Occupational contact dermatitis in painters and varnishers: Data from the Information Network of Departments of Dermatology (IVDK), 2000 to 2019.

INTRODUCTION: Painters and varnishers ("painters") are exposed to various contact allergens and skin irritants, and therefore, are at risk for developing occupational dermatitis (OD). OBJECTIVE: To describe the spectrum of occupational sensitizations in painters and revise the corresponding current patch test recommendations. PATIENTS AND METHODS: Retrospective analysis of Information Network of Departments of Dermatology (IVDK) data from 2000 to 2019 with focus on male painters with OD, ages 20-59 years (n = 557) in comparison to age-matched male painters without OD (n = 422) and male OD patients who have had never worked as painters (n = 13 862). RESULTS: Male painters with OD have a significantly higher rate of allergic contact dermatitis and face dermatitis than male patients with OD who work in other professions. Positive patch tests to epoxy resin, methylisothiazolinone (MI), and methylchloroisothiazolinone (MCI)/MI were significantly more frequent in painters with OD than in the other groups. Epoxy resin sensitization was significantly associated with face dermatitis. CONCLUSIONS: Epoxy resin, MI, and MCI/MI represent the most important occupational sensitizers in painters. In addition to baseline, resins and glues, and industrial biocides series, the patients' own workplace materials should be tested in painters with suspected OD.

The methylisothiazolinone epidemic goes along with changing patients' characteristics - After cosmetics, industrial applications are the focus.

BACKGROUND: Sensitization to methylisothiazolinone (MI) has seen an exceptional epidemic, mainly attributed to its use in cosmetics. OBJECTIVES: To trace the epidemic of MI allergy (2009-2018), and to analyze a possible change of patients' characteristics. METHODS: Informationsverbund Dermatologischer Kliniken-data of patients patch tested between 2009 and 2018 with MI (0.05% aq.) were analyzed concerning anamnestic items and sensitization frequencies. RESULTS: Overall, 4.9% reacted positive to MI. Comparing sensitization to MI in three periods (2009, 2013/14, and 2017/18), there was an increase to 7% in 2013 and a decrease to 3.4% in 2018. The MOAHLFA Index (M=Men, O=Occupational Dermatitis, A=Atopic Dermatitis, L=Leg Dermatitis, F=Face Dermatitis, A= Age > 40) for the period 2013/14 is characterized by a lower proportion of occupational dermatitis and a higher proportion of face dermatitis. The period 2017/18 is characterized by increases of occupational dermatitis and hand dermatitis, and a decrease of face dermatitis. Painters, personal care workers, and hairdressers were particularly affected. Sensitization in hairdressers and personal care workers (mostly cosmeticians) decreased after the peak in 2013/14, whereas sensitization to MI in painters continued to increase. CONCLUSIONS: After an unprecedented epidemic of MI allergy, mainly caused by its use in cosmetics, the continuous use of MI in industrial applications, for example, paints, and subsequent sensitization remain a matter of concern.

Contact allergy to lanolin: temporal changes in prevalence and association with atopic dermatitis.

BACKGROUND: Lanolin has been tested as lanolin alcohols (30% pet.) in baseline patch test series since 1969, and this has shown clinically relevant allergic contact dermatitis cases. OBJECTIVES: To investigate the temporal development of lanolin allergy (i.e. positive reaction to lanolin alcohols and/or Amerchol™ L-101), and the association between contact allergy to lanolin and patient characteristics from the MOAHLFA index. METHODS: A retrospective observational study of consecutively patch tested dermatitis patients (n = 9577) between 1 January 2004 and 31 December 2015 with lanolin alcohols 30% pet. and Amerchol™ L-101 50% pet. was performed. RESULTS: The prevalence of lanolin allergy increased from 0.45% in 2004 to 1.81% in 2015. In age-adjusted and sex-adjusted analyses, weak, significant associations were found between atopic dermatitis and lanolin and lanolin alcohols allergy, respectively, but no association with Amerchol™ L-101 allergy was found. Among 9286 dermatitis patients who were tested with both allergens, 108 had a positive test reaction to either lanolin alcohols or Amerchol™ L-101, whereas only 29 patients had positive test reactions to both markers. CONCLUSIONS: The prevalence of lanolin contact allergy has increased over a 12-year period, and inclusion of Amerchol™ L-101 will increase the chance of detecting lanolin contact allergy. Patch testing with lanolin is helpful in atopics with dermatitis and suspected cosmetic allergy.

Epidemiological data on airborne contact dermatitis - results of the IVDK.

BACKGROUND: Airborne contact dermatitis (AirbCD) is not uncommon, according to a large number of published case reports and review articles. Epidemiological data on AirbCD based on larger clinical samples have not yet been published. OBJECTIVES: To investigate demographic characteristics and patch test reactivity in patients diagnosed with both occupational and non-occupational AirbCD. METHODS: A retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK), 1994-2013, including 201 344 consecutively patch tested patients, was performed. RESULTS: One thousand two hundred and three patients (0.6%) were diagnosed with AirbCD, 421 (35.0%) of these with an occupational background. Occupational dermatitis and face involvement were more prevalent than in patients without AirbCD (n = 200 141). Sensitization to epoxy resin and sensitization to methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) were significantly associated with AirbCD, and there was a trend for sensitization to Compositae mix and/or sesquiterpene lactone mix to be associated with AirbCD. Adhesives, plastics, construction materials, paints and varnishes in occupational cases, and plants in non-occupational cases, were the most commonly documented culprit product categories. CONCLUSIONS: AirbCD is more common in patients with occupational dermatitis than in patients with non-occupational dermatitis. In our clinical sample, components of epoxy resin systems, MCI/MI and Compositae allergens were the most important contact allergens associated with AirbCD. Patch testing with additional allergens is important.