Allergic contact dermatitis to para-phenylenediamine.

Exposure to hair dye is the most frequent route of sensitisation to para-phenylenediamine (PPD), a common contact allergen. International studies have examined the profile of PPD, but Australian-sourced information is lacking. Patients are often dissatisfied with advice to stop dyeing their hair. This study examines patients' characteristics, patch test results and outcomes of PPD allergy from a single Australian centre, through a retrospective analysis of patch test data from 2006 to 2013 at the Liverpool Hospital Dermatology Department. It reviews the science of hair dye allergy, examines alternative hair dyes and investigates strategies for hair dyeing. Of 584 patients, 11 were allergic to PPD. Our PPD allergy prevalence rate of 2% is at the lower end of international reported rates. About half these patients also react to para-toluenediamine (PTD). Affected patients experience a significant lifestyle disturbance. In all, 78% tried alternative hair dyes after the patch test diagnosis and more than half continued to dye their hair. Alternative non-PPD hair dyes are available but the marketplace can be confusing. Although some patients are able to tolerate alternative hair dyes, caution is needed as the risk of developing an allergy to other hair dye ingredients, especially PTD, is high.

Frequency of positive patch test reactions to preservatives: The Australian experience.

BACKGROUND/OBJECTIVES: Preservatives are important causes of allergic contact dermatitis. The frequency of allergy to preservatives in Australia has been unknown to date. Our objectives are to report the frequency of positive preservative patch test reactions in Australia, comparing them to the published international data, as well as exploring the current regulations in place for preservative use in Australia. METHODS: This was the first retrospective study of patch testing results, aggregated from four patch test clinics in three centres in Melbourne and Sydney. RESULTS: In all, 6845 patients were patch-tested during 1993-2006 and in this period the five most frequent preservative allergens were formaldehyde (4.6%), Euxyl K400 (containing methyldibromo glutaronitrile and phenoxyethanol) (3.3%), quaternium-15 (2.9%), diazolidinyl urea (2.4%), and methylchloroisothiazolinone/methylisothiazolinone (2.3%). These were followed by dimethylol dimethyl DMDM hydantoin (2.1%), chloroacetamide (2.1%) and imidazolidinyl urea (1.9%). The least frequent sensitisers were parabens (1.1%), 2-bromo-2-nitropropane-1, 3-diol (0.9%) and benzyl alcohol (0.4%). CONCLUSIONS: Formaldehyde was the most prevalent preservative allergen. Chloroacetamide allergy was more commonly seen in Australia. Parabens, 2-bromo-2-nitropropane-1,3-diol and benzyl alcohol were the least frequent sensitisers. Household products in Australia are not required to list all ingredients preventing sensitised individuals from properly assessing their exposure.