Suwanchai C, Udompataikul M, Kamanamool N, Kanokrungsee S. A comparative study on the effect of alcohol-based hand sanitizers in spray and gel formulation on the skin: a prospective, randomised, crossover trial. Contact Dermatitis. 2024;90(4):394–401. https://onlinelibrary.wiley.com/doi/10.1111/cod.14476
In paragraph 1 of the ‘Materials and Methods’ section, the text ‘EC 329/64’ was incorrect. This should be: ‘SWUEC/F-329/2564’.
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Regulatory actions significantly reduced methyldibromo glutaronitrile (MDBGN)-induced allergic contact dermatitis (ACD) from cosmetics in Europe. Turkey banned MDBGN in 2015.
To assess sensitization and ACD rates to MDBGN before and after its ban in Turkey.
Data from 2653 consecutively patch tested patients between 1996 and 2023 with MDBGN 0.1% pet. (n = 573) or 0.2%–0.3% pet. (n = 1310) or 0.5% pet. (n = 770) were analysed. MDBGN was tested as MDBGN/phenoxyethanol (PE) in 1434 patients.
The sensitization prevalence was 1.7% (45/2653), peaking at 5.3% in 2018 and 2023 with MDBGN 0.3% pet. There was a two-fold male predominance, with patients exclusively ≥20 years old. None of the patients reacted to PE. ACD occurred in 0.7% (19/2653), mainly affecting hands and linked to non-occupational exposure (78.9%), particularly from rinse-off/leave-on cosmetics. The pattern of ‘middle-aged men with hand eczema and fragrance allergy' was particularly notable. Occupational ACD was rare (21.1%), occurring mainly in hairdressers from hair gel. Positive reactions with current clinical relevance dropped from 48.3% (1996–2014) to zero after 2015 (p < 0.001).
The ban effectively reduced MDBGN-induced ACD in Turkey, yet the prevalence of positive patch test reactions remains high, likely due to past exposures or other undisclosed sources. We suggest continued testing of MDBGN in the EBS in Turkey.
Hand eczema (HE) is a prevalent disease among professional cleaners.
To investigate how often cleaners have their self-reported HE, induced or worsened by cleaners' occupational activities, reported as an occupational disease to the authorities in Denmark and to identify reasons for underreporting. In addition, consultation by physicians and treatment for HE among cleaners were also investigated.
This cross-sectional questionnaire-based study included hospital cleaners at three different hospitals in Region Zealand, Denmark.
We included 224 out of 234 cleaners from three hospitals (response rate: 96%). The lifetime prevalence of self-reported HE with onset in adulthood was 18.3% (n = 41), with cleaners believing every case to be caused or exacerbated by their occupation. Only 9.7% (n = 4/41) of the cases were reported as an occupational disease to the authorities. The most common reasons for non-reporting were a lack of perceived seriousness of the disease (40.5%) and unawareness of the risk of self-reported HE being of occupational origin (32.4%). Remarkably, only 75.7% (n = 28/37) of workers with unreported cases had consulted a physician at some point. Additionally, among cleaners who self-reported HE attributed or aggravated by their occupation, but not officially reported as such, only 56.8% (n = 21/37) had ever used hand moisturisers, while less than 45% had ever used topical steroids or calcineurin inhibitors.
Our findings reveal substantial underreporting of self-reported HE, perceived to be induced or worsened by the cleaner's occupational activities, as an occupational disease to the authorities.
The use of methylisothiazolinone (MI) as a preservative in cosmetic products caused an alarming increase in MI contact allergy across Europe in the 2010s. This was followed by regulations of use with a total ban on leave-on (implemented in 2017) and reduced use concentrations in rinse-off cosmetics (2018).
To follow-up on the prevalence of contact allergy to MI and the related benzisothiazolinone (BIT) and octylisothiazolinone (OIT) in consecutively patch-tested patients in Europe.
A cross-sectional audit following the design of two previous audits on MI contact allergy from 1 May 2022 to 31 October 2022 included all patients patch tested with the European baseline series, including or supplemented with MI, BIT and OIT across 10 departments in eight European countries.
A total of 2554 patients were consecutively patch tested with the three isothiazolinones during the study period. The prevalence of MI and BIT contact allergy was 2.9% (95% confidence interval [CI]: 2.3%–3.7%; range 1.1%–5.8%) and 3.1% (95% CI: 2.4%–3.9%; range 0.0%–6.6%), respectively; that of OIT was 0.7% (95% CI: 0.4%–1.1%; range 0%–3.2%). Rinse-off cosmetic (73.3%) and leave-on cosmetic products (13.3%) were still associated with eliciting allergic contact dermatitis to MI.
We confirmed a positive impact of regulatory measures on the prevalence of MI contact allergy in Europe, which halved compared to 2015. However, our data suggest that consumers may still be exposed to older cosmetic products containing MI. BIT has superseded MI in causing contact allergy, despite not being allowed for use in cosmetic products.
Permanent tattooing is the invasive introduction of tattoo ink (pigments) into the dermis. The ink and aftercare cosmetics applied on pre-damaged skin may contain skin sensitisers.
To identify patient characteristics and the pattern of sensitisation in tattooed patients patch tested within the Information Network of Departments of Dermatology (IVDK).
Comparative analysis of patient characteristics and reaction frequencies to baseline series allergens in 1648 consecutive patients with and 8045 consecutive patients without permanent tattoos. Non-overlapping 95%-confidence intervals were considered as significant.
Having permanent tattoos was related with female sex, age <40 years, tobacco smoking, atopic dermatitis, (occupational) hand dermatitis and being employed in particular occupational groups (e.g., healthcare workers, mechanics, hairdressers). Sensitisation to nickel was increased in tattooed patients and associated with female sex (OR 4.23 [95%-CI, 3.48–5.18]), age ≥40 years (OR 1.26 [95%-CI, 1.08–1.49]), tobacco smoking (OR 1.19 [95%-CI, 1.01–1.40]) and having permanent tattoos (OR 1.27 [95%-CI, 1.05–1.53]).
The association between nickel sensitisation and permanent tattoos is probably confounded by past reactions to pierced costume jewellery. Socio-economic factors most probably contribute to the connection between tattoos, tobacco smoking, occupational or hand dermatitis, and being employed in particular occupational groups.
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