1
|
Ekstein SF, Warshaw EM. Sulfites: Allergen of the Year 2024. Dermatitis 2024; 35:6-12. [PMID: 37590472 DOI: 10.1089/derm.2023.0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Sodium disulfite, also known as sodium metabisulfite or sodium pyrosulfite, is an inorganic compound, which may cause allergic contact dermatitis. Sulfites act as antioxidants and preservatives; common sources include food/beverages, pharmaceuticals, and personal care products. Importantly, sulfites are not included in most screening patch test series and thus may be missed as a relevant contact allergen. The American Contact Dermatitis Society chose sulfites as the Allergen of the Year for 2024 to raise awareness about this significant allergen.
Collapse
Affiliation(s)
- Samuel F Ekstein
- From the Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota, USA
| | - Erin M Warshaw
- From the Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
| |
Collapse
|
2
|
Hamann CR, Baker C, O'Hern K, Zug KA. Occupational allergic contact dermatitis to sodium metabisulfite in shredded coconut. Contact Dermatitis 2022; 87:385-386. [PMID: 35715879 DOI: 10.1111/cod.14175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Carsten R Hamann
- Contact Dermatitis Institute, Phoenix, Arizona, USA
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
- HonorHealth Dermatology Residency, Scottsdale, Arizona, USA
| | - Catherine Baker
- Department of Dermatology, Yale New Haven Hospital, New Haven, Connecticut, USA
| | - Keegan O'Hern
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| |
Collapse
|
3
|
Warshaw EM, Buonomo M, DeKoven JG, Atwater AR, Reeder MJ, Belsito DV, Silverberg JI, Taylor JS, Maibach HI, Zug KA, Sasseville D, Fowler JF, Pratt MD, DeLeo VA, Zirwas MJ. Patch testing with sodium disulfite: North American Contact Dermatitis Group experience, 2017 to 2018. Contact Dermatitis 2021; 85:285-296. [PMID: 33843061 DOI: 10.1111/cod.13860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/23/2021] [Accepted: 04/07/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sodium disulfite (SD), also known as sodium metabisulfite, is an increasingly recognized cause of allergic contact dermatitis. OBJECTIVES The objective of this work was to characterize individuals with positive patch test reactions to SD as well as analyse reaction strength, clinical relevance, and sources. METHODS This is a retrospective analysis of patients patch tested with SD (1% petrolatum) by the North American Contact Dermatitis Group (NACDG), 2017 to 2018. RESULTS Of 4885 patients patch tested with SD, 132 (2.7%) had a positive reaction. Common primary anatomic sites of dermatitis were face (28.8%), hands (20.5%), and a scattered/generalized distribution (13.6%). Compared with SD-negative patients, SD-positive patients were more likely male (odds ratio 2.81, 95% confidence interval 1.98-4.00) and/or over 40 years (odds ratio 1.95, 95% confidence interval 1.30-2.94). Reactions were most commonly + (50.4%) or ++ (34.1%); 65.2% were considered currently relevant. About 15.2% were definitively confirmed in sources, commonly personal care products (18.9%, especially hair dye), and drugs/medications/alcoholic beverages (9.1%). Only 2.3% of positive reactions were linked to occupation. CONCLUSIONS Positive reactions to SD occurred in 2.7% of tested patients. Reactions were often clinically relevant and linked to personal care products and drugs/medications/alcoholic beverages.
Collapse
Affiliation(s)
- Erin M Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA.,Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
| | - Michele Buonomo
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA.,Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.,University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical School, New York, New York, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Denis Sasseville
- Division of Dermatology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Joseph F Fowler
- Division of Dermatology, University of Louisville, Louisville, Kentucky, USA
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California, USA
| | - Matt J Zirwas
- Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, USA
| |
Collapse
|
4
|
Bauer A, Schubert S, Geier J, Mahler V. [Type IV contact allergies in the food processing industry: an update]. DER HAUTARZT 2019; 69:443-448. [PMID: 29721627 DOI: 10.1007/s00105-018-4174-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The food sector is one of the high-risk areas for occupational irritative and allergic contact eczema. OBJECTIVES The present work provides an overview of the main allergens as well as sensitization frequencies and risk in various food industry occupations. METHODS The literature on type IV sensitization in the food sector is summarized. RESULTS The relative risk of developing a work-related eczema in food processing is increased by more than 3 times. The comparison group was calculated on the basis of the proportion of documented cases in the IVDK (Informationsverbund Dermatologischer Kliniken) network per 100,000 working persons in relation to the average of the years 2005 and 2010. For this purpose, the average risk of all patients was set as reference to 1. Bakers, pastry chefs, cooks and meat and fish processors are mainly affected. In addition to irritant contact eczema, allergic contact eczema and protein contact dermatitis often occur. Leading haptens (main allergens) are rubber ingredients, but also disinfectants and compositae. CONCLUSION Only a few contact allergens are responsible for the majority of job-relevant sensitizations in the food industry.
Collapse
Affiliation(s)
- A Bauer
- Klinik und Poliklinik für Dermatologie, Universitäts AllergieCentrum, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - S Schubert
- Informationsverbund Dermatologischer Kliniken (IVDK), Universitätsmedizin Göttingen, Georg-August Universität Göttingen, Göttingen, Deutschland
| | - J Geier
- Informationsverbund Dermatologischer Kliniken (IVDK), Universitätsmedizin Göttingen, Georg-August Universität Göttingen, Göttingen, Deutschland
| | - V Mahler
- Paul-Ehrlich-Institut, Langen, Deutschland.,Med. Fakultät, Universität Erlangen-Nürnberg, Erlangen, Deutschland
| |
Collapse
|
5
|
Häberle M, Geier J, Mahler V. Kontaktallergie auf Sulfite und Sulfitunverträglichkeit: klinische und berufliche Relevanz. ALLERGO JOURNAL 2017. [DOI: 10.1007/s15007-017-1298-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
6
|
|
7
|
Contact allergy and intolerance to sulphite compounds: clinical and occupational relevance. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s40629-016-0003-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
8
|
Abstract
For centuries, food additives have been used for flavouring, colouring and extension of the useful shelf life of food, as well as the promotion of food safety. During the last 20 years, the studies implicating the additives contained in foods and medicine as a causative factor of allergic reactions have been proliferated considerably. In this review, we aimed to overview all of the food additives which were approved to consume in EU and find out how common and serious allergic reactions come into existence following the consuming of food additives.
Collapse
Affiliation(s)
- Fatih Gultekin
- Medical Biochemistry Department, Medical Faculty, Suleyman Demirel University, Cunur, Isparta, Turkey.
| | | |
Collapse
|
9
|
García-Gavín J, Parente J, Goossens A. Allergic contact dermatitis caused by sodium metabisulfite: a challenging allergen. A case series and literature review. Contact Dermatitis 2012; 67:260-9. [DOI: 10.1111/j.1600-0536.2012.02135.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
10
|
Roberts DW, Basketter D, Kimber I, White J, McFadden J, White IR. Sodium metabisulfite as a contact allergen - an example of a rare chemical mechanism for protein modification. Contact Dermatitis 2012; 66:123-7. [DOI: 10.1111/j.1600-0536.2011.02038.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
11
|
|
12
|
Sasseville D, El-Helou T. Occupational allergic contact dermatitis from sodium metabisulfite. Contact Dermatitis 2009; 61:244-5. [DOI: 10.1111/j.1600-0536.2009.01618.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
13
|
Steiner M, Scaife A, Semple S, Hulks G, Ayres JG. Sodium metabisulphite induced airways disease in the fishing and fish-processing industry. Occup Med (Lond) 2008; 58:545-50. [PMID: 18832347 DOI: 10.1093/occmed/kqn130] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sodium metabisulphite (SMBS) is recognized as a potential cause of airway irritation and possibly occupational asthma, but awareness of its use in the fishing and fish-processing industry is low. AIMS AND METHODS To describe three cases of occupational airways disease due to SMBS exposure and to review the literature. RESULTS Three patients, one trawlerman and two prawn processors, developed work-related airways disease due to exposure to SMBS, one with irritant-induced asthma with a positive-specific bronchial challenge associated with very high sulphur dioxide exposures, one with occupational asthma and one with vocal cord dysfunction and underlying asthma. Of the nine cases recorded in the literature, most were non-atopic and responses to specific bronchial challenge when undertaken showed an immediate response. Exposures to sulphur dioxide in these settings are very high, in excess of 30 ppm. CONCLUSION SMBS should be regarded as a cause of occupational airways disease and its use in the fish and prawn-processing industry investigated further to better identify risks from exposure and handling of the agent in the workplace.
Collapse
Affiliation(s)
- M Steiner
- Department of Environmental & Occupational Medicine, University of Aberdeen, Aberdeen AB25 2ZP, UK.
| | | | | | | | | |
Collapse
|
14
|
Abstract
Positive patch tests to sodium metabisulfite (SMB) are frequent. Standard series patch testing to SMB in 1751 patients showed 71 reactions interpreted as positive and allergic. 33 (46.5%) reactions were originally reported as relevant and 38 (53.5%) were of unexplained relevance depending on the presence or absence of identifiable sources responsible for the presenting dermatitis. A breakdown of these findings is presented. An additional detailed study of the sources of SMB in the environment and a retrospective analysis of these results have been undertaken to identify further, possibly overlooked sources of SMB exposure based on the occupational and recreational history. Most of the positive reactions in the relevant group were attributed to the use of Trimovate cream (63%). 5 patients (13%) with positive reactions in the unexplained relevance group were potentially exposed to SMB in local anaesthetic solutions while at work. 3 patients in the unexplained relevance group (7.8%) and 4 (12.1%) in the relevant group had potential for occupational exposure to SMB as bakers or caterers. Overall, occupational exposure was considered as a possible source of sensitization in 10 (26.3%) patients in the unexplained relevance group. We propose that sensitization to SMB from parenteral solutions and occupational exposure from food handling may account for some of the otherwise unexplained positive patch test reactions. A detailed occupational history should be therefore be sought in otherwise unexplained positive reactions to SMB. We also propose that it is worthwhile including SMB in our standard series in the UK.
Collapse
Affiliation(s)
- Vishal Madan
- Contact Dermatitis Investigation Unit, University of Manchester, School of Medicine, Hope Hospital, Manchester, UK.
| | | | | |
Collapse
|
15
|
Huang PY, Chu CY. Allergic contact dermatitis due to sodium metabisulfite in a bleaching cream. Contact Dermatitis 2007; 56:123-4. [PMID: 17244094 DOI: 10.1111/j.1600-0536.2007.00962.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Pei-Ying Huang
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan
| | | |
Collapse
|
16
|
Affiliation(s)
- Cornelia S Seitz
- Department of Dermatology, Venerology and Allergology, University of Würzburg, Würzburg, Germany
| | | | | |
Collapse
|
17
|
Abstract
The skin of bakers is heavily exposed to dough, spices, water and detergents. This is follow-up of a previous Swedish questionnaire study showing bakers to have a 3-fold increased risk of hand eczema. The aims were to establish diagnoses and to study consequences of hand eczema. From a cohort study of 2226 bakers, a random sample among bakers reporting hand eczema was examined. Of 60 randomly selected bakers reporting a history of hand eczema, 52 attended an examination comprising a standardized interview, documentation of clinical skin signs, patch testing and prick testing with standard and bakery series, and serum analyses. In all, 45 bakers confirmed a history of hand eczema, for which 11 (24%) had been on sick leave, with a median duration of 14 weeks. 13 (29%) had changed their occupation due to skin disease, 19 had positive patch test reactions to standard contact allergens - and 5 to bakery contact allergens. 16 bakers had positive prick tests to standard allergens, 10 to bakery allergens, of whom 9 reacted to flours. Since considerable medical and social consequences of hand eczema are seen, thorough diagnosis of contact allergy and IgE-mediated allergy in bakers, as well as preventive measures, are essential.
Collapse
Affiliation(s)
- B Meding
- Occupational Dermatology, National Institute for Working Life, Stockholm, Sweden
| | | | | | | |
Collapse
|