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BACKGROUND: Reports of allergic contact dermatitis (ACD) to phytonadione epoxide (PE) in cosmetics suggest that PE is as powerful a sensitiser as its parent compound phytonadione. OBJECTIVE: To evaluate a case series of ACD to PE in Spain. METHODS: We reviewed the records of 20 patients with ACD to cosmetics containing PE diagnosed across Spain between January 2019 and June 2023. RESULTS: All 20 patients developed patch test (PT) or repeated open application test (ROAT) reactions to cosmetics containing PE. All involved women with eyelid eczema. PT or ROAT with PE preparations were positive in 17/20 (85%). PE at 1%, 5%, 10% and 20% in pet. was patch-tested in 8/17, 14/17, 11/17 and 8/17 patients; being positive in 6/8 (75%), 13/14 (92.85%), 11/11 (100%) and 8/8 (100%), respectively. CONCLUSION: Regulators should, not only ban the specific dangerous cosmetic ingredients, but also consider to ban or keep under close surveillance those closely related products or derivatives that might potentially cause similar harmful effects. PTs with PE are suggested to be performed at a 5% concentration in pet. Higher concentrations (10% pet.) should be tested whenever PTs with 5% pet. PE are negative.
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BACKGROUND: Allergic contact dermatitis from (meth)acrylic monomers (ACDMA) in manicure products is increasing. OBJECTIVE: To evaluate the prognosis, work performance impairment and sequelae of a cohort of beauticians and manicure consumers with ACDMA sensitized from the exposure to manicure products. METHODS: We conducted a telephone survey with patients diagnosed with ACDMA. RESULTS: One hundred and six patients were evaluated, including 75 (70.8%) beauticians and 31 (29.2%) consumers. All were women with a mean age of 39 (19-62). Thirty-seven of 75 beauticians (49.3%) continued to work. Twenty-seven of 106 (25.5%) patients continued to use manicure products with (meth)acrylates regularly. Seventeen of 51 (33.3%) patients who discontinued the exposure described ongoing nail/periungual changes. Nine of 58 (15.5%) patients who required dental restoration, orthodontic or occlusal splint materials recalled reactions from them; and, 25 of 96 (26%) who used sanitary napkins recalled intolerance to them starting after the diagnosis of ACDMA. Fifteen of 25 (60%) discontinued the use of sanitary napkins. CONCLUSION: 49.3% beauticians continued to work; most patients stopped wearing acrylic manicure materials; reactions from dental materials were not uncommon, however, removal of dental materials was never required; and, reactions to sanitary napkins developing after the diagnosis of ACDMA were common most leading to discontinuation of use.
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Dermatitis Alérgica por Contacto , Dermatitis Profesional , Humanos , Femenino , Adulto , Masculino , Dermatitis Alérgica por Contacto/diagnóstico , Acrilatos/efectos adversos , Pruebas del Parche , Pronóstico , Materiales Dentales , Metacrilatos/efectos adversosRESUMEN
Background: Persistent localized dermatitis (PLD) or eczema flare-ups (EF) may occur in atopic dermatitis (AD) patients treated with dupilumab. They may reflect concomitant allergic contact dermatitis (ACD) exposed by the inhibition of the Th2 pathway by dupilumab in some cases. Objective: To evaluate the prevalence and etiology of these events and the impact of dupilumab on patch test outcome. Methods: We performed patch tests on 54 AD patients treated with dupilumab and evaluated the prevalence and final diagnosis of EF and PLD as well as the patch test results. Results: The patch test results were positive in 20/54 (37.0%). 21/54 patients (38.9%) had PLD and 12/54 (22.2%) had EF. Ten of 54 (18.5%) had both conditions and 11/54 (20.4%) had neither PLD nor EF. 64.5% of PLD involved the face. 83.9% patients with PLD and 90.9% patients with EF were diagnosed with inadequately controlled AD. 9.7% patients with PLD and 4.5% patients with EF were finally diagnosed with ACD. Nine of 21 (42.9%) patients patch tested twice were positive either before and/or during dupilumab. Patch tests results changed over time in all of them. Conclusions: Patch testing assisted us to exclude ACD as the cause of PLD/EF in AD patients treated with dupilumab. Most PLD and EF were, however, diagnosed as poorly controlled AD. Dupilumab appeared to impact the patch test outcomes.
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Dermatitis Alérgica por Contacto , Dermatitis Atópica , Humanos , Dermatitis Atópica/epidemiología , Pruebas del Parche , España/epidemiología , Resultado del Tratamiento , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Índice de Severidad de la EnfermedadAsunto(s)
Industria de la Construcción , Dermatitis Alérgica por Contacto , Dermatitis Profesional , Humanos , Acrilatos/efectos adversos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Dermatitis Profesional/diagnóstico , Dermatitis Profesional/etiología , Alérgenos , Metacrilatos , Pruebas del ParcheRESUMEN
We report the first two cases of allergic contact dermatitis from resacetophenone in a nail antifungal preparation. Patch tests gave positive reactions to resacetophenone (0.1% and 1% pet.). No cross-reactions with resorcinol or phenylethyl resorcinol were found. Patch testing with individual ingredients is paramount to diagnose new allergens.
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Dermatitis Alérgica por Contacto , Humanos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Antifúngicos/efectos adversos , Pruebas del Parche , Resorcinoles , AlérgenosAsunto(s)
Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Profesional/diagnóstico , Presión/efectos adversos , Ropa de Protección/efectos adversos , Zapatos/efectos adversos , Enfermedades Cutáneas Vesiculoampollosas/diagnóstico , Urticaria/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Dermatitis Profesional/etiología , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Cutáneas Vesiculoampollosas/etiología , Urticaria/etiologíaAsunto(s)
Cosméticos/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Glycyrrhiza/efectos adversos , Extractos Vegetales/efectos adversos , Acné Vulgar/tratamiento farmacológico , Adulto , Cosméticos/química , Dermatitis Alérgica por Contacto/diagnóstico , Femenino , Humanos , Pruebas del Parche , Extractos Vegetales/análisisRESUMEN
BACKGROUND: Fragrances constitute the second most frequent cause of allergic contact dermatitis in Spain. OBJECTIVES: To determine the rate of sensitization to the individual fragrances of fragrance mix (FM) I and FM II for each of the demographic and clinical factors included in the MOAHLFA (male, occupational dermatitis, atopic dermatitis, hand dermatitis, leg dermatitis, facial dermatitis, age) index. METHODS: We conducted a 5-year retrospective study in 23 Spanish centres. We identified the patients who had undergone patch testing with a specific fragrance series after reacting positively to fragrance markers in a baseline series. We obtained the MOAHLFA index items in this population, then calculated for each demographic and clinical factor the frequencies of sensitization to the individual fragrances of FM I and FM II. RESULTS: A specific fragrance series was patch tested in 1013 patients. The most frequent allergens in men, women, children, and retired people were Evernia prunastri (16%), geraniol (16.6%), isoeugenol (17.9%), and geraniol (22.4%), respectively. Citral (20.5%) and hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) (14.5%) were the most common allergens in occupational eczemas and were also associated with a large proportion of hand and facial dermatitis. CONCLUSIONS: Frequency of sensitization to the individual fragrances of FM I and FM II varies with age, sex, affected body region, and history of occupational or atopic dermatitis.
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Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Odorantes , Adulto , Edad de Inicio , Niño , Dermatitis Atópica/epidemiología , Dermatitis Atópica/etiología , Dermatitis Profesional/epidemiología , Dermatitis Profesional/etiología , Dermatosis Facial/epidemiología , Dermatosis Facial/etiología , Femenino , Dermatosis de la Mano/etiología , Humanos , Dermatosis de la Pierna/epidemiología , Dermatosis de la Pierna/etiología , Masculino , Pruebas del Parche/métodos , Estudios Retrospectivos , España/epidemiologíaAsunto(s)
Linfadenopatía/diagnóstico por imagen , Linfadenopatía/etiología , Pruebas del Parche/efectos adversos , Pruebas del Parche/métodos , Tiazoles/efectos adversos , Adulto , Axila/diagnóstico por imagen , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Femenino , Dermatosis de la Mano/diagnóstico , Dermatosis de la Mano/etiología , Humanos , Enfermedades de la Uña/diagnóstico , Enfermedades de la Uña/etiología , UltrasonografíaRESUMEN
BACKGROUND: Contact sensitization is frequent among patients with frontal fibrosing alopecia (FFA) (52%-76%). OBJECTIVE: To evaluate the frequency of sensitization/photosensitization in an FFA population. METHODS: A population of FFA patients were patch tested (Spanish Contact Dermatitis Research Group [GEIDAC] baseline; cosmetic and fragrance series), and photopatch tested (sunscreen series). RESULTS: Thirty-six patients (mean age: 64.6 years; 35/36: women) were studied. A history of dermatitis was recorded in 69.4% (frequently involving the face). Overall, 80.5% patients showed positive patch-test reactions. The most frequently positive allergens were nickel sulfate (25%), benzyl salicylate (22%), gallates (16.6%), propolis (16.6%), and limonene hydroperoxides (13.8%). Benzyl salicylate was likely relevant to the dermatitis (labeled on personal care products and most patients reporting clinical improvement with allergen avoidance). Patch tests with sunscreens showed positive reactions to 11 materials (five patients). Photopatch tests were positive in one case. CONCLUSION: We speculate a possible relationship between sensitization to benzyl salicylate and FFA. Hypothetically, the most likely explanation is that sensitization to benzyl salicylate involving FFA patients is a consequence of increased exposure to it. It is unclear whether allergen avoidance may impact the prognosis of alopecia. However, it seems to significantly improve the patients´ quality of life by lessening dermatitis and pruritus.
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Alérgenos/efectos adversos , Alopecia/complicaciones , Cosméticos/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Fotoalérgica/etiología , Salicilatos/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Odorantes , Prurito/etiología , Calidad de Vida , Estudios Retrospectivos , España , Protectores Solares/efectos adversosAsunto(s)
Dermatitis Alérgica por Contacto/etiología , Dermatitis Exfoliativa/inducido químicamente , Psoriasis/tratamiento farmacológico , Quinolinas/efectos adversos , Corticoesteroides/uso terapéutico , Dermatitis Alérgica por Contacto/tratamiento farmacológico , Dermatitis Exfoliativa/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Pruebas del Parche , Aceites de Plantas/efectos adversos , Psoriasis/complicacionesRESUMEN
BACKGROUND: Fragrance chemicals constitute the second most frequent cause of contact allergy in Spain. There are no data available concerning the individual fragrances that are most frequently involved. OBJECTIVES: To describe the diagnostic contribution provided by specific fragrance series to the results obtained with baseline series fragrance markers by correlating the results of both series. MATERIALS AND METHODS: We performed a 5-year retrospective study of fragrance marker-positive patients tested with specific fragrance series in 23 Spanish centres. We collected the demographic and clinical characteristics, and compared the results of patch tests obtained from different suppliers. RESULTS: Of 19 588 patients patch tested with the Spanish baseline series, 1590 (8.1%) reacted positively to a fragrance marker. Of these, 1013 (63.7%) were patch tested with a fragrance series, and 664 patients reacted positively to at least one individual fragrance other than hydroxyisohexyl 3-cyclohexene carboxaldehyde. Geraniol was the most frequent allergen. Positive reactions to substances not included in fragrance mix (FM) I or FM II were found in 230 patients. Of the 436 FM I-positive patients and the 419 FM II-positive patients, 184 (42%) and 64 (39.1%), respectively, had no positive reactions to fragrance series. In the case of FM I, negative results were more common when individual fragrances were patch tested at low concentrations. CONCLUSIONS: We recommend patch testing all patients positive for any fragrance marker with a specific fragrance series. The correlation between the results of baseline series and fragrance series could be improved by increasing the concentrations of individual fragrances.