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Tang H, Wang H, Hamblin MR, Jiang L, Zhou Y, Xu Y, Wen X. Contact dermatitis caused by prevention measures during the COVID-19 pandemic: a narrative review. Front Public Health 2023; 11:1189190. [PMID: 37546301 PMCID: PMC10400336 DOI: 10.3389/fpubh.2023.1189190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction During the outbreak of Coronavirus disease 2019 (COVID-19), health care workers wore personal protective equipment including masks, gloves and goggles for a long time. In order to reduce the transmission routes of the virus, public places were sprayed with disinfectant. Moreover, the body, hands and clothing were frequently disinfected and washed for hygiene purposes. Studies have shown that these practices could easily irritate the skin and damage the skin barrier. Long-term irritation or exposure to allergens may lead to the occurrence of contact dermatitis (CD). Methods Subject headings were searched via the National Library of Medicine (PubMed) and web of science databases: COVID-19; contact dermatitis; adverse skin reaction; PPE; dermatitis; mask; glory; hand hygiene, disinfection; face shield; goggle; protect cloth. A total of 246 and 646 articles were retrieved from the two databases, respectively. 402 articles remained after removing duplicates. Reviews, non-English articles, articles that could not be accessed to read or did not conform to our topic were excluded. Finally, a total of 32 cross-sectional studies, 9 case reports and 2 randomized controlled trials were included. Discussion This article reviews reports of CD caused by various prevention and hygiene measures during the COVID-19 pandemic. The amount of skin damage caused by COVID-19 prevention measures could be decreased by improved education about skin management.
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Affiliation(s)
- Huimiao Tang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Wang
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Michael R. Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
| | - Lu Jiang
- Outpatient Department of West China Hospital, Sichuan University, Chengdu, China
| | - Yanjun Zhou
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yidan Xu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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2
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Sriprachya-anunt S, Rutnin S, Suchonwanit P. Granular Parakeratosis of the Eccrine Ostium: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:1807-1810. [PMID: 37469551 PMCID: PMC10352123 DOI: 10.2147/ccid.s421152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/04/2023] [Indexed: 07/21/2023]
Abstract
Granular parakeratosis (GP) is a unique keratotic disorder that often affects the intertriginous areas. GP usually presents as erythematous or brownish hyperkeratotic papules or plaques and can be further classified into five types. GP of the eccrine ostium is a rare subtype; its pathological defects are mainly localized to the stratum corneum of the eccrine ostia. Due to its rarity, there is usually a delay in diagnosing GP, and these patients are often misdiagnosed with other dermatological conditions. In this report, we present the case of a 64-year-old Thai female who presented with recurrent pruritic erythematous rashes on her neck since approximately 40 years. She was previously diagnosed with eczema or folliculitis. Histopathological examination confirmed a final diagnosis of GP of the eccrine ostium. She was advised to avoid excessive heat and keep her intertriginous areas dry. Her condition improved significantly during the follow-up visit.
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Affiliation(s)
- Sittha Sriprachya-anunt
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthinee Rutnin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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3
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Arnold W, Blum A, Branyan J, Bruton TA, Carignan CC, Cortopassi G, Datta S, DeWitt J, Doherty AC, Halden RU, Harari H, Hartmann EM, Hrubec TC, Iyer S, Kwiatkowski CF, LaPier J, Li D, Li L, Muñiz Ortiz JG, Salamova A, Schettler T, Seguin RP, Soehl A, Sutton R, Xu L, Zheng G. Quaternary Ammonium Compounds: A Chemical Class of Emerging Concern. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:7645-7665. [PMID: 37157132 PMCID: PMC10210541 DOI: 10.1021/acs.est.2c08244] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 05/10/2023]
Abstract
Quaternary ammonium compounds (QACs), a large class of chemicals that includes high production volume substances, have been used for decades as antimicrobials, preservatives, and antistatic agents and for other functions in cleaning, disinfecting, personal care products, and durable consumer goods. QAC use has accelerated in response to the COVID-19 pandemic and the banning of 19 antimicrobials from several personal care products by the US Food and Drug Administration in 2016. Studies conducted before and after the onset of the pandemic indicate increased human exposure to QACs. Environmental releases of these chemicals have also increased. Emerging information on adverse environmental and human health impacts of QACs is motivating a reconsideration of the risks and benefits across the life cycle of their production, use, and disposal. This work presents a critical review of the literature and scientific perspective developed by a multidisciplinary, multi-institutional team of authors from academia, governmental, and nonprofit organizations. The review evaluates currently available information on the ecological and human health profile of QACs and identifies multiple areas of potential concern. Adverse ecological effects include acute and chronic toxicity to susceptible aquatic organisms, with concentrations of some QACs approaching levels of concern. Suspected or known adverse health outcomes include dermal and respiratory effects, developmental and reproductive toxicity, disruption of metabolic function such as lipid homeostasis, and impairment of mitochondrial function. QACs' role in antimicrobial resistance has also been demonstrated. In the US regulatory system, how a QAC is managed depends on how it is used, for example in pesticides or personal care products. This can result in the same QACs receiving different degrees of scrutiny depending on the use and the agency regulating it. Further, the US Environmental Protection Agency's current method of grouping QACs based on structure, first proposed in 1988, is insufficient to address the wide range of QAC chemistries, potential toxicities, and exposure scenarios. Consequently, exposures to common mixtures of QACs and from multiple sources remain largely unassessed. Some restrictions on the use of QACs have been implemented in the US and elsewhere, primarily focused on personal care products. Assessing the risks posed by QACs is hampered by their vast structural diversity and a lack of quantitative data on exposure and toxicity for the majority of these compounds. This review identifies important data gaps and provides research and policy recommendations for preserving the utility of QAC chemistries while also seeking to limit adverse environmental and human health effects.
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Affiliation(s)
- William
A. Arnold
- University
of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Arlene Blum
- Green
Science Policy Institute, Berkeley, California 94709, United States
- University
of California, Berkeley, California 94720, United States
| | - Jennifer Branyan
- California
Department of Toxic Substances Control, Sacramento, California 95814, United States
| | - Thomas A. Bruton
- California
Department of Toxic Substances Control, Sacramento, California 95814, United States
| | | | - Gino Cortopassi
- University
of California, Davis, California 95616, United States
| | - Sandipan Datta
- University
of California, Davis, California 95616, United States
| | - Jamie DeWitt
- East
Carolina University, Greenville, North Carolina 27834, United States
| | - Anne-Cooper Doherty
- California
Department of Toxic Substances Control, Sacramento, California 95814, United States
| | - Rolf U. Halden
- Arizona
State University, Tempe, Arizona 85287, United States
| | - Homero Harari
- Icahn
School of Medicine at Mount Sinai, New York, New York 10029, United States
| | | | - Terry C. Hrubec
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia 24060, United States
| | - Shoba Iyer
- California Office of Environmental Health Hazard Assessment, Oakland, California 94612, United States
| | - Carol F. Kwiatkowski
- Green
Science Policy Institute, Berkeley, California 94709, United States
- North Carolina State University, Raleigh, North Carolina 27695 United States
| | - Jonas LaPier
- Green
Science Policy Institute, Berkeley, California 94709, United States
| | - Dingsheng Li
- University
of Nevada, Reno, Nevada 89557, United States
| | - Li Li
- University
of Nevada, Reno, Nevada 89557, United States
| | | | - Amina Salamova
- Indiana University, Atlanta, Georgia 30322, United States
| | - Ted Schettler
- Science and Environmental Health Network, Bolinas, California 94924, United States
| | - Ryan P. Seguin
- University of Washington, Seattle, Washington 98195, United States
| | - Anna Soehl
- Green
Science Policy Institute, Berkeley, California 94709, United States
| | - Rebecca Sutton
- San Francisco Estuary Institute, Richmond, California 94804, United States
| | - Libin Xu
- University of Washington, Seattle, Washington 98195, United States
| | - Guomao Zheng
- Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
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4
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Ewulu A, Cardis MA, Habeshian KA. An intertriginous eruption in an infant. Pediatr Dermatol 2022; 39:979-981. [PMID: 36440993 DOI: 10.1111/pde.15111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Adaora Ewulu
- Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Michael A Cardis
- Department of Dermatology, Medstar Washington Hospital Center/Georgetown University Hospital, Washington, District of Columbia, USA
| | - Kaiane A Habeshian
- Department of Dermatology, George Washington University School of Medicine/Children's National, Washington, District of Columbia, USA
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5
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Kuo YW. Erythematous flexural eruption in a young man. Clin Exp Dermatol 2022; 47:2052-2054. [PMID: 36004411 DOI: 10.1111/ced.15331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 11/27/2022]
Abstract
A young man presented with a 2-week history of well-defined erythematous plaques symmetrically distributed in multiple intertriginous areas. He had received topical corticosteroids, antifungals and oral prednisolone without improvement. Histopathological examination revealed confluent parakeratosis with retention of basophilic keratohyalin granules within the stratum corneum.
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Affiliation(s)
- Yi-Wen Kuo
- Department of Dermatology, E-Da Cancer Hospital, Kaohsiung, Taiwan
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6
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Dear K, Gan D, Stavrakoglou A, Nixon R, Ronaldson C. Hyperkeratotic flexural erythema (more commonly known as granular parakeratosis) with use of laundry rinses containing benzalkonium chloride – a case series. Clin Exp Dermatol 2022; 47:2196-2200. [DOI: 10.1111/ced.15358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Katherine Dear
- Occupational Dermatology Research and Education Centre Skin Health Institute, Level 1/80 Drummond Street Carlton Victoria Australia 3053
| | - Desmond Gan
- Melbourne Eastside Dermatology, 210 Canterbury Rd, Blackburn South Victoria Australia 3130
| | | | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre Skin Health Institute, Level 1/80 Drummond Street Carlton Victoria Australia 3053
| | - Claire Ronaldson
- Occupational Dermatology Research and Education Centre Skin Health Institute, Level 1/80 Drummond Street Carlton Victoria Australia 3053
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7
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Lin Q, Zhang D, Ma W. Granular Parakeratosis: A Case Report. Clin Cosmet Investig Dermatol 2022; 15:1367-1370. [PMID: 35874456 PMCID: PMC9297043 DOI: 10.2147/ccid.s371558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/06/2022] [Indexed: 11/23/2022]
Abstract
Granular parakeratosis is an uncommon acquired keratinization disorder that occurs in the armpit, groin, and other parts of the body. It may be related to stimulation by detergents and antiperspirants. This article reports a case of granular parakeratosis in the groin. The patient was a young man with no predisposing factors. The clinical manifestations included symmetrical bilateral inguinal erythema, dryness, and a small amount of bran-like desquamation. After histopathological examination, the final diagnosis was granular parakeratosis, which was cured by topical application of glucocorticoid cream and silicone oil cream. Granular parakeratosis is a rare skin disease of unknown etiology. Clinicians need to pay attention to this disease and differentiate it from various diseases to avoid misdiagnosis.
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Affiliation(s)
- Qingxia Lin
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Dong Zhang
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Weiyuan Ma
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
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8
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Herat A, Gonzalez Matheus G, Kumarasinghe SP. Hyperkeratotic flexural erythema/granular parakeratosis responding to doxycycline. Australas J Dermatol 2022; 63:368-371. [PMID: 35535765 DOI: 10.1111/ajd.13868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/29/2022] [Accepted: 04/25/2022] [Indexed: 11/29/2022]
Abstract
Hyperkeratotic flexural erythema (HKFE), also termed granular parakeratosis (GP), is a rare skin condition thought to be linked to a skin barrier dysfunction process, however the exact cause of this is yet to be determined. Management options are varied, with no consensus on treatment. Several previous reports have recorded successful treatment with amoxycillin-clavulanic acid combination. We propose the use of oral doxycycline in addition to topical coconut oil compound as a treatment option in therapy resistant HKFE.
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Affiliation(s)
- Asoka Herat
- South East Dermatology, Annerley, Queensland, Australia
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9
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Kim TK, Jang M, Hwang YS. Adsorption of benzalkonium chlorides onto polyethylene microplastics: Mechanism and toxicity evaluation. JOURNAL OF HAZARDOUS MATERIALS 2022; 426:128076. [PMID: 34952503 DOI: 10.1016/j.jhazmat.2021.128076] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/29/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
Usage of disposable plastic products and disinfectants has been skyrocketing due to the COVID-19 pandemic. The random disposal of plastic products may result in greater microplastic pollution. Benzalkonium chloride is known as one of the most common ingredients of disinfectants. In this study, the adsorption behavior of benzalkonium chlorides (BAC12, BAC14, BAC16) on polyethylene microplastics (PE-MPs) and the combined toxic effects were investigated using batch adsorption experiment and Daphnia magna. The results showed that PE-MPs had strong adsorption capacity for BACs and the adsorption capacity increased (11.03-22.77 mg g-1) with their octanol-water distribution coefficients. The effect of pH was negligible while dissolved organic matter inhibited the adsorption. A slightly inverse relationship between particle size of PE-MPs and adsorption was observed. Additionally, the MP aging with UV/H2O2 increased the adsorption of BAC12 but decreased that of relatively hydrophobic BAC14 and BAC16. The survival rate of Daphnia magna increased up to 100% in the presence of PE-MPs depending upon their adsorption capacities, suggesting that PE-MPs do not act as a carrier but rather as a scavenger for BACs. This study provides important information necessary for environmental risk assessment with regard to the combined pollution of MPs and toxic chemicals.
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Affiliation(s)
- Tae-Kyoung Kim
- Environmental Fate and Exposure Research Group, Korea Institute of Toxicology, Jinju, Republic of Korea; Department of Civil and Environmental Engineering, University of California, Berkeley, California 94720, United States
| | - Minhee Jang
- Environmental Fate and Exposure Research Group, Korea Institute of Toxicology, Jinju, Republic of Korea
| | - Yu Sik Hwang
- Environmental Fate and Exposure Research Group, Korea Institute of Toxicology, Jinju, Republic of Korea.
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10
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Ip KH, Li A. Clinical features, histology, and treatment outcomes of granular parakeratosis: a systematic review. Int J Dermatol 2022; 61:973-978. [PMID: 35094385 PMCID: PMC9546368 DOI: 10.1111/ijd.16107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/19/2021] [Accepted: 01/05/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Ken Hiu‐Kan Ip
- Victorian Melanoma Service Alfred Health Melbourne Victoria Australia
- School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
| | - Angela Li
- Department of Obstetrics and Gynaecology Eastern Health Melbourne Victoria Australia
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11
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Choong DJ, Kumarasinghe SP, Wood B. Hyperkeratotic flexural erythema and response to amoxicillin-clavulanic acid: Two cases within the same family. Australas J Dermatol 2021; 63:e97-e99. [PMID: 34665460 DOI: 10.1111/ajd.13737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/18/2021] [Accepted: 10/02/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Dean Jeremy Choong
- Department of Dermatology, Fiona Stanley Hospital, Murdoch, Western Australia,, Australia
| | | | - Benjamin Wood
- PathWest, QEII Medical Centre, Nedlands, Western Australia,, Australia
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12
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Herron JM, Tomita H, White CC, Kavanagh TJ, Xu L. Benzalkonium Chloride Disinfectants Induce Apoptosis, Inhibit Proliferation, and Activate the Integrated Stress Response in a 3-D in Vitro Model of Neurodevelopment. Chem Res Toxicol 2021; 34:1265-1274. [PMID: 33472002 PMCID: PMC8131244 DOI: 10.1021/acs.chemrestox.0c00386] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We previously found that the widely used disinfectants, benzalkonium chlorides (BACs), alter cholesterol and lipid homeostasis in neuronal cell lines and in neonatal mouse brains. Here, we investigate the effects of BACs on neurospheres, an in vitro three-dimensional model of neurodevelopment. Neurospheres cultured from mouse embryonic neural progenitor cells (NPCs) were exposed to increasing concentrations (from 1 to 100 nM) of a short-chain BAC (BAC C12), a long-chain BAC (BAC C16), and AY9944 (a known DHCR7 inhibitor). We found that the sizes of neurospheres were decreased by both BACs but not by AY9944. Furthermore, we observed potent inhibition of cholesterol biosynthesis at the step of DHCR7 by BAC C12 but not by BAC C16, suggesting that cholesterol biosynthesis inhibition is not responsible for the observed reduction in neurosphere growth. By using immunostaining and cell cycle analysis, we found that both BACs induced apoptosis and decreased proliferation of NPCs. To explore the mechanisms underlying their effect on neurosphere growth, we carried out RNA sequencing on neurospheres exposed to each BAC at 50 nM for 24 h, which revealed the activation of the integrated stress response by both BACs. Overall, these results suggest that BACs affect neurodevelopment by inducing the integrated stress response in a manner independent of their effects on cholesterol biosynthesis.
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Affiliation(s)
- Josi M. Herron
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
- Department of Medicinal Chemistry, University of Washington, Seattle, WA
| | - Hideaki Tomita
- Department of Medicinal Chemistry, University of Washington, Seattle, WA
| | - Collin C. White
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
| | - Terrance J. Kavanagh
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
| | - Libin Xu
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
- Department of Medicinal Chemistry, University of Washington, Seattle, WA
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13
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Dear K, Palmer A, Nixon R. Contact allergy and allergic contact dermatitis from benzalkonium chloride in a tertiary dermatology center in Melbourne, Australia. Contact Dermatitis 2021; 85:146-153. [PMID: 33656745 DOI: 10.1111/cod.13826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/30/2021] [Accepted: 02/03/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Benzalkonium chloride (BAK) is a quaternary ammonium compound that is used widely as an antiseptic and preservative. It is a strong irritant and considered a weak sensitizer. OBJECTIVE To analyze the temporal trend of BAK sensitization and the demographics of sensitized patients. METHODS We conducted a single-center retrospective study of 7390 patients who were patch tested with BAK between January 1, 2003 and December 31, 2019. RESULTS Of the 7390 patients who were patch tested to BAK, 108 (1.5%) had a positive reaction, with 21 reactions deemed clinically relevant (0.3% of total patch tested) and a further 5 doubtful reactions deemed clinically relevant, resulting in a total of 26 relevant reactions (0.4% of total patch tested). Common sources of exposure were ophthalmic drops (30.8%), topical antiseptic preparations (26.9%), cosmetics (15.4%), disinfectant solutions (11.5%), hand sanitizers (11.5%), and hand washes (7.7%). One fifth of patients with relevant reactions were health care workers. There has been a dramatic increase in the number of positive reactions since 2017, for reasons not totally clear. CONCLUSION Contact allergy (CA) and allergic contact dermatitis (ACD) in response to BAK are now increasing at our center. Awareness of this trend is important, given that the coronavirus disease 2019 (COVID-19) pandemic is likely to further expose people to BAK.
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Affiliation(s)
- Kate Dear
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - Amanda Palmer
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
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14
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Lee G, Fischer G. Support for a Microbial Basis for Hyperkeratotic Flexural Erythema. Australas J Dermatol 2020; 61:377-378. [PMID: 32342991 DOI: 10.1111/ajd.13303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Geoffrey Lee
- Department of Dermatology, Royal North Shore Hospital, St Leonards, Australia
| | - Gayle Fischer
- Department of Dermatology, Royal North Shore Hospital, St Leonards, Australia
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15
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Mitochondrial Dysfunctions May Be One of the Major Causative Factors Underlying Detrimental Effects of Benzalkonium Chloride. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:8956504. [PMID: 32104543 PMCID: PMC7035552 DOI: 10.1155/2020/8956504] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/23/2019] [Accepted: 01/10/2020] [Indexed: 02/06/2023]
Abstract
Benzalkonium chloride (BAC) is currently the most commonly used antimicrobial preservative in ophthalmic solutions, nasal sprays, and cosmetics. However, a large number of clinical and experimental investigations showed that the topical administration of BAC-containing eye drops could cause a variety of ocular surface changes, from ocular discomfort to potential risk for future glaucoma surgery. BAC-containing albuterol may increase the risk of albuterol-related systemic adverse effects. BAC, commonly present in personal care products, in cosmetic products can induce irritation and dose-dependent changes in the cell morphology. The cationic nature of BAC (it is a quaternary ammonium) suggests that one of the major targets of BAC in the cell may be mitochondria, the only intracellular compartment charged negatively. However, the influence of BAC on mitochondria has not been clearly understood. Here, the effects of BAC on energy parameters of rat liver mitochondria as well as on yeast cells were examined. BAC, being a "weaker" uncoupler, potently inhibited respiration in state 3, diminished the mitochondrial membrane potential, caused opening of the Ca2+/Pi-dependent pore, blocked ATP synthesis, and promoted H2O2 production by mitochondria. BAC triggered oxidative stress and mitochondrial fragmentation in yeast cells. BAC-induced oxidative stress in mitochondria and yeast cells was almost totally prevented by the mitochondria-targeted antioxidant SkQ1; the protective effect of SkQ1 on mitochondrial fragmentation was only partial. Collectively, these data showed that BAC acts adversely on cell bioenergetics (especially on ATP synthesis) and mitochondrial dynamics and that its prooxidant effect can be partially prevented by the mitochondria-targeted antioxidant SkQ1.
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16
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Kumarasinghe SP, Chandran V, Raby E, Wood B. Granular parakeratosis is a reaction pattern in hyperkeratotic flexural erythema. Australas J Dermatol 2019; 61:159-160. [DOI: 10.1111/ajd.13216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 11/17/2019] [Indexed: 01/01/2023]
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17
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Zhang AJ, Clark ML, Guo AM. Pruritic papules in multiple intertriginous areas. BMJ Case Rep 2019; 12:12/5/e229604. [PMID: 31088821 DOI: 10.1136/bcr-2019-229604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Amy J Zhang
- University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota, USA
| | - Matthew L Clark
- Dermatology, Saint Louis University Hospital, St Louis, Missouri, USA
| | - A Mary Guo
- Dermatology, Saint Louis University Hospital, St Louis, Missouri, USA
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18
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Kumarasinghe SPW, Chandran V, Raby E, Wood B. Hyperkeratotic flexural erythema responding to amoxicillin–clavulanic acid therapy: Report of four cases. Australas J Dermatol 2019; 60:311-314. [DOI: 10.1111/ajd.13069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 04/03/2019] [Indexed: 12/28/2022]
Affiliation(s)
| | | | - Edward Raby
- Fiona Stanley Hospital Perth Western Australia Australia
| | - Benjamin Wood
- Pathwest, QE II Medical Centre Perth Western Australia Australia
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19
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Shen S, Pham CT, Ryan A, Bruce F. Granular parakeratosis in an adult female secondary to exposure to benzalkonium chloride laundry rinse. Australas J Dermatol 2019; 60:254-256. [DOI: 10.1111/ajd.12997] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah Shen
- Department of Dermatology Austin Health Melbourne VictoriaAustralia
| | - Cecilia T Pham
- Department of Dermatology Austin Health Melbourne VictoriaAustralia
| | - Andrew Ryan
- Histolab Pty Ltd Kew East Victoria Australia
| | - Fiona Bruce
- Department of Dermatology Austin Health Melbourne VictoriaAustralia
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