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Soriano LF, Chowdhury MMU, Cousen P, Dawe S, Ghaffar SA, Haworth A, Holden CR, Hollywood A, Johnston GA, Kirk S, Mughal AA, Orton DI, Parker R, Rajeev A, Scharrer K, Sinha A, Stone NM, Thompson D, Wakelin S, Whitehouse H, Wootton C, Buckley DA. Sensitisation to the acrylate co-polymers glyceryl acrylate/acrylic acid co-polymer, sodium polyacrylate and acrylates/C10-30 alkyl acrylate cross-polymer (Carbopol®) is rare. Contact Dermatitis 2024; 91:491-496. [PMID: 39187930 DOI: 10.1111/cod.14679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/11/2024] [Accepted: 08/08/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Acrylate polymers and cross-polymers (ACPs) are frequently used cosmetic ingredients. The British Society for Cutaneous Allergy (BSCA) and the UK Cosmetic, Toiletry and Perfumery Association (CTPA) collaborated to investigate the allergenic potential of three commonly-used ACPs. OBJECTIVES The objective of this study is to determine the prevalence of allergic contact dermatitis (ACD) to three ACPs: glyceryl acrylate/acrylic acid co-polymer, sodium polyacrylate, and acrylates/C10-30 alkyl acrylate cross-polymer (Carbopol®). MATERIALS AND METHODS The BSCA prospectively audited data collected from 20 centres in the UK and Ireland between 1st September 2021 and 1st September 2022. Patients with suspected ACD to (meth)acrylates, with facial dermatitis, or consecutive patients, were patch tested to glyceryl acrylate/acrylic acid co-polymer 10% aqueous (aq.) sodium polyacrylate 2% aq., and to acrylates/C10-30 alkyl acrylate cross-polymer 2% aq. (Carbopol®). The frequencies of positive, irritant, and doubtful reactions were recorded. RESULTS In total, 1302 patients were patch tested. To glyceryl acrylate/acrylic acid co-polymer, there was one doubtful reaction in a patient allergic to multiple (meth)acrylates, and one irritant. To sodium polyacrylate, there were four irritant reactions, one doubtful, and one positive reaction; in all cases, relevance was unknown and there was no demonstrable (meth)acrylate allergy. There were no reactions to Carbopol®. CONCLUSIONS Sensitisation to these concentrations of the three tested ACPs is rare. Elicitation of dermatitis in (meth)acrylate-sensitised patients by exposure to these three ACPs appears unlikely.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Asha Rajeev
- East Kent Hospitals University NHS Foundation Trust, Kent, UK
| | | | - Aparna Sinha
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Donna Thompson
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Sarah Wakelin
- OneWelbeck Skin Health and Allergy, London, UK
- Imperial College Healthcare NHS Trust, London, UK
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Vallon F, Bortolosso P, Lazzarato I, Larese Filon F. Acrylates and Methacrylates Sensitization in Patients with Orthopedic and Dental Prostheses: Asymptomatic Pre-Implant and Symptomatic Post-Implant Testing. Dermatitis 2024; 35:476-482. [PMID: 38805305 DOI: 10.1089/derm.2023.0363] [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: 05/30/2024]
Abstract
Acrylates and methacrylates are widely used in dental and orthopedic prostheses, false nails, adhesives, glues, and paints, and are strong sensitizers. The aim of our study was to assess the prevalence of acrylate sensitization in patients before the application of dental or orthopedic prostheses or after the application in case of potentially related contact dermatitis. Methods: The subjects were tested according to haptens reported in safety data sheets, including methyl methacrylate (MMA) 5%, methyl acrylate (MA) 1%, ethyl methacrylate (EMA) 2%, ethyl acrylate (EA) 1%, butylacrylate 0.1%, 2 hydroxyethyl methacrylate (HEMA) 5%, ethylene glycol dimethacrylate 2% (EGDMA), tetraethylene glycol dimethacrylate 2% (TEGDMA), and dimethyl amino ethyl methacrylate 0.2% (DAEMA). Multivariable logistic regression was used to study the factors associated with (meth)acrylate sensitization. Results: Six hundred sixty-five patients (75.4% of the total sample) without contact dermatitis before the placement of any dental or orthopedic prosthesis and 217 patients (24.6% of the total sample) with contact dermatitis potentially due to already placed prostheses were involved. In total, 37 cases of patch test positivity to at least 1 acrylate (4.2%) were found. In the pre-implant population, previous dermatitis and respiratory allergy were associated with increased sensitization to acrylates in multivariable regression analysis (odds ratio [OR] 2.38, 95% confidence interval [CI] 1.05-5.39; OR 2.96, 95% CI 1.32-6.64, respectively). The prevalence of sensitization was 3.5% for EGDMA, 2.7% for EA, 1.5% for 2-HEMA, 1.4% for both MA and MMA, 1.28% for DAEMA, and 0.8% for EMA. No statistically significant difference was found in the prevalence of sensitization between the pre- and post-implant groups. Discussion: Our study found a similar profile of sensitization in pre-implant and post-implant patients, suggesting the need to better study the specificity and sensitivity of patch tests to (meth)acrylate and to define relevance considering a detailed history of exposure.
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Affiliation(s)
- Francesca Vallon
- From the Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | - Paolo Bortolosso
- From the Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | - Ilaria Lazzarato
- From the Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
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Pannu CD, Farooque Md K. Allergic Contact Dermatitis to Octyl Cyanoacrylate Skin Glue After Surgical Wound Closure: A Systematic Review. Dermatitis 2024; 35:443-466. [PMID: 38386590 DOI: 10.1089/derm.2023.0342] [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: 02/24/2024]
Abstract
The rising incidence of allergic contact dermatitis (ACD) after cyanoacrylate adhesive use necessitates a comprehensive understanding of its clinical presentations, risk factors, and management. In this systematic review, we conducted an exhaustive search following PRISMA guidelines within Medline and PubMed databases to identify studies reporting cases of ACD resulting from cyanoacrylate adhesive application in wound closure. A total of 47 studies, covering 193 ACD cases, were included in our analysis. These cases involved 35 male, 120 female patients, and 38 cases without gender information (M:F ratio = 1:3.43), with ages ranging from 7 to 92 years (mean age 43.9 years). The majority of cases (n = 140) were part of 6 orthopedic studies, focusing on joint replacements (n = 68), orthopedic surgeries (n = 38), and breast surgeries (n = 29). The remaining 58 cases encompassed various surgical procedures. Common clinical manifestations included swelling, pruritic rash, erythema, vesicles, and itching around the surgical sites, typically appearing around 10 days post-adhesive application (within a range of 6 hours to 6 weeks). Patients with prior exposure to 2-octyl cyanoacrylate tended to exhibit earlier symptoms. Similar rates of dermatitis were observed across different adhesive brands, suggesting brand independence. Treatment strategies involved adhesive removal, administration of steroids and antihistamines, meticulous wound care, and, in some cases, surgical intervention. Notably, 3.1% of the 193 cases required surgical intervention. Risk factors, including a history of atopic dermatitis, high body mass index, diabetes, prior adhesive exposure, and surgical history, were identified in the studies. Patch tests confirmed 2-octyl cyanoacrylate as the allergen in 21 studies. Our review aims to enhance health care professionals' understanding of ACD resulting from the use of cyanoacrylate adhesive, facilitating improved postsurgical management and prevention strategies. Recognizing diverse risk factors, understanding varying clinical presentations, distinguishing ACD from infection, and employing appropriate treatment approaches are essential for achieving optimal outcomes in such cases.
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Affiliation(s)
- Chaitanya Dev Pannu
- From the Department of Specialist Surgery, Royal National Orthopaedic Hospital, London, United Kingdom
| | - Kamran Farooque Md
- Department of Orthopaedics and Trauma, All India Institute of Medical Sciences, New Delhi, India
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Gkousiaki M, Karalis VD, Kyritsi A, Almpani C, Geronikolou S, Stratigos A, Rallis MC, Tagka A. Contact allergy caused by acrylates in nail cosmetics: A pilot study from Greece. Contact Dermatitis 2024; 90:273-279. [PMID: 38164086 DOI: 10.1111/cod.14485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 11/03/2023] [Accepted: 12/08/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The growing popularity of nail techniques based on acrylates has led to a higher frequency of sensitization in both nail technicians and users. OBJECTIVES The study aimed to assess cases of allergic contact dermatitis (ACD) caused by acrylates in individuals with occupational or non-occupational exposure to nail techniques. METHODS A preliminary study was conducted on 30 patients with ACD caused by acrylates in nail techniques, who were patch tested from September 2022 to March 2023 at the First Department of Dermatology and Venereology of Andreas Syggros Hospital, Athens, Greece. RESULTS Thirty female patients with ACD to acrylates were documented (15 users and 15 nail technicians and users). The most common allergens were: 2-hydroxyethyl methacrylate (HEMA), 2-hydroxypropyl methacrylate (HPMA) and ethyleneglycol dimethacrylate (EGDMA), which tested positive in all 30 patients (100.0%). Twenty patients (66.7%) had been exposed to dental procedures involving acrylates, before the onset of ACD. Nail technicians exhibited extensive skin lesions, 40.0% experienced ACD within the first year of work and 13.3% during their professional practice. Three of them (20.0%) had to discontinue their work. CONCLUSION Acrylates have been identified as potent allergens, necessitating the implementation of safety measures for the use of these chemicals in nail techniques.
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Affiliation(s)
- Maria Gkousiaki
- Section of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Vangelis D Karalis
- Section of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Kyritsi
- Section of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Chara Almpani
- Section of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Styliani Geronikolou
- Clinical Translational and Experimental Surgery Center, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Alexandros Stratigos
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Syggros Hospital, Athens, Greece
| | - Michail Christou Rallis
- Section of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Tagka
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Syggros Hospital, Athens, Greece
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Axler EN, Lipner SR. Unveiling an Acrylate Allergy Epidemic: Analysis of Dermatologic Findings Associated With At-Home Gel Nails on TikTok. J Cutan Med Surg 2024; 28:92-94. [PMID: 38189266 DOI: 10.1177/12034754231220930] [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] [Indexed: 01/09/2024]
Affiliation(s)
- Eden N Axler
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
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6
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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: 15] [Impact Index Per Article: 15.0] [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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7
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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: 14] [Impact Index Per Article: 7.0] [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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8
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Havmose M, Thyssen JP, Zachariae C, Johansen JD. Artificial Nails and Long-lasting Nail Polish in Danish Hairdressers: Self-use, Occupational Exposure and Related Eczema. Acta Derm Venereol 2022; 102:adv00818. [PMID: 36317860 PMCID: PMC9811296 DOI: 10.2340/actadv.v102.4524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 11/07/2022] Open
Abstract
Artificial nail modelling systems (ANMS), encompassing artificial nails and long-lasting nail polish, are sources of acrylate exposure in beauticians and users of ANMS. Hairdressers' exposure to ANMS from self-use and occupational exposure is currently unknown. In 2020 a questionnaire was sent to all hairdressers graduating during 2008 to 2018 in Denmark (n = 4,830). Self-use of ANMS was reported by 87.6% of respondents (1,251/1,428), and application of ANMS to others was reported by 22.1% (316/1,428). Of these, application to others was performed in a salon by 37.1% (109/294), privately by 51.0% (150/294) and in both settings by 11.9% (35/294). Compliance with glove use was seen in 23.0% (67/291) among those applying ANMS to others. Among hairdressers exposed to ANMS, 4.3% (52/1,218) reported ANMS-related hand eczema. Being a trained beautician (adjusted odds ratio 3.26, 95% confidence interval 1.06-9.99) and having had a positive patch-test to acrylates (adjusted odds ratio 7.70, 95% confidence interval 1.44-41.13) were associated with ANMS-related hand dermatitis. In conclusion, hairdressers have a high prevalence of exposure to ANMS and ANMS-related hand dermatitis. Compliance with glove use when applying ANMS to others is poor. Patch-testing with acrylates is valuable in the diagnostic work-up of hand eczema in hairdressers.
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Affiliation(s)
- Martin Havmose
- National Allergy Research Center, Department of Dermatology and Allergy, Gentofte Hospital, Gentofte Hospitalsvej 20A, DK-2900 Hellerup, Denmark.
| | - Jacob P Thyssen
- National Allergy Research Center, Department of Dermatology and Allergy, Gentofte Hospital, Gentofte Hospitalsvej 20A, DK-2900 Hellerup, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jeanne D Johansen
- National Allergy Research Center, Department of Dermatology and Allergy, Gentofte Hospital, Gentofte Hospitalsvej 20A, DK-2900 Hellerup, Denmark
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Abstract
Gel nail polish (GNP) has recently gained worldwide popularity. We have conducted a comprehensive summary of the complications of GNP through a literature search using the PubMed, Scopus, and Google Scholar databases to identify eligible contributions. Complications were divided into mechanical and traumatic nail disorders, allergic contact dermatitis (ACD), and ultraviolet (UV)-induced lesions. A total of 12 contributions were included, identifying 88 patients, all of whom were women. Six of the reports described ACD (62 cases, 70.5%), 3 concerned mechanical nail damage (23 cases, 26.1%), and 3 reported UV-induced skin lesions (3 cases, 3.4%). ACD developed an average of 30 months after GNP initiation. The most frequent culprit allergens were 2-hydroxypropyl methacrylate and 2-hydroxyethyl methacrylate. Pterygium inversum unguis was the most frequent mechanical lesion (n = 17). Squamous cell carcinoma was reported in 3 cases. The delay between UV exposure and the diagnosis of squamous cell carcinoma ranged from 11 to 15 years. Scant literature and a lack of education among consumers and beauticians have led to the uncontrolled use of GNP. The principle of managing nail cosmetic problems is prevention through education. There is a need for understanding the processes involved and the associated complications to facilitate appropriate treatment and safe use.
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Affiliation(s)
- Noureddine Litaiem
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculté de Médecine de Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Massara Baklouti
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculté de Médecine de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Faten Zeglaoui
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculté de Médecine de Tunis, University of Tunis El Manar, Tunis, Tunisia
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Alotaibi NN, Ahmad T, Rabah SM, Sheikh MT. Type IV Hypersensitivity Reaction to Dermabond (2-Octyl Cyanoacrylate) in Plastic Surgical Patients: A Retrospective Study. Plast Surg (Oakv) 2022; 30:222-226. [PMID: 35990393 PMCID: PMC9389055 DOI: 10.1177/22925503211015448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 02/27/2021] [Accepted: 03/22/2021] [Indexed: 08/03/2023] Open
Abstract
Background: The Dermabond (2-octyl cyanoacrylate) is a commonly used skin adhesive in plastic surgery. There are some reports in the literature regarding Dermabond associated contact dermatitis. In this retrospective cohort study, we evaluated the incidence and characteristics of contact dermatitis (type IV hypersensitivity reaction) post application of Dermabond (Trade name PRINEO manufactured by ETHICON) in patients who underwent plastic surgical breast procedures in our hospital. Methods: Sixty patients had undergone plastic surgical breast procedures (mastopexy and reduction mammoplasty) with Dermabond application over the period of last 3 years in our hospital. The records of these 60 patients were studied retrospectively. Results: Four patients (6.6%) out of the 60 patients taken for study had developed type IV hypersensitivity reaction to Dermabond. All of these patients presented with pruritus and skin rash in the second week of their post-operative period and none of them had any known past allergic history. Conclusion: We conclude that the incidence of type IV hypersensitivity allergic reaction post application of Dermabond (2-octyl cyanoacrylate) is significantly high and its possibility should be explained to the patients prior to its application.
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Affiliation(s)
- Nawaf Naif Alotaibi
- Plastic Surgery, King Abdullah bin Abdulaziz
University Hospital (Princess Nourah Bint Abdulrahman University), Riyadh, Saudi
Arabia
| | - Tawheed Ahmad
- Plastic Surgery, King Abdullah bin Abdulaziz
University Hospital (Princess Nourah Bint Abdulrahman University), Riyadh, Saudi
Arabia
| | - Sari Monzer Rabah
- Plastic Surgery, King Abdullah bin Abdulaziz
University Hospital (Princess Nourah Bint Abdulrahman University), Riyadh, Saudi
Arabia
| | - Mohammad Tafazul Sheikh
- Plastic Surgery, King Abdullah bin Abdulaziz
University Hospital (Princess Nourah Bint Abdulrahman University), Riyadh, Saudi
Arabia
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Abstract
Many ingredients found within nail cosmetic products are capable of sensitizing patients’ immune systems and causing contact dermatitis (CD). These include but are not limited to tosylamide, (meth)acrylates, and formaldehyde. A clear temporal relationship between nail cosmetic procedures and an eczematous outbreak on the hands, face, or other ectopic body regions can be a key indicator of CD secondary to nail cosmetic exposure. Once an inciting allergen is identified through patch testing, elimination and avoidance becomes a mainstay of treatment alongside the use of emollients and topical anti-inflammatory therapies. Patients should be counselled to approach future nail cosmetic products and procedures with caution and careful attention to ingredients, regardless of whether or not it has a “hypoallergenic” label.
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Acrylates as a significant cause of allergic contact dermatitis: new sources of exposure. Postepy Dermatol Alergol 2021; 38:555-560. [PMID: 34658693 PMCID: PMC8501444 DOI: 10.5114/ada.2020.95848] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 02/11/2020] [Indexed: 11/22/2022] Open
Abstract
Acrylate monomers have a wide range of applications. Since the 1950s, many reports of occupational origin allergic contact dermatitis due to (meth)acrylate monomers have been published. During last decades, (meth)acrylate allergy has undergone an occupational shift from dentistry toward beauty industry and medical devices. The aim of the study was to conduct a literature review on acrylates as a cause of allergic contact dermatitis, current sources of exposure as well as identification of professional groups with an increased risk of this allergy and methods of effective prevention. Database review: Medline search (PubMed), Wiley Online Library and Web of Science base in years 1956–2019 using the following keywords: acrylates, manicurists, dentists, dental technicians, medical devices, occupational exposure, and allergic contact dermatitis. 204 346 articles containing the term ‘acrylates‘ have been found. They include 2 042 articles with the word ‘manicurists’, 169 919 – ‘dentists’, 218 236 – ‘dental technicians’, 2 427 418 – ‘medical devices’. Fifty-nine articles were chosen based on analysis of abstracts and full texts. In the past allergy to acrylates was mainly of occupational origin and dental technicians were the most often affected professional group. Since the long-lasting manicure has become popular, this problem concerns both manicurists and their customers. Moreover, the new significant trend is non-occupational allergic contact dermatitis caused by medical devices especially dedicated to diabetes patients.
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Li Y, Li L. Contact Dermatitis: Classifications and Management. Clin Rev Allergy Immunol 2021; 61:245-281. [PMID: 34264448 DOI: 10.1007/s12016-021-08875-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 01/04/2023]
Abstract
Contact dermatitis (CD) is a common inflammatory skin disease caused by exposure to contact allergens and irritants. It is also the most common reason of occupational dermatitis and contributes greatly to hand dermatitis and facial dermatitis. Besides the two major forms of contact dermatitis: allergic contact dermatitis and irritant contact dermatitis, other subtypes of CD have been recognized including immediate skin reactions, photoinduced contact dermatitis, systemic contact dermatitis, and non-eczematous contact dermatitis. CD is a great imitator which can mimic many kinds of skin diseases, such as atopic dermatitis, lichen planus, and angioedema. For the diagnosis of CD, a complete medical history, including occupational history, is very important. It can give a clue of CD and provide a list of suspected substances. Besides the well-known diagnostic test, patch testing, there are many other diagnostic tests can be used to help diagnosis of CD and identify the causative allergens, including photopatch test, skin tests for detecting of immediate contact reactions, serum allergen-specific IgE test, and qualitative and quantitative testing of allergen in the suspected materials patients exposed to and challenge test. Before the treatment, the suspected irritants or allergens should be avoided completely. This includes both the removal of the patient from the environment that contains those substances and the promotion of the metabolism and expulsion of the allergens that have been absorbed by the body. In addition, it is also important to restore the skin barrier and reduce skin inflammation through multiple treatments, such as emollients, topical corticosteroids, and antihistamines, as well as systemic corticosteroids and immunosuppressants. Early and appropriate treatments are important to prevent further deterioration and persistence of the skin condition.
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Affiliation(s)
- Yan Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Linfeng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
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Occupational Methacrylate Allergy in Dental Personnel. ALLERGIES 2021. [DOI: 10.3390/allergies1020010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose of the article: Acrylate and methacrylate (MA) use in the dental industry is widespread, being utilized in dental prostheses and composite resins, dentin bonding materials, and glass ionomers. However, occupational methacrylate allergy in dental personnel is a growing phenomenon. The aims of this retrospective observational study are to evaluate the risk of occupational contact dermatitis following exposure to methacrylates in dental personnel and to identify possible preventive measures. Materials and Methods: A total of 126 subjects exposed to acrylic and methacrylic resins in their professional context and who reported clinical manifestations were included from our outpatient department database. These were subdivided into two groups: 81 dental technicians and 45 dental hygienists. All the subjects had undergone patch testing with a “methacrylate series” (FIRMA) and readings were taken after 2 days (D2), 4 days (D4), and 7 days (D7). Results: A significantly higher incidence of methacrylate allergy was found in the dental technician group compared to the dental hygienists. Among the dental technicians, 40.7% of the subjects presented skin manifestations. The hands were the most frequently affected sites. Conclusion: Our results confirm the high sensitizing potential of MA in the workplace for dental personnel and in particular an increased professional risk in work where the hands are directly involved (dental technicians). Patch testing as an integrated part of a screening tray is needed for a complete evaluation of occupational skin allergy due to MA in dental personnel. The adoption of proper primary preventive measures, including gloves, protective eyewear, face shields, and disposable gowns, can be useful in preventing new cases of contact dermatitis, which may lead to a change of occupation in dental personnel.
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Contact Allergy to Plastic Materials and Glues. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Engelina S, Shim TN. Atypical cases of pseudo-psoriatic nails associated with acrylate contact allergy. Contact Dermatitis 2020; 84:342-344. [PMID: 33184858 DOI: 10.1111/cod.13741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/01/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Shendy Engelina
- Dermatology Department, University Hospital Coventry and Warwickshire, Coventry, UK
| | - Tang Ngee Shim
- Dermatology Department, University Hospital Coventry and Warwickshire, Coventry, UK
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18
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Fluellen S, Mackey K, Hagglund K, Aslam MF. Randomized clinical trial comparing skin closure with tissue adhesives vs subcuticular suture after robotic urogynecologic procedures. World J Methodol 2020; 10:1-6. [PMID: 33194565 PMCID: PMC7603786 DOI: 10.5662/wjm.v10.i1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 10/06/2020] [Accepted: 10/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Skin closure techniques during minimally-invasive gynecologic surgery is largely based on surgeon preference. The optimum technique would theoretically be safe, rapid, inexpensive, and result in good cosmetic appearance. Cyanoacrylate tissue adhesive (Dermabond) may be a comparable and safe option for port site closure as compared with subcuticular suture. In this randomized clinical trial, we hypothesized that operative time for skin closure would be less than subcuticular suture during robotic urogynecologic procedures. AIM To compare skin closure during robotic urogynecologic surgeries for tissue adhesives and subcuticular suture. METHODS Fifty female subjects > 18 years of age undergoing robotic urogynecologic procedures were randomized to have port site closure with either cyanoacrylate tissue adhesive (n = 25) or subcuticular suture (n = 25). All procedures and postoperative evaluations were performed by the same board certified Female Pelvic Medicine and Reconstructive Surgeon. Incisional closure time was recorded. Each subject was followed for 12-wk postoperatively. Incision cosmesis was evaluated using the Stony Brook Scar Evaluation Scale. RESULTS A total of 47 subjects (cyanoacrylate group, n = 23; suture group, n = 24) completed the 12-wk postoperative evaluation. Closure time was significantly less (P < 0.0005) using cyanoacrylate tissue adhesive (5.4 ± 2.0 min) than subcuticular suture (24.9 ± 5.6 min). Cosmesis scores were significantly higher in the cyanoacrylate tissue adhesive group than subcuticular suture (P = 0.025). No differences were found between bleeding, infection, or dehiscence (P = 1.00, P = 0.609, P = 0.234, respectively). No statistical demographical differences existed between the two study arms. CONCLUSION Our study supported our original hypothesis that cyanoacrylate tissue adhesive for port site closure during robotic urogynecolgic procedures uses less time than with subcuticular suture. Our study also supports that tissue adhesive is comparable to cosmetic outcome while not jeopardizing rates of bleeding, infection, or dehiscence.
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Affiliation(s)
- Sunetris Fluellen
- Department of Obstetrics and Gynecology, Ascension St John Hospital and Medical Center, Detroit, MI 48236, United States
| | - Kyle Mackey
- Department of Obstetrics and Gynecology, Ascension St John Hospital and Medical Center, Detroit, MI 48236, United States
| | - Karen Hagglund
- Medical Research, Ascension St John Hospital and Medical Center, Detroit, MI 48236, United States
| | - Muhammad Faisal Aslam
- Department of Obstetrics and Gynecology, Ascension St John Hospital and Medical Center, Detroit, MI 48236, United States
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Asai C, Inomata N, Sato M, Koh N, Goda S, Ishikawa H, Tanaka M, Aihara M. Allergic contact dermatitis due to the liquid skin adhesive Dermabond® predominantly occurs after the first exposure. Contact Dermatitis 2020; 84:103-108. [PMID: 32909284 DOI: 10.1111/cod.13700] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND The clinical characteristics of patients with allergic contact dermatitis (ACD) due to a skin adhesive containing 2-octyl cyanoacrylate, Dermabond®, have not yet been elucidated. OBJECTIVE To investigate the clinical characteristics of patients with ACD caused by Dermabond® application. METHODS In this retrospective study, 577 patch tested patients were included. We identified patients with positive patch test results for Dermabond® and evaluated their results concerning (meth)acrylates and ethyl cyanoacrylate adhesive. RESULTS Nine patients had positive patch test results to Dermabond®; six had developed secondary generalization.The mean time between Dermabond® application and ACD onset was 34 days (range, 27-44) in six patients with ACD after the first use, whereas, in the other three patients, it was 5.6 days (range, 4-8) after the second use. The time was significantly different between the two groups (P < .01). Positive reactions to ethyl cyanoacrylate adhesive (Aron Alpha) occurred in seven of nine patients, to ethyl cyanoacrylate 10% pet. in four of eight patients tested, and to 2-hydroxyethyl methacrylate in one of eight patients tested. CONCLUSIONS Dermabond®-induced ACD is apparently characterized by a high prevalence of primary sensitization at first exposure to Dermabond®, secondary generalization is frequent, and most patients show cross-reactivity to ethyl cyanoacrylate.
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Affiliation(s)
- Chika Asai
- Department of Environmental Immuno-Dermatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Naoko Inomata
- Department of Environmental Immuno-Dermatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Megumi Sato
- Department of Environmental Immuno-Dermatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Nao Koh
- Department of Environmental Immuno-Dermatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Seiko Goda
- Department of Environmental Immuno-Dermatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Hideyuki Ishikawa
- Department of Environmental Immuno-Dermatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Masako Tanaka
- Department of Environmental Immuno-Dermatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Michiko Aihara
- Department of Environmental Immuno-Dermatology, Yokohama City University School of Medicine, Yokohama, Japan
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20
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Gardeen S, Hylwa S. A review of acrylates: Super glue, nail adhesives, and diabetic pump adhesives increasing sensitization risk in women and children. Int J Womens Dermatol 2020; 6:263-267. [PMID: 33015283 PMCID: PMC7522914 DOI: 10.1016/j.ijwd.2020.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/01/2020] [Accepted: 04/18/2020] [Indexed: 11/27/2022] Open
Abstract
Allergic contact dermatitis (ACD) is a cutaneous type IV hypersensitivity immune reaction mounted against substances in contact with the skin to which the patient has been sensitized. ACD is common, affecting approximately 72 million Americans per year, and is more common in women. One common contact allergen group is acrylates, which are monomers that are polymerized in the making of glues, adhesives, and plastic materials. It is the monomers that are sensitizing, whereas the final polymers are inert. Acrylates were the 2012 Contact Allergen of the Year with the specific acrylate, isobornyl acrylate, being the 2020 Contact Allergen of the Year. This article reviews the history of acrylate use, epidemiology, and both known and emerging sources of acrylates resulting in ACD.
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Affiliation(s)
- Samantha Gardeen
- Department of Medicine, Hennepin County Medical Center, Minneapolis, MN, United States
| | - Sara Hylwa
- Department of Dermatology, Hennepin County Medical Center, Minneapolis, MN, United States
- Park Nicollet Contact Dermatitis Clinic, Health Partners Institute, Minneapolis, MN, United States
- Department of Dermatology, University of Minnesota, Minneapolis, MN, United States
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21
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Contact Dermatitis Associated With Nail Care Products: Retrospective Analysis of North American Contact Dermatitis Group Data, 2001–2016. Dermatitis 2020; 31:191-201. [DOI: 10.1097/der.0000000000000583] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Gillman N, Lloyd D, Bindra R, Ruan R, Zheng M. Surgical applications of intracorporal tissue adhesive agents: current evidence and future development. Expert Rev Med Devices 2020; 17:443-460. [PMID: 32176853 DOI: 10.1080/17434440.2020.1743682] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Introduction: Traditional mechanical closure techniques pose many challenges including the risk of infection, tissue reaction, and injury to both patients and clinicians. There is an urgent need to develop tissue adhesive agents to reform closure technique. This review examined a variety of tissue adhesive agents available in the market in an attempt to gain a better understanding of intracorporal tissue adhesive agents as medical devices.Areas covered: Fundamental principles and clinical determinants of the tissue adhesives were summarized. The available tissue adhesives for intracorporal use and their relevant clinical evidence were then presented. Lastly, the perspective of future development for intracorporal tissue adhesive were discussed. Clinical evidence shows current agents are efficacious as adjunctive measures to mechanical closure and these agents have been trialed outside of clinical indications with varied results.Expert opinion: Despite some advancements in the development of tissue adhesives, there is still a demand to develop novel technologies in order to address unmet clinical needs, including low tensile strength in wet conditions, non-controllable polimerization and sub-optimal biocompatibility. Research trends focus on producing novel adhesive agents to remit these challenges. Examples include the development of biomimetic adhesives, externally activated adhesives, and multiple crosslinking strategies. Economic feasibility and biosafety are limiting factors for clinical implementation.
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Affiliation(s)
- Nicholas Gillman
- School of Medicine, Griffith University School of Medicine, Gold Coast, QLD, Australia.,Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia
| | - David Lloyd
- Griffith Centre for Orthopaedic Research and Engineering, Menzies Health Institute, Gold Coast, QLD, Australia
| | - Randy Bindra
- School of Medicine, Griffith University School of Medicine, Gold Coast, QLD, Australia.,Department of Plastic and Reconstructive Surgery, Gold Coast University Hospital, Southport, QLD, Australia
| | - Rui Ruan
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia.,Griffith Centre for Orthopaedic Research and Engineering, Menzies Health Institute, Gold Coast, QLD, Australia
| | - Minghao Zheng
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia.,Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, 6009, Australia
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23
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Voller L, Warshaw E. Acrylates: new sources and new allergens. Clin Exp Dermatol 2020; 45:277-283. [DOI: 10.1111/ced.14093] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/10/2019] [Accepted: 08/13/2019] [Indexed: 11/28/2022]
Affiliation(s)
- L.M. Voller
- Department of Dermatology Park Nicollet Health Services Minneapolis MN USA
- University of Minnesota Medical School Minneapolis MN USA
| | - E.M. Warshaw
- Department of Dermatology Park Nicollet Health Services Minneapolis MN USA
- Department of Dermatology University of Minnesota Minneapolis MN USA
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Romita P, Foti C, Barlusconi C, Hansel K, Tramontana M, Stingeni L. Contact allergy to (meth)acrylates in gel nail polish in a child: An emerging risk for children. Contact Dermatitis 2020; 83:39-40. [DOI: 10.1111/cod.13503] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 02/24/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Paolo Romita
- Department of Biomedical Science and Human Oncology, Dermatological ClinicUniversity of Bari Bari Italy
| | - Caterina Foti
- Department of Biomedical Science and Human Oncology, Dermatological ClinicUniversity of Bari Bari Italy
| | - Chiara Barlusconi
- Department of Biomedical Science and Human Oncology, Dermatological ClinicUniversity of Bari Bari Italy
| | - Katharina Hansel
- Dermatology Section, Department of MedicineUniversity of Perugia Perugia Italy
| | - Marta Tramontana
- Dermatology Section, Department of MedicineUniversity of Perugia Perugia Italy
| | - Luca Stingeni
- Dermatology Section, Department of MedicineUniversity of Perugia Perugia Italy
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Abstract
BACKGROUND Allergic contact dermatitis (ACD) caused by (meth)acrylates used in nail products is being increasingly reported in nail technicians and consumers. OBJECTIVES The aim of the study was to assess the incidence of sensitization to (meth)acrylates in technicians and users of nail products with ACD, referred for patch testing in a tertiary center, during the last 10 years. METHODS All patients with ACD, who reported a profession associated with cosmetic nail procedures or use of such services and were referred for patch tests in our department between January 2009 and December 2018, were identified. The incidence of positive sensitization to (meth)acrylates was assessed. RESULTS Contact allergy to 1 or more (meth)acrylates was found in 116 (74.4%) of 156 nail technicians or nail product users, all women. One hundred thirty-eight (88.5%) were occupationally exposed, and 18 (11.5%) were consumers. In addition, there was a statistically significant increase in (meth)acrylate ACD during 2014-2018 (100/127 cases [79%]) when compared with 2009-2013 (16/29 cases [55%]). The most common sensitizer among the 156 allergic individuals was ethylene glycol dimethacrylate, which was positive in 113 cases (72.4%), and among patients with acrylate-positive patch test, the rate was 97.4%. CONCLUSIONS Our experience confirms the worldwide changing landscape of rising (meth)acrylate sensitization in nail technicians and nail products users with ACD. Efforts to improve prevention are needed, and clinicians should have a high index for suspicion in this occupational group.
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Contact Allergy to Plastic Materials and Glues. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_79-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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27
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Nakagawa M, Hanada M, Amano H. Occupational contact dermatitis in a manicurist. J Dermatol 2019; 46:1039-1041. [PMID: 31486106 DOI: 10.1111/1346-8138.15062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/30/2019] [Indexed: 11/29/2022]
Abstract
We report a case of a manicurist who developed an allergic skin reaction to acrylates, manifested by itchy erythema, papules, vesicles and fissures on her hands, fingertips, forearm and eyelids. Patch tests showed positive reactions to three nail products used: ethylene glycol dimethacrylate, 2-hydroxyethyl methacrylate, ethyl acrylate and 2-hydroxyethyl acrylate in (meth)acrylate series. By using gel nail products, our patient became sensitized to 2-hydroxyethyl methacrylate. We assume that this had been the trigger, leading to the occurrence of cross-reactions between numerous acrylates including ethylene glycol dimethacrylate, ethyl acrylate and 2-hydroxyethyl acrylate. When handling nail products, it is necessary to prevent airway sensitization, contact sensitization and cross-reaction between various acrylates.
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Affiliation(s)
- Michiyo Nakagawa
- Department of Dermatology, Iwate Medical University School of Medicine, Morioka, Japan
| | - Miho Hanada
- Department of Dermatology, Iwate Medical University School of Medicine, Morioka, Japan
| | - Hiroo Amano
- Department of Dermatology, Iwate Medical University School of Medicine, Morioka, Japan
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29
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Carr C, Liu M, Goff HW. Acrylate Allergic Contact Dermatitis-Induced Lichen Planus of the Nail. Dermatitis 2019; 30:233-234. [PMID: 31045937 DOI: 10.1097/der.0000000000000480] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Christian Carr
- From the Department of Dermatology, UT Southwestern Medical Center, Dallas, TX
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Abstract
BACKGROUND Patch testing is an important diagnostic tool for the assessment of allergic contact dermatitis (ACD). OBJECTIVE This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2015, to February 28, 2017. METHODS At 13 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ test. RESULTS A total of 5597 patients were tested. There were 3725 patients (66.6%) who had at least 1 positive reaction, and 2798 patients (50.2%) were ultimately determined to have a primary diagnosis of ACD. A total of 572 patients (10.2%) had occupationally related skin disease. There were 10,983 positive allergic reactions. Nickel remained the most commonly detected allergen (17.5%). Methylisothiazolinone, which was added to the screening series for the 2013-2014 cycle, had the second highest positive reaction rate of allergens tested (13.4%). Compared with the previous reporting periods (2013-2014) and (2005-2014), positive reaction rates for the top 35 screening allergens statistically increased for only 1 allergen: hydroxyethyl methacrylate (3.4%; risk ratios, 1.24 [confidence interval, 1.00-1.54] and 1.46 [confidence interval, 1.23-1.73]). Three newly added allergen preparations-ammonium persulfate (1.7%), chlorhexidine (0.8%), and hydroquinone (0.3%)-all had a reaction rate of less than 2%. Twenty-three percent of the tested patients had at least 1 relevant allergic reaction to an allergen not on the NACDG series; 12% of these were occupationally related. T.R.U.E. Test (SmartPractice Denmark, Hillerød, Denmark) would have hypothetically missed one quarter to almost 40% of reactions detected by the NACDG screening series. CONCLUSIONS These results confirm that the epidemic of sensitivity to methylisothiazolinone has continued in North America. Patch testing with allergens beyond a screening tray is necessary for a complete evaluation of occupational and nonoccupational ACD.
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31
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Fisch A, Hamnerius N, Isaksson M. Dermatitis and occupational (meth)acrylate contact allergy in nail technicians—A 10‐year study. Contact Dermatitis 2019; 81:58-60. [DOI: 10.1111/cod.13216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 01/09/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Alexandra Fisch
- Department of Dermatology and Venerology Gävle Hospital Gävle Sweden
- Department of Occupational and Environmental Dermatology, Skåne University Hospital Lund University Malmö Sweden
| | - Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Skåne University Hospital Lund University Malmö Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital Lund University Malmö Sweden
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32
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Dinani N, George S. Nail cosmetics: a dermatological perspective. Clin Exp Dermatol 2019; 44:599-605. [DOI: 10.1111/ced.13929] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2018] [Indexed: 01/01/2023]
Affiliation(s)
- N. Dinani
- Dermatology Department Brighton and Sussex University Hospitals NHS Trust Brighton UK
| | - S. George
- Dermatology Department Brighton and Sussex University Hospitals NHS Trust Brighton UK
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33
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Lin YT, Tsai SW, Yang CW, Tseng YH, Chu CY. Allergic contact dermatitis caused by acrylates in nail cosmetic products: Case reports and review of the literatures. DERMATOL SIN 2018. [DOI: 10.1016/j.dsi.2018.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Contact Dermatitis Caused by Dermabond Advanced Use. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1841. [PMID: 30349768 PMCID: PMC6191225 DOI: 10.1097/gox.0000000000001841] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 05/04/2018] [Indexed: 11/25/2022]
Abstract
Background: Dermabond Advanced (DBA) has been widely used globally; however, severe contact dermatitis (CD) can be a serious adverse effect of DBA use. In this study, we investigated the characterization and incidence rate of CD after using DBA and the safe use of DBA. Methods: One hundred consecutive patients who underwent skin closure with DBA were investigated. All patients were women undergoing breast reconstruction. DBA was applied to their trunk and limbs following reconstruction. Results: Seven patients (7%) presented with CD. Of these, 4 patients exhibited CD after the second DBA use; sensitization influence by the first DBA use was considered. One of 3 patients presenting with CD after the first DBA use was allergic to cosmetic glue, and the influence of immunological cross-reaction of acrylates was suggested. Conclusion: We consider that DBA use is inadequate for wounds with an improper margin and in dry and low-skin barrier areas such as the trunk and limbs because it may induce irritant CD and sensitization of DBA and subsequent allergic CD. Frequent use can also induce sensitization. If patients have a history of acrylate allergies, DBA use should be avoided because immunological cross-reaction from acetylates could result.
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Abstract
BACKGROUND Allergic contact dermatitis commonly occurs on the face. Facial cleansing wipes may be an underrecognized source of allergens. OBJECTIVE The aim of this study was to determine the frequency of potentially allergenic ingredients in facial wet wipes. METHODS Ingredient lists from name brand and generic facial wipes from 4 large retailers were analyzed. RESULTS In the 178 facial wipes examined, a total of 485 ingredients were identified (average, 16.7 ingredients per wipe). Excluding botanicals, the top 15 potentially allergenic ingredients were glycerin (64.0%), fragrance (63.5%), phenoxyethanol (53.9%), citric acid (51.1%), disodium EDTA (44.4%), sorbic acid derivatives (39.3%), tocopherol derivatives (38.8%), polyethylene glycol derivatives (32.6%), glyceryl stearate (31.5%), sodium citrate (29.8%), glucosides (27.5%), cetearyl alcohol (25.8%), propylene glycol (25.3%), sodium benzoate (24.2%), and ceteareth-20 (23.6%)/parabens (23.6%). Of note, methylisothiazolinone (2.2%) and methylchloroisothiazolinone (1.1%) were uncommon. The top potential allergens of botanical origin included Aloe barbadensis (41.0%), chamomile extracts (27.0%), tea extracts (21.3%), Cucumis sativus (20.2%), and Hamamelis virginiana (10.7%). CONCLUSIONS Many potential allergens are present in facial wet wipes, including fragrances, preservatives, botanicals, glucosides, and propylene glycol.
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37
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Uter W, Werfel T, White IR, Johansen JD. Contact Allergy: A Review of Current Problems from a Clinical Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061108. [PMID: 29844295 PMCID: PMC6025382 DOI: 10.3390/ijerph15061108] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/20/2018] [Accepted: 05/26/2018] [Indexed: 12/17/2022]
Abstract
Contact allergy is common, affecting 27% of the general population in Europe. Original publications, including case reports, published since 2016 (inclusive) were identified with the aim of collating a full review of current problems in the field. To this end, a literature search employing methods of systematic reviewing was performed in the Medline® and Web of Science™ databases on 28 January 2018, using the search terms (“contact sensitization” or “contact allergy”). Of 446 non-duplicate publications identified by above search, 147 were excluded based on scrutiny of title, abstract and key words. Of the remaining 299 examined in full text, 291 were deemed appropriate for inclusion, and main findings were summarised in topic sections. In conclusion, diverse sources of exposures to chemicals of widely-differing types and structures, continue to induce sensitisation in man and may result in allergic contact dermatitis. Many of the chemicals are “evergreen” but others are “newcomers”. Vigilance and proper investigation (patch testing) are required to detect and inform of the presence of these haptens to which our populations remain exposed.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, 91054 Erlangen, Germany.
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, 30625 Hannover, Germany.
| | - Ian R White
- St John's Institute of Dermatology, Guy's Hospital, London SE1 9RT, UK.
| | - Jeanne D Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Herlev and Gentofte, 2900 Hellerup, Denmark.
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38
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Cervantes J, Sanchez M, Eber AE, Perper M, Tosti A. Pterygium inversum unguis secondary to gel polish. J Eur Acad Dermatol Venereol 2017; 32:160-163. [PMID: 28960450 DOI: 10.1111/jdv.14603] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 09/20/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pterygium inversum unguis (PIU) is characterized by the abnormal adherence of the hyponychium to the ventral surface of the nail plate. It can be both unsightly and painful, resulting in morbidity for patients. Gel polish is a popular nail cosmetic that has been reported to cause several complications. PIU may be another adverse outcome. OBJECTIVE To highlight a newly recognized adverse effect of a popular beauty technique. METHODS This retrospective and prospective case series reports 17 women who developed PIU after gel polish use. All study-related activities occurred at a University of Miami dermatology outpatient clinic. RESULTS All 17 subjects developed PIU after two to five years of gel polish application. Nine of 17 patients reported using both UVA and LED light to cure gel polish. Of the remaining eight, five used LED light only and three did not know or could not remember. All but two patients had a resolution of PIU a few weeks after switching from gel polish to regular polish manicures. CONCLUSION While it remains undiscerned whether PIU is related to chemicals present in the gel polish or to the application and/or removal process of such, patients and dermatologists should be aware of the potential risks of gel manicures.
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Affiliation(s)
- J Cervantes
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M Sanchez
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - A E Eber
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M Perper
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - A Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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DeKoven S, Holness DL. Contact dermatitis caused by methacrylates in nail products. CMAJ 2017; 189:E1193. [PMID: 28923798 DOI: 10.1503/cmaj.170264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Samuel DeKoven
- Doctor of Medicine Program (DeKoven), Schulich School of Medicine and Dentistry, London, Ont.; Division of Occupational Medicine (DeKoven, Holness), Department of Medicine, St. Michael's Hospital; Dalla Lana School of Public Health and Department of Medicine (Holness), University of Toronto; Centre for Urban Health Solutions (Holness), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.
| | - D Linn Holness
- Doctor of Medicine Program (DeKoven), Schulich School of Medicine and Dentistry, London, Ont.; Division of Occupational Medicine (DeKoven, Holness), Department of Medicine, St. Michael's Hospital; Dalla Lana School of Public Health and Department of Medicine (Holness), University of Toronto; Centre for Urban Health Solutions (Holness), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont
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DeKoven S, DeKoven J, Holness DL. (Meth)Acrylate Occupational Contact Dermatitis in Nail Salon Workers: A Case Series. J Cutan Med Surg 2017; 21:340-344. [DOI: 10.1177/1203475417701420] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Recently, many cases of acrylate-associated allergic contact dermatitis have appeared among nail salon workers. Common acrylate-containing products in nail salons include traditional nail polish, ultraviolet-cured shellac nail polish, ultraviolet-cured gel nails, and press-on acrylic nails. Methods: Nail salon technicians seen in the occupational medicine clinic in 2015 and 2016 were identified, and their patch test results and clinical features were summarized. Patch testing was done with the Chemotechnique (Meth)Acrylate nail series, and either the North American Standard series or the North American Contact Dermatitis Group screening series. Results: Six patients were identified, all women, ages 38 to 58. Common presentations included erythematous dermatitis of the dorsa of the hands, palms, and forearms and fissures on the fingertips. Less common sites of eruptions included the periorbital region, cheeks, posterior ears, neck, sacral area, lateral thighs, and dorsa of the feet. All patients reacted to hydroxyethyl methacrylate, and 5 patients reacted to ethyl acrylate. Each patient also reacted to (meth)acrylates that are not found on either standard series, including ethyleneglycol dimethacrylate, 2-hydroxypropyl methacrylate, and 2-hydroxyethyl acrylate. Conclusions: The authors report 6 cases of allergic contact dermatitis to acrylates in nail technicians seen over the past year, representing a new trend in their clinic. These cases are reflective of a growing trend of nail technicians with allergic contact dermatitis associated with occupational (meth)acrylate exposure. Efforts to improve prevention are needed.
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Affiliation(s)
- Samuel DeKoven
- Doctor of Medicine Program, Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Joel DeKoven
- Division of Occupational Medicine, Department of Medicine, St Michael’s Hospital, Toronto, ON, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - D. Linn Holness
- Division of Occupational Medicine, Department of Medicine, St Michael’s Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health and Department of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada
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