Baby Wet Wipes: An Unusual Culprit of Lymphomatoid Contact Dermatitis Mimicking Mycosis Fungoides.

ABSTRACT: Lymphomatoid contact dermatitis (LCD) is a rare, benign pseudolymphoma with clinicopathologic features of both allergic contact dermatitis and cutaneous T-cell lymphoma (CTCL). In this article, we report a fascinating case of LCD secondary to chronic baby wet wipe use with clinical features of allergic contact dermatitis and histopathologic changes of mycosis fungoides, a subtype of CTCL. We argue that LCD should be added to the list of mimickers of mycosis fungoides, a subtype of CTCL.

Patterns of Allergic Contact Dermatitis in African Americans in a Major Metropolitan Area Over a 10-Year Period.

BACKGROUND: Differences in patterns of allergic contact dermatitis (ACD) among underrepresented minority populations are not well studied. OBJECTIVE: The aim of the study was to investigate patterns of ACD in African American and White patch-tested patients in a distinct metropolitan area over a 10-year period. METHODS: We conducted a retrospective review of 297 ACD patients patch tested from 2009 to 2019. Differences in allergen frequency, relevance, and sources of exposure were evaluated. Fisher exact test analyses were performed to examine these differences. RESULTS: Among 297 patients, 215 were White and 47 were African American. The most common sensitizers differed between the 2 groups. African American patients also reacted with statistically significant greater frequency to disperse dye blue (P = 0.019) and textile dye mix (P = 0.001). The most common source of positive patch tests for all patients was personal care products (72%). Occupational allergy was greater in African American male patients, and personal care product exposure was greater in White male patients (P = 0.009). CONCLUSIONS: Our study highlights the differing patterns of sensitization seen in African American and White patients. This is likely due to differences in personal care product use or occupational allergy. Additional studies with larger sample sizes are needed to expand upon these differences.

Trends in preservative allergy: Benzisothiazolinone emerges from the pack.

BACKGROUND: Preservatives are used widely in cosmetic, household, and industrial products to prevent microbial growth and spoiling of the products. There has been a recent epidemic of contact allergy to methylisothiazolinone (MI). OBJECTIVES: To establish emerging trends in preservative contact allergy as MI is replaced. METHODS: We performed a retrospective study on consecutively patch-tested patients at our center from January 2011 to December 2019. RESULTS: A total of 7846 consecutively patch-tested patients were included who were patch tested between January 2011 and December 2019. The prevalence of allergy to MI fell from a peak of 9.39% in 2013 to 1.98% in 2019. MI/methylchloroisothiazolinone (MCI) followed a similar trend, with a peak prevalence of 7.85% in 2014 and falling to 1.39% in 2018. The prevalence of contact allergy to benzisothiazolinone (BIT) has increased steadily increased in 2014 from 0.26% (confidence interval [CI] 0.03-0.93) to 3.42% (CI 2.43-4.66) in 2019. CONCLUSIONS: Our data show a significant increase in the prevalence of contact allergy to BIT over the last 6 years, probably as a consequence of increased use in household products. It is essential to continue to look for emerging trends in contact allergy to enable prompt preventative measures to be taken.

Baby wipes and nappy rash - what is the relationship? A review.

Baby wipes are a commonly used cleansing method for infants. A literature review has been performed to assess if using baby wipes is beneficial or harmful compared to water and cloth in terms of nappy rash. This includes a detailed analysis of baby wipe ingredients, as many skin irritants as well as allergens are identified. MedLine, Embase and PubMed were searched and after 420 titles and abstracts were screened, 21 studies remained for inclusion. Baby wipes are deemed as superior to water and cloth in the majority of the literature. However, no definitive conclusion can be drawn as many studies are also industry funded. The most notable allergens identified are fragrances, such as linalool, cocamidopropyl betaine (surfactant), formaldehyde-releasing preservatives and other preservatives, including methylisothiazolinone and methylchloroisothiazolinone. As not all allergens are listed on the label accurately, this can be misleading for the consumer.

Tracing colophonium in consumer products.

BACKGROUND: Colophonium (rosin) can cause allergic contact dermatitis, mainly due to autoxidation of abietic acid (AbA). Products containing ≥0.1% colophonium should be labeled with EUH208 - "Contains rosin; colophony. May produce an allergic reaction." How should this be measured? OBJECTIVE: To compare the results from different strategies for estimating colophonium levels in consumer products: (a) from AbA, and (b) the sum of all major resin acids. To investigate the ratio of 7-oxodehydroabietic acid (7-O-DeA)/AbA as indication of autoxidation. METHODS: Resin acids were extracted from consumer products, derivatized, and then separated by gas chromatography/mass spectrometry (GC/MS). RESULTS: Resin acids were detected in 9 of 15 products. No product contained colophonium ≥0.1%. Estimation based on AbA resulted in underestimation of the colophonium levels in four of nine products. For three products, the obtained levels from this strategy were only one of two compared to when estimating from the sum of all resin acids. The ratio 7-O-DeA/AbA varied from 74% to 1.4%. CONCLUSIONS: We propose to measure colophonium based on the sum of all detectable major resin acids, including 7-O-DeA. The ratio of 7-O-DeA/AbA should be used as a marker of autoxidation, indicating an increased risk of sensitization. The presented analytical method is simple to use and suitable for further screening studies.

Pediatric Burns With Cyanoacrylate Glue: An Inconspicuous Danger.

Burns are a common cause of pediatric injury and represent significant morbidity and mortality in this age group. In children, most burns are thermal, resulting from exposure to a hot surface, liquid, or fire. Cyanoacrylate is a liquid compound commonly found in households, mainly in "superglue" and nail glue. This compound solidifies through an exothermic reaction that is magnified when in contact with certain fibers that act as catalysts, such as cotton. In these circumstances, intense heat is produced in the contact area, potentially causing severe thermal burns. Despite its widespread availability, there is a paucity of safety information about cyanoacrylate and its role as a cause for burns. In the literature, only 18 cases of cyanoacrylate burns are reported in children. We present two cases of pediatric burns with cyanoacrylate and a review of the literature.

Skin exposure to scented products used in daily life and fragrance contact allergy in the European general population - The EDEN Fragrance Study.

BACKGROUND: Fragrances are widely used in scented products used in daily life with the potential to induce skin sensitization. OBJECTIVE: To evaluate exposure to scented products and to explore associations between exposure and fragrance contact allergy. METHODS: A cross-sectional study on individuals from 18 to 74 years of age, who were randomly selected from the general population in five European countries. A random sample (N = 3119) was patch tested and interviewed on exposure to scented products. RESULTS: Female participants were strongly associated with exposure to scented products relative to male participants. Participants age 40 years and older showed an inverse association with exposure to scented products. Compared to Sweden, The Netherlands followed by Germany showed the highest overall exposure to scented products. Sensitive skin was associated with exposure to scented products and with fragrance allergy. In univariable regression analysis, exposure to leave-on products and to specific scented product subgroups was significantly associated with fragrance allergy. CONCLUSION: Exposure to scented products depends primarily on sex and age. Female sex and sensitive skin are relevant indicators for developing fragrance allergy. Because aggregate exposure, especially to scented leave-on products, may enhance the prevalence of contact allergy to fragrances, further investigations into exposure amounts and frequencies is warranted.

Characteristics of ocular nail glue exposures reported to the National Electronic Injury Surveillance System during 2000-2019.

INTRODUCTION: Nail glue often consists of a mixture of alcohol, cyanoacrylate, or photo-bonded methacrylate. Ocular exposures to nail glue may result in potentially serious clinical effects, and patients may be treated at healthcare facilities. The objective of this study was to characterize ocular nail glue exposures treated at United States emergency departments. METHODS: Data were obtained from the National Electronic Injury Surveillance System, a database of consumer product-related injuries collected from approximately 100 United States hospital emergency departments. Ocular nail glue exposures reported during 2000-2019 were identified by reviewing all records with product code 0909 (Adhesives) and with "nail" and "glue" or "nail" and "adhesive" in the Narrative field. RESULTS: A total of 498 ocular nail glue exposures were identified, resulting in a national estimate of 18,402 exposures. Of the estimated exposures, the age distribution was 14.1% 0-5 years, 15.1% 6-12 years, 14.3% 13-19 years, and 56.6% 20 years or older; 87.5% of the patients were female. The nail glue was mistaken for eye drops in 20.8% of the cases, splashed into the eye in 15.0% cases, and rubbed into the eye in 3.3% cases. The most commonly reported clinical effects were 41.8% foreign body, 33.8% corneal abrasion, and 11.0% conjunctivitis. CONCLUSION: The most common circumstance leading to ocular nail glue exposures treated at United States emergency departments involved nail glue being mistaken for eye drops. The most frequently reported clinical effects were the presence of a foreign body, corneal abrasion, and conjunctivitis.