Background Patch testing is essential for identification of culprits causing allergic contact dermatitis. Objective We sought to identify trends and allergen changes in our standard series during ...2006 to 2010, compared with our previous report (2001-2005). Methods We conducted a retrospective review of patch-test results. Results A total of 3115 patients were tested with a mean of 73.0 allergens. Since our prior report, 8 allergens were added to the standard series; 14 were deleted. Significantly higher rates of allergic positive reaction were documented for carba mix, 3%, and Disperse Orange 3, 1%. Rates were lower for 10 allergens: neomycin sulfate, 20%; gold sodium thiosulfate, 0.5%; hexahydro-1,3,5-tris(2-hydroxyethyl)triazine, 1%; disperse blue 124, 1%; disperse blue 106, 1%; diazolidinyl urea, 1%; hexylresorcinol, 0.25%; diazolidinyl urea, 1% aqueous; 2-bromo-2-nitropropane-1,3-diol, 0.25%; and lidocaine, 5%. Many final patch-test readings for many allergens were categorized as mild reactions (erythema only). Overall allergenicity and irritancy rates declined significantly since our prior report. Results were generally comparable with those in a North American Contact Dermatitis Group report from 2005 to 2006. Limitations This was a retrospective study; there is a lack of long-term follow-up. Conclusions Since our previous report, our standard series composition has changed, and overall rates of allergenicity and irritancy have decreased. Notably, many final patch-test readings showed mild reactions.
Background
There is an ongoing discussion on whether routinely patch testing with p‐phenylenediamine (PPD) 1.0% pet. is safe, owing to the risk of patch test sensitization. Late‐appearing patch test ...reactions may reflect patch test sensitization, but may also be attributable to a low degree of pre‐existing sensitization.
Objectives
To follow the positive patch test reactions to PPD and its salt PPD dihydrochloride (PPD‐DHC) in order to characterize reaction patterns concerning time and dose in PPD‐sensitized individuals.
Methods
Volunteers with previous reactions to PPD 1.0% were included and patch tested with PPD and PPD‐DHC in equimolar dilution series. There were then seven follow‐up visits over a period of 28 days.
Results
Twenty‐six volunteers completed the study, of whom 23 of 26 (88%) reacted to PPD 1.0%, and 69% reacted to PPD 0.32%. Altogether, 42% and 27% reacted to the corresponding equimolar concentrations of PPD‐DHC. After day 7, no new reactions were observed to any concentration tested, either of PPD or of PPD‐DHC.
Conclusion
No late‐appearing reactions to PPD or PPD‐DHC were observed at any dose. There is a risk of missing contact allergy when the dose is decreased.
The relationship between atopic dermatitis (AD) and allergic contact dermatitis (ACD) is a matter of debate.
The purpose of our study is to assess the frequency of ACD in patients with AD, the ...incriminated allergens and the potential risk factors.
This is a prospective study, including cases of AD diagnosed based on Hanifin and Rajka's criteria. All patients were patch tested to the European baseline series and corticosteroid series.
Ninety-three patients were included. Fifty-six patients (60.2%) had positive patch test results of which 71.4% were relevant. The most frequent allergens were: textile dye mix (24.7%), nickel (20.4%), cobalt (12.9%), isothiazolinone (8.6%), quanterium 15 (4.3%) and balsam of Peru (4.3%). Chromium, fragrance mix I, fragrance mix II and PTBP were positive in three cases (3.2%). Two cases of allergy to corticoids were identified. Facial involvement and duration of AD were significantly associated with contact sensitization (p = 0.04 and p = 0.005, respectively). Avoidance of relevant allergens resulted in a statistically significant decrease in SCORAD (p < 0.001).
ACD remains an important co-morbidity of AD. We observed a high frequency of ACD to textile dyes, isothiazolinones and fragrances. Avoidance of relevant allergens has resulted in an improvement of patients' skin symptoms.
Eyelid dermatitis is a frequent reason of dermatological consultation. Its aetiology is not univocal, being contact dermatitis, both allergic and irritant, the most frequent. The primary sources of ...allergen exposure include cosmetics, metals, and topical medications, from direct, indirect, or airborne contact.
To define the frequency of positive patch test reactions to SIDAPA baseline series allergens, to document positive allergens, and to precise the final diagnosis in patients with eyelid involvement.
A total of 8557 consecutive patients from 12 Italian Dermatology Clinics underwent patch testing with SIDAPA baseline series in 2018 and 2019. Patients were divided into two groups: (i) with eyelid involvement with or without other involved sites (E-Group) and (ii) without eyelid involvement (NE-Group). The final diagnosis and the frequency of positive relevant patch test reactions were evaluated.
E-Group consisted of 688 patients (females 78.6%, mean age 45.3 years), 8.0% of 8557 consecutively patch-tested patients. The final diagnosis in E-Group was ADC in 42.4%, ICD in 34.2%, and AD in 30.5%. The highest reaction rates were elicited by nickel sulphate and methylchloroisothiazolinone/methylisothiazolinone in both E-Group and NE-Group, even if these allergens were significantly more frequently positive in NE-Group patients than in E-Group ones. Positive patch test reactions to fragrance Mix II, dimethylaminopropylamine, and sorbitan sesquiolate were significantly more frequent in E-Group patients than in NE-Group ones.
Eyelid dermatitis is a frequent dermatological complaint. Allergic contact dermatitis is the most frequent diagnosis commonly caused by nickel sulphate, isothiazolinones, and fragrances. The surfactants dimethylaminopropylamine and sorbitan sesquioleate are emerging causes of eyelid allergic contact dermatitis.
Background
Patch test is the gold standard for diagnosing allergic contact dermatitis. Conventionally, the patches are applied for 48 h, which in tropical weather conditions causes excessive ...sweating, leading to irritation, and sometimes the patches come off, making the test inconclusive.
Objective
To compare the patch test positivity after 24 and 48 h of occlusion time in patients of allergic contact dermatitis, using standard allergen concentration.
Materials and methods
Clinically suspected patients of allergic contact dermatitis were enrolled and patch tested using the Indian Standard Series, parthenium acetone extracts (1:50, 1:100 and 1:200 dilutions) and patient material. Patches were applied in duplicate on either side of the back, using a random number table. One set of patches was removed after 24‐h of occlusion, while the other set after 48‐h. Readings were performed at 48‐ and 96‐h by two independent dermatologists, blinded to the duration of occlusion.
Results
The study had 97 adult patients (58 males and 39 females; mean age: 48.12 ± 13.07 years). A total of 133 and 142 positive reactions were observed after 48 h occlusion at 48 and 96 h reading, respectively. Of these 117 (87.9%) and 132 (92.9%) patches were positive and concordant and noted at 24 h occlusion time. The Cohen's kappa coefficient were 0.94 for 48 h and 0.97 for 96 h reading, hence showing an almost complete agreement (ⱪ > 0.81) between patches occluded for 24 and 48 h.
Conclusion
Though there is no significant difference in patch test positivity among ISS allergens after either occlusion time, 48 h occlusion performs significantly better compared with 24 h, when reactions of all allergens (ISS, patient material and parthenium acetone extract) are analysed together.
Our study compares patch test positivity in 97 patients of allergic contact dermatitis after 24 and 48 h of application. Using standard allergen concentrations, we found no significant difference in Indian Standard Series allergens. However, when analysing all allergens together, 48 h application outperformed 24 h. Moreover, positive reactions after 48 h had increased severity (grading) as compared with after 24 h. Our results suggest that a shorter occlusion time may be sufficient, enhancing patient comfort and test reliability, particularly in tropical climates. Consideration for a new standard occlusion time is proposed, with further multicentre studies needed for validation.
Background
There is speculation that some environmental factors may be impacting the increasing incidence of frontal fibrosing alopecia (FFA). In a recent publication, sensitisation to benzyl ...salicylate was shown to be prevalent among 36 patients with FFA. Ethylhexyl salicylate (EHS), a light stabiliser, ultraviolet (UV) B absorber and UV filter, frequently found in photoprotectors/cosmetics and, rarely reported as a sensitiser, was not patch tested in said research.
Methods
From January 2021 to February 2022, 33 patients with FFA were patch‐tested with the European Photopatch Series, including EHS 10% pet. in two hospitals. In addition, we conducted a literature review and a market survey.
Results
Patch test reactions to EHS were identified in 9 of 33 (27.3%). Four of nine also reacted to their personal sunscreens (containing EHS). All involved women with a mean age of 54 (30–65). Five patients had been diagnosed with FFA before the patch tests; and, four were diagnosed with FFA during the patch test investigations.
Conclusion
Sensitisation to EHS was frequently found in a selected population of patients with FFA. We propose to expand the spectrum of contact allergens described in patients with FFA to include EHS and discuss the possible need for optimization of the patch test preparation.
Ethylhexyl salicylate (EHS), a light stabiliser, ultraviolet B absorber and ultraviolet filter, was patch‐tested in 33 women with frontal fibrosing alopecia (FFA). Positive reactions involved 9 of 33 (27.3%). Four also reacted to their sunscreens. We propose to expand the allergen spectrum described in FFA (to include EHS) and to optimise the patch test preparation.
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