{"title":"Re: A Slippery Slope: Is Benzyl Alcohol a Contact Allergen?","authors":"Richard J. Schmidt","doi":"10.1111/cod.70067","DOIUrl":"10.1111/cod.70067","url":null,"abstract":"","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 3","pages":"308-309"},"PeriodicalIF":4.6,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Han-Bi Kim, Min-Gyu Choi, Hyung-Woo Jo, Ji-Young Um, So-Yeon Lee, Bo-Young Chung, Chun-Wook Park, Hye-One Kim
Background
Sensitive skin syndrome (SSS) is a common disorder showing abnormal responses to stimuli, without approved treatments and unclear neuropathic mechanisms.
Objective
To evaluate pregabalin efficacy in reducing SSS symptoms and identify predictors of treatment response.
Methods
A systematic retrospective cohort of 112 clinically diagnosed SSS patients (mean age 40.5 years). The primary outcome was sensitive scale-10 (SS-10) score change at 12 weeks; response was defined as a ≥ 30% reduction. Secondary outcomes included dermatology life quality index (DLQI), hospital anxiety and depression scale (HADS), skin biophysical parameters, von Frey thresholds and facial erythema.
Results
At 12 weeks, 46.4% of patients responded. Most patients (86.6%) received less than 75 mg/day. Higher baseline SS-10 scores (r = 0.5) and tingling symptoms (p = 0.050) were associated with greater response, while discomfort was associated with non-response (p = 0.005). SS-10 scores correlated with DLQI (r = 0.49) and total HADS (r = 0.29). Reduced von Frey thresholds (r = −0.28) and increased facial erythema (r = 0.39) were observed in responders.
Conclusion
Pregabalin improved symptoms in SSS, supporting its potential role in managing neuropathic features and reinforcing the neurogenic hypothesis underlying its therapeutic mechanism.
{"title":"A Retrospective Cohort Study on the Efficacy of Pregabalin in Patients With Sensitive Skin","authors":"Han-Bi Kim, Min-Gyu Choi, Hyung-Woo Jo, Ji-Young Um, So-Yeon Lee, Bo-Young Chung, Chun-Wook Park, Hye-One Kim","doi":"10.1111/cod.70063","DOIUrl":"10.1111/cod.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sensitive skin syndrome (SSS) is a common disorder showing abnormal responses to stimuli, without approved treatments and unclear neuropathic mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate pregabalin efficacy in reducing SSS symptoms and identify predictors of treatment response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic retrospective cohort of 112 clinically diagnosed SSS patients (mean age 40.5 years). The primary outcome was sensitive scale-10 (SS-10) score change at 12 weeks; response was defined as a ≥ 30% reduction. Secondary outcomes included dermatology life quality index (DLQI), hospital anxiety and depression scale (HADS), skin biophysical parameters, von Frey thresholds and facial erythema.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 12 weeks, 46.4% of patients responded. Most patients (86.6%) received less than 75 mg/day. Higher baseline SS-10 scores (<i>r</i> = 0.5) and tingling symptoms (<i>p</i> = 0.050) were associated with greater response, while discomfort was associated with non-response (<i>p</i> = 0.005). SS-10 scores correlated with DLQI (<i>r</i> = 0.49) and total HADS (<i>r</i> = 0.29). Reduced von Frey thresholds (<i>r</i> = −0.28) and increased facial erythema (<i>r</i> = 0.39) were observed in responders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pregabalin improved symptoms in SSS, supporting its potential role in managing neuropathic features and reinforcing the neurogenic hypothesis underlying its therapeutic mechanism.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 3","pages":"286-295"},"PeriodicalIF":4.6,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ania Stras, Sarah Mannaert, Michaël Canfyn, Tine Weytjens, Eric Deconinck, Bart Desmedt, Tamara Vanhaecke
Introduction
Diisocyanates are potent sensitizers extensively used in polyurethane-based materials, with numerous case reports linking them to allergic contact dermatitis (ACD). Recent extractables studies have detected residual diisocyanates in medical devices such as wound dressings. However, these assessments typically rely on non-physiological extraction methods, limiting their relevance to actual skin exposure conditions.
Objectives
This study aimed to develop and validate a physiologically relevant method for quantifying residual 4,4′-diphenylmethane diisocyanates (MDI), dicyclohexylmethane-4,4-diisocyanates (DMDI), hexamethylene diisocyanates (HDI), toluene diisocyanates (2,4- and 2,6-TDI) and isophorone diisocyanates (IPDI) leaching from wound dressings, and subsequently assess their risk of sensitisation induction and ACD elicitation.
Methods
Diisocyanate standards were stabilised as di-lysine adducts in an artificial sweat solution, simulating skin exposure. An optimised LC–MS/MS method was used for quantification. The method was validated across a wide concentration range and subsequently applied to 36 commercial wound dressings. Exposure levels were evaluated against toxicological thresholds for quantitative risk assessments.
Results
The method proved reliable for all target diisocyanates (except IPDI) at concentrations ≥ 15 ppb. Analysis of the samples revealed that 44% contained quantifiable levels of residual diisocyanates. Notably, over 50% of the HDI-positive and 20% of MDI-positive samples exceeded the acceptable exposure level (AEL) for sensitisation induction. Moreover, all samples exceeding the AEL fell above the acceptable non-eliciting area dose for contact dermatitis (ANEAD).
Conclusion
We developed and validated a physiologically relevant method to quantify diisocyanate residues leaching from wound dressings, demonstrating that HDI, in particular, poses a significant risk for sensitisation induction and can elicit ACD in individuals who are already sensitised.
{"title":"Quantitative Risk Assessment of Diisocyanates Leaching From Wound Dressings Under Physiological Conditions","authors":"Ania Stras, Sarah Mannaert, Michaël Canfyn, Tine Weytjens, Eric Deconinck, Bart Desmedt, Tamara Vanhaecke","doi":"10.1111/cod.70061","DOIUrl":"10.1111/cod.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Diisocyanates are potent sensitizers extensively used in polyurethane-based materials, with numerous case reports linking them to allergic contact dermatitis (ACD). Recent extractables studies have detected residual diisocyanates in medical devices such as wound dressings. However, these assessments typically rely on non-physiological extraction methods, limiting their relevance to actual skin exposure conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to develop and validate a physiologically relevant method for quantifying residual 4,4′-diphenylmethane diisocyanates (MDI), dicyclohexylmethane-4,4-diisocyanates (DMDI), hexamethylene diisocyanates (HDI), toluene diisocyanates (2,4- and 2,6-TDI) and isophorone diisocyanates (IPDI) leaching from wound dressings, and subsequently assess their risk of sensitisation induction and ACD elicitation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Diisocyanate standards were stabilised as di-lysine adducts in an artificial sweat solution, simulating skin exposure. An optimised LC–MS/MS method was used for quantification. The method was validated across a wide concentration range and subsequently applied to 36 commercial wound dressings. Exposure levels were evaluated against toxicological thresholds for quantitative risk assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The method proved reliable for all target diisocyanates (except IPDI) at concentrations ≥ 15 ppb. Analysis of the samples revealed that 44% contained quantifiable levels of residual diisocyanates. Notably, over 50% of the HDI-positive and 20% of MDI-positive samples exceeded the acceptable exposure level (AEL) for sensitisation induction. Moreover, all samples exceeding the AEL fell above the acceptable non-eliciting area dose for contact dermatitis (ANEAD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We developed and validated a physiologically relevant method to quantify diisocyanate residues leaching from wound dressings, demonstrating that HDI, in particular, poses a significant risk for sensitisation induction and can elicit ACD in individuals who are already sensitised.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 3","pages":"245-258"},"PeriodicalIF":4.6,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>A 34-year-old woman was referred to the department of Dermato-Allergology because of facial complaints when using sunscreen products. The complaints had started 3 years before. She experienced itch, swelling and tingling in her face within an hour after applying several sunscreens. She later also experienced complaints after applying day cream with SPF. The complaints disappeared when avoiding SPF-containing products.</p><p>In her history, she mentioned she was diagnosed with frontal fibrosing alopecia (FFA). The complaints of the SPF-containing products and the FFA started simultaneously.</p><p>Patch tests were performed on the upper back with the European baseline series, a departmental extension, perfumes series and the patient's own products. Allergens were acquired from the series (allergens obtained from Chemotechnique Diagnostics, Vellinge, Sweden and Allergeaze, SmartPractice, Phoenix, USA). Allergens were tested using van der Bend test chambers (van der Bend, Brielle, the Netherlands) with Omnifix Elastic (Hartmann, Neuhausen, Switzerland). Readings and tests were performed on day (D) 2 and D3 according to the ESCD guideline.</p><p>Tests were positive for benzyl salicylate 10% pet (D2: +, D3: +), epoxy resin 1.0% pet (D2: +, D3: ++), fragrance mix 1 8.0% pet (D2: –, D3: +), nickel sulphate 5% pet (D2: –, D3: +), limonene hydroperoxide 0.3% pet (D2: +, D3: ++), imidazolidinyl urea 2.0% pet (D2: –, D3: +) and Paula's Choice broad spectrum SPF30 as is (D2: +, D3: +).</p><p>The reaction to her own skin care product was deemed clinically relevant. After checking the ingredient list however, none of the discovered allergens was used in the product. We therefore decided to perform additional patch tests with the photopatch series (without UV exposure), textile finishes (because of the imidazolidinyl urea reaction), perfumes and flavours series and acetyl salicylic acid. Salicylic acid was not available at the time of patch testing this patient due to logistic problems. Positive reactions were found for homosalate (trimethylcyclohexyl salicylate) 10% pet (D2: +, D3: +) and octyl salicylate (ethylhexylsalicylate) 10% pet (D2: +, D3: +). The reactions covered the whole test area, as shown in Figure 1.</p><p>Homosalate was one of the ingredients in her Paula's Choice Ultra Sheer day cream. After specifically avoiding salicylates in SPF-containing products and the other identified allergens, the skin complaints alleviated. The FFA remained present, though stable.</p><p>After avoiding the allergens for several months, specifically the salicylates, the patient felt her complaints of tingling/itching and skin rash disappeared. She also mentioned that the activity of her FFA had stabilised without any further therapeutic approach. The hair loss was not reversible, as was to be expected because of the cicatricial nature of the disease.</p><p>In our patient positive patch tests were found for three different salicylates: benzyl salicylate (CAS 118–58-1
一名34岁的女性因使用防晒产品时出现面部不适而被转介到皮肤过敏科。这些投诉始于3年前。在涂了几次防晒霜后，她在一个小时内感到脸部发痒、肿胀和刺痛。后来，她在涂了防晒日霜后也遇到了投诉。当避免使用含spf的产品时，投诉消失了。在她的病史中，她提到她被诊断为额部纤维化性脱发（FFA）。含spf产品和FFA的投诉同时开始。使用欧洲基线系列、部门扩展系列、香水系列和患者自己的产品对上背部进行了斑贴试验。过敏原从该系列中获得（过敏原来自瑞典Vellinge的Chemotechnique Diagnostics和美国凤凰城SmartPractice的Allergeaze）。使用van der Bend试验箱（van der Bend, Brielle，荷兰）和Omnifix Elastic （Hartmann, Neuhausen，瑞士）对过敏原进行测试。根据ESCD指南，在第(D) 2和D3天进行读数和测试。试验对水杨酸苄酯10% pet (D2: +, D3: +)，环氧树脂1.0% pet (D2: +, D3: +)，香料混合物1 8.0% pet (D2: -, D3: +)，硫酸镍5% pet (D2: -, D3: +)，柠檬烯氢过氧化0.3% pet (D2: +, D3: +)，咪唑烷基脲2.0% pet （D2: -, D3: +）和保拉选择广谱SPF30 （D2: +, D3: +）呈阳性。对她自己的护肤品的反应被认为是临床相关的。然而，在检查了成分表后，发现的过敏原都没有在产品中使用。因此，我们决定对光贴片系列（没有紫外线照射）、纺织品整理剂（因为咪唑烷酰脲反应）、香水和香料系列以及乙酰水杨酸进行额外的贴片测试。由于后勤问题，在对该患者进行贴片试验时，水杨酸是不可用的。10%水杨酸酯（D2∶+,D3∶+）和10%水杨酸酯（乙基己基水杨酸酯）（D2∶+,D3∶+）均呈阳性反应。反应覆盖了整个测试区域，如图1所示。同盐酸盐是她的宝拉选择超透明日霜的成分之一。在明确避免使用含有spf的产品中的水杨酸盐和其他已确定的过敏原后，皮肤不适减轻了。FFA虽然稳定，但仍然存在。在避免使用过敏原几个月后，特别是水杨酸类药物，患者感到刺痛/瘙痒，皮疹消失。她还提到，在没有任何进一步治疗的情况下，她的FFA活性已经稳定下来。由于这种疾病的瘢痕性，脱发是不可逆转的。在我们的患者中，贴片试验发现三种不同的水杨酸盐呈阳性：水杨酸苄酯（CAS 118-58-1）、水杨酸乙己基（CAS 118-60-5）和同型水杨酸盐（CAS 118-56-9）。虽然该测试的目的不是评估FFA的投诉，而是评估含spf产品的投诉，但我们的患者报告说，她以前发生的投诉在避免过敏原后也稳定了。此前的一项综述评估了防晒霜使用与游离脂肪酸含量之间的可能联系。西班牙研究小组的病例系列更具体地报道了化妆品中用作UVB吸收剂的水杨酸盐、致敏性和FFA之间的关系[2,3]。尽管这种关系的病因学（因果、意外、共激活因素）尚不清楚，病例系列也存在一些潜在的偏差，但重要的是要意识到接触致敏和FFA之间的可能联系，并评估这些患者对防晒霜可能的不耐受。据报道，对水杨酸盐的致敏性很低。一项更大的前瞻性研究，用患者自己的防晒霜和单独的水杨酸盐对FFA患者进行贴片测试，甚至光贴片测试，可能会提供更多关于对紫外线吸收剂的致敏是否与FFA有任何关系的信息，值得进一步研究。Sylvie Mireille Franken：调查，写作：原稿准备，写作：审查和编辑。托马斯·罗斯泰耶：调查、监督、写作、审查和编辑。病人已经同意发表这个病例。由于这是一份病例报告，因此没有要求伦理委员会的批准。作者声明无利益冲突。数据共享不适用于本文，因为在当前研究期间没有生成或分析数据集。
{"title":"Salicylate Allergy and Frontal Fibrosing Alopecia: A Case Report With Stabilisation of the Complaints After Allergen Avoidance","authors":"Sylvie Mireille Franken, Thomas Rustemeyer","doi":"10.1111/cod.70062","DOIUrl":"10.1111/cod.70062","url":null,"abstract":"<p>A 34-year-old woman was referred to the department of Dermato-Allergology because of facial complaints when using sunscreen products. The complaints had started 3 years before. She experienced itch, swelling and tingling in her face within an hour after applying several sunscreens. She later also experienced complaints after applying day cream with SPF. The complaints disappeared when avoiding SPF-containing products.</p><p>In her history, she mentioned she was diagnosed with frontal fibrosing alopecia (FFA). The complaints of the SPF-containing products and the FFA started simultaneously.</p><p>Patch tests were performed on the upper back with the European baseline series, a departmental extension, perfumes series and the patient's own products. Allergens were acquired from the series (allergens obtained from Chemotechnique Diagnostics, Vellinge, Sweden and Allergeaze, SmartPractice, Phoenix, USA). Allergens were tested using van der Bend test chambers (van der Bend, Brielle, the Netherlands) with Omnifix Elastic (Hartmann, Neuhausen, Switzerland). Readings and tests were performed on day (D) 2 and D3 according to the ESCD guideline.</p><p>Tests were positive for benzyl salicylate 10% pet (D2: +, D3: +), epoxy resin 1.0% pet (D2: +, D3: ++), fragrance mix 1 8.0% pet (D2: –, D3: +), nickel sulphate 5% pet (D2: –, D3: +), limonene hydroperoxide 0.3% pet (D2: +, D3: ++), imidazolidinyl urea 2.0% pet (D2: –, D3: +) and Paula's Choice broad spectrum SPF30 as is (D2: +, D3: +).</p><p>The reaction to her own skin care product was deemed clinically relevant. After checking the ingredient list however, none of the discovered allergens was used in the product. We therefore decided to perform additional patch tests with the photopatch series (without UV exposure), textile finishes (because of the imidazolidinyl urea reaction), perfumes and flavours series and acetyl salicylic acid. Salicylic acid was not available at the time of patch testing this patient due to logistic problems. Positive reactions were found for homosalate (trimethylcyclohexyl salicylate) 10% pet (D2: +, D3: +) and octyl salicylate (ethylhexylsalicylate) 10% pet (D2: +, D3: +). The reactions covered the whole test area, as shown in Figure 1.</p><p>Homosalate was one of the ingredients in her Paula's Choice Ultra Sheer day cream. After specifically avoiding salicylates in SPF-containing products and the other identified allergens, the skin complaints alleviated. The FFA remained present, though stable.</p><p>After avoiding the allergens for several months, specifically the salicylates, the patient felt her complaints of tingling/itching and skin rash disappeared. She also mentioned that the activity of her FFA had stabilised without any further therapeutic approach. The hair loss was not reversible, as was to be expected because of the cicatricial nature of the disease.</p><p>In our patient positive patch tests were found for three different salicylates: benzyl salicylate (CAS 118–58-1","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 3","pages":"306-307"},"PeriodicalIF":4.6,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emma M. van Oers, Anton C. de Groot, Patrick Verolme, Norbertus A. Ipenburg, Thomas Rustemeyer
Background
Diagnostic patch testing in patients with suspected allergic Contact Dermatitis from glucose sensors, insulin pumps, and infusion sets is seriously hampered by a lack of information on the chemical composition of these diabetes devices.
Objectives
To identify the chemicals present in diabetes devices.
Materials and Methods
Forty acetone extracts of 27 devices (10 sensors, 3 patch pumps, 12 infusion sets and 2 single adhesives) were investigated by gas chromatography—mass spectrometry.
Results
Two hundred eighty four individual chemicals were identified. All 40 extracts contained one or more chemicals that were previously identified as allergens in diabetes devices causing allergic Contact Dermatitis. Fourteen of 27 devices (52%) contained one or more acrylates, 8 (30%) colophonium derivatives, all 27 (100%) one or two phenolic allergens (2,4-di-tert-butylphenol, p-tert-butylphenol, butylated hydroxytoluene), and 9 (33%) 1-hydroxycyclohexyl phenyl ketone. None of the other chemicals were well-known haptens, with the exception of bisphenol A, which was present in half of the extracts, in some cases in very high concentrations.
Conclusions
All products investigated contained chemicals already known to be sensitizers in diabetes devices. The data can help determine the relevance of positive patch tests, facilitate targeted patch testing with potential allergens and aid in advising safer alternatives for sensitized patients.
{"title":"Results of GC–MS Analyses of 40 Extracts of Diabetes Devices","authors":"Emma M. van Oers, Anton C. de Groot, Patrick Verolme, Norbertus A. Ipenburg, Thomas Rustemeyer","doi":"10.1111/cod.70052","DOIUrl":"10.1111/cod.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diagnostic patch testing in patients with suspected allergic Contact Dermatitis from glucose sensors, insulin pumps, and infusion sets is seriously hampered by a lack of information on the chemical composition of these diabetes devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify the chemicals present in diabetes devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Forty acetone extracts of 27 devices (10 sensors, 3 patch pumps, 12 infusion sets and 2 single adhesives) were investigated by gas chromatography—mass spectrometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred eighty four individual chemicals were identified. All 40 extracts contained one or more chemicals that were previously identified as allergens in diabetes devices causing allergic Contact Dermatitis. Fourteen of 27 devices (52%) contained one or more acrylates, 8 (30%) colophonium derivatives, all 27 (100%) one or two phenolic allergens (2,4-di-<i>tert</i>-butylphenol, <i>p</i>-<i>tert-</i>butylphenol, butylated hydroxytoluene), and 9 (33%) 1-hydroxycyclohexyl phenyl ketone. None of the other chemicals were well-known haptens, with the exception of bisphenol A, which was present in half of the extracts, in some cases in very high concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>All products investigated contained chemicals already known to be sensitizers in diabetes devices. The data can help determine the relevance of positive patch tests, facilitate targeted patch testing with potential allergens and aid in advising safer alternatives for sensitized patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 3","pages":"234-244"},"PeriodicalIF":4.6,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Personal care products (PCPs), such as shampoos, conditioners and body washes, can contain ingredients that may cause allergic contact dermatitis (ACD). Hotels commonly offer complimentary toiletries; however, there is limited data regarding the allergen content of these products.
Objective
This study aims to identify allergens within PCPs that may cause ACD in hotels across Canada, the United States (US) and Europe.
Methods
A cross-sectional analysis was conducted to identify American Contact Dermatitis Society (ACDS) core allergens listed in the ingredients of PCPs sampled from 90 hotels across Canada, the US and Europe. Hotels were stratified equally into luxury, mid-scale and budget-friendly categories.
Results
Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) was found in 4.4% of hotel products in Europe, which is significantly lower than its prevalence in Canada (47.8%) and the US (40.0%) (p < 0.0001). In Canada and the US, DMDM hydantoin, a formaldehyde-releasing preservative, was detected in approximately one in seven products but was absent in the toiletries from European hotels (Canada vs. Europe: p = 0.01; US vs. Europe: p = 0.02).
Conclusion
A higher percentage of multiple ACDS core allergens were identified in complimentary hotel toiletries in Canada and the US than in Europe. This study underscores the importance of patient and clinician awareness of the potential risk of ACD resulting from exposure to hotel products.
{"title":"A Cross-Sectional Study of Contact Allergens in Hotel Personal Care Products in Canada, the United States and Europe","authors":"Vanessa Viltakis, Mark G. Kirchhof","doi":"10.1111/cod.70057","DOIUrl":"10.1111/cod.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Personal care products (PCPs), such as shampoos, conditioners and body washes, can contain ingredients that may cause allergic contact dermatitis (ACD). Hotels commonly offer complimentary toiletries; however, there is limited data regarding the allergen content of these products.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to identify allergens within PCPs that may cause ACD in hotels across Canada, the United States (US) and Europe.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional analysis was conducted to identify American Contact Dermatitis Society (ACDS) core allergens listed in the ingredients of PCPs sampled from 90 hotels across Canada, the US and Europe. Hotels were stratified equally into luxury, mid-scale and budget-friendly categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) was found in 4.4% of hotel products in Europe, which is significantly lower than its prevalence in Canada (47.8%) and the US (40.0%) (<i>p</i> < 0.0001). In Canada and the US, DMDM hydantoin, a formaldehyde-releasing preservative, was detected in approximately one in seven products but was absent in the toiletries from European hotels (Canada vs. Europe: <i>p</i> = 0.01; US vs. Europe: <i>p</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A higher percentage of multiple ACDS core allergens were identified in complimentary hotel toiletries in Canada and the US than in Europe. This study underscores the importance of patient and clinician awareness of the potential risk of ACD resulting from exposure to hotel products.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 2","pages":"173-181"},"PeriodicalIF":4.6,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fieke M. Rosenberg, Robert F. Ofenloch, Peter J. van der Most, Laura Loman, Harold Snieder, Marie L. A. Schuttelaar
Background
Sociodemographic and lifestyle factors may be related to the use of cosmetic procedures with potential adverse skin effects, such as hair dye use.
Objectives
To investigate the association of several sociodemographic and lifestyle factors with (adverse skin reactions to) hair dye use in the Dutch general population.
Methods
This cross-sectional study used questionnaire-derived data from the population-based Lifelines cohort regarding lifetime hair dye use and adverse skin reactions (n = 70 987). Logistic regression analyses investigated associations of sociodemographic factors (ethnicity, hair colour, marital status, educational attainment, income, neighbourhood socioeconomic status) and lifestyle factors (smoking, alcohol consumption, and body mass index [BMI]) with adverse skin reactions to hair dye use.
Results
Hair dye use was significantly positively associated with having dark blonde or brown hair colour, lower educational attainment, smoking, daily alcohol consumption and higher BMI. Hair dye use was significantly negatively associated with having red or auburn hair colour. Furthermore, adverse skin reactions to hair dye were significantly positively associated with higher BMI.
Conclusions
Our findings highlight several positive associations between sociodemographic and lifestyle factors and both hair dye use and its adverse skin reactions. Notably, elevated BMI was consistently positively associated with both hair dye use and adverse skin reactions.
{"title":"The Association of Hair Dye Use With Sociodemographic and Lifestyle Factors in the Dutch General Population: A Cross-Sectional Questionnaire-Based Study","authors":"Fieke M. Rosenberg, Robert F. Ofenloch, Peter J. van der Most, Laura Loman, Harold Snieder, Marie L. A. Schuttelaar","doi":"10.1111/cod.70053","DOIUrl":"10.1111/cod.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sociodemographic and lifestyle factors may be related to the use of cosmetic procedures with potential adverse skin effects, such as hair dye use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the association of several sociodemographic and lifestyle factors with (adverse skin reactions to) hair dye use in the Dutch general population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study used questionnaire-derived data from the population-based Lifelines cohort regarding lifetime hair dye use and adverse skin reactions (<i>n</i> = 70 987). Logistic regression analyses investigated associations of sociodemographic factors (ethnicity, hair colour, marital status, educational attainment, income, neighbourhood socioeconomic status) and lifestyle factors (smoking, alcohol consumption, and body mass index [BMI]) with adverse skin reactions to hair dye use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Hair dye use was significantly positively associated with having dark blonde or brown hair colour, lower educational attainment, smoking, daily alcohol consumption and higher BMI. Hair dye use was significantly negatively associated with having red or auburn hair colour. Furthermore, adverse skin reactions to hair dye were significantly positively associated with higher BMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings highlight several positive associations between sociodemographic and lifestyle factors and both hair dye use and its adverse skin reactions. Notably, elevated BMI was consistently positively associated with both hair dye use and adverse skin reactions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 2","pages":"137-148"},"PeriodicalIF":4.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maël Blanchard, Ophélie Marchal, Gabriela Blanchard, Pierre Piletta-Zanin
<p>Allergic contact dermatitis (ACD) is the most common cause of eyelid dermatitis [<span>1</span>]. Cosmetic creams are a major source of eyelid ACD cases, due to contact allergens such as fragrances, preservatives, emulsifiers and nickel. The cosmetics industry has long relied on natural plant resources to discover new active ingredients. We report the first case of eyelid ACD to Terminalia Chebula Fruit Extract in a cosmetic night cream.</p><p>A 31-year-old Caucasian atopic female developed a recurrent, well-demarcated, itchy eyelid (Figure 1A) and lip erythema. Patch tests were performed using the European baseline, preservative and eyelid series (Chemotechnique Diagnostics, Vellinge, Sweden) using IQ Ultra chambers (Chemotechnique Diagnostics) and the patient's own products (‘as is’). Allergens were applied for 48 h. Readings on day (D) 2 and D4 showed positive reactions for Hyaluron Activ B3 triple correction eye cream (+++) and Hyaluron Activ B3 multi-intensive night cream (+) (Avène, France) (Figure 1B). The European baseline, preservative and eyelid series were all negative except for a +++ positive reaction to paraphenylenediamine (PPD), which was not considered relevant to the current skin reactions. Indeed, the patient presented a strong response to a henna tattoo during adolescence.</p><p>Thus, we hypothesized that the personal creams showing a positive reaction, likely contained a common allergen that was not detected in our standard test panels. The individual ingredients of both, Hyaluron Activ B3 triple correction eye cream and multi-intensive night cream, kindly provided by the manufacturer, were subsequently patch-tested. They showed a positive reaction (D2+, D4++) to a single ingredient, Terminalia Chebula Fruit Extract (Figure 1C). Five unexposed controls were negative to this extract.</p><p>Positive patch tests for both Hyaluron Activ B3 triple correction eye cream and multi-intensive night cream and for only one of their ingredients confirm the diagnosis of ACD caused by Terminalia Chebula Fruit Extract. Amine-based PPD and phenolic compounds from this fruit share an aromatic ring structure as part of their molecular backbone, but we did not identify any direct structural similarity between them. <i>T. chebula</i> Retz. is an Asian plant from the Combretaceae family which is commonly used in Tibetan and Ayurvedic medicine for various indications [<span>2, 3</span>], especially antioxidant activity. The topical use has been suggested to treat tinea corporis [<span>4</span>], as well as for anti-aging purposes [<span>5</span>] with an overall good toxicity profile [<span>2</span>]. To date, more than one hundred compounds have been identified for its fruit's extracts, including phenolic acids, tannins, lignans, triterpenoids, flavonoids and volatiles. Among others, gallate esters (derivatives from gallic acid), ellagic acid and caffeic acid could potentially be implicated given their already document
{"title":"Allergic Contact Dermatitis to Terminalia Chebula Fruit Extract in Antiaging Creams","authors":"Maël Blanchard, Ophélie Marchal, Gabriela Blanchard, Pierre Piletta-Zanin","doi":"10.1111/cod.70060","DOIUrl":"10.1111/cod.70060","url":null,"abstract":"<p>Allergic contact dermatitis (ACD) is the most common cause of eyelid dermatitis [<span>1</span>]. Cosmetic creams are a major source of eyelid ACD cases, due to contact allergens such as fragrances, preservatives, emulsifiers and nickel. The cosmetics industry has long relied on natural plant resources to discover new active ingredients. We report the first case of eyelid ACD to Terminalia Chebula Fruit Extract in a cosmetic night cream.</p><p>A 31-year-old Caucasian atopic female developed a recurrent, well-demarcated, itchy eyelid (Figure 1A) and lip erythema. Patch tests were performed using the European baseline, preservative and eyelid series (Chemotechnique Diagnostics, Vellinge, Sweden) using IQ Ultra chambers (Chemotechnique Diagnostics) and the patient's own products (‘as is’). Allergens were applied for 48 h. Readings on day (D) 2 and D4 showed positive reactions for Hyaluron Activ B3 triple correction eye cream (+++) and Hyaluron Activ B3 multi-intensive night cream (+) (Avène, France) (Figure 1B). The European baseline, preservative and eyelid series were all negative except for a +++ positive reaction to paraphenylenediamine (PPD), which was not considered relevant to the current skin reactions. Indeed, the patient presented a strong response to a henna tattoo during adolescence.</p><p>Thus, we hypothesized that the personal creams showing a positive reaction, likely contained a common allergen that was not detected in our standard test panels. The individual ingredients of both, Hyaluron Activ B3 triple correction eye cream and multi-intensive night cream, kindly provided by the manufacturer, were subsequently patch-tested. They showed a positive reaction (D2+, D4++) to a single ingredient, Terminalia Chebula Fruit Extract (Figure 1C). Five unexposed controls were negative to this extract.</p><p>Positive patch tests for both Hyaluron Activ B3 triple correction eye cream and multi-intensive night cream and for only one of their ingredients confirm the diagnosis of ACD caused by Terminalia Chebula Fruit Extract. Amine-based PPD and phenolic compounds from this fruit share an aromatic ring structure as part of their molecular backbone, but we did not identify any direct structural similarity between them. \u0000 <i>T. chebula</i>\u0000 Retz. is an Asian plant from the Combretaceae family which is commonly used in Tibetan and Ayurvedic medicine for various indications [<span>2, 3</span>], especially antioxidant activity. The topical use has been suggested to treat tinea corporis [<span>4</span>], as well as for anti-aging purposes [<span>5</span>] with an overall good toxicity profile [<span>2</span>]. To date, more than one hundred compounds have been identified for its fruit's extracts, including phenolic acids, tannins, lignans, triterpenoids, flavonoids and volatiles. Among others, gallate esters (derivatives from gallic acid), ellagic acid and caffeic acid could potentially be implicated given their already document","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 2","pages":"196-197"},"PeriodicalIF":4.6,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emma Encarnaçao Domingos-Ancement, Laurent Misery, Numa Deydier
<p>Baby wipes are a common cause of contact dermatitis in children, particularly on the diaper area and face. The allergens most frequently involved are fragrances and preservatives. Before 2017 and the ban on its use in Europe on non-rinse-off cosmetic products, methylisothiazolinone was a preservative frequently responsible for contact allergies to baby wipes [<span>1</span>]. Such reactions are less common in adults. We report a rare case of allergic contact dermatitis in an adult due to hexamidine diisethionate (CAS No. 659-40-5), an uncommon allergen found in baby wipes [<span>2-4</span>].</p><p>A 51-year-old man with a history of childhood eczema presented with eczematous lesions in both axillae (Figure 1A), which later spread to the face (Figure S1). Initial history did not identify any relevant exposures. Treatment with a potent topical corticosteroid led to marked improvement, allowing patch testing to be performed.</p><p>Patch tests were carried out using the European baseline series, the cosmetic series, and the patient's personal products (Chemotechnique Diagnostics), according to European Society of Contact Dermatitis (ESCD) guidelines [<span>5</span>]. The tests were applied using IQ Ultimate chambers and read on days 2 and 3, following ICDRG criteria. Personal products such as shampoo, soap and deodorant were tested and found to be negative. Positive reactions to potassium dichromate and Compositae mix, both considered irrelevant were observed.</p><p>A second, more detailed, history revealed that the patient had recently changed to a new brand of baby wipes, which he used on his axillae and face. These wipes, labelled “Pure Water,” listed only two ingredients: water and hexamidine diisethionate (Figure S2A,B). The baby wipes were intended to be used without rinsing. The concentration of hexamidine in the wipes was 0.1%.</p><p>A Repeated Open Application Test (ROAT) using the wipes of the patient was positive on day 3 (Figure 1B), confirming allergic contact dermatitis (ACD) to hexamidine diisethionate [<span>5</span>]. The patient recalled possible prior exposure to hexamidine during treatment of a panaritium. No recurrence occurred after discontinuing the wipes.</p><p>While baby wipes are a well-known cause of contact dermatitis in infants, this case of axillary and face involvement in an adult is unusual. To our knowledge, no previous cases have reported baby wipes containing hexamidine diisethionate as the cause of ACD. The diagnosis of ACD was based on the delayed positivity of the ROAT test, which is in favour of contact eczema, and on the low concentration of hexamidine in the wipes, which minimises the risk of irritation. However, irritant dermatitis cannot be formally ruled out.</p><p>Interestingly, hexamidine was included in our cosmetic series used for patch testing but did not elicit a positive response, suggesting either false negativity or insufficient exposure through this method. The ROAT was instrumental in establis
{"title":"Axillary Contact Dermatitis in an Adult Caused by Hexamidine Diisethionate From Baby Wipes Labelled “Pure Water”","authors":"Emma Encarnaçao Domingos-Ancement, Laurent Misery, Numa Deydier","doi":"10.1111/cod.70055","DOIUrl":"10.1111/cod.70055","url":null,"abstract":"<p>Baby wipes are a common cause of contact dermatitis in children, particularly on the diaper area and face. The allergens most frequently involved are fragrances and preservatives. Before 2017 and the ban on its use in Europe on non-rinse-off cosmetic products, methylisothiazolinone was a preservative frequently responsible for contact allergies to baby wipes [<span>1</span>]. Such reactions are less common in adults. We report a rare case of allergic contact dermatitis in an adult due to hexamidine diisethionate (CAS No. 659-40-5), an uncommon allergen found in baby wipes [<span>2-4</span>].</p><p>A 51-year-old man with a history of childhood eczema presented with eczematous lesions in both axillae (Figure 1A), which later spread to the face (Figure S1). Initial history did not identify any relevant exposures. Treatment with a potent topical corticosteroid led to marked improvement, allowing patch testing to be performed.</p><p>Patch tests were carried out using the European baseline series, the cosmetic series, and the patient's personal products (Chemotechnique Diagnostics), according to European Society of Contact Dermatitis (ESCD) guidelines [<span>5</span>]. The tests were applied using IQ Ultimate chambers and read on days 2 and 3, following ICDRG criteria. Personal products such as shampoo, soap and deodorant were tested and found to be negative. Positive reactions to potassium dichromate and Compositae mix, both considered irrelevant were observed.</p><p>A second, more detailed, history revealed that the patient had recently changed to a new brand of baby wipes, which he used on his axillae and face. These wipes, labelled “Pure Water,” listed only two ingredients: water and hexamidine diisethionate (Figure S2A,B). The baby wipes were intended to be used without rinsing. The concentration of hexamidine in the wipes was 0.1%.</p><p>A Repeated Open Application Test (ROAT) using the wipes of the patient was positive on day 3 (Figure 1B), confirming allergic contact dermatitis (ACD) to hexamidine diisethionate [<span>5</span>]. The patient recalled possible prior exposure to hexamidine during treatment of a panaritium. No recurrence occurred after discontinuing the wipes.</p><p>While baby wipes are a well-known cause of contact dermatitis in infants, this case of axillary and face involvement in an adult is unusual. To our knowledge, no previous cases have reported baby wipes containing hexamidine diisethionate as the cause of ACD. The diagnosis of ACD was based on the delayed positivity of the ROAT test, which is in favour of contact eczema, and on the low concentration of hexamidine in the wipes, which minimises the risk of irritation. However, irritant dermatitis cannot be formally ruled out.</p><p>Interestingly, hexamidine was included in our cosmetic series used for patch testing but did not elicit a positive response, suggesting either false negativity or insufficient exposure through this method. The ROAT was instrumental in establis","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 2","pages":"190-191"},"PeriodicalIF":4.6,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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