| 1. |
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| 2. |
- Andernord, D., et al.
(författare)
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Contact allergy to haptens in the Swedish baseline series: Results from the Swedish Patch Test Register (2010 to 2017)
- 2022
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 86:3, s. 175-188
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Tidskriftsartikel (refereegranskat)abstract
- Background Allergic contact dermatitis has considerable public health impact and causative haptens vary over time. Objectives To report the prevalence of contact allergy to allergens in the Swedish baseline series 2010 to 2017, as registered in the Swedish Patch Test Register. Methods Results and demographic information for patients tested with the Swedish baseline series in 2010 to 2017 were analysed. Results Data for 21 663 individuals (females 69%) were included. Females had significantly more positive patch tests (54% vs 40%). The reaction prevalence rates were highest for nickel sulfate (20.7%), fragrance mix I (7.1%), Myroxylon pereirae (6.9%), potassium dichromate (6.9%), cobalt chloride (6.8%), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI; 6.4%), MI (3.7%), colophonium (3.5%), fragrance mix II (3.2%), and formaldehyde (3.2%). Myroxylon pereirae reaction prevalence increased from 5% in 2010 to 9% in 2017 and that for methyldibromo glutaronitrile from 3.1% to 4.6%. MCI/MI and MI reactions decreased in prevalence after 2014. Nickel reaction prevalence decreased among females aged 10 to 19 years. Conclusions Nickel remains the most common sensitizing agent, with reaction prevalence decreasing among females younger than 20 years. The changes in MCI/MI and MI reaction prevalence mirrored those in Europe. The register can reveal changes in contact allergy prevalence over time among patients patch tested in Sweden.
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| 3. |
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| 9. |
- Asplund, Monika, et al.
(författare)
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Prurigo nodularis - vid svårare symtom kan pregabalin övervägas.
- 2015
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Ingår i: Läkartidningen. - 0023-7205. ; 112
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Prurigo nodularis is a pruritic condition characterized by skin noduli. Different treatment options have been used with limited success. Pregabalin is a drug licensed for treatment of neuropathic pain in adults. As prurigo nodularis involves suffering for the patients and is difficult to treat, the aim of this case report is to report the effect of pregabalin treatment in seven patients with prurigo nodularis, treated in the dermatology clinic in Malmö, Sweden. Four patients experienced good effect of pregabalin, though two patients had a transient effect. Side effects of pregabalin have been reported. This case report indicates that pregabalin is a treatment option for therapy-resistant prurigo nodularis; even though one must be aware of that the effect may not be permanent and that there are side effects. The aim must be to use the drug for a limited time, taking the patient to a remission state, where the vicious itch-scratch cycle can be inhibited.
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| 10. |
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| 11. |
- Balato, Anna, et al.
(författare)
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European Task Force on Contact Dermatitis statement on coronavirus 19 disease (COVID-19) outbreak and the risk of adverse cutaneous reactions
- 2020
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 34:8, s. 353-354
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Tidskriftsartikel (refereegranskat)abstract
- Among the basic protective measures against COVID-19, the need to wash hands frequently and in a prolonged way using soap, and to regularly use alcohol-based hand sanitizers is well established for the whole population. Healthcare workers in general, and particularly those involved in the direct care of COVID-19 patients, have to wear personal protective equipment (PPE) daily for many hours and also accomplish general preventive measurements outside their work. Cutaneous adverse reactions can develop that need to be prevented, identified and therapeutically managed. According to the data reported by Lin et al 1, based in the experience from healthcare workers in Wuhan, adverse skin reactions were reported in 74% of responders (n=376) to a general survey. The most commonly reported types of eruptions were skin dryness or desquamation (68.6%), papules or erythema (60.4%) and maceration (52,9%).
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| 12. |
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| 13. |
- Björk, Ann-Kristin, et al.
(författare)
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Occupational allergic contact dermatitis to gloves, follow-up of investigated patients
- 2014
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 70:Suppl s1, s. 94-94
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: In the Department of Occupational and Environmental Dermatology there has been an increase in the inflow of patients, working as surgical nurses or surgeons. They have been referred due to presumed occupational contact dermatitis. Results from investigated patients have in part been presented previously, where the investigation has shownmultiple contact allergies caused by their occupational use of gloves. Allergens such as diphenylguanidine were found in the gloves and contact allergies to their rubber gloves were found. Many of the patients have been working for decades in their present occupation, but the hand dermatitis had often been present for less than a year. Objectives: To present a follow-up of patientswith hand dermatitis due to gloves. Methods: A follow-up of the patients and a structure for the investigation of the individual patient are given. Results: The cases will be presented with their contact allergies, howtheinvestigation isperformedandtheoutcomeof theprevention by avoiding gloves containing the allergens diagnosed in the individual patients. Conclusions: For health care personnel hand hygiene and the wearing of protective gloves are mandatory. Our findings indicate that the increased need to use rubber gloves and at the same time the exclusion of latex gloves give rise to new contact allergies which are clinically relevant. In the investigation, and the advice given to the patients, several factors have to be taken into consideration, including the fast change of glove material. The cases indicate the importance of close cooperation between chemists and dermatologists and the possibility to perform chemical analysis. Furthermore, and just as important for this patient group, is that with correct diagnosis and advice the contact dermatitis can actually heal completely and the patients continue in their work.
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| 14. |
- Björk, Ann Kristin, et al.
(författare)
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The reactivity of the back revisited. Are there differences in reactivity in different parts of the back?
- 2017
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 76:1, s. 19-26
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Tidskriftsartikel (refereegranskat)abstract
- Background: In the contact dermatitis literature, it is regularly stated that the patch test reactivity on various areas of the back differs; this might have a large impact on the reproducibility of patch testing. Objectives: To investigate the reproducibility of patch testing on the upper back with regard to the left as opposed to the right side and the medial as opposed to the lateral part of the upper back. The reproducibility over time and with regard to the reactivity pattern was also investigated. Methods: Thirty-one subjects with contact allergy to the metals gold (n=19) or nickel (n=12) were patch tested with serial dilutions, in triplicate applications, on different locations on the upper back. The Friedman test was used for statistical calculations. Results: No significant differences in the reactivity of the back were found. In all gold-allergic patients and 11 of 12 nickel-allergic patients, the allergy could be reproduced with regard to previous patch testing, but the degree of reactivity differed. Conclusions: When a high level of standardization of the patch test technique with the same test system was used, there were no differences in patch test reactions and sites of application on the upper back.
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| 15. |
- Bruze, Magnus, et al.
(författare)
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Contact allergy to oxidised geraniol may be over-represented in individuals with photocontact allergy to ketoprofen
- 2024
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Ingår i: Contact Dermatitis. - 0105-1873. ; 90:1, s. 79-83
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Tidskriftsartikel (refereegranskat)abstract
- Background: Simultaneous overrepresentations of contact allergies and photocontact allergies are common in individuals with photocontact allergy to ketoprofen. Aims: To investigate whether contact allergy to oxidised (ox.) geraniol, geraniol, geranial, neral and citral is overrepresented in individuals with photocontact allergy to ketoprofen. Methods: The contact allergy rates to ox. geraniol, geraniol, geranial, neral and citral in routinely patch tested dermatitis patients were compared with the corresponding rates in individuals with photocontact allergy to ketoprofen. Results: Allergic patch test reactions were noted to ox. geraniol 11% (n = 39, 5.8%), ox. geraniol 6% (n = 12, 1.8%), geraniol 6% (n = 2, 0.3%), geranial (n = 18, 2.7%), neral (n = 7, 1.0%) and citral (n = 15, 2.2%). In those four patients who were diagnosed with photocontact allergy to ketoprofen during the test period, a significant overrepresentation (p = 0.020) of simultaneous contact allergy to ox. geraniol 11% was demonstrated. Overrepresentation of simultaneous contact allergy to various combinations of ox. geraniol, ox. limonene and ox. linalool was also noted in ketoprofen-photoallergic patients. Conclusions: Contact allergy to ox. geraniol, geranial and citral is common in routinely tested dermatitis patients. There is an overrepresentation of simultaneous contact allergy to ox. geraniol, ox. limonene and ox. linalool in patients with photocontact allergy to ketoprofen.
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| 16. |
- Bruze, Magnus, et al.
(författare)
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Contact Allergy to Oxidized Linalool and Oxidized Limonene is Over-represented in Individuals with Photocontact Allergy to Ketoprofen
- 2021
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057. ; 101:5
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Tidskriftsartikel (refereegranskat)abstract
- Simultaneous contact allergies are common in individuals with photocontact allergy to ketoprofen. The rate of contact allergy to the fragrance substances oxidized linalool and oxidized limonene in ketoprofen-photo-allergic individuals were investigated in comparison with the corresponding rates in individuals without photo-contact allergy to ketoprofen, using Fisher's exact test. A total of 4,021 patients were routinely tested with oxidized linalool; of whom 190 (4.7%) tested positively. For oxidized limonene the numbers were 3,797 patients and 111 positive reactions (2.9%). A total of 19 contact allergic reactions to oxidized linalool were noted in 29 patients (65.5%) who also had photocontact allergy to ketoprofen (p < 0.0001). The corresponding figures for oxidized limonene were 10 positive reactions in 24 ketoprofen-photoallergic individuals (41.7%) (p < 0.0001). Contact allergy to oxidized linalool and/or oxidized limonene is common in routinely tested patients with dermatitis and, particularly, in those patients who are photoallergic to ketoprofen.
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| 17. |
- Bruze, Magnus, et al.
(författare)
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Increased rates of fragrance allergy in fibromyalgia individuals tested with the Swedish baseline patch test series
- 2023
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 37:1, s. 104-113
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Tidskriftsartikel (refereegranskat)abstract
- Background: Contact allergy can manifest in a variety of ways clinically. Systemic contact allergy may occasionally present with pain in muscles and joints. Fibromyalgia is a chronic rheumatic disease characterized by pain and with virtually unknown aetiology. Objectives: The aim of this study was to investigate the contact allergy rates to the sensitizers in a baseline series and compare with corresponding rates in dermatitis patients and the general population. Methods: Patch testing with the Swedish baseline series was performed in 120 individuals with fibromyalgia. Fisher's exact test was used for pair-wise comparisons of contact allergy rates between the fibromyalgia group and two control groups, dermatitis patients and individuals in the general population. Results: Contact allergy was significantly more common in the fibromyalgia group compared to the general population concerning nickel and the fragrance markers Myroxolon pereirae and fragrance mix I. There were fewer allergic reactions to preservatives in the fibromyalgia group compared with the dermatitis group. Conclusions: Myroxolon pereirae and fragrance mix I represent besides fragrance allergy also allergy to flavouring substances which indicate that oral exposure to flavouring substances and hygiene products might be important for sensitization and possibly elicitation of systemic contact allergy symptoms in fibromyalgia individuals.
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| 18. |
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| 19. |
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| 20. |
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| 21. |
- Bruze, Magnus, et al.
(författare)
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Patch test concentrations (doses in mg/cm(2) ) for the 12 non-mix fragrance substances regulated by European legislation.
- 2012
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 66:3, s. 131-136
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Tidskriftsartikel (refereegranskat)abstract
- Background. According to EU legislation, 26 fragrance substance allergens must be labelled on cosmetic products. For 12 of them, the optimal patch test concentration/dose has not been evaluated. Objectives. To establish the optimal patch test doses in mg/cm(2) for the 12 fragrance substances that are not included in fragrance mix I or II in the European baseline patch test series. Materials and Methods. Patch testing with the 12 fragrance substances was performed in a stepwise manner encompassing up to five rounds in at least 100 dermatitis patients for each round. Before patch testing, an individual maximum concentration/dose was determined for each fragrance substance. Results. The predetermined maximum patch test concentrations/doses could be tested for all 12 fragrance substances, with no observable adverse reactions being noted. Conclusions. For each fragrance substance investigated, it is recommended that half of the maximum patch test dose (mg/cm(2) ) be used for aimed and screening patch testing.
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| 22. |
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| 23. |
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| 24. |
- Brynolf, Andreas, et al.
(författare)
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Contact allergy investigations in healthcare workers with face mask-related skin disease
- 2023
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Ingår i: Contact Dermatitis. - 0105-1873. ; 89:1, s. 16-19
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Tidskriftsartikel (refereegranskat)abstract
- Background: During the COVID-19 pandemic, the use of face masks has increased among healthcare workers (HCWs). Questionnaire studies have shown a high frequency of self-reported facial adverse skin reactions. Case reports have been published on face mask-induced allergic contact dermatitis and urticaria. Objectives: To describe the results of the contact allergy investigations in consecutive HCWs investigated for skin reactions to face masks during the COVID-19 pandemic and the results of the chemical investigations of face masks supplied by the hospital. Methods: Participants were patch tested with baseline series and chemicals previously reported in face masks not included in the baseline series. Face mask(s) brought by the HCW were tested as is and/or in acetone extract. Chemical analyses were performed on nine different face masks for potential allergens. Results: Fifty-eight HCWs were investigated. No contact allergies were found to the face mask(s) tested. Eczema was the most common type of skin reaction, followed by an acneiform reaction. Colophonium-related substances were found in one respirator and 2,6-di-t-butyl-4-methylphenol (BHT) were found in two respirators. Conclusion: Based on this report, contact allergies to face masks is uncommon. Patch test with colophonium-related substances and BHT should be considered when investigating adverse skin reactions to face masks.
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| 25. |
- Comstedt, Lisbeth Rosholm, et al.
(författare)
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Effects of aluminium chloride added to common patch test substances
- 2023
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 88:6, s. 456-462
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Tidskriftsartikel (refereegranskat)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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| 26. |
- Dahlin, Jakob, et al.
(författare)
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Chemical burns caused by trifluoroacetic acid.
- 2013
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 69:3, s. 176-180
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Tidskriftsartikel (refereegranskat)abstract
- Trifluoroacetic acid is a very strong carboxylic acid. The acid has been suspected to have similar toxic effects as hydrofluoric acid on skin contact. Hydrofluoric acid is highly toxic, owing to skin penetration by fluoride ions. A spill of hydrofluoric acid on the skin may be fatal. As trifluoroacetic acid contains fluorine, patients with chemical burns caused by trifluoroacetic acid have been given particular attention when treated in the hospital.
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| 27. |
- Dahlin, Jakob, et al.
(författare)
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Chemical Methods for Detection of Allergens and Skin Exposure
- 2020
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Ingår i: Contact Dermatitis : Sixth Edition - Sixth Edition. - Cham : Springer International Publishing. - 9783030363352 - 9783030363345 ; , s. 631-652
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Bokkapitel (refereegranskat)abstract
- Many allergens are widely used in both consumer and occupational products. In many cases, it is difficult to know all the ingredients of a product since most products are not sufficiently labelled. To diagnose and prevent allergic contact dermatitis, the demonstration of allergens in the products from the patient’s environment is important. Chemical analysis of a product can make it possible to demonstrate the presence or absence of known allergens. Simple spot tests or documented analytical methods such as thin-layer chromatography (TLC), high-performance liquid chromatography (HPLC), gas chromatography (GC), atomic absorption spectrophotometry (AAS), and inductively coupled plasma-mass spectrometry (ICP-MS) can be used. Moreover, with chemical methods, the purity of a substance can be checked and new allergens can be isolated and identified. Advanced methods such as mass spectrometry (MS), nuclear magnetic resonance spectroscopy (NMR), and infrared spectrophotometry (IR) are often required to identify isolated allergens.
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| 28. |
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| 29. |
- Ekqvist, Susanne, et al.
(författare)
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A correlation found between gold concentration in blood and patch test reactions in patients with coronary stents.
- 2008
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 59:3, s. 137-142
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with dental gold restorations are known to have a higher level of gold concentration in blood (B-Au). OBJECTIVES: To further investigate, in a study on patients with intracoronary stents and contact allergy to metals, the gold and nickel release from stainless steel stent with (Au stent) and without (Ni stent) gold plating. METHOD: A total of 460 patients treated with stenting underwent patch testing with metals, and information on gold and nickel exposure and blood samples were collected. About 200 blood samples were randomly selected and the analysis of B-Au and nickel concentration in blood (B-Ni) was made using inductively coupled plasma mass spectrometry. RESULTS: There was a correlation between the intensity of Au patch test reaction and B-Au (P < 0.001). This correlation could not be seen between Ni patch test reaction and B-Ni. A Au stent gave a fivefold higher B-Au than a Ni stent. CONCLUSIONS: Gold is released from the Au stent and patients with a Au stent have a fivefold higher B-Au than patients with an Ni stent. The patch test reactions for gold were correlated with B-Au.
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| 30. |
- Ekqvist, Susanne, et al.
(författare)
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Does gold concentration in the blood influence the result of patch testing to gold?
- 2009
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 160:5, s. 1016-1021
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Tidskriftsartikel (refereegranskat)abstract
- We have recently found a correlation between contact allergy to gold sodium thiosulphate (GSTS) and gold concentration in the blood (B-Au) in a stented population: the higher the B-Au, the stronger the patch-test reaction. To further investigate the correlation between B-Au and patch-test reactivity to gold. In this provocation control cross-over trial of 24 patients with dermatitis with a known contact allergy to gold, the patients were randomized into two groups where one was topically provoked to gold (15 mg GSTS) and one to the control. All patients were simultaneously patch tested with GSTS in 10 aqueous dilutions (1.1 mg GSTS). Patch-test readings were performed and blood was drawn. After 6 weeks, the experiment was repeated and the group that had previously been provoked with gold was now provoked with the control and vice versa. B-Au was higher after gold provocation whereas no treatment effect was discerned for minimal eliciting concentration (MEC) or summarized test score (STS). Instead, significant differences in period effect were observed implying higher B-Au and STS and lower MEC on test occasion II. The most likely explanation is the increased B-Au and/or booster effect from test occasion I. There was a correlation between B-Au and MEC: the higher the B-Au, the lower the MEC. The correlation between B-Au and MEC indicates that the B-Au is of importance for the skin reactivity to gold.
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| 31. |
- Ekqvist, Susanne, et al.
(författare)
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High frequency of contact allergy to gold in patients with endovascular coronary stents
- 2007
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 157:4, s. 730-738
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Tidskriftsartikel (refereegranskat)abstract
- Background Stent implantation is an effective method for treatment of atherosclerotic disease. Factors predisposing to in-stent restenosis are still largely unknown. Contact allergy to metal ions eluted from the stent has been suggested to be a risk factor. Objectives To explore whether there is a possible induction of contact allergy to metals used in stents among patients with a stainless steel stent containing nickel (Ni stent) and patients with a gold-plated stent (Au stent). Methods Adults (n = 484) treated with coronary stent implantation participated in the study with patch testing. The study design was retrospective and cross-sectional with no assessment of contact allergy before stenting. Age- and sex-matched patch-tested patients with dermatitis (n = 447) served as controls. Results Of Au-stented patients, 54 of 146 (37%) were allergic to gold compared with 85 of 447 (19%) controls (P < 0.001). Within the stented population there were no statistically significant differences in contact allergy to gold or nickel between Ni-stented and Au-stented patients. In multivariate models where other risk factors for contact allergy to gold were considered, the Au stent showed a trend towards statistical significance (odds ratio 1.43, 95% confidence interval 0.95-2.16; P = 0.09). Conclusions As the frequency of contact allergy to gold is higher in stented patients independent of stent type it suggests a previous sensitization. However, several pieces of circumstantial evidence as well as statistical analysis indicate the possibility of sensitization in the coronary vessel by the Au stent. Ni stents and Au stents should not be ruled out as risk factors for induction of contact allergy to these metals.
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| 32. |
- Enberg, Johanna, et al.
(författare)
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The use of carvone in consecutive patch testing
- 2023
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Ingår i: Contact Dermatitis. - : John Wiley & Sons. - 0105-1873 .- 1600-0536. ; 88:3, s. 206-211
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Carvone (l-carvone) is a mint-tasting flavour additive that most of us is exposed to and can cause allergic contact reactions.OBJECTIVES: To analyse the frequency and the relevance of positive carvone reactions in a dermatitis population.METHOD: A retrospective analysis of dermatitis patients consecutively tested with carvone from 2017 to 2021. Data were retrieved from the department's patch-test database.RESULTS: Of 3554 patients tested with carvone, 28 (0.79%) had a positive reaction. Carvone-positive patients had higher mean age, were significantly more likely female (p < 0.001) and had often an intraoral/lip involvement (p < 0.001). In the carvone-positive group, 50% (n = 14) had a relevant reaction, and in 4 of 14, the relevance was first revealed after test reading. Of the carvone-positive patients, 18 of 28 did not have a coexisting allergy to a fragrance/flavour allergen and of these 44% had a relevant allergy.CONCLUSIONS: The study suggests that a significant fraction of relevant carvone contact allergies may be overlooked if the allergen is not tested. Furthermore, as the exposure is widespread, inclusion of carvone in the Swedish baseline series may be justified even if the contact allergy prevalence is below 1%.
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| 33. |
- Engfeldt, Malin, et al.
(författare)
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Can patch testing with methylchloroisothiazolinone/methylisothiazolinone be optimized using a new diagnostic mix? - A multicenter study from the Swedish Contact Dermatitis Research Group
- 2020
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 82:5, s. 283-289
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Tidskriftsartikel (refereegranskat)abstract
- Background Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and methylisothiazolinone (MI) are tested to detect contact allergy to these isothiazolinones. Objectives To study if an aqueous patch test preparation with MCI and MI in a mix of 0.015% and 0.2%, respectively, detects more contact allergies than the commonly used preparations of MCI/MI in 0.02% aq. and MI in 0.2% aq. Methods A total of 1555 patients with dermatitis in five Swedish dermatology departments were tested consecutively with MCI/MI 0.215% aq., MCI/MI 0.02% aq., and MI 0.2% aq. Results The share of contact allergy to MCI/MI 0.215% aq., MCI/MI 0.02% aq., and MI 0.2% aq. varied in the test centers between 7.9% and 25.9%, 3.2% and 10.3%, and 5.8% and 12.3%, respectively. MCI/MI 0.215% aq. detected significantly more patch-test positive individuals than both MCI/MI 0.02% aq. (P < .001) and MI 0.2% aq. (P < .001), as well as either one of MCI/MI and MI (P < .001). In the patients only reacting to MCI/MI 0.215% aq., 57.7% were recorded as having a dermatitis that was explained or aggravated by exposure to either MCI/MI or MI. Conclusion The results speak in favor of replacing the preparations MCI/MI 0.02% aq. and MI 0.2% aq. with MCI/MI 0.215% aq. as the screening substance in the Swedish baseline series, which has been implemented in 2020.
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| 34. |
- Engfeldt, Malin, et al.
(författare)
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Patch Testing with a New Composition of Mercapto Mix: A Multi-centre Study by the Swedish Contact Dermatitis Research Group
- 2019
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 99:11, s. 960-963
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated whether more patients with contact allergies were detected by patch testing with mercapto mix with a higher concentration of 2-mercaptobenzothiazolinone (MBT) than the commonly used mercapto mix. A total of 3,143 dermatitis patients in 5 Swedish dermatology departments were patch-tested with 3 mercapto test preparations: MBT 2.0% petrolatum (pet.); mercapto mix 2.0% pet.; and mercapto mix 3.5% pet. Positive reactions to these mercapto mixes varied between 0-0.50%, 0-0.93%, and 0-1.4%, respectively, in the 5 centres. Numerically, mercapto mix 3.5% pet. detected all positive patients and more patch-test positive patients than did the 2 other substances, but the difference was not statistically significant. The authors recommend replacing mercapto mix 2.0% pet. in the Swedish baseline series with mercapto mix 3.5% pet., since the latter also detected those patients who would have been missed because MBT 2.0% is not included in the Swedish baseline series.
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| 35. |
- Engfeldt, Malin, et al.
(författare)
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Patch testing with hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) - a multicentre study of the Swedish Contact Dermatitis Research Group
- 2017
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 76:1, s. 34-39
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Tidskriftsartikel (refereegranskat)abstract
- Background. In 2014, the fragrance hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) was excluded from the Swedish baseline series. Objectives. To study (i) whether fragrance mix (FM) II with 5% HICC detects more positive reactions than usual FM II with 2.5% HICC, and (ii) the reproducibility of patch testing with HICC. Methods. Two thousand one hundred and eighteen dermatitis patients at five Swedish dermatology departments were consecutively tested with FM II 14% pet., FM II 16.5% pet., and duplicate preparations of HICC 5% pet. Results. Of the patients, 3.2% reacted to FMII 14%, and 1.5% reacted to HICC. Separate testing with HICC detected 0.3% reactions without concomitant reactivity to FM II. FM II with 5% HICC did not give rise to more irritant reactions or signs of active sensitization than FM II with 2.5% HICC. Patch testing with duplicate applications of HICC increased the overall prevalence of HICC contact allergy to 1.9%. Conclusion. FMII with5% HICC does not detect more positive reactions than FMII with 2.5% HICC. Separate testing with HICC does not detect a sufficient proportion of patients who react only to HICC, without concomitant reactions to FMII, to warrant its inclusion in a baseline series.
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| 36. |
- Engfeldt, Malin, et al.
(författare)
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Swedish Experiences From Patch-testing Methylisothiazolinone Separately
- 2015
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 95:6, s. 717-719
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Tidskriftsartikel (refereegranskat)abstract
- The preservative methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is a well-known sensitiser and present in the Swedish baseline series since the 1980s. The proportions of MCI/MI are 3:1. MI alone has been used as a preservative since less than 10 years. This study was conducted on behalf of the Swedish Contact Dermatitis Research Group to evaluate inclusion of MI in the Swedish baseline series since the preparation of MCI/MI might fail to detect contact-allergic reactions to MI alone. Patients with suspected allergic contact dermatitis at 5 Swedish dermatology departments were consecutively patch-tested with MI 2,000 ppm aq and MCI/MI 200 ppm aq. The number of cases with exclusive contact allergy to MI varied between 0.8-4.2%. In total, 1.9% reacted exclusively to MI and not to MCI/MI. Due to the considerable frequency of contact allergy to MI not traced by MCI/MI, MI 2,000 ppm aq is included in the Swedish baseline series from January 2014. This corresponds to a dose of 60 mu g/cm(2).
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| 37. |
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| 38. |
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| 39. |
- Frosch, PJ, et al.
(författare)
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Patch testing with a new fragrance mix detects additional patients sensitive to perfumes and missed by the current fragrance mix
- 2005
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 52:4, s. 207-215
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Tidskriftsartikel (refereegranskat)abstract
- The currently used 8% fragrance mix (FM I) does not identify all patients with a positive history of adverse reactions to fragrances. A new FM II with 6 frequently used chemicals was evaluated in 1701 consecutive patients patch tested in 6 dermatological centres in Europe. FM II was tested in 3 concentrations - 28% FM II contained 5% hydroxyisohexyl 3-cyclohexene carboxaldehyde (Lyral((R))), 2% citral, 5% farnesol, 5% coumarin, 1% citronellol and 10%alpha-hexyl-cinnamic aldehyde; in 14% FM II, the single constituents' concentration was lowered to 50% and in 2.8% FM II to 10%. Each patient was classified regarding a history of adverse reactions to fragrances: certain, probable, questionable, none. Positive reactions to FM I occurred in 6.5% of the patients. Positive reactions to FM II were dose-dependent and increased from 1.3% (2.8% FM II), through 2.9% (14% FM II) to 4.1% (28% FM II). Reactions classified as doubtful or irritant varied considerably between the 6 centres, with a mean value of 7.2% for FM I and means ranging from 1.8% to 10.6% for FM II. 8.7% of the tested patients had a certain fragrance history. Of these, 25.2% were positive to FM I; reactivity to FM II was again dose-dependent and ranged from 8.1% to 17.6% in this subgroup. Comparing 2 groups of history - certain and none - values for sensitivity and specificity were calculated: sensitivity: FM I, 25.2%; 2.8% FM II, 8.1%; 14% FM II, 13.5%; 28% FM II, 17.6%; specificity: FM I, 96.5%; 2.8% FM II, 99.5%; 14% FM II, 98.8%; 28% FM II, 98.1%. 31/70 patients (44.3%) positive to 28% FM II were negative to FM I, with 14% FM II this proportion being 16/50 (32%). In the group of patients with a certain history, a total of 7 patients were found reacting to FM II only. Conversely, in the group of patients without any fragrance history, there were significantly more positive reactions to FM I than to any concentration of FM II. In conclusion, the new FM II detects additional patients sensitive to fragrances missed by FM I; the number of false-positive reactions is lower with FM II than with FM I. Considering sensitivity, specificity and the frequency of doubtful reactions, the medium concentration, 14% FM II, seems to be the most appropriate diagnostic screening tool.
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| 40. |
- Frosch, PJ, et al.
(författare)
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Patch testing with a new fragrance mix - reactivity to the individual constituents and chemical detection in relevant cosmetic products
- 2005
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 52:4, s. 216-225
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Tidskriftsartikel (refereegranskat)abstract
- A new fragrance mix (FM II), with 6 frequently used chemicals not present in the currently used fragrance mix (FM I), was evaluated in 6 dermatological centres in Europe, as previously reported. In this publication, test results with the individual constituents and after repeated open application test (ROAT) of FM II are described. Furthermore, cosmetic products which had caused a contact dermatitis in patients were analysed for the presence of the individual constituents. In 1701 patients, the individual constituents of the medium (14%) and the highest (28%) concentration of FM II were simultaneously applied with the new mix at 3 concentrations (break-down testing for the lowest concentration of FM II (2.8%) was performed only if the mix was positive). ROAT was performed with the concentration of the FM II which had produced a positive or doubtful (+ or ?+) patch test reaction. Patients' products were analysed for the 6 target compounds by gas chromatography-mass spectrometry (GC-MS). Results: 50 patients (2.9%) showed a positive reaction to 14% FM II and 70 patients (4.1%) to 28% FM II. 24/50 (48%) produced a positive reaction to 1 or more of the individual constituents of 14% FM II and 38/70 (54.3%) to 28% FM II, respectively. If doubtful reactions to individual constituents are included, the break-down testing was positive in 74% and 70%, respectively. Patients with a positive reaction to 14% FM II showed a higher rate of reactions to the individual constituent of the 28% FM II: 36/50 (72%). Positive reactions to individual constituents in patients negative to FM II were exceedingly rare. If doubtful reactions are regarded as negative, the sensitivity, specificity, positive predictive value and negative predictive value for the medium concentration of FM II towards at least 1 individual constituent was 92.3% (exact 95% confidence interval 74.9-99.1%), 98.4% (97.7-99.0%), 48% (33.7-62.6%) and 99.9% (99.6-"100.0%), respectively. For the high concentration, the figures were very similar. The frequency of positive reactions to the individual constituents in descending order was the same for both FM II concentrations: hydroxyisohexyl 3-cyclohexene carboxaldehyde (Lyral((R))) > citral > farnesol > citronellol > alpha-hexyl-cinnamic aldehyde (AHCA). No unequivocally positive reaction to coumarin was observed. Lyral((R)) was the dominant individual constituent, with positive reactions in 36% of patients reacting to 14% FM II and 37.1% to 28% FM II. 5/11 patients developed a positive ROAT after a median of 7 days (range 2-10). The 5 patients with a doubtful or negative reaction to 28% FM II were all ROAT negative except 1. There were 7 patients with a certain fragrance history and a positive reaction to either 28% or 14% FM II but a negative reaction to FM I. Analysis with GC-MS in a total of 24 products obtained from 12 patients showed at least 1-5 individual constituents per product: Lyral((R)) (79.2%), citronellol (87.5%), AHCA (58.3%), citral (50%) and coumarin (50%). The patients were patch test positive to Lyral((R)), citral and AHCA. In conclusion, patients with a certain fragrance history and a negative reaction to FM I can be identified by FM II. Testing with individual constituents is positive in about 50% of cases reacting to either 14% or 28% FM II.
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| 41. |
- Gatica-Ortega, María Elena, et al.
(författare)
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Contact dermatitis from glucose sensors in Spain : A multicentric approach
- 2021
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 85:5, s. 554-562
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Tidskriftsartikel (refereegranskat)abstract
- Background: Allergic contact dermatitis from glucose sensors may interfere with their ongoing application. Objective: To evaluate a series of Spanish patients with contact dermatitis to glucose sensors regarding former sources of contact allergens, patch test results, and outcomes from the ongoing use of the device. Methods: A series of patients with contact dermatitis from glucose sensors was investigated in eight dermatology departments across Spain (epidemiological features, brands, latency time to develop dermatitis, the ability to continue using the devices as well as the patch test results). Results: Thirty patients were evaluated (mean age 20.9 years). A total of 66.7% were children and 66.7% female. Ninety per cent used Freestyle Libre (FSL). Eight of 26 (30.8%) reacted to isobornyl acrylate (IBOA) and two of 20 (10.0%) to N,N dimethylacrylamide (DMAA). The mean latency time to develop dermatitis was 9 months. Sixteen of 29 (55.2%) patients continued using the same sensor causing the reaction. Thirteen of 29 (44.8%) patients were unable to continue using the sensor because of severe reactions. Of these, five were positive to IBOA, one to IBOA and DMAA, one to DMAA, one to colophony, and one to isopropyl alcohol wipes. In one patient, the outcome was unknown. Conclusion: The frequency of sensitisation to IBOA and DMAA, was lower than in other European series, but similar to a previously published Spanish article. Legislation requiring manufacturers to provide information regarding the composition of medical devices and cooperate with the investigations into contact dermatitis is urgently needed.
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| 42. |
- Gatica-Ortega, María Elena, et al.
(författare)
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Nonoccupational Allergic Contact Dermatitis to 4-Acryloylmorpholine in Smartwatch Screen Protectors Glue
- 2022
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Ingår i: Dermatitis. - 1710-3568. ; 33:6, s. 429-434
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Tidskriftsartikel (refereegranskat)abstract
- Background We recently identified an outbreak of occupational allergic contact dermatitis (ACD) involving workers of a Spanish company selling smartphone protective cases from a glue product. A chemical analysis of one glue sample revealed the presence of 4-acryloylmorpholine among other allergens. The same glue is also used to attach tempered glass protective cases to Apple smartwatches. Objective Our objective was to describe a case series of nonoccupational consumer ACD from the previously mentioned Apple smartwatch protective case glue. Methods We evaluated epidemiological and clinical data, as well as patch tests results. Results Three women were diagnosed with nonoccupational ACD from the adhesive. An annular vesicular inflammatory plaque involving the dorsal aspect of the wrist was initially observed in all. Two of the 3 patients were patch tested with 4-acryloylmorpholine 0.5% with positive strong reactions. Both also strongly reacted to a sample of the glue semiopen tested in a drop of petrolatum. One of them was also positive for various acrylates. Conclusions 4-Acryloylmorpholine has been identified in an adhesive used to attach protective cases to smartwatches. Nonoccupational ACD have been described to involve consumers of smartwatches. A UV-curable adhesive used to attach protective cases to smartwatches has been considered to be the culprit.
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| 43. |
- Gonçalo, Margarida, et al.
(författare)
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Allergic contact dermatitis caused by nail acrylates in Europe. An EECDRG study
- 2018
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 78:4, s. 254-260
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Tidskriftsartikel (refereegranskat)abstract
- Background: Allergic contact dermatitis (ACD) caused by nail acrylates, also including methacrylates and cyanoacrylates here, is being increasingly reported. Methods: A retrospective study in 11 European Environmental Contact Dermatitis Research Group (EECDRG) clinics collected information on cases of ACD caused by nail acrylates diagnosed by aimed testing between 2013 and 2015. Results: Among 18 228 studied patients, 136 had ACD caused by nail acrylates (0.75%; 95%CI: 0.60–0.90), representing 67.3% (95%CI: 60.4–73.7) of ACD cases caused by acrylates. There were 135 females and 1 male, with a mean age ± standard deviation of 36.7 ± 12.2 years; 59 (43.4%) were exposed as consumers, and 77 (56.6%) were occupationally exposed. Occupational cases were more frequent in southern Europe (83.7%), and were younger (mean age of 33.4 ± 8.9 years); most developed ACD during the first year at work (65.0%), and at least 11.7% had to leave their jobs. Skin lesions involved the hands in 121 patients (88.9%) and the face in 50 (36.8%), with the face being the only affected site in 14 (10.3%). Most patients reacted to two or more acrylates on patch testing, mainly to 2-hydroxyethyl methacrylate (HEMA) (92.5%), 2-hydroxypropyl methacrylate (88.6%), ethylene glycol dimethacrylate (69.2%), and ethyl cyanoacrylate (9.9%). Conclusions: Nail cosmetics were responsible for the majority of ACD cases caused by acrylates, affecting nail beauticians and consumers, and therefore calling for stricter regulation and preventive measures. As HEMA detects most cases, and isolated facial lesions may be overlooked, inclusion of this allergen in the baseline series may be warranted.
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| 44. |
- Gånemo, Agneta, et al.
(författare)
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Usefulness of Rajka and Langeland Eczema Severity Score in Clinical Practice.
- 2016
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 96:4, s. 521-524
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Tidskriftsartikel (refereegranskat)abstract
- Simple, validated eczema severity scores are required for the evaluation of interventions. The Rajka and Langeland (R and L) scale is based on 3 domains (extent, course, and intensity); however, its validity is not yet confirmed. The aim of this study was to investigate the quality aspects of the R and L scale in clinical practice. In the first part of the study, experts and consumers judged the content validity of the scale. The second part of the study was performed with 87 children during a 4-month eczema school. Construct validity, internal consistency, sensitivity to change, time consumption and health-related quality of life variables were investigated. The content of the R and L scale was considered valid by 45 panellists. Inter- and intra-observer reliability was very good. Divergent construct validity was adequate, while convergent construct validity and internal consistency were inadequate. The R and L scale was able to define a significant improvement in eczema during the eczema school. The time required for completing the R and L assessment was significantly shorter than for objective Severity Scoring of Atopic Dermatitis (SCORAD). The R and L scale is a simple, fast, valid, reliable and sensitive tool for scoring of atopic dermatitis in everyday clinical practice.
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| 45. |
- Hagvall, Lina, 1978, et al.
(författare)
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Contact allergy to citral and its constituents geranial and neral, coupled with reactions to the prehapten and prohapten geraniol
- 2020
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 82:1, s. 31-38
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Tidskriftsartikel (refereegranskat)abstract
- Background Citral is commonly used as a fragrance and flavor material and consists of the aldehydes geranial and neral. Citral is included in fragrance mix (FM) II. Geranial and neral have also been identified in autoxidation of geraniol, a fragrance compound present in FM I. Objectives To study contact allergy to citral, geranial, and neral, and concomitant reactivity to oxidized geraniol and fragrance markers of the baseline series. Methods A total of 1476 dermatitis patients with suspected allergic contact dermatitis were patch tested using geranial, neral, and citral, all 3.5% petrolatum (pet.) as well as geraniol 6.0% and oxidized geraniol 11% pet. in addition to the Swedish baseline series. Results Frequencies of positive reactions to citral, geranial, and neral were 2.9%, 3.4% and 1.9%, respectively. Together, citral and geranial gave 4.2% positive patch test reactions in consecutive dermatitis patients. In patients with positive reactions to citral or its components, 25% to 34% reacted to FM II and 61% reacted to oxidized geraniol. Conclusions Patch testing with citral, its components, or oxidized geraniol detects contact allergic reactions not detected using the baseline series. Patch testing with pure geraniol was shown to be of little value. Geranial and neral, although closely chemically related, are concluded to be separate haptens.
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| 46. |
- Hagvall, Lina, 1978, et al.
(författare)
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Contact allergy to oxidized geraniol among Swedish dermatitis patients-A multicentre study by the Swedish Contact Dermatitis Research Group
- 2018
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 79:4, s. 232-238
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Tidskriftsartikel (refereegranskat)abstract
- Background: Geraniol is a widely used fragrance terpene, and is included in fragrance mix I. Geraniol is prone to autoxidation, forming the skin sensitizers geranial, neral, and geraniol-7-hydroperoxide. Oxidized geraniol has previously been patch tested in 1 clinic, giving 1% to 4.6% positive reactions in consecutive patients when tested at 2% to 11%. Aim: To compare test reactions to pure and oxidized geraniol, to compare 2 different test concentrations of oxidized geraniol and to investigate the pattern of concomitant reactions to fragrance markers of the baseline series in a multicentre setting. Methods: One thousand four hundred and seventy-six consecutive patients referred for patch testing were patch tested with geraniol 6% pet. and oxidized geraniol 6% and 11% pet. Results: Pure geraniol 6% pet., oxidized geraniol 6% pet. and oxidized geraniol 11% pet. gave 1%, 3% and 8% positive patch test reactions and 0.7%, 3% and 5% doubtful reactions, respectively. Approximately 50% of the patients with doubtful reactions to oxidized geraniol 6% pet. had positive reactions to oxidized geraniol 11% pet. Conclusions: Oxidized geraniol 11% pet. provides better detection than oxidized geraniol 6% pet. As most patients reacted only to oxidized geraniol, it is important to explore further whether oxidized geraniol should be included in a baseline patch test series.
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| 47. |
- Hamnerius, Nils, et al.
(författare)
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Colophonium-related Allergic Contact Dermatitis Caused by Medical Adhesive Tape Used to Prevent Skin Lesions in Soldiers
- 2023
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Ingår i: Acta Dermato-Venereologica. - 0001-5555. ; 103
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Tidskriftsartikel (refereegranskat)abstract
- Medical adhesive tapes are commonly recommended for the prevention of friction blisters during hiking and military marches. The aim of this paper is to report on the results of investigations into an outbreak of taperelated foot dermatitis in 26 military conscripts following continuous use of medical adhesive tapes for several days during a field exercise. Patch tests were performed using baseline series and aimed testing was performed with colophonium-related substances and different medical adhesive tapes. Contact allergy to the adhesive tapes used was found in 20 (77%) subjects, and contact allergy to colophonium in 16 (61%). Chemical analysis detected colophonium-related substances in the culprit tapes. Compared with consecutive dermatitis patients investigated at our Department of Occupational and Environmental Dermatology in the previous 10 years, conscripts with colophonium allergy had increased odds ratios for concomitant contact allergy to phenol formaldehyde resins and fragrance substances including hydroperoxides of limonene and linalool. The results show that prolonged use of medical adhesive tapes on intact skin carries a high risk for allergic contact dermatitis. Prior to their introduction on the market, medical devices should be assessed for possible side-effects.
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| 48. |
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| 49. |
- Hamnerius, Nils, et al.
(författare)
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Hand eczema and occupational contact allergies in healthcare workers with a focus on rubber additives
- 2018
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 79:3, s. 149-156
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hand eczema (HE) in healthcare workers (HCWs) is common. Besides wet work, healthcare work also implies exposure to contact allergens. Objectives: To assess HE and contact allergy related to occupational exposures in HCWs. Methods: In a cross-sectional study, 311 HCWs with HE within the preceding 12 months and a control group of 114 HCWs without HE were investigated with the baseline series and a special patch test series based on substances found in the gloves, soaps, alcoholic hand disinfectants and hand creams provided at the hospitals. Results: Contact allergy to rubber additives was significantly more common in HCWs with HE (6%) than in HCWs without HE (1%, P =.02). The corresponding percentages for fragrances were 11% and 3%, respectively (P =.004). Occupational HE was found in 193 of 311 (62%) HCWs. Of these, 22 of 193 (11%) had occupational allergic contact dermatitis, including 17 with glove-related rubber contact allergy. Contact allergy to diphenylguanidine was as common as contact allergy to thiurams. Occupational contact allergy to rubber additives was significantly associated with sick-leave related to HE. Conclusion: Contact allergy to rubber additives in medical gloves is the most common cause of occupational allergic contact dermatitis in HCWs. Aimed patch testing with relevant rubber additives is mandatory when HE in HCWs is investigated.
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| 50. |
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