Background
Compositae contact sensitization may be difficult to diagnose, because of a lack of reliable screening allergens.
Objectives
To assess the suitability of Compositae mix II 2.5% pet. ...(CM2.5) as a screening mix in the baseline series combined with sesquiterpene lactone (SL) mix and parthenolide (PTH).
Methods
CM2.5 was added to the baseline series, which included SL mix and PTH 0.1% pet., in January 2015, and PTH was included in TRUE Test Panel 3 in October 2015. All Compositae‐sensitive patients diagnosed or tested in the next 4 years were assessed.
Results
Altogether, 57 patients (2.7%) presented with Compositae allergy. On primary testing in 53 newly diagnosed patients, SL mix elicited positive reactions most frequently (53% positive), followed by CM2.5 (47% positive), and PTH (45% positive). CM2.5 and PTH pet. elicited a few irritant reactions. Three patients had late reactions. Altogether, 16 patients (28%) were not detected by any of the three screening agents.
Conclusions
SL mix is an indispensable, although insufficient, screening mixture in Denmark. It may be relatively safely supplemented with CM2.5 and PTH in the TRUE Test system for screening, but, when Compositae sensitization is suspected, further extracts should be tested on the basis of the history.
Summary
Background
Compositae dermatitis was originally described as airborne contact dermatitis. More recent studies have reported a wider clinical spectrum, but often in polysensitized patients.
...Objective
To evaluate the clinical features of patients sensitized to Compositae only.
Patients/Methods
Consecutive Compositae‐sensitive eczema patients, tested between 1990 and 2015, who, at the patch testing session diagnosing their Compositae allergy, were found to be sensitized only to the plant family, were included.
Results
Altogether, 529 of 13 139 patients tested (4.0%) were sensitized to Compositae, and 95 (18% of these) were monosensitized. The majority had hand eczema, and 39 (44%) had a vesicular volar pattern. Eighty‐one patients were classified into one of three groups of similar size: localized eczema, eczema of exposed skin, and localized eczema turning into widespread eczema.
Conclusions
The prevalence of Compositae sensitization is continuously high in consecutive eczema patients. Sensitization may occur at any age. Clinical features in monosensitized patients vary, but, with continuing exposure, the patients may develop more widespread dermatitis similar to classic Compositae dermatitis. Avoidance may clear the exogenous part, but not endogenous aetiological factors such as vesicular hand eczema or possible photosensitivity. Thorough clinical assessment and patient education are important in reducing the impact of Compositae contact allergy.
Summary
Background
Allergic contact dermatitis (ACD) caused by nail acrylates, also including methacrylates and cyanoacrylates here, is being increasingly reported.
Methods
A retrospective study in ...11 European Environmental Contact Dermatitis Research Group (EECDRG) clinics collected information on cases of ACD caused by nail acrylates diagnosed by aimed testing between 2013 and 2015.
Results
Among 18 228 studied patients, 136 had ACD caused by nail acrylates (0.75%; 95%CI: 0.60–0.90), representing 67.3% (95%CI: 60.4–73.7) of ACD cases caused by acrylates. There were 135 females and 1 male, with a mean age ± standard deviation of 36.7 ± 12.2 years; 59 (43.4%) were exposed as consumers, and 77 (56.6%) were occupationally exposed. Occupational cases were more frequent in southern Europe (83.7%), and were younger (mean age of 33.4 ± 8.9 years); most developed ACD during the first year at work (65.0%), and at least 11.7% had to leave their jobs. Skin lesions involved the hands in 121 patients (88.9%) and the face in 50 (36.8%), with the face being the only affected site in 14 (10.3%). Most patients reacted to two or more acrylates on patch testing, mainly to 2‐hydroxyethyl methacrylate (HEMA) (92.5%), 2‐hydroxypropyl methacrylate (88.6%), ethylene glycol dimethacrylate (69.2%), and ethyl cyanoacrylate (9.9%).
Conclusions
Nail cosmetics were responsible for the majority of ACD cases caused by acrylates, affecting nail beauticians and consumers, and therefore calling for stricter regulation and preventive measures. As HEMA detects most cases, and isolated facial lesions may be overlooked, inclusion of this allergen in the baseline series may be warranted.
Summary
The present guideline summarizes all aspects of patch testing for the diagnosis of contact allergy in patients suspected of suffering, or having been suffering, from allergic contact ...dermatitis or other delayed‐type hypersensitivity skin and mucosal conditions. Sections with brief descriptions and discussions of different pertinent topics are followed by a highlighted short practical recommendation. Topics comprise, after an introduction with important definitions, materials, technique, modifications of epicutaneous testing, individual factors influencing the patch test outcome or necessitating special considerations, children, patients with occupational contact dermatitis and drug eruptions as special groups, patch testing of materials brought in by the patient, adverse effects of patch testing, and the final evaluation and patient counselling based on this judgement. Finally, short reference is made to aspects of (continuing) medical education and to electronic collection of data for epidemiological surveillance.
Background
Both florists’ chrysanthemums (Chrysanthemum cultivars) and marguerite daisies (Argyranthemum frutescens L. Sch.Bip. and its varieties and cultivars) are popular ornamental plants in ...Denmark.
Objectives
To present results of aimed patch testing with chrysanthemum and marguerite daisy extracts in Danish patients with Compositae sensitization.
Methods
The results of patch testing with chrysanthemum extract 3% petrolatum (pet.) and marguerite daisy extract 3% pet. (and possibly 1% pet.) from 1998 to 2019 were analyzed.
Results
Altogether, 111/191 (58%) patients tested positive to chrysanthemum extract and 104/179 (58%) tested positive to marguerite daisy. The majority was recreationally exposed, and most reactions were considered relevant. Feverfew extract 1% pet., Compositae mix 5% or 6% pet., or parthenolide 0.1% pet. may cross‐react with chrysanthemum; Compositae mix seems to be best at detecting sensitization to marguerite daisy.
Conclusions
In areas where exposure to chrysanthemum or marguerite daisies is prevalent, it is suggested to include extracts of these plants in the plant series to improve diagnosis of, and advice to, Compositae‐allergic patients.
Percentage of positive reactions to Compositae mix 5% or 6% petrolatum and feverfew extract in Compositae‐sensitive patients with chrysanthemum sensitization (chrys+) and without chrysanthemum sensitization (chrys–).
Background
Compositae plant sensitization in children is relatively frequent. From 1995–2006, we found a prevalence of 1.8% sesquiterpene lactone (SL) mix/parthenolide patch test positives among ...consecutive eczema patients <18 years.
Objectives
To report the results of patch test screening for Compositae sensitization in patients <18 years in the last 13 years.
Methods
Children and adolescents <18 years, diagnosed with Compositae sensitization between 2007 and 2019, were included.
Results
Among 388 children tested, 12 (3%) were Compositae‐sensitized, and 11 (2.8%) had positive reactions to SL mix. Compositae mix 5% pet. elicited positive reactions in six of seven patients tested, and dandelion extract 2.5% pet. in six of 10 patients tested. The mean age of the five girls and seven boys was 9.4 years and 11.7 years, respectively. Eleven children had a personal and one a family history of atopy, and 11 children had hand eczema. Only two were mono‐sensitized to Compositae.
Conclusions
SL mix is a suitable screening agent among children and adolescents in our area, well supplemented with Compositae mix 5% and dandelion extract. The study emphasizes the importance of Compositae screening in children with a personal and/or family history of atopy, hand eczema or widespread airborne dermatitis, summer exacerbation, and plant exposure.
When screening for Compositae sensitization with sesquiterpene lactone mix, supplemented with Compositae mix 5% pet., dandelion 2.5% pet., and other Compositae extracts among 388 children and adolescents, the prevalence of sensitization was 3% in the last 13 years
All children and adolescents had a personal and/or family history of atopy, and most of them currently had or have had hand eczema
The study emphasizes the importance of screening for Compositae sensitization in even small children with atopy, personal or familiar, hand eczema or widespread, possibly airborne eczema, summer exacerbation, and plant exposure
Lettuce contact allergy Paulsen, Evy; Andersen, Klaus E.
Contact dermatitis,
February 2016, Letnik:
74, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Summary
Lettuce (Lactuca sativa L.) and its varieties are important vegetable crops worldwide. They are also well‐known, rarely reported, causes of contact allergy. As lettuce allergens and extracts ...are not commercially available, the allergy may be underdiagnosed. The aims of this article are to present new data on lettuce contact allergy and review the literature. Lettuce is weakly allergenic, and occupational cases are mainly reported. Using aimed patch testing in Compositae‐allergic patients, two recent Danish studies showed prevalence rates of positive lettuce reactions of 11% and 22%. The majority of cases are non‐occupational, and may partly be caused by cross‐reactivity. The sesquiterpene lactone mix seems to be a poor screening agent for lettuce contact allergy, as the prevalence of positive reactions is significantly higher in non‐occupationally sensitized patients. Because of the easy degradability of lettuce allergens, it is recommended to patch test with freshly cut lettuce stem and supplement this with Compositae mix. As contact urticaria and protein contact dermatitis may present as dermatitis, it is important to perform prick–to–prick tests, and possibly scratch patch tests as well. Any person who is occupationally exposed to lettuce for longer periods, especially atopics, amateur gardeners, and persons keeping lettuce‐eating pets, is potentially at risk of developing lettuce contact allergy.
Summary
The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence‐ and consensus‐based approach. The guidelines consider a systematic Cochrane review on ...interventions for HE, which is based on a systematic search of the published literature (including hand‐searching). In addition to the evidence‐ and consensus‐based recommendation on the treatment of HE, the guidelines cover mainly consensus‐based diagnostic aspects and preventive measures (primary and secondary prevention). Treatment recommendations include non‐pharmacological interventions, topical, physical and systemic treatments. Topical corticosteroids are recommended as first line treatment in the management of HE, however continuous long‐term treatment beyond six weeks only when necessary and under careful medical supervision. Alitretinoin is recommended as a second line treatment (relative to topical corticosteroids) for patients with severe chronic HE. Randomized control trials (RCT) are missing for other used systemic treatments and comparison of systemic drugs in “head‐to‐head” RCTs are needed.
The guidelines development group is a working group of the European Society of Contact Dermatitis (ESCD) and has carefully tried to reconcile opposite views, define current optimal practice and provide specific recommendations, and meetings have been chaired by a professional moderator of the AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften; Association of the Scientific Medical Societies in Germany).
No financial support was given by any medical company. The guidelines are expected to be valid until December 2017 at the latest.
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