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- Engfeldt, Malin, et al.
(author)
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Multicenter patch testing with methylchloroisothizoline/methylisothiazolinone in 100 and 200 ppm within the international contact dermatitis research group
- 2017
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In: Dermatitis. - 1710-3568. ; 28:3, s. 215-218
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Journal article (peer-reviewed)abstract
- Background: The preservative methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is a well-known contact sensitizer. Historically, there have been different opinions on the optimal patch test concentration of MCI/MI, and both 0.01% and 0.02% aqueous (aq.) have been proposed. In 2011, based on literature reviews, it was recommended that the concentration of 0.02% aq. should be used in the international baseline series. Objectives: The aim of this study was to verify the recommendation from 2011 by comparing the patch test results from consecutive patch testing with MCI/MI 0.01% and 0.02% in clinics representing countries around the world. Patients and Methods: Two thousand seven hundred three consecutive patients with dermatitis in 8 dermatology clinics representing 8 countries were patch tested with MCI/MI 0.01% aq. and, in parallel with MCI/MI 0.02% aq., provisionally included in the baseline series. Results: Contact allergy to MCI/MI at 0.01% and 0.02% was found in 3.7% and 5.6% of the patients, respectively (P G 0.001). Conclusions: Methylchloroisothiazolinone/MI 0.02% aq. (dose, 6 Kg/cm2) diagnoses significantly more contact allergy than 0.01% (dose, 3 Kg/cm2), without resulting in more adverse reactions.Methylchloroisothiazolinone/MI at 0.02% aq. should therefore be continuously used in the international baseline series.
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- Gonçalo, Margarida, et al.
(author)
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Allergic contact dermatitis caused by nail acrylates in Europe. An EECDRG study
- 2018
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In: Contact Dermatitis. - : Wiley. - 0105-1873. ; 78:4, s. 254-260
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Journal article (peer-reviewed)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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- Herman, Anne, et al.
(author)
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Allergic contact dermatitis caused by isobornyl acrylate in Freestyle® Libre, a newly introduced glucose sensor
- 2017
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In: Contact Dermatitis. - : Wiley. - 0105-1873. ; 77:6, s. 367-373
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Journal article (peer-reviewed)abstract
- Background: Glucose sensors, such as FreeStyle® Libre, are innovative medical devices developed for diabetes patients as a replacement for classic glucose meters, ensuring continuous glucose monitoring without the disadvantage of regular skin finger pricks. Objectives: To report several cases of allergic contact dermatitis caused by FreeStyle® Libre, and to report on isobornyl acrylate as a culprit allergen. Patients and Methods: Fifteen patients presented with allergic contact dermatitis caused by FreeStyle® Libre. All but 1 were patch tested with a baseline series, and with pieces and/or ultrasonic bath extracts of (the adhesive part of) the glucose sensor. Isobornyl acrylate was patch tested, in various concentrations and vehicles, in 13 patients. Gas chromatography–mass spectrometry (GC-MS) of the sensors was performed. Results: All patients reacted to the adhesive part of the sensor, and 12 patients were shown to be sensitized to isobornyl acrylate. Simultaneous reactions to other allergens were rarely observed. GC-MS showed the presence of isobornyl acrylate in the sensors. Conclusions: Cases of allergic contact dermatitis caused by FreeStyle® Libre are increasingly being observed, and isobornyl acrylate is a relevant culprit allergen. Cross-reactivity to other acrylates was infrequently observed, but other, hitherto unidentified, contact allergens may still be present in the device.
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- Herman, Anne, et al.
(author)
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Allergic contact dermatitis caused by isobornyl acrylate in the Enlite glucose sensor and the Paradigm MiniMed Quick-set insulin infusion set
- 2019
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In: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 81:6, s. 432-437
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Journal article (peer-reviewed)abstract
- Background: The FreeStyle Libre glucose sensor has caused many cases of allergic contact dermatitis, and isobornyl acrylate (IBOA) in this sensor has been identified as one of the culprit allergens. Objectives: To report on the presence of IBOA in devices produced by Medtronic, namely, Enlite sensor and insulin infusion set Paradigm MiniMed Quick-set. Patients and Methods: Five patients reacting to the glucose sensor Enlite and/or the insulin infusion set Paradigm MiniMed Quick-set observed in three clinics (two Belgian and one Swedish) were patch tested with the baseline and other series, as well as with IBOA; four of them also with pieces of adhesive patches from the devices, and two with a thin layer chromatogram of Enlite glucose sensor extracts. Gas chromatography-mass spectrometry (GC-MS) analyses were performed. Results: Four patients reacted to IBOA and one to colophonium, a known allergen in Enlite, and three to the adhesive part of the sensor or the insulin infusion set. IBOA was identified in the sensor by GC-MS, and its presence was indicated in the infusion set. Conclusions: IBOA is a contact allergen in Enlite glucose sensor, and likely also in the infusion set. Therefore, these devices are not suitable alternatives for patients sensitized to the FreeStyle Libre sensor.
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- Herman, Anne, et al.
(author)
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The preservative 2-(thiocyanomethylthio)benzothiazole : A potential allergen in leather products
- 2019
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In: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 81:4, s. 262-265
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Journal article (peer-reviewed)abstract
- Background: Allergic contact dermatitis caused by leather is common, and several responsible allergens, such as tanning agents, glues, mercaptobenzothiazole derivatives, and dyes, but also antimicrobials and antifungals, are involved. Material and methods: Three female patients were referred to the Departments of Dermatology in a Belgian university hospital following skin reactions caused by leather products (shoes, belt, and car seats). They were patch tested with the European baseline series and samples of suspected leather products, and additionally with 2-(thiocyanomethylthio)benzothiazole (TCMTB), an antifungal agent previously reported to be a contact allergen in footwear. Chromatographic analyses of samples of all the leather materials tested were performed at the Department of Occupational and Environmental Dermatology in Malmö, Sweden. Results: The patients reacting to the leather samples were shown to be sensitized to TCMTB, the presence of which could be confirmed by chemical analyses of samples obtained from the patients. Conclusion: Patch tests with TCMTB should be considered in patients with contact dermatitis caused by leather items.
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- Herman, Anne, et al.
(author)
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Unexpected positive patch test reactions to sesquiterpene lactones in patients sensitized to the glucose sensor FreeStyle Libre
- 2019
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In: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 81:5, s. 354-367
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Journal article (peer-reviewed)abstract
- Background: Most diabetic patients sensitized to FreeStyle Libre react to isobornyl acrylate (IBOA), with a considerable number of them also showing unexpected positive patch test reactions to sesquiterpene lactone (SL) mix (SLM) tested in the baseline series. Objectives: To compile patch test results of subjects affected, and provide potential explanations for this association. Patients and Methods: Fifty-three Freestyle Libre-allergic patients were patch tested with IBOA and/or SLM, and several were also patch tested with the components of SLM. Chromatographic analyses were performed on the glucose sensor, IBOA, and the components of SLM. Results: Thirty-three patients reacted positively to the components of SLM, and 11 of 27 patients reacted positively to alantolactone, in particular. Gas chromatography-mass spectrometry (GC-MS) analyses did not detect these chemicals in the different parts of the glucose sensor, or in IBOA. Conclusion: Significant co-sensitizations between SLs on the one hand and the glucose sensor FreeStyle Libre and/or isobornyl acrylate on the other hand exist, without evidence of the presence of SLs via GC-MS analysis. Cross-reactions between them seem improbable. As a possible hypothesis, a common precursor for both, such as camphene, may exist. Highlights: Of the diabetic patients sensitized to the glucose sensor FreeStyle Libre and/or IBOA, 62.3% reacted positively to SLM. Cross-reactions between IBOA and the three components of SLM (alantolactone, costunolide, and dehydrocostus lactone) seem unlikely, because of their different spatial structures. Co-sensitization between IBOA and SLS can be explained by the fact that there is a common precursor, such as camphene, between these two molecules.
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- Hulstaert, Eva, et al.
(author)
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Contact dermatitis caused by a new rubber compound detected in canvas shoes
- 2018
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In: Contact Dermatitis. - : Wiley. - 0105-1873. ; 78:1, s. 12-17
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Journal article (peer-reviewed)abstract
- BACKGROUND: In 2015 and 2016, female patients in Flanders consulted a dermatologist because they developed skin lesions after wearing a specific brand of canvas shoes.OBJECTIVES: To identify the culprit allergen in the shoes.METHODS: Eighteen young females aged 14-22 years presented with itching and erythematous to purple-coloured eczematous lesions on both feet. They were patch tested by 10 dermatologists with the European baseline series. Some patients underwent testing with additional series. Pieces of the shoe fabrics were tested in 11 of 18 patients. Chemical analysis of the shoe materials was performed. Finally, patients were tested with a thin-layer chromatogram of the shoe extracts and dilutions of the suspected rubber compound.RESULTS: All 18 patients showed positive reactions to thiuram mix. Ten of 11 patients reacted to a piece of shoe fabric. Chemical analysis showed the presence of dimethylthiocarbamylbenzothiazole sulfide (DMTBS). No thiurams were detected. Four patients tested with the chromatogram developed positive reactions to DMTBS. Positive reactions to low concentrations were observed in the 4 patients tested with a DMTBS dilution series; one patient reacted to 0.00001% in acetone.CONCLUSIONS: DMTBS, the culprit allergen, is a component formed during rubber vulcanization that probably cross-reacts with the thiuram mix.
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- Isaksson, Marléne, et al.
(author)
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Multicenter patch testing with methylisothiazolinone and methylchloroisothiazolinone/methylisothiazolinone within the international contact dermatitis research group
- 2017
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In: Dermatitis. - 1710-3568. ; 28:3, s. 210-214
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Journal article (peer-reviewed)abstract
- Background: The preservatives methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI are well-known contact sensitizers. Recently, an increase in the contact allergy frequency for MI 0.2% aqueous (aq) has been seen in many European countries paralleled with an increase in MCI/MI allergy. Many of the MI-allergic patients do not react to MCI/MI 0.01% or 0.02% because the concentration of MI in these preparations is too low (25 and 50 ppm, respectively) to elicit a positive patch test reaction. Objectives: The aims of this study were to investigate the prevalence of contact allergy to MI in the participating clinics representing various countries all over the world, to assess how many additional individuals with contact allergy are found by testing MI 0.2% aq in parallel with MCI/MI 0.02%, and to assess the clinical relevance of MI and MCI/MI allergies. Patients and Methods: In 9 dermatology clinics representing 9 countries, 3865 consecutive patients with dermatitis were patch tested with MI 0.2% aq and in parallel with MCI/MI 0.02% aq, provisionally included into the baseline series. An assessment of clinical relevance in those allergic to MI was also made. Results: Contact allergy to MI was found in 284 patients (7.3%). The frequency of contact allergy varied from 0.8% to 10.9% in different centers. Simultaneous reactivity to 200 ppm of MCI/MI was found in 67.3% of the MI-positive patients. Contact allergy to MI alone without any simultaneous contact allergy to 200 ppm of MCI/MI was diagnosed in 93 patients (32.7%; 2.4% of all tested patients). The contact allergy to MI and/or MCI/MI could explain or contribute to dermatitis in more than 60% of the MI-allergic patients. Conclusions: Methylisothiazolinone of 2000 ppm needs to be patch tested on its own to not miss contact allergy.
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