical experience has suggested that the presently recommended patch-test concentration (1.0%) for formaldehyde in the baseline series might be too low. Therefore, consecutively patch-tested dermatitis patients were tested simultaneously with formaldehyde 1.0% and 2.0% (w/v) in aqua. Formaldehyde 1.0% and 2.0% were applied with a micro-pipette (15 microl) to filter paper discs in Finn Chambers (0.30 mg/cm(2) and 0.60 mg/cm(2), respectively). A total of 1397 patients with dermatitis were patch-tested. In all, 68 (4.9%) patients reacted positively to formaldehyde; 37 reacted only to 2.0%, 29 reacted to both concentrations, and 2 reacted only to 1.0%. Significantly more patients were thus diagnosed with contact allergy to formaldehyde 2.0% compared with 1.0% (p < 0.001). We detected 0.1%, 0.4%, and 29.6% irritant reactions to 1.0%, 2.0%, and 3.0% formaldehyde, respectively. We conclude that, with an optimized patch-test technique, doubling the dose per area detects significantly more contact allergies to formaldehyde, but an even higher test concentration causes too many irritant reactions to be usable.
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| 5. |
- Dubnika Hauksson, Inese, et al.
(författare)
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Skin care products containing low concentrations of formaldehyde detected by the chromotropic acid method can not be safely used in formaldehyde-allergic patients.
- 2015
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963.
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Tidskriftsartikel (refereegranskat)abstract
- Preservatives are widely used to prevent microbial growth both for skin care products and in the industry. Many of them have allergic potential. Allergic contact dermatitis caused by preservatives can often be chronic, probably because it is difficult to suspect contact allergy to these chemicals based on the patient's history only. Formaldehyde is a common cause of contact allergy and has been included in the baseline series since the 1930s (1) . The prevalence of formaldehyde allergy has been reported to be 2-3% in European countries and 8-9% in the US (2) . The use of free formaldehyde as a preservative has decreased and formaldehyde-releasing agents are used instead. Individuals who are allergic to formaldehyde are recommended not only to avoid products preserved with formaldehyde but also products containing formaldehyde-releasers. This article is protected by copyright. All rights reserved.
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| 6. |
- Engfeldt, Malin, et al.
(författare)
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Comparison of three different techniques for application of water solutions to Finn Chambers®.
- 2010
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 63:5, s. 284-288
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: With regard to contact allergy, the dose of a sensitizer per unit skin area is an important factor for both sensitization and elicitation, and therefore a known amount/volume of test preparation should be applied at patch testing. OBJECTIVES: To compare three different techniques for the application of aqueous solutions to Finn Chambers, in order to determine the precision and accuracy of each technique when the recommended 15 µl volume is applied. METHODS: Four technicians applied formaldehyde 1.0% aq. (wt/vol) and methylchloroisothiazolinone/methylisothiazolinone 200 ppm (wt/vol) in sets of 10 onto Finn Chambers, with three different techniques: (i) micro-pipetting; (ii) dripping the solutions; and (iii) dripping the solutions followed by removal of excess solution with a soft tissue. Assessment of the variations was performed with the use of descriptive data. The ability to apply the exact amount was assessed by Fisher's exact test by categorizing each application as in or out of the range 12-18 µl. RESULTS/CONCLUSIONS: The micro-pipette technique had the best accuracy and precision, as well as the lowest inter-individual variation. The technique in which excess solution was removed had good precision, but failed in the application of the defined amount, i.e. 15 µl.
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| 7. |
- Isaksson, Marléne, et al.
(författare)
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Methylisothiazolinone Contact Allergy is Rising to Alarming Heights Also in Southern Sweden.
- 2015
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 95:1, s. 31-34
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Tidskriftsartikel (refereegranskat)abstract
- The preservative methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is a well-known sensitiser and present in most baseline series since at least 20 years. The proportions of MCI/MI are 3:1. MI alone has been used as a preservative in occupational and household products, and cosmetics since less than 10 years. MCI/MI tested at 100 ppm fails to detect a significant percentage of contact-allergic reactions to MI. Our aim was to investigate whether a separate test preparation with MI picks up additional cases of contact allergy to MI not detected with MCI/MI 200 ppm. MI was inserted into the baseline series of the Malmö clinic in 2003 starting at 475 ppm, then 900 ppm, then 1,000 ppm, 1,500 ppm and finally 2,000 ppm. In 5,881 consecutively tested dermatitis patients the contact allergy rate for MI varied between 0.5 and 6.5%, with a marked increase in recent years. The contact allergy rate to MI 2,000 ppm alone, not traced by MCI/MI 200 ppm, varied between 0 and 1.9%. In conclusion, due to the increase of contact allergy to MI not traced by MCI/MI 200 ppm, MI in water at 2,000 ppm should be tested in a baseline series. Independent of patch test technique a dose of 60 µg/cm should not be exceeded to avoid adverse reactions and particularly patch test sensitisation.
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| 8. |
- Mowitz, Martin, et al.
(författare)
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Chromate and amine contact allergies in workers manufacturing precast concrete elements
- 2016
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 75:6, s. 363-369
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Tidskriftsartikel (refereegranskat)abstract
- Background: Five workers from a plant manufacturing concrete wall panels and beams were referred to our department because of suspected occupational dermatitis. When patch tested, 3 workers reacted to potassium dichromate. Four workers reacted to ethylenediamine dihydrochloride, without any obvious exposure. Owing to the high proportion of workers with recent-onset skin disease, an investigation of all workers at the plant was initiated. Objectives: To investigate the prevalence of occupational dermatitis and contact allergy in the workers at the plant. Methods: All 24 workers at the plant underwent a clinical investigation and were patch tested. Results: Four cases of allergic occupational contact dermatitis and 3 cases of irritant occupational contact dermatitis were diagnosed. Contact allergy to potassium dichromate was found in 4 workers. All 4 also reacted to ethylenediamine dihydrochloride and/or amines that were present as additives in the cement. Conclusions: Chromate contact allergy can still be found in concrete workers, despite the legislation regulating the amount of hexavalent chromium (chromate) in cement. Occupational contact allergy to amines can be found in workers exposed to cement and concrete, so amines should be tested in these workers.
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| 9. |
- Pontén, Ann, et al.
(författare)
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Concomitant contact allergies to formaldehyde, methylchloroisothiazolinone/methylisothiazolinone, methylisothiazolinone, and fragrance mixes I and II
- 2016
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 75:5, s. 285-289
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Tidskriftsartikel (refereegranskat)abstract
- Background: Contact allergies to the preservatives formaldehyde and methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) have been reported to appear together at a statistically significant level. Recently, revisions concerning the patch test preparations of MCI/MI, MI and formaldehyde have been recommended for the European baseline series. Aim: To investigate (i) the number of concomitant contact allergies to the preservatives, (ii) the number of concomitant contact allergies to the preservatives and the fragrance mixes (FM I and FM II) and (iii) gender differences. Methods: Patients tested with the Swedish baseline series during the period 2012-2014 at the Department of Occupational and Environmental Dermatology in Malmö, Sweden were investigated. Results: 2165 patients were patch tested with the baseline series (34% males and 66% females). Contact allergies to formaldehyde and MCI/MI and/or MI were significantly associated (p
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| 10. |
- Pontén, Ann, et al.
(författare)
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Delayed reactions to reusable protective gloves.
- 2009
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 60:4, s. 50-227
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Tidskriftsartikel (refereegranskat)abstract
- The materials in plastic protective gloves are thought to cause less contact allergy than rubber gloves. Our aim was to estimate the frequency of delayed reactions to different types of reusable protective gloves among dermatitis patients. 2 x 2 cm pieces of polyvinyl chloride (PVC) gloves, nitrile gloves, and natural rubber latex (NRL) gloves were tested as is in consecutive dermatitis patients tested with the baseline series. Among 658 patients, 6 patients reacted to PVC gloves and 6 patients to the NRL gloves. None reacted to both these types of gloves. Five of six patients with reactions to rubber gloves reacted to thiuram mix in the baseline series. Delayed reactions to reusable PVC gloves may be as common as to reusable NRL gloves. In contrast to most reactions to the NRL glove, the reactions to the PVC glove had no obvious association with reactions to any allergen(s) in the baseline series.
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