Contact Dermatitis最新文献

Background: Contact allergy to benzisothiazolinone (BIT) has increased in recent years, but exposure to it is not always found. It's important to know whether the gloves might be an isothiazolinone source especially in patients with symptoms from gloves and isothiazolinone contact allergy with or without allergy to rubber chemicals.

Objectives: To present results of chemical analysis of isothiazolinones in disposable rubber gloves of patients in an occupational dermatology clinic.

Methods: We went through our chemical analysis record from 2018-2025 and identified isothiazolinone analyses done from disposable rubber gloves. The chemical analysis of glove extracts was done by liquid chromatography-mass spectrometry (LC-MS). We screened the respective patients' files and collected information on their occupation, glove usage, patch test reactions as well as basic information on their hand eczema.

Results: We discovered BIT in 30/54 (60%) analysed gloves (27 nitrile rubber gloves, 2 neoprene rubber gloves and 1 natural rubber glove) in concentrations of 0.3-73.7 ppm (mean 12.7 ppm, median 4.2 ppm). Methylisothiazolinone (MI) was found in solitary gloves in small concentrations. Isothiazolinone-containing gloves were samples from altogether 21 patients, and six of them had several gloves that contained isothiazolinones. Many patients had also other isothiazolinone sources at work or at home.

Conclusions: Disposable rubber gloves are a possible BIT source. Several gloves contained BIT in a concentration that may be enough to induce contact allergy when gloves are used frequently.

S. Botvid, N. H. Bennike, A. B. Simonsen, J. D. Johansen, and W. Uter, “Contact Sensitization to Fragrance Mix I and Fragrance Mix II Among European Dermatitis Patients: A Systematic Review,” Contact Dermatitis 91, no. 3 (2024): 177–185, https://doi.org/10.1111/cod.14618.

An incorrect description of regional prevalences was included in the Abstract and Discussion sections, though the data presented in the Results section were correct.

instead of ‘Sensitization to FM I was most prevalent in Central and Eastern Europe and to FM II in Western Europe’.

instead of ‘The prevalence of CA to FM I was highest in Central and Eastern Europe and lowest in Southern Europe. Conversely, CA to FM II was highest in Northwestern Europe’.

The sentence should read ‘The prevalence of CA both to FM I and FM II was highest in Northwestern Europe, compared to the other parts of Europe’

We apologize for these errors.

Background: Skin barrier disruption can be induced through experimental models, yet standardised comparisons are scarce. Transepidermal water loss (TEWL) and corneometry (CM) are established methods to quantify barrier impairment. Electrical impedance spectroscopy (EIS) is a novel approach, which may provide complementary information.

Objectives: To compare EIS against TEWL and CM and to assess different barrier disruption models in humans in vivo.

Methods: 15 healthy adults (7 female, 8 male; median age 27 years) were recruited. Experiment I compared 3 adhesive tapes for tape stripping (TS). Experiment II evaluated TS, 0.5% sodium lauryl sulphate (SLS), SLS + TS, and gluten using TEWL, EIS, and CM.

Results: D-Squame tape caused stronger barrier impairment than Scotch and Tesa (TEWL p < 0.01, EIS p < 0.05). SLS + TS induced the most (8 h: TEWL p < 0.001; EIS p < 0.05; CM p < 0.05) and persistent disruption (24 h: TEWL p < 0.05, EIS p < 0.05), followed by TS (8 h: TEWL p < 0.01; EIS p < 0.05). SLS and aqua caused minor, non-significant effects; gluten had no measurable impact. EIS correlated strongly with TEWL (ρ = -0.62, p < 0.0001) and CM (ρ = -0.61, p < 0.0001).

Conclusions: This first human study of EIS after experimental barrier disruption demonstrated strong concordance with TEWL and CM. Combined mechanical and chemical stress best reflects real-life barrier insults and represents a potent model.

Background: Hair cosmetic products contain various chemicals which are partly potent contact sensitizers. These may cause occupational hand eczema in hairdressers, but also scalp and face dermatitis in consumers.

Objective: To (i) highlight differences between the spectrum of occupational and non-occupational exposure reflected in sensitization, and (ii) correlate trends in the last decades with regulatory interventions (or the lack thereof).

Methods: Patch test and clinical data collected by the IVDK (https://www.ivdk.org) between 01/1995 and 12/2020 were subjected to a pooled re-analysis. Age-stratified sensitization prevalences in female hairdressers and consumers, respectively, were calculated for 2-yearly intervals spanning the study period. Log-binomial regression models were employed to estimate the association between contact allergy and (i) subgroup (hairdresser vs. consumer), (ii) a 3-level age category, and/or (iii) time period, respectively.

Results: Hair dyes were the most frequent sensitizers in hairdressers and consumers; however, there was a marked increase in (particularly the young) consumers. Pyrogallol had been banned in 1992 but still elicited positive patch test reactions even in the young. Hydroquinone, banned in 2013 in dyes, showed no decline in sensitization prevalence. Glyceryl thioglycolate has been withdrawn and later banned in Germany since around 1995, which caused contact allergy prevalence to drop to almost zero in the youngest age group, largely until today.

Conclusion: As a limitation, putatively differing selection for patch testing render prevalences difficult to compare between hairdressers and consumers. The importance of hair dye allergy is evident, needing continued efforts to increase product safety from the manufacturing and regulatory side. The potential of (self-)regulatory intervention is well illustrated by the decline of contact allergy to glyceryl thioglycolate.

Background: The vast majority of allergic tattoo reactions involve red-shaded tattoos without a causal explanation.

Objective: To determine rosin oxidation products (ROPs) in pigments and tattoo inks as a hypothesised source of tattoo allergenicity.

Materials and methods: Content of pigment samples (n = 112) and tattoo inks (n = 119) was analysed using newly developed UHPLC/PDA/MS methods, XRD and high-resolution MS.

Results: ROPs were found at varying levels in 32 pigments and 38 tattoo inks. The mean ROP level of red inks was approximately three-fold higher than that of non-red-spectrum inks. Among 24 red-spectrum inks with ROPs, azo pigments PR170, PR266, PR22, PY74 and quinacridones PR122 and PV19 were frequently identified. PR170 was present in 21 of those inks.

Conclusions: To explain results, a manufacturing model was developed showing rosination pathways, with only some having likely allergenic outcomes. Inks whose pigments were produced with rosin incorporated and/or irreversibly bound are the most likely to be allergenic. ROPs within those inks are believed to remain in the body after tattooing, acting as haptens. This view is consistent with biopsy reports of allergic reactions to red-shaded tattoos. We propose that ROPs may be at least partially responsible for those reactions. Pending proof of this proposal, tattoo-ink manufacturers might choose to avoid rosinated pigments.

Background: Sodium lauryl sulfate (SLS) has been included as an irritant control in the baseline patch test series of the German Contact Dermatitis Research Group (DKG) for two decades, although its diagnostic value remains controversial.

Objective: To evaluate the strengths and limitations of SLS as an irritant control in patch testing.

Methods: We retrospectively analysed data from 43 478 consecutive patients patch tested with 0.25% SLS aq. and 189 allergens within the IVDK network. SLS reactions were graded from 1 (weak) to 5 (strong). Associations between SLS reactivity and allergen-specific responses were examined.

Results: Overall, 22.4% of all patients reacted positively to SLS, most with weak erythema (SLS 1). Stronger SLS reactions (SLS 2-5) were associated with male sex, age ≥ 40 years, occupational dermatitis and hand dermatitis. Positive SLS reactions correlated with several allergens of high irritative potential, notably cocamidopropyl betaine, formaldehyde, sorbic acid and diphenylguanidine. In contrast, plant-derived allergens showed weak or inconsistent associations. Importantly, grading SLS reactions (1-5) did not improve diagnostic discrimination compared to a simple positive/negative classification.

Conclusion: While SLS can indicate skin irritability for certain allergens, it is not a universal marker. Our large-scale analysis supports binary SLS classification and provides a robust evidence base for the ongoing debate on whether and how irritant controls should be used in patch testing.

Background: Skin barrier impairment is central to irritant (ICD) and allergic contact dermatitis (ACD). Stratum corneum (SC) components cholesterol sulphate (CholSulph), glucosylcholesterol (CholGlc) and natural moisturising factor (NMF) are critical for barrier function, but their changes in ICD and ACD remain underexplored.

Objectives: To measure CholSulph, CholGlc, NMF and IL-1α in patch-induced ICD and ACD and in hand dermatitis (HD) diagnosed as ICD or ACD.

Methods: SC samples were collected from HD patients undergoing patch testing. Biomarkers were analysed in positive reactions to sodium lauryl sulphate (ICD, n = 44), allergens (ACD, n = 113; nickel, chromium, methylisothiazolinone [MI]), lesional HD skin (n = 45) and control (empty chamber, n = 121).

Results: CholGlc was significantly elevated in patch-induced ICD and ACD. CholSulph was increased in ICD and chromium- and MI-induced ACD. NMF decreased in ICD, while IL-1α decreased in ICD and chromium ACD. Chromium induced the strongest response, nickel the weakest. In HD, ICD and ACD showed elevated CholGlc, reduced NMF and IL-1α, with CholSulph increased only in ACD. No biomarker differences were detected between clinical ICD and ACD.

Conclusions: Both induced and clinical ICD and ACD show consistent SC biomarker changes reflecting barrier dysfunction, with no differences between clinical ICD and ACD.