Contact Dermatitis最新文献

Background

Registry-based data are increasingly used in dermatological research. A recent epidemiological study has shown that the use of non-specific diagnostic codes is common among dermatologists.

Objectives

To study closely the use of the diagnostic codes L23.8 (‘allergic contact dermatitis [ACD] for other agents’) and L23.9 (‘ACD with unspecified cause’) by using single-centre data.

Patients/Materials/Methods

This retrospective study included all patients whose record contained at least one entry of either code, recorded at the Oulu University Hospital, Finland, between the Years 1999 and 2022.

Results

The database search retrieved records of 472 patients with the L23.8 code, 264 patients with L23.9. Over the 20-year follow-up period, the use of L23.8 increased and that of L23.9 decreased. In most (85.1%) cases, the L23.8 code was used even though the more specified L23 code could have been chosen. In one-third of cases, L23.8 was used to cover ACD with multiple allergens that would otherwise be identified by their specific sub-codes. The L23.9 code was used most often prior to patch testing (69.1% cases).

Conclusions

This study revealed several imprecisions in the use of both codes. Our study highlights the importance of correct coding in clinical practice, as it emphasises the most common pitfalls.

Background

There is a current fashion for the use of methacrylate-containing nail cosmetics that can induce allergic contact dermatitis. European Union (EU) legislation was introduced in 2021 that had the aim of preventing its development.

Objectives

To assess prevalence and exposures causing contact allergy to 2-hydroxyethyl methacrylate (HEMA) prior to and following implementation of the legislation.

Methods

A retrospective audit was conducted by 7 European centres patch testing to HEMA prior to the legislation and for 2 years afterwards.

Results

A total of 26 297 patients were tested to HEMA in the baseline series between 2016 and 2023. The prevalence of contact allergy to HEMA from all sources amongst females was 2.82% compared to 0.34% amongst males.

The prevalence of nail related contact allergy rose from 0.91% in 2016 (2 centres) to: 0.99% in 2017 (3 centres); 1.24% in 2018 (5 centres); 1.23% in 2019 (6 centres); 1.36% in 2020 (7 centres); 1.30% in 2021 (7 centres); 1.52% in 2022 (7 centres) and 1.98% in 2023 (7 centres).

Contact allergy to HEMA from exposure to nail cosmetics accounted for 3.4% of all occupational skin disease.

Conclusions

EU legislation appears not to have had the intended impact on controlling allergic contact dermatitis from methacrylates in nail cosmetics. There is an urgent need to revisit Scientific Committee on Consumer Safety (SCCS) opinion to reconsider exposure to methacrylates and cross-reactions between them. A strategy needs to be developed and implemented to better control the current outbreak.

Background

The European Photopatch Testing Baseline Series (EPTBS) was published in 2013. However, limited data exist regarding the real-world clinical application of the EPTBS.

Objectives

This study aims to describe the photopatch test experience with the EPTBS over 11 years at a tertiary hospital in Spain.

Methods

A retrospective chart review spanning from February 2012 to October 2023 was conducted on patients who underwent photopatch testing (PPT) with the EPTBS. Additionally, patch testing was performed on all patients according to the European recommendations.

Results

Data from 148 patients were collected, and showed a PPT positivity rate of 7.4% (n = 11). Specifically, we found a photoallergic contact dermatitis (PACD) in 11/148 patients (15 positive reactions to 8 different allergens, including one patient own's product). Of them, 87% had current relevance and non-steroidal anti-inflammatory drugs (NSAIDS) were the main culprits of PACD (60%). Alternatively, we found a contact allergy to the EPTBS allergens in 14/148 (9.3%) patients, (21 positive reactions both in the irradiated and non-irradiated set to 17 different allergens, including many patients' products). Of them, UV solar filters represented the main cause of ACD. Regarding the patch testing results, we observed a positivity rate of 39.9% (116 positives in 59 different patients). The most frequent were methylchloroisothiazolinone/methylisothiazolinone, fragrance mix I and II and Myroxylon pereirae resin (balsam of Peru).

Conclusion

EPTBS implementation has permitted a more accurate study of PACD. Our positivity rate for PPT is slightly lower than previous reports, however the main culprits for PACD remain to be NSAIDS. The inclusion of contact allergens applied in photoexposed areas in the EPTBS could contribute to discriminating between PACD, photoaggravated ACD and ACD.

Background

2-(Thiocyanomethylthio)benzothiazole (TCMTB) is a fungicide product widely used in the leather industry, particularly since the 1990s. However, reports of allergic contact dermatitis triggered by this chemical are scarce.

Objectives

To investigate three cases of dermatitis following contact with leather products, possibly related to TCMTB.

Methods

Three female patients, aged 33–53, were referred with suspected allergic contact dermatitis related to leather products. Two patients presented with dermatitis on the feet, while one patient had dermatitis on the back and thighs. All patients were patch-tested with the European baseline series, a shoe series, TMCTB (0.1% pet), and scrapings from their personal leather products.

Results

All patients showed reactions to the scrapings from their personal products (+ to ++) and to TCMTB (++ to +++). Additionally, one patient was sensitised to mercapto mix and mercaptobenzothiazole (both ++), while another reacted to chromium (++), cobalt (+), 4-tert-butylphenol-formaldehyde resin (+) and colophonium (++). All patients were advised to avoid TCMTB and to be cautious with leather, synthetic leather, and varnished wood.

Conclusions

If contact dermatitis related to leather exposure is suspected, patch testing with TCMTB 0.1% pet should be included, as it might be the only positive finding.