Contact allergy in Danish children: Current trends.

BACKGROUND: Contact allergy is common in children, but may be underdiagnosed. Importantly, the clinical relevance of specific allergies is subject to constant change, and it is therefore important to continuously monitor the trends and changes of contact allergies in the paediatric population. OBJECTIVES: To identify possible changes in contact allergy and allergic contact dermatitis among Danish children referred for patch testing. METHODS: A retrospective study was performed based on patch test data from the Danish National Database of Contact allergy. The current data were compared with previously published data on Danish children referred for patch testing. RESULTS: Between 2012 and 2016, 1573 children and adolescents were patch tested. Overall, 385 (24.5%) had at least 1 positive patch test reaction. The overall prevalence was similar in boys and girls, across age groups, and in patients with and without atopic dermatitis. Statistically significant increases in contact allergy to fragrances and isothiazoliones were seen, whereas a decrease in nickel allergy was found. CONCLUSION: Allergic contact dermatitis continues to be a common disease in children, and is even significantly increasing for some allergens.

Occupational contact dermatitis in blue-collar workers: results from a multicentre study from the Danish Contact Dermatitis Group (2003-2012).

BACKGROUND: Blue-collar workers have a high risk of occupational contact dermatitis, but epidemiological studies are scarce. OBJECTIVES: To investigate allergic contact dermatitis in blue-collar workers with dermatitis registered by the Danish Contact Dermatitis Group. METHODS: A retrospective analysis of patch test data from 1471 blue-collar workers and 1471 matched controls tested between 2003 and 2012 was performed. A logistic regression was used to test for associations. RESULTS: The blue-collar workers often had occupational hand dermatitis (p < 0.001). Atopic dermatitis was less commonly observed among blue-collar workers (19.6%) than among controls (23.9%) (p = 0.005). Allergens with a statistically significant association with the occupational group of blue-collar workers were epoxy resins, methyldibromo glutaronitrile, 2-bromo-2-nitro-1,3-propanediol, potassium dichromate, and methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI). The following occupations were additionally identified as risk factors for contact sensitization to MCI/MI and MI, epoxy resins, and potassium dichromate, respectively: painting, construction work, and tile setting/terrazzo work. CONCLUSION: Contact allergy is a major problem among blue-collar workers. The data indicate a healthy worker effect among blue-collar workers diagnosed with dermatitis, as blue-collar workers were diagnosed significantly less often with atopic dermatitis than were controls.

Occupational contact dermatitis in hairdressers: an analysis of patch test data from the Danish contact dermatitis group, 2002-2011.

BACKGROUND: Occupational contact dermatitis among hairdressers is frequent, owing to daily exposure to irritants and allergens. OBJECTIVES: To identify sensitization to the most common allergens associated with the occupation of hairdressing. METHODS: Patch test results of 399 hairdressers and 1995 matched controls with contact dermatitis, registered by the Danish Contact Dermatitis Group between January 2002 and December 2011, were analysed. All patients were patch tested with the European baseline series, and hairdressers were additionally tested with the hairdressing series. RESULTS: Occupational contact dermatitis (p < 0.001) and hand eczema (p < 0.001) were observed significantly more often among hairdressers than among controls. Atopic dermatitis was less commonly observed among hairdressers (21.3%) than among controls (29.4%) (p < 0.01). Allergens from the European baseline series with a statistically significant association with the occupation of hairdressing were p-phenylenediamine, thiuram mix, and benzocaine. Frequent sensitizers from the hairdressing series were ammonium persulfate, toluene-2,5-diamine, 3-aminophenol, and 4-aminophenol. Cysteamine hydrochloride and chloroacetamide emerged as new sensitizers. CONCLUSIONS: These results indicate a healthy worker effect among hairdressers diagnosed with eczema. Ammonium persulfate and p-phenylenediamine remain frequent sensitizers in hairdressers with contact dermatitis. Cysteamine hydrochloride and chloroacetamide should be included in future surveillance studies.

Occupational contact dermatitis in painters: an analysis of patch test data from the Danish Contact Dermatitis Group.

BACKGROUND: Painters are among the occupational groups that most commonly experience occupational contact dermatitis, but few investigations exist concerning this occupation. OBJECTIVES: To characterize painters with contact dermatitis and identify the most common allergens associated with the occupation. Materials and methods. All patch test results of 219 painters and 1095 matched controls registered by the Danish Contact Dermatitis Group between 2001 and 2010 were analysed. RESULTS: Hand eczema (p < 0.0001) and occupational contact dermatitis (p < 0.0001) were observed significantly more often in the painters than in the group of controls. Sensitizations to the following allergens from the European baseline series were associated with the occupation and were statistically significant: methylchloroisothiazolinone/methylisothiazolinone, epoxy resin, formaldehyde, and quaternium-15. Three different isothiazolinones emerged as the most frequent sensitizers of the allergens tested in addition to the baseline series. CONCLUSIONS: The results indicate that painters have an increased risk of developing occupational hand eczema. Isothiazolinones and epoxy resin proved to be the two most frequent sensitizers in painters.

Nickel reactivity and filaggrin null mutations--evaluation of the filaggrin bypass theory in a general population.

BACKGROUND: It was recently shown that filaggrin null mutation carrier status was associated with nickel allergy and self-reported intolerance to costume jewellery. Because of the biochemical characteristics of filaggrin, it may show nickel barrier properties in the stratum corneum. OBJECTIVES: To investigate whether subjects with filaggrin null mutations report nickel dermatitis at an earlier age than wild-type individuals, and to analyse whether null mutation carriers have stronger patch test reactivity to nickel sulfate than do wild-type individuals. MATERIALS: A total of 3471 Danes (18-69 years of age) answered a questionnaire about general health, and underwent patch testing and filaggrin genotyping. RESULTS: The mean number of years at risk of developing nickel dermatitis was significantly lower for the filaggrin null genotype than for the wild-type genotype when ear piercing status was considered. In positive patch test readings, the proportion of null mutants increased with increasing reaction strength. CONCLUSIONS: Filaggrin null mutations may lower the age of onset of nickel dermatitis. The hypothesis that ear piercings obscure the effect of filaggrin null mutations on the development of nickel allergy in statistical analyses was supported. An association between the null genotype and increased nickel sensitivity was indicated by patch test reading and questionnaire data.

Effect of tobacco smoking and alcohol consumption on the prevalence of nickel sensitization and contact sensitization.

There is evidence that stimulants such as alcohol and tobacco have an effect on the immune system, but little is known about how these lifestyle factors affect the prevalence of contact sensitization. This study investigated whether smoking and alcohol consumption were associated with contact sensitization and nickel sensitization. A random sample of adults (n=3460) from the general population of Copenhagen was invited to participate in a general health examination including patch-testing. Alcohol consumption was not associated with nickel sensitization, whereas a significant trend (p<0.05) was identified between smoking status and nickel sensitization in an adjusted model; i.e. nickel sensitization was higher among both previous smokers (odds ratio (OR) = 1.19; confidence interval (CI) = 0.81-1.76), current light smokers (OR=1.50; CI=0.94-2.37) and current heavy smokers (OR=1.56; CI = 0.87-2.80) compared with never smokers. This study confirmed that smoking is associated with nickel sensitization, but rejected an association with alcohol consumption.

Decreasing trends in methyldibromo glutaronitrile contact allergy--following regulatory intervention.

BACKGROUND: The preservative methyldibromo glutaronitrile (MDBGN) has been banned, first from stay-on, and later from rinse-off cosmetics, in the EU countries because of increasing rates of contact allergy. OBJECTIVES: To evaluate the frequency of contact allergy to MDBGN among patients patch tested by the Danish Contact Dermatitis Group just before and following regulatory decisions. PATIENTS/METHODS: The data set comprised 19 279 consecutive eczema patients patch tested from 2003-2007 with MDBGN 0.3% in petrolatum (pet.) or, in a minority of patients, with Euxyl K 400 1.5% in pet. RESULTS: A significantly decreasing trend in the frequency of positive patch tests to MDBGN was found from 4.6% in 2003 to 2.6% in 2007 (P < 0.001). The decreasing trend was seen for both men and women. A significantly decreasing proportion of cases with a current relevance of contact allergy to MDBGN was also seen from 51.3% in 2003 to 29% in 2007 (P < 0.001). CONCLUSIONS: Regulatory interventions have already had a major effect on allergic disease due to MDBGN in Denmark. The same trends are likely to be seen in other EU countries.

Paralysis of the first dorsal interosseous muscle after external fixation of a distal radial fracture treated by transfer of the extensor indicis proprius tendon.

We describe a patient in whom the motor branch to the first dorsal interosseous muscle was injured by the pins of an fixator used to treat an unstable fracture of the distal radius. She was successfully treated by extensor indicis proprius transfer to the base of the proximal phalanx of the index finger.

[Reflex dystrophy. Complex regional pain syndrome type I]. / Refleksdystrofi. "Complex regional pain syndrome" type I.

Reflex sympathetic dystrophy or complex regional pain syndrome type I is primarily a clinical diagnosis. The syndrome is most common after soft tissue damage or fractures and is more often seen in women than in men. The paramount symptom is pain, but oedema, a limited range of motion, changes in sensibility, and trophic changes are also seen. The pathogenesis is unknown, but most clinicians believe it to be caused by disturbances in the sympathetic or sensory nervous system and/or an excessive inflammatory response, most likely neurogenic inflammation. It seems that early treatment with physiotherapy and corticosteroids has a positive effect on the disease. Despite lack of documentation, the principles of treatment usually prescribed for the treatment of neurogenic pain must be taken into consideration. There is a lack of large double-blind studies on all aspects of the syndrome.

[Ganglion--cysts of the hand and wrist]. / Ganglion--seneknude på hånd og håndled.

Ganglion cysts of the hand and wrist occur most frequently during the second through fourth decade and women are more frequently affected than men. Ganglion cysts may arise in any location in the hand and wrist but are usually adjacent to joins or tendons and sometimes bones. Patients often present with a history of an asymptomatic mass and many patients seek the advice of a physician because of the cosmetic appearance of the cyst. Observation is acceptable in most instances. Indication for operative treatment includes pain, interference with activity, nerve compression and ulceration of the mucous cysts.