Occupational and non-occupational allergic contact dermatitis to hair dyes in Greece. A 10-year retrospective study.

BACKGROUND: Oxidative hair dyes are an important source of chemical exposure and a major risk factor for the development of occupational and non-occupational allergic contact dermatitis (ACD) worldwide. OBJECTIVE: To identify the frequency of common allergens associated with occupational and non-occupational ACD to hair dyes during the last 10 years, in Greece. METHODS: We retrospectively reviewed the medical records of patients with suspected ACD to hair dyes from 2010-2019. All patients with patch-test-confirmed ACD to hair dyes were evaluated. RESULTS: Out of 501 patients with suspected ACD to hair dyes, 362 had at least one positive reaction to hair dye allergens (62.4% were customers and 37.6% were hairdressers). The mean age of customers and hairdressers was 43.8 years and 30.8 years, respectively. Of the customers, 58.9% were exposed to dyes for >10 years and 61% of hairdressers for <5 years. The most common site of ACD among customers was the scalp (85%) and among hairdressers the hands (90%). p-Phenylenediamine (PPD) was the most common contact allergen (52.2%), followed by toluene-2,5-diamine, p-aminophenol, m-aminophenol, and ammonium persulfate. CONCLUSIONS: Sensitization prevalences for PPD and cross-reacting allergens have increased in Greece during the last decade, regardless of occupational or non-occupational exposure to hair dyes.

Epidemiology of Onychomycosis in an Academic Nail Unit in South Greece during a Three-Year Period.

BACKGROUND: Onychomycosis is the most common disease of the nails. OBJECTIVE: This retrospective study aimed at evaluating the epidemiology of onychomycosis in adult patients in South Greece during the 2015-2017 period. MATERIAL AND METHODS: A total of 3,226 patients with clinical signs of possible onychomycosis were included. Diagnosis was confirmed by microscopy with KOH 20% and by culture in Sabouraud agar with and without actidione. RESULTS: Diagnosis of onychomycosis was confirmed in 27.99% of the patients. Men were infected more often (40.04%) than women (23.30%). Toenails (68.77%) were infected more than fingernails (31.23%) in both sexes. Onychomycosis in fingernails was more common among women (39.74%) than men (18.51%). Men were more often diagnosed with onychomycosis in toenails (81.49%) than women (60.26%). Dermatophytes were the most frequently isolated fungi (34.11%), followed by Candida(29.79%) and non-dermatophyte molds (NDM) (7.20%). In fingernails, the most frequently isolated fungus was Candida spp. (84.04%), followed by dermatophytes (3.55%) and NDM (0.71%). In toenails, dermatophytes (47.99%) were more commonly identified, followed by NDM (10.14%) and Candida spp. (5.15%). CONCLUSION: Onychomycosis in Greece follows a pattern of higher incidence in males, with toenails more frequently infected with T. rubrum and fingernails more frequently infected with C. albicans in the present era.

The Rising Incidence of Allergic Contact Dermatitis to Acrylates.

BACKGROUND: Allergic contact dermatitis (ACD) caused by (meth)acrylates used in nail products is being increasingly reported in nail technicians and consumers. OBJECTIVES: The aim of the study was to assess the incidence of sensitization to (meth)acrylates in technicians and users of nail products with ACD, referred for patch testing in a tertiary center, during the last 10 years. METHODS: All patients with ACD, who reported a profession associated with cosmetic nail procedures or use of such services and were referred for patch tests in our department between January 2009 and December 2018, were identified. The incidence of positive sensitization to (meth)acrylates was assessed. RESULTS: Contact allergy to 1 or more (meth)acrylates was found in 116 (74.4%) of 156 nail technicians or nail product users, all women. One hundred thirty-eight (88.5%) were occupationally exposed, and 18 (11.5%) were consumers. In addition, there was a statistically significant increase in (meth)acrylate ACD during 2014-2018 (100/127 cases [79%]) when compared with 2009-2013 (16/29 cases [55%]). The most common sensitizer among the 156 allergic individuals was ethylene glycol dimethacrylate, which was positive in 113 cases (72.4%), and among patients with acrylate-positive patch test, the rate was 97.4%. CONCLUSIONS: Our experience confirms the worldwide changing landscape of rising (meth)acrylate sensitization in nail technicians and nail products users with ACD. Efforts to improve prevention are needed, and clinicians should have a high index for suspicion in this occupational group.