Mainly women work as foot care specialists (FCS). They are at risk to develop occupational dermatitis (OD).
The objective of this study is to describe the contact sensitisation pattern of female FCS with OD.
In a retrospective study, patch test and clinical data collected by the Network of Departments of Dermatology (IVDK) from 2008 to 2022 were analysed. Data of 116 female FCS with OD were compared with data of 13 930 female patients with OD working in other professions and 78 612 female patients without OD.
Hand dermatitis (93.1%) was significantly more common and face dermatitis (0.9%) significantly less common in female FCS with OD compared to other female patients with or without OD. Frequent suspected allergen sources were disinfectants, gloves, leave-on and nail cosmetics. Occlusion and wetness were important co-factors. The most common diagnoses were irritant contact dermatitis (26.7%) and allergic contact dermatitis (21.6%). No sensitisation to any of the baseline series allergens was significantly more frequent in female FCS with OD than in the two control groups. However, sensitisations to allergens which FCS are abundantly exposed to, including fragrances, preservatives, rubber ingredients and disinfectants, were most common.
FCS should be aware of the OD risk and prevention should be promoted.
Machine learning (ML) offers an opportunity in contact dermatitis (CD) research, where with full clinical picture, may support diagnosis and patch test accuracy.
This review aims to summarise the existing literature on how ML can be applied to CD in its entirety.
Embase, Medline, IEEE Xplore, and ACM Digital Library were searched from inception to February 7, 2024, for primary literature reporting on ML models in CD.
7834 articles were identified in the search, with 110 moving to full-text review, and six articles included. Two used ML to identify key biomarkers to help distinguish between allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD), three used image data to distinguish between ACD and ICD, and one used clinical and demographical data to predict the risk of positive patch tests. All studies used supervision in their ML model training with a total of 49 704 patients across all data sets. There was sparse reporting of the accuracy of these models.
Although the available research is still limited, there is evidence to suggest that ML has potential to support diagnostic outcomes in a clinical setting. Further research on the use of ML in clinical practice is recommended.
We report the case of a 55-year-old male office worker, who developed extensive urticarial lesions starting on the scalp and face followed by abdominal cramps, nausea and vomiting less than 30 min after hair dye application. He immediately consulted the emergency department of our hospital where an extensive urticarial rash without respiratory or cardiovascular complications was documented. His condition rapidly improved upon treatment with prednisolone and antihistamines [Correction added on 7 August 2024, after first online publication: IV was deleted from the preceding sentence.].
The patient had a pre-existing diagnosis of chronic plaque psoriasis. He had no previous history of atopy, no previous immediate reactions to hair dyes and never had any temporary black henna tattoos done.
However, for more than 1 year, he had noticed itching of the scalp associated with eczematous lesions of the ears and forehead some days after dyeing his hair. As his symptoms were less severe, he did not feel the need to seek medical attention.
General consent was obtained from the patient. Skin tests were performed under strict medical monitoring. Standard patch tests with our baseline, cosmetic, and hairdressing series (supplied by Chemotechnique Diagnostics, Vellinge, Sweden) using IQ ultra patch test chambers (Chemotechnique Diagnostics) as well as semi-opened patch testing with the patients' personal dyes diluted with 10% aqua were applied. As rapidly as 20 min after epicutaneous application of American Crew—Precision Blend (AC) (American Crew, New-York, USA) and Wella-Koleston Perfect (Wella, Rothenkirchen, Germany) (W) dyes with and without adjunction of hydrogen peroxide the patient developed a localised papular reaction on the test site. There was no malaise or other systemic symptoms. Allergens were then applied for 48 h and readings performed on day (D) 2 and D4. Readings on D2 and D4 showed +++ positive reactions for p-phenylenediamine (PPD; 1% pet.) and toluene-2,5-diamine (PTD; 1% pet.), and ++ positive reactions to AC and W dyes.
Prick tests with the colour blend formula AC and W gave positive results (6 and 4 mm wheals, respectively) with appropriate positive and negative controls. We also performed prick test with PPD 1% pet., PTD 1% pet., m-aminophenol 1% pet., resorcinol 1% pet. A positive reaction at 20 min (7 mm wheal) was only seen with PTD.
Allergic contact dermatitis (ACD) to hair dyes is a frequent problem, both in consumers and hairdressers.1 The two main culprits usually are PPD and PTD, but many other components of hair dyes are described as eliciting substances. In recent years, it has been shown that the use of PTD in commercial products in Europe was increasingly more frequent than PPD.2 A few cases of anaphylactoid reactions to hair dyes with acute facial lesions mimicking angioedema occurring hours following dye application were also publ
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