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de Groot AC, Rustemeyer T. 2-Hydroxyethyl methacrylate (HEMA): A clinical review of contact allergy and allergic contact dermatitis. Part 2. Cross- and co-sensitization, other skin reactions to HEMA, position of HEMA among (meth)acrylates, sensitivity as screening agent, presence of HEMA in commercial products and practical information on patch test procedures. Contact Dermatitis 2024; 90:1-16. [PMID: 37778325 DOI: 10.1111/cod.14430] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023]
Abstract
This is the second part of a literature review of the clinical aspects of contact allergy to and allergic contact dermatitis from 2-hydroxyethyl methacrylate (HEMA). Topics include cross- and co-sensitization, atypical manifestations of contact allergy, frequency of positive patch tests to HEMA compared with other (meth)acrylates, sensitivity of HEMA as a screening agent, the presence of HEMA in commercial products, and practical information on patch testing procedures. Primary sensitization to methacrylates including HEMA may result in methacrylate and acrylate cross-sensitization. There is a strong cross-allergy between HEMA, ethylene glycol dimethacrylate (EGDMA), and hydroxypropyl methacrylate; many reactions to EGDMA are cross-reactions to primary HEMA sensitization. Rare atypical manifestations of HEMA-allergy include lichen planus, lymphomatoid papulosis, systemic contact dermatitis, leukoderma after positive patch tests, and systemic side effects such as nausea, diarrhoea, malaise, and palpitations. The occurrence of respiratory disease caused by methacrylates such as asthma is not infrequent. HEMA is the most frequently patch test-positive methacrylate. It is a good screening agent for allergy to other (meth)acrylates. Patch test sensitization to HEMA 2% pet. is extremely rare. There are (some) indications that HEMA is frequently used in dental products and nail cosmetics.
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Affiliation(s)
| | - Thomas Rustemeyer
- Dermato-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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de Groot AC, Rustemeyer T. 2-Hydroxyethyl methacrylate (HEMA): A clinical review of contact allergy and allergic contact dermatitis-Part 1. Introduction, epidemiology, case series and case reports. Contact Dermatitis 2023; 89:401-433. [PMID: 37752620 DOI: 10.1111/cod.14405] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 07/31/2023] [Accepted: 08/04/2023] [Indexed: 09/28/2023]
Abstract
2-Hydroxyethyl methacrylate (HEMA) has been increasingly recognised as a contact allergen and was added to the European baseline series in 2019. In this article (2 parts), the results of an extensive literature review of the clinical aspects of contact allergy/allergic contact dermatitis to HEMA are presented. In part 1, the epidemiology of HEMA contact allergy is discussed and detailed information on published case series and case reports presented. HEMA is an important cause of contact allergy/allergic contact dermatitis in North America and Europe with recent prevalences of >3% in the USA + Canada and 1.5%-3.7% in Europe. Currently, most cases are caused by nail cosmetics, both in consumers and professional nail stylists. In our literature review, we have found 24 studies presenting case series of patients with allergic contact dermatitis attributed to HEMA and 168 case reports. However, the presence of HEMA in the products causing ACD was established in only a minority. Part 2 will discuss cross- and co-sensitisation, and other skin reactions to HEMA, will assess whether HEMA is the most frequent (meth)acrylate allergen and how sensitive HEMA as a screening agent is, investigate the presence of HEMA in commercial products and provide practical information on patch testing procedures.
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Affiliation(s)
| | - Thomas Rustemeyer
- Dermato-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, AZ, The Netherlands
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Affiliation(s)
- M. Gonçalo
- Clinic of Dermatology Coimbra University Hospital and Faculty of Medicine University of Coimbra University Hospital Praceta Mota Pinto P‐3000‐075 Coimbra Portugal
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Marrero-Alemán G, Sabater-Abad J, Miquel FJ, Boix-Vilanova J, Mestre Bauzá F, Borrego L. Allergic contact dermatitis to (meth)acrylates involving nail technicians and users: Prognosis and differential diagnosis. Allergy 2019; 74:1386-1389. [PMID: 30739348 DOI: 10.1111/all.13736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/27/2018] [Accepted: 01/17/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Gabriel Marrero-Alemán
- Department of Dermatology; Complejo Hospitalario Universitario Insular-Materno Infantil; Universidad de Las Palmas de Gran Canaria; Las Palmas de Gran Canaria Spain
| | | | | | - Julián Boix-Vilanova
- Department of Dermatology; Hospital Universitari Son Espases; Palma de Mallorca Spain
| | | | - Leopoldo Borrego
- Department of Dermatology; Complejo Hospitalario Universitario Insular-Materno Infantil; Universidad de Las Palmas de Gran Canaria; Las Palmas de Gran Canaria Spain
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Morgado F, Batista M, Gonçalo M. Short exposures and glove protection against (meth)acrylates in nail beauticians-Thoughts on a rising concern. Contact Dermatitis 2019; 81:62-63. [PMID: 30653679 DOI: 10.1111/cod.13222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/13/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Francisca Morgado
- Dermatology Department, Coimbra University Hospital, Coimbra, Portugal
| | - Mariana Batista
- Dermatology Department, Coimbra University Hospital, Coimbra, Portugal
| | - Margarida Gonçalo
- Dermatology Department, Coimbra University Hospital, Coimbra, Portugal.,Clinic of Dermatology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Gonçalo M, Pinho A, Agner T, Andersen KE, Bruze M, Diepgen T, Foti C, Giménez-Arnau A, Goossens A, Johanssen JD, Paulsen E, Svedman C, Wilkinson M, Aalto-Korte K. Allergic contact dermatitis caused by nail acrylates in Europe. An EECDRG study. Contact Dermatitis 2017; 78:254-260. [DOI: 10.1111/cod.12942] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 10/26/2017] [Accepted: 11/01/2017] [Indexed: 01/11/2023]
Affiliation(s)
- Margarida Gonçalo
- Department of Dermatology, Coimbra University Hospital, and Faculty of Medicine; University of Coimbra; 3000-075 Coimbra Portugal
| | - André Pinho
- Department of Dermatology, Coimbra University Hospital, and Faculty of Medicine; University of Coimbra; 3000-075 Coimbra Portugal
| | - Tove Agner
- Dermatology Department, Bispebjerg Hospital; University of Copenhagen; 2400 Copenhagen Denmark
| | - Klaus E. Andersen
- Department of Dermatology and Allergy Centre; Odense University Hospital; 5000 Odense Denmark
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology; Lund University Skåne University Hospital; 205 02 Malmö Sweden
| | - Thomas Diepgen
- Department of Social Medicine, Occupational and Environmental Dermatology; University Hospital Heidelberg; 69115 Heidelberg Germany
| | - Caterina Foti
- Unit of Dermatology, Department of Biomedical Science and Human Oncology; University of Bari; 70121 Bari Italy
| | - Ana Giménez-Arnau
- Department of Dermatology, Hospital del Mar, Institut Mar d'Investigations Mediques; Universitat Autonoma; 08003 Barcelona Spain
| | - An Goossens
- Contact Allergy Unit, Department of Dermatology; University Hospital K. U. Leuven; 3000 Leuven Belgium
| | - Jeanne D. Johanssen
- National Allergy Research Centre, Department of Dermatology and Allergy, Gentofte Hospital; University of Copenhagen; 2900 Hellerup Denmark
| | - Evy Paulsen
- Department of Dermatology and Allergy Centre; Odense University Hospital; 5000 Odense Denmark
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology; Lund University Skåne University Hospital; 205 02 Malmö Sweden
| | - Mark Wilkinson
- Dermatology; Leeds Teaching Hospitals NHS Trust; Leeds LS7 4SA UK
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Affiliation(s)
- Mark Wilkinson
- Dermatology; Leeds Teaching Hospitals NHS Trust; Leeds LS7 4SA UK
| | - David Orton
- Dermatology; Hillingdon Hospital; Uxbridge UB8 3NN UK
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Abstract
Over the past several decades, the commercialization of nail cosmetics has increased. From nail polishes to artificial nails, different methods of nail beautification have become popularized. However, the impact of these products remains largely unknown. Governments have passed legislation in attempts to regulate nail cosmetics, but these regulations may not be adequate and are difficult to enforce. Knowledge of the safety and efficacy of nail products remains limited due to the relative dearth of literature published on the topic. This review serves to summarize and interpret the data available regarding common nail products and their safety and efficacy. Nail products such as nail polish, nail polish removers, and artificial nails have shown to have some adverse effects through case reports and studies. Harmful substances such as toluenesulfonamide-formaldehyde resin and methacrylates have been identified in commercial nail products, leading to several adverse effects, but in particular, allergic contact dermatitis. Exposure to substances such as acetonitrile found in removers may have more toxic and caustic effects, especially if ingested. In addition, for nail technicians there are negative effects linked with occupational exposure. Compounds used in nail products may become aerosolized and lead to asthma, eye and throat irritation, and even neurocognitive changes.
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Gatica-Ortega ME, Pastor-Nieto MA, Mercader-García P, Silvestre-Salvador JF. Allergic contact dermatitis caused by (meth)acrylates in long-lasting nail polish - are we facing a new epidemic in the beauty industry? Contact Dermatitis 2017; 77:360-366. [PMID: 28656588 DOI: 10.1111/cod.12827] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 04/02/2017] [Accepted: 04/03/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) caused by (meth)acrylates has been described both in occupational and in non-occupational settings. OBJECTIVES To evaluate the clinical patterns, the most frequent allergens and the prognosis in patients sensitized to (meth)acrylates in long-lasting nail polish. METHODS The files of patients with ACD caused by (meth)acrylates in long-lasting nail polish diagnosed between January 2013 and June 2016 in four dermatology departments in Spain were reviewed. Patients were followed up by telephone interview. RESULTS Overall, 2353 patients were patch tested. Forty-three (1.82%) were diagnosed with ACD caused by (meth)acrylates in long-lasting nail polish during that period; all were female, and all had hand dermatitis. Patients were mostly less than 40 years old (72.1%), non-atopic (95.4%) and had an occupational cause of their dermatitis (93%), which developed ∼10.1 months after they had started to use this technique. The most frequent positive allergens were: 2-hydroxypropyl methacrylate, 2-hydroxyethyl methacrylate, and tetrahydrofurfuryl methacrylate. Eight of the 22 interviewed patients were able to improve their working technique and used 4H® protective material (fingerstalls/gloves). CONCLUSIONS Long-lasting nail polishes have become widespread, and it is a matter of concern that we may be facing a new epidemic of ACD caused by these. Policies regulating their use are urgently needed.
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Affiliation(s)
| | - Maria-Antonia Pastor-Nieto
- Dermatology Department, University Hospital of Guadalajara, 19002 Guadalajara, Spain.,Medicine and Medical Specialties Department, Alcalá de Henares University, 28801, Alcalá de Henares, Spain
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Raposo I, Lobo I, Amaro C, Lobo MDL, Melo H, Parente J, Pereira T, Rocha J, Cunha AP, Baptista A, Serrano P, Correia T, Travassos AR, Dias M, Pereira F, Gonçalo M. Allergic contact dermatitis caused by (meth)acrylates in nail cosmetic products in users and nail technicians - a 5-year study. Contact Dermatitis 2017; 77:356-359. [DOI: 10.1111/cod.12817] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/18/2017] [Accepted: 03/21/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Inês Raposo
- Department of Dermatology; Centro Hospitalar do Porto; 4099-001 Porto Portugal
| | - Inês Lobo
- Department of Dermatology; Centro Hospitalar do Porto; 4099-001 Porto Portugal
| | - Cristina Amaro
- Department of Dermatology; Centro Hospitalar Lisboa Central; 1169-050 Lisboa Portugal
| | - Maria de Lurdes Lobo
- Department of Dermatology; Centro Hospitalar Lisboa Central; 1169-050 Lisboa Portugal
| | - Helena Melo
- Department of Dermatology; Hospital CUF Descobertas; 1998-018 Lisboa Portugal
| | - Joana Parente
- Department of Dermatology; Hospital de Santarém; 2005-177 Santarém Portugal
| | - Teresa Pereira
- Department of Dermatology; Hospital de Braga; 4710 Braga Portugal
| | - Joana Rocha
- Department of Dermatology; Hospital Pedro Hispano; 4460 Matosinhos Portugal
| | - Ana P. Cunha
- Department of Dermatology; Centro Hospitalar São João; 4200-319 Porto Portugal
| | - Armando Baptista
- Department of Dermatology; Centro Hospitalar Vila Nova de Gaia; 4400-129 Vila Nova de Gaia Portugal
| | - Pedro Serrano
- Department of Dermatology; Hospital Garcia da Orta; 2801-951 Almada Portugal
| | - Teresa Correia
- Department of Dermatology, Hospital de Santa Maria; Centro Hospitalar Lisboa Norte; 1649-035 Lisboa Portugal
| | - Ana R. Travassos
- Department of Dermatology; Hospital CUF Descobertas; 1998-018 Lisboa Portugal
- Department of Dermatology, Hospital de Santa Maria; Centro Hospitalar Lisboa Norte; 1649-035 Lisboa Portugal
| | - Margarida Dias
- Department of Dermatology, Hospital Egas Moniz; Centro Hospitalar Lisboa Ocidental; 1349-019 Lisboa Portugal
| | - Fátima Pereira
- Department of Dermatology; Hospital CUF Infante Santo; 1350-070 Lisboa Portugal
| | - Margarida Gonçalo
- Clinic of Dermatology, University Hospital and Faculty of Medicine; University of Coimbra; 3000-075 Coimbra Portugal
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Crepy M. Allergie cutanée professionnelle : données récentes. REVUE FRANÇAISE D'ALLERGOLOGIE 2017. [DOI: 10.1016/j.reval.2017.02.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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