Prevalence of allergic contact dermatitis in children with and without atopic dermatitis: A multicenter retrospective case-control study.

BACKGROUND: As both allergic contact dermatitis and atopic dermatitis (AD) have similar clinical presentations and are characterized by spongiotic dermatitis on skin biopsy, many children with AD are not referred for patch testing and allergic contact dermatitis is underdiagnosed. OBJECTIVE: To provide updated prevalence data of common contact allergens in children with and without AD. METHODS: This is a retrospective case-control study using the Pediatric Allergic Contact Dermatitis Registry from 2018 to 2022. RESULTS: A total of 912 children were included (615 with AD and 297 without AD). Children with AD were more likely to have a longer history of dermatitis (4.1 vs 1.6 years, P < .0001), have seen more providers (2.3 vs 2.1, P = .003), have greater than 1 positive patch test (PPT) result (P = .005), have a greater number of PPT results overall (2.3 vs 1.9, P = .012), and have a more generalized distribution of dermatitis (P = .001). PPT to bacitracin (P = .030), carba mix (P = .025), and cocamidopropyl betaine (P = .0007) were significantly increased in children with AD compared to those without AD. LIMITATIONS: Technical variation between providers and potential for misclassification, selection, and recall biases. CONCLUSION: Children with AD are significantly more likely to have PPT reactions and should be referred for evaluation of allergic contact dermatitis and obtain patch testing.

Safety profile of laser-assisted drug delivery of vitamin C, E, and ferulic acid serum following ablative fractional resurfacing: A retrospective chart review.

OBJECTIVES: The topical application of a combination Vitamin C, Vitamin E, and Ferulic acid serum following ablative fractional resurfacing has been reported to shorten post-procedure downtime and improve wound healing. However, transcutaneous drug delivery of cosmeceuticals initially meant for topical application have also been shown to have unintended side effects. The objective of our study was to report safety data from our single academic center experience consisting of patients treated with topical application of a vitamin C-containing cosmeceutical immediately following fractional ablative CO2 laser treatment with a focus on reportable side effects. METHODS: A retrospective chart review of all patients at the University of Minnesota M Health Cosmetic Center who had fractional ablative CO2 (10,600 nm) laser procedure for any diagnosis followed by immediate one-time application of a combination serum containing 15% Vitamin C, 1% Vitamin E, and 0.5% Ferulic acid (C E Ferulic®, SkinCeuticals Inc., New York, NY) from Jan 1, 2015 to Dec 31, 2018 was performed. Pediatric and research opt-out patients were excluded. The medical records of these patients were manually reviewed for the following: age, sex, diagnosis, location, after-care instructions, antiviral and/or antibacterial prophylaxis use, and documentation of post-procedure side effects. RESULTS: Thirty-three patients, encompassing a total of 45 treatment encounters, met inclusion criteria. There were ten cases of expected side effects: erythema (6), erythema with tenderness (1), erythema with mild bumpiness (1), skin peeling with pattern marking (1), and pain with slight bleeding (1). These were attributed to the normal post-procedure course and resolved without complications. There were no reported side effects related to the topical application of Vitamin C, Vitamin E, and Ferulic acid serum. CONCLUSIONS: The topical application of a Vitamin C, Vitamin E, and Ferulic acid serum immediately following fractional ablative CO2 laser therapy did not result in associated complications. However, these results may not be generalizable to longer application courses beyond the immediate post-procedure time period, nor to other cosmeceutical formulations. More studies examining the safety profile of topical cosmeceutical serums in laser-assisted drug delivery are needed.

Patch Testing Results From the Massachusetts General Hospital Occupational and Contact Dermatitis Clinic, 2017-2022.

Background: Patch testing is gold standard for identifying the source of allergic contact dermatitis (ACD). Objective: To report patch testing results from the Massachusetts General Hospital (MGH) Occupational and Contact Dermatitis Clinic from 2017 to 2022. Methods: Retrospective analysis of patients referred to MGH for patch testing, 2017-2022. Results: In total, 1438 patients were included. At least 1 positive patch test (PPT) reaction was observed in 1168 (81.2%) patients and at least 1 relevant PPT reaction was observed in 1087 (75.6%) patients. The most common allergen with a PPT was nickel (21.5%), followed by hydroperoxides of linalool (20.4%) and balsam of Peru (11.5%). Sensitization rates statistically increased over time for propylene glycol and decreased for 12 other allergens (all P values <0.0004). Limitations: Retrospective design, single institution tertiary referral population, and variations in allergens and suppliers across the study period. Conclusion: The field of ACD is constantly evolving. Regular analysis of patch test data is crucial to identify emerging and diminishing contact allergen trends.

Is Laundry Detergent a Common Cause of Allergic Contact Dermatitis?

Both patients and health care providers commonly suspect laundry detergent as the cause of skin problems; however, research suggests that the prevalence of laundry detergent-associated allergic contact dermatitis (ACD) may be quite low. Herein, we provide a summary of the evidence for the potential allergenicity of laundry detergent, including common allergens present in laundry detergent, the role of machine washing, and the differential diagnosis for laundry detergent-associated ACD.

Janus Kinase Inhibitors: A Promising Therapeutic Option for Allergic Contact Dermatitis.

Janus kinase (JAK) inhibitors represent a promising class of small molecule inhibitors that treat a range of inflammatory skin diseases, such as atopic dermatitis (AD), psoriasis, and alopecia areata. Although the evidence for their use in allergic contact dermatitis (ACD) remains limited, early results from animal studies and case reports are promising. Herein, we provide an overview of JAK inhibitors and the evidence for their use in ACD.

Lanolin: The 2023 American Contact Dermatitis Society Allergen of the Year.

In 2023, lanolin was named the American Contact Dermatitis Society Allergen of the Year. Despite its widespread use in personal care products and industrial goods, lanolin is thought to be a rare sensitizer in patients with healthy skin; however, those with chronic inflammatory skin conditions are at a higher risk for allergic contact dermatitis (ACD) to lanolin. The proper patch test formulation for lanolin is a source of contention. In this article, we discuss ACD to lanolin with a focus on its paradoxical nature and the subtleties to consider when patch testing to this controversial allergen.

A Deep Dive Into Instagram's Top Skinfluencers.

We characterized skinfluencers from various training backgrounds and compared their posts on Instagram featuring skin care products.

Patch Test Results Among Older Adults: A Retrospective Analysis of the North American Contact Dermatitis Group Data (2009-2020).

Background: Allergic contact dermatitis (ACD) in older adults (OA) represents a significant health burden, but few studies examine the prevalence and characteristics of contact allergy and ACD in this population. Objective: To compare positive and clinically relevant patch test results in OA versus younger adults (YA) and children. Methods: Retrospective analysis of patch test results obtained in OA (≥65 years), YA (19-64 years), and children (≤18 years) by the North American Contact Dermatitis Group, 2009 to 2020. Results: Of 28,177 patients patch tested, 5366 (19.0%) were OA. OA were more likely to have a final primary diagnosis of ACD as compared with YA (50.8% vs 49.2%, P = 0.035) and children (44.6%, P < 0.0001). The primary site of dermatitis also differed by age group, with OA having a higher proportion of dermatitis affecting the trunk, scalp, anogenital region, and "under clothing," and a lower proportion of dermatitis affecting the face, lips, and feet. Limitations: Retrospective design, lack of follow-up, and referral population. Conclusion: OA were as likely and were statistically even more likely to have a final primary diagnosis of ACD compared with YA and children. Anatomic site of dermatitis also differed by age group. This underscores the need for patch testing in OA when ACD is suspected.

Current and Emerging Therapies in Pediatric Atopic Dermatitis.

Atopic dermatitis (AD) is the most common inflammatory skin disease seen in children. It is a heterogeneous disorder, with a variety of associated manifestations and symptoms. Cases may range from mild to severe. As a result, a spectrum of prescription and nonprescription therapies may be utilized when managing this condition. This article provides an extensive overview of these therapies, with equal consideration provided to current, emerging, and alternative options used in the pediatric population.

Dupilumab for Allergic Contact Dermatitis: An Overview of Its Use and Impact on Patch Testing.

Allergic contact dermatitis (ACD) has been estimated to affect up to 20% of the general population. Patch testing is the gold standard for identification of causative allergens. When allergen avoidance fails, current treatment options include topical and oral corticosteroids, systemic immunosuppressants, and phototherapy. Dupilumab, a monoclonal antibody targeting IL-4/IL-13, is approved by the US Food and Drug Administration for the treatment of moderate to severe atopic dermatitis. It also has been used off label with some success in the treatment of ACD. This article discusses the evidence for using dupilumab to treat ACD as well as considerations for patch testing in patients who are taking this medication.

Photoallergic Contact Dermatitis: No Fun in the Sun.

Photoallergic contact dermatitis (PACD) is a form of allergic contact dermatitis that occurs due to the interaction between a topically applied chemical and exposure to UV radiation. It can be difficult to identify and requires photopatch testing (PPT) for definitive diagnosis. In this article, we provide an overview of PACD, including clinical features, the most common photoallergens, and why cases may go undiagnosed.

Can Atopic Dermatitis and Allergic Contact Dermatitis Coexist?

Due to their seemingly divergent immune pathways, it previously was thought that atopic dermatitis (AD) and allergic contact dermatitis (ACD) could not occur together. However, novel research suggests that the 2 conditions may be more closely related than previously understood. Herein, we discuss the overlapping relationship between AD and ACD and review the evidence for their coexistence. We also review management strategies to consider for patients with dual diagnoses of AD and ACD.

Factors and cost associated with atopic dermatitis in Nevada.

Objectives: Atopic dermatitis, or eczema, is an inflammatory illness that impacts individuals of all ages. The cost of treating AD and the impact on the quality of life have not been well documented in the state of Nevada. This study seeks to fill this gap by identifying factors that impact the cost of AD in the state utilizing clinical and patient demographics. Methods: ANOVA with Bonferroni adjustment was performed using a large hospital utilization database to examine the cost of AD in the state of Nevada across all hospital settings. Results: Several significant factors were associated with the overall cost of AD in Nevada, including hospital setting type (outpatient vs. inpatient), physician type, region, AD diagnosis level, and age (p < 0.05). Stratified analysis was performed by setting type. In the inpatient setting, region, diagnosis level, and records with age listed between 0 and 5 years remained significant (p < 0.05). In the outpatient setting, physician type, region, and African American race remained significant (p < 0.05). Conclusions: Data from this study indicate that the AD cost burden is dependent on both demographic and clinical factors in the state of Nevada. These differences suggest that patients with AD may encounter higher costs depending on age, race, and clinical factors.