| 1. |
- Bruze, Magnus, et al.
(author)
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Aluminum-Allergen of the Year 2022
- 2022
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In: Dermatitis. - 1710-3568. ; 33:1, s. 10-15
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Journal article (peer-reviewed)abstract
- Exposure to elemental aluminum and its salts is unavoidable. Aluminum as a metal is present in transport, construction, packaging, and electronic equipment. Aluminum salts are present in consumer products, food items and drinking water, vaccines, drugs, and antiperspirants. Aluminum in vaccines and preparations for allergen-specific immunotherapy are the major sensitization sources. The predominent clinical manifestations of aluminum allergy are pruritic subcutaneous nodules and eczematous dermatitis. Patch testing shall be performed with aluminum chloride hexahydrate (ACH) in petrolatum. The preparation with ACH 10% detects substantially more aluminum allergy than ACH 2%. A patch test with elemental aluminum, for example, an empty Finn Chamber, is only positive when there is a strong aluminum allergy. A patch test reading should be performed 1 week after the application so as not to miss 15% to 20% of aluminum allergy. Aluminum should be included in any baseline patch test series for children and investigated for a possible inclusion in baseline series for adults. Aluminum test chambers can interfere with the testing resulting in both false-negative and false-positive patch test reactions to nonaluminum contact sensitizers.
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| 2. |
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| 3. |
- Comstedt, Lisbeth Rosholm, et al.
(author)
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Effects of aluminium chloride added to common patch test substances
- 2023
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In: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 88:6, s. 456-462
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Journal article (peer-reviewed)abstract
- Background: A modulating effect of aluminium regarding type IV reactions might exist but has not been further investigated. Objectives: The aim of this study was to investigate the effect on patch test reactions when adding aluminium chloride hexahydrate (Al-Cl) to common test preparations. Materials and methods: Al-Cl in different concentrations was added to nickel sulphate 15.0% aqua (Ni), methylisothiazolinone 0.2% aqua (MI) and fragrance mix I 10.0% aqua/ethanol (FM I). The Ni preparations were tested in 120 consecutive patients. MI and FM I were tested in participants known to have contact allergy to the respective allergen. McNemar's test was used to decide which Ni preparation had the highest sensitivity. Wilcoxon signed-rank test was used to calculate pairwise comparison in summarized test score for the preparations with MI and FM I. Results: Adding Al-Cl 20.0%/30.0% to Ni identified twice as many patients with contact allergy to nickel compared to Ni without Al-Cl. Adding Al-Cl 20.0%/10.0% to MI, decreased the patch test reactivity compared to MI without Al-Cl. No differences in patch reactivity were noticed when adding Al-Cl to FM I. Conclusion: Al-Cl 20.0% or 30.0% seems to enhance the patch test reactivity to Ni 15.0% aqua.
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| 4. |
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| 5. |
- Mowitz, Martin, et al.
(author)
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New device, ‘old’ allergens. Allergic contact dermatitis caused by the Dexcom G7 glucose sensor
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In: Contact Dermatitis. - 0105-1873.
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Journal article (peer-reviewed)abstract
- Background: Allergic contact dermatitis (ACD) has been reported as an adverse effect from the use of several glucose sensors and insulin pumps from different manufacturers. Isobornyl acrylate (IBOA) has been identified as a major culprit sensitizer, but also other acrylates and (modified) colophonium have been reported as causes of ACD. Objectives: To report the two first cases diagnosed with ACD caused by the Dexcom G7 (DG7) glucose sensor. Patients and Methods: Two children with suspected ACD from DG7 were patch tested with our medical device series with an addition of selected test preparations including two variants of modified colophonium – methyl hydrogenated rosinate (MHR) and glyceryl hydrogenated rosinate (GHR). Both patients were also tested with acetone extracts made from different parts of the DG7 sensor. The extracts were analysed by gas chromatography–mass spectrometry (GC–MS). Results: Both patients tested positive to IBOA, hydroabietyl alcohol and GHR. In addition, patient 1 had a positive reaction to MHR and patient 2 had a positive reaction to colophonium. The GC–MS analyses showed the presence of IBOA and colophonium-related substances in the DG7 extracts. Conclusions: Both patients were diagnosed with contact allergy to well-known medical device-related sensitizers. The presence of IBOA and (modified) colophonium in a newly introduced (on the Swedish market in 2023) glucose sensor is remarkable and indicates an inadequate toxicological assessment of the materials used in the sensor.
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| 6. |
- Netterlid, Eva, et al.
(author)
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Does Allergen-specific Immunotherapy Induce Contact Allergy to Aluminium?
- 2013
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In: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 93, s. 50-56
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Journal article (peer-reviewed)abstract
- Persistent, itching nodules have been reported to appear at the injection site after allergen-specific immuno-therapy with aluminium-precipitated antigen extract, occasionally in conjunction with contact allergy to aluminium. This study aimed to quantify the development of contact allergy to aluminium during allergen-specific immunotherapy. A randomized, controlled, single-blind multicentre study of children and adults entering allergen-specific immunotherapy was performed using questionnaires and patch-testing. A total of 205 individuals completed the study. In the 3 study groups all subjects tested negative to aluminium before allergen-specific immunotherapy and 4 tested positive after therapy. In the control group 4 participants tested positive to aluminium. Six out of 8 who tested positive also had atopic dermatitis. Positive test results were found in 5/78 children and 3/127 adults. Allergen-specific immunotherapy was not shown to be a risk factor for contact allergy to aluminium. Among those who did develop aluminium allergy, children and those with atopic dermatitis were more highly represented.
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| 7. |
- Siemund, Ingrid, et al.
(author)
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Allergic contact dermatitis due to 1,6-hexanediol diacrylate in ostomy patients
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In: Contact Dermatitis. - 0105-1873.
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Journal article (peer-reviewed)abstract
- Background: Many people live with ostomies after life-saving surgery. Ostomy patients often suffer from peristomal dermatitis. Allergic contact dermatitis (ACD) has been reported, mostly due to contact allergy (CA) to topical agents. Objectives: We present three patients with therapy resistant peristomal dermatitis, suggesting ACD caused by different stoma products. Methods: Patch testing was performed with baseline series, additional series, and selected allergens. They were also tested with their own ostomy products as is and separate extracts of the products. Extracts were analysed using Gas Chromatography–Mass Spectrometry (GC–MS). Results: In all three patients we diagnosed CA to 1,6-hexanediol diacrylate (HDDA), +++ in case (C) 1 and 3, ++ in C 2. HDDA was detected in C 2's ostomy pouch adhesive and in C 1's and 3's flange extenders used to improve the adhesion of the ostomy pouches. Conclusion: Therapy resistant peristomal dermatitis should always be suspected of ACD and patch testing, especially with the patient's own products, should be performed.
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| 8. |
- Siemund, Ingrid, et al.
(author)
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Contact allergy in atopic individuals in relation to allergen-specific immunotherapy
- 2016
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In: European Journal of Dermatology. - : John Libbey Eurotext. - 1167-1122 .- 1952-4013. ; 26:3, s. 271-280
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Journal article (peer-reviewed)abstract
- Background: Type I sensitizations and atopic dermatitis (AD) often appear in the same patient. Beneficial effects of allergen-specific immunotherapy (ASIT) in patients with bothADand type I allergies have been reported. The predisposing role of AD to the development of type IV sensitization is discussed. Whether ASIT for type I allergy also influences type IV allergies is unknown. Objectives: To compare the number of contact allergies between patients with and without AD, before and after one year’s treatment with ASIT. Materials and Methods: A controlled, single-blind multicentre study of children/adults with allergic asthma and/or rhinoconjunctivitis, treated or untreated with ASIT, was performed. The history of AD was collected using questionnaires. The number of contact allergies was assessed by patch testing with a baseline series. Results: 205 individuals completed the study; 133 treated with ASIT (exposed) and 72 before starting ASIT (unexposed). For participants with AD, significantly more contact allergies were found in the groups of all children (p = 0.002), all exposed children (p<0.001), and all exposed study persons (p = 0.013). Independent of AD, significantly more contact allergies were noted in the groups of all unexposed adults (p = 0.004) and all unexposed study persons (p = 0.004). Conclusions: The higher number of contact allergies in patients with AD indicates that AD may be a risk factor for type IV sensitization in those with allergic asthma and/or rhinoconjunctivitis. The lower number of contact allergies in patients exposed to ASIT suggests an immunomodulatory effect on type IV sensitization.
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| 9. |
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| 10. |
- Siemund, Ingrid
(author)
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Contact allergy to aluminium
- 2018
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In: Forum for Nordic Dermato-Venerology. - 1402-2915. ; 23:1
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Journal article (peer-reviewed)
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