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Bocquel S, Soria A, Raison-Peyron N, Badaoui A, Marcant P, Bara C, Giordano-Labadie F, Amsler E, Milpied B, Delaunay J, Darrigade AS, Pralong P, Boulard C, Ferrier Le Bouedec MC, Tauber M, Pasteur J, Valois A, Le Thuaut A, Crépy MN, Bernier C. Impact of dupilumab on patch test results and allergic contact dermatitis: A prospective multicenter study. J Am Acad Dermatol 2024; 90:512-520. [PMID: 37871801 DOI: 10.1016/j.jaad.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Limited and conflicting data have been reported on the impact of dupilumab (DUPI) on patch test (PT) results and its efficacy against allergic contact dermatitis (ACD). OBJECTIVE This study was undertaken to analyze PT reactivities and relevance during treatment with DUPI to determine whether they could detect ACD in patients with uncontrolled or worsened atopic dermatitis (AD) who were receiving this agent. METHODS This prospective, multicenter study examined 76 DUPI-treated patients who had undergone PTs. The relevant information was collected during 3 visits. RESULTS Overall, 36 patients (47%) had ≥1 positive PT reaction, and 142 PT results were positive. Twenty-three patients (30%) had ≥1 positive and clinically relevant PT result. Five of them had clinical eczema improvement after allergen avoidance. We compared the PT results of 36 patients before and during DUPI therapy, representing 1230 paired PT allergens, of which 1022 were the same, 34 were positive, 44 were lost, and 130 were uninterpretable. LIMITATIONS Because the number of patients included remains limited, our findings should be confirmed with a larger sample. CONCLUSION Our results confirmed the usefulness of PTs for patients receiving DUPI, with good PT reproducibility. We suggest that all DUPI-treated patients with AD developing partial responses or experiencing symptom worsening should undergo PTs to look for contact sensitization.
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Affiliation(s)
- Sarah Bocquel
- Department of Dermatology, Nantes University Hospital, Nantes, France
| | - Angèle Soria
- Médecine Sorbonne Université, Service de Dermatologie et d'Allergologie, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris (AP-HP), Dermatology and allergy department, Tenon hospital, AP-HP, Paris, France
| | | | - Antoine Badaoui
- Department of Dermatology, Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France
| | | | - Corina Bara
- Department of Dermatology, CH Le Mans, Le Mans, France
| | | | - Emmanuelle Amsler
- Médecine Sorbonne Université, Service de Dermatologie et d'Allergologie, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris (AP-HP), Dermatology and allergy department, Tenon hospital, AP-HP, Paris, France
| | - Brigitte Milpied
- Department of Dermatology, Hôpital Saint-André, Bordeaux, France
| | | | | | | | - Claire Boulard
- Department of Dermatology, CH Jacques-Monod, Le Havre, France
| | | | - Marie Tauber
- Department of Dermatology, CHU Toulouse, Toulouse, France
| | - Justine Pasteur
- Department of Dermatology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Aude Valois
- Department of Dermatology, HIA, Toulon, France
| | | | - Marie-Noëlle Crépy
- Department of Occupational and Environmental Diseases, Hôtel-Dieu Hospital, Paris, France
| | - Claire Bernier
- Department of Dermatology, Nantes University Hospital, Nantes, France.
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Lidholm AG, Inerot A, Gillstedt M, Bergfors E, Trollfors B. Long-term prognosis of vaccine-induced contact allergy to aluminium: Third patch-test with additional test preparations. Contact Dermatitis 2023; 89:359-367. [PMID: 37548037 DOI: 10.1111/cod.14386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND A high incidence of local itching subcutaneous nodules and aluminium allergy was observed in clinical trials of a new aluminium adsorbed pertussis vaccine in Gothenburg, Sweden, in the 1990s. A total of 495 children with itching nodules were patch tested with aluminium chloride hexahydrate 2% and an empty Finn Chamber®, 377 (76%) with positive reactions. When 241 of them were re-tested some years later 186 (3 out of 4) had unexpectedly lost their patch test reactivity. AIM To investigate the long-term prognosis of vaccine-induced contact allergy to aluminium by a third patch test about 20 years after Patch test I. METHODS Twenty individuals with positive and 11 with negative results in Patch test II were tested a third time with the same sensitisers as in in the first two tests. Three additional aluminium preparations were also tested. RESULTS A total 15 out of 20 persons with positive results in the second test had lost their patch test reactivity. Two of 11 with negative tests had turned positive again. The addition of the preparations gave no conclusive results. CONCLUSION Contact allergy to aluminium caused by vaccination with aluminium-adsorbed vaccines in childhood seems to fade away with time as measured by loss of patch test reactivity.
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Affiliation(s)
- Anette Gente Lidholm
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Annica Inerot
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martin Gillstedt
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Elisabet Bergfors
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Birger Trollfors
- Department of Paediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden
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Docampo-Simón A, Sánchez-Pujol MJ, Pastor-Nieto MA, Giménez-Arnau A, Rodríguez-Serna M, Serra-Baldrich E, Miquel J, Sánchez-Pérez J, Sanz-Sánchez T, Zaragoza-Ninet V, Sánchez-Pedreño P, Carrascosa JM, Gatica-Ortega ME, Fernández-Redondo V, Córdoba-Guijarro S, González-Pérez R, Silvestre JF. Patch Testing in Patients With Severe Atopic Dermatitis Treated With Dupilumab: A Multicentric Approach in Spain. Dermatitis 2023; 34:315-322. [PMID: 37001174 DOI: 10.1089/derm.2022.0023] [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: 04/03/2023]
Abstract
Background: Persistent localized dermatitis (PLD) or eczema flare-ups (EF) may occur in atopic dermatitis (AD) patients treated with dupilumab. They may reflect concomitant allergic contact dermatitis (ACD) exposed by the inhibition of the Th2 pathway by dupilumab in some cases. Objective: To evaluate the prevalence and etiology of these events and the impact of dupilumab on patch test outcome. Methods: We performed patch tests on 54 AD patients treated with dupilumab and evaluated the prevalence and final diagnosis of EF and PLD as well as the patch test results. Results: The patch test results were positive in 20/54 (37.0%). 21/54 patients (38.9%) had PLD and 12/54 (22.2%) had EF. Ten of 54 (18.5%) had both conditions and 11/54 (20.4%) had neither PLD nor EF. 64.5% of PLD involved the face. 83.9% patients with PLD and 90.9% patients with EF were diagnosed with inadequately controlled AD. 9.7% patients with PLD and 4.5% patients with EF were finally diagnosed with ACD. Nine of 21 (42.9%) patients patch tested twice were positive either before and/or during dupilumab. Patch tests results changed over time in all of them. Conclusions: Patch testing assisted us to exclude ACD as the cause of PLD/EF in AD patients treated with dupilumab. Most PLD and EF were, however, diagnosed as poorly controlled AD. Dupilumab appeared to impact the patch test outcomes.
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Affiliation(s)
- Alexandre Docampo-Simón
- From the Dermatology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - María J Sánchez-Pujol
- From the Dermatology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Maria A Pastor-Nieto
- Dermatology Department, Hospital General Universitario de Guadalajara, Faculty of Medicine and Health Sciences, Medicine and Medical Specialties Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Ana Giménez-Arnau
- Dermatology Department, Hospital del Mar, Institut Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra, Barcelona, Spain
| | | | | | - Javier Miquel
- Dermatology Department, Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | | | | | | | - Paloma Sánchez-Pedreño
- Dermatology Department, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Spain
| | - Jose M Carrascosa
- Dermatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Maria E Gatica-Ortega
- Dermatology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Virginia Fernández-Redondo
- Dermatology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | - Juan F Silvestre
- From the Dermatology Department, Hospital General Universitario de Alicante, Alicante, Spain
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Kamphuis E, Loman L, Han HL, Romeijn GLE, Politiek K, Schuttelaar MLA. Experiences from daily practice of upadacitinib treatment on atopic dermatitis with a focus on hand eczema: Results from the BioDay registry. Contact Dermatitis 2023; 88:351-362. [PMID: 36621910 DOI: 10.1111/cod.14276] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/12/2022] [Accepted: 01/05/2023] [Indexed: 01/10/2023]
Abstract
BACKGROUND Real-world data on the effectiveness of upadacitinib on atopic dermatitis (AD), hand eczema (HE) and HE in the context of AD are limited. OBJECTIVES To evaluate the effectiveness and safety of upadacitinib on AD and on HE in patients with AD. METHODS This prospective observational cohort study includes clinical outcomes: Eczema Area and Severity Index (EASI), Investigator's Global Assessment (IGA), Hand Eczema Severity Index (HECSI), Photographic guide; and PROMs: average pruritus and pain Numeric Rating Scale (NRS) score of the past week, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Eczema, Dermatology Life Quality Index (DLQI), Atopic Dermatitis Control Tool (ADCT), Patient Global Assessment of Disease (PGAD), Quality Of Life Hand Eczema Questionnaire (QOLHEQ) at baseline, Week 4, and Week 16 of upadacitinib-treated patients. Adverse events were monitored during each visit. RESULTS Thirty-eight patients were included, of which 32 patients had HE. At Week 16, EASI-75 was achieved by 50.0%. Absolute cutoff score NRS-pruritus ≤4 was reached by 62.5%, POEM ≤7 by 37.5%, DLQI ≤5 by 59.4%, ADCT <7 by 68.8%, and PGAD rating of at least 'good' by 53.1%. HECSI-75 was achieved by 59.3% and (almost) clear on the Photographic guide by 74.1%. The minimally important change in QOLHEQ was achieved by 57.9%. Sub-analysis in patients with concomitant irritant contact dermatitis showed no differences. Safety analysis showed no new findings compared to clinical trials. CONCLUSIONS Upadacitinib can be an effective treatment for patients with AD and concomitant HE in daily practice. Future studies should focus on the effectiveness of upadacitinib on chronic HE, especially on the different etiological subtypes of HE, including HE in non-atopic individuals.
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Affiliation(s)
- Esmé Kamphuis
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Laura Loman
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henry L Han
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Geertruida L E Romeijn
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Klaziena Politiek
- Department of Dermatology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Marie L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Voorberg AN, Romeijn GLE, de Bruin-Weller MS, Schuttelaar MLA. The long-term effect of dupilumab on chronic hand eczema in patients with moderate to severe atopic dermatitis - 52 week results from the Dutch BioDay registry. Contact Dermatitis 2022; 87:185-191. [PMID: 35279856 PMCID: PMC9545501 DOI: 10.1111/cod.14104] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 11/25/2022]
Abstract
Background The hands are a common predilection site of atopic dermatitis (AD). Dupilumab is licensed for the treatment of AD but not for chronic hand eczema (CHE), while CHE is challenging to treat. Objectives To evaluate the long‐term effect of dupilumab on hand eczema (HE) in patients with AD from the BioDay Registry. Methods A prospective observational study of adult patients with HE, treated for AD with dupilumab. Patients with a HE severity of at least moderate at baseline were considered for analysis. Patients with other concomitantly systemic immunosuppressive treatments were excluded. Clinical effectiveness on HE severity, using the Hand Eczema Severity Index (HECSI) and photographic guide, and health‐related quality of life, using the Quality of Life in Hand Eczema Questionnaire (QOLHEQ), were evaluated. Results A total of 72 patients were included. HECSI‐75 was achieved by 54/62 patients (87.1%) and HECSI‐90 by 39/72 (62.9%) at 52 weeks. Based on the photographic guide, 56/62 patients (90.3%) achieved the endpoint of ‘clear’ or ‘almost clear’. Mean QOLHEQ reduction was −63.5% (95% confidence interval −38.23 to −27.41). There was no difference in response between HE subtypes. Conclusions The results from this study hold promise for dupilumab to be a suitable treatment option for isolated CHE.
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Affiliation(s)
- Angelique N Voorberg
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Geertruida L E Romeijn
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Lefevre M, Nosbaum A, Rozieres A, Lenief V, Mosnier A, Cortial A, Prieux M, De Bernard S, Nourikyan J, Jouve P, Buffat L, Hacard F, Ferrier‐Lebouedec M, Pralong P, Dzviga C, Herman A, Baeck M, Nicolas J, Vocanson M. Unique molecular signatures typify skin inflammation induced by chemical allergens and irritants. Allergy 2021; 76:3697-3712. [PMID: 34174113 DOI: 10.1111/all.14989] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/26/2021] [Accepted: 06/09/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Skin exposure to chemicals may induce an inflammatory disease known as contact dermatitis (CD). Distinguishing the allergic and irritant forms of CD often proves challenging in the clinic. METHODS To characterize the molecular signatures of chemical-induced skin inflammation, we conducted a comprehensive transcriptomic analysis on the skin lesions of 47 patients with positive patch tests to reference contact allergens and nonallergenic irritants. RESULTS A clear segregation was observed between allergen- and irritant-induced gene profiles. Distinct modules pertaining to the epidermal compartment, metabolism, and proliferation were induced by both contact allergens and irritants; whereas only contact allergens prompted strong activation of adaptive immunity, notably of cytotoxic T-cell responses. Our results also confirmed that: (a) unique pathways characterize allergen- and irritant-induced dermatitis; (b) the intensity of the clinical reaction correlates with the magnitude of immune activation. Finally, using a machine-learning approach, we identified and validated several minimal combinations of biomarkers to distinguish contact allergy from irritation. CONCLUSION These results highlight the value of molecular profiling of chemical-induced skin inflammation for improving the diagnosis of allergic versus irritant contact dermatitis.
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Affiliation(s)
- Marine‐Alexia Lefevre
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
- Department of Dermatology and Allergology Centre Hospitalier Universitaire de Saint‐Etienne Saint‐Priest‐en‐Jarez France
| | - Audrey Nosbaum
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
- Department of Allergy and Clinical Immunology Centre Hospitalier Lyon‐Sud Pierre‐Benite France
| | - Aurore Rozieres
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
| | - Vanina Lenief
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
| | - Amandine Mosnier
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
| | - Angèle Cortial
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
| | - Margaux Prieux
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
| | | | | | | | | | - Florence Hacard
- Department of Allergy and Clinical Immunology Centre Hospitalier Lyon‐Sud Pierre‐Benite France
| | | | - Pauline Pralong
- Department of Dermatology, Allergology and Photobiology Centre Hospitalier Universitaire Grenoble Alpes La Tronche France
| | - Charles Dzviga
- Department of Dermatology and Allergology Centre Hospitalier Universitaire de Saint‐Etienne Saint‐Priest‐en‐Jarez France
| | - Anne Herman
- Department of Dermatology Cliniques universitaires Saint‐Luc Université Catholique de Louvain Brussels Belgium
| | - Marie Baeck
- Department of Dermatology Cliniques universitaires Saint‐Luc Université Catholique de Louvain Brussels Belgium
| | - Jean‐François Nicolas
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
- Department of Allergy and Clinical Immunology Centre Hospitalier Lyon‐Sud Pierre‐Benite France
| | - Marc Vocanson
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
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7
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Riedel F, Aparicio-Soto M, Curato C, Thierse HJ, Siewert K, Luch A. Immunological Mechanisms of Metal Allergies and the Nickel-Specific TCR-pMHC Interface. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10867. [PMID: 34682608 PMCID: PMC8535423 DOI: 10.3390/ijerph182010867] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/03/2021] [Accepted: 10/11/2021] [Indexed: 12/19/2022]
Abstract
Besides having physiological functions and general toxic effects, many metal ions can cause allergic reactions in humans. We here review the immune events involved in the mediation of metal allergies. We focus on nickel (Ni), cobalt (Co) and palladium (Pd), because these allergens are among the most prevalent sensitizers (Ni, Co) and immediate neighbors in the periodic table of the chemical elements. Co-sensitization between Ni and the other two metals is frequent while the knowledge on a possible immunological cross-reactivity using in vivo and in vitro approaches remains limited. At the center of an allergic reaction lies the capability of a metal allergen to form T cell epitopes that are recognized by specific T cell receptors (TCR). Technological advances such as activation-induced marker assays and TCR high-throughput sequencing recently provided new insights into the interaction of Ni2+ with the αβ TCR-peptide-major histocompatibility complex (pMHC) interface. Ni2+ functionally binds to the TCR gene segment TRAV9-2 or a histidine in the complementarity determining region 3 (CDR3), the main antigen binding region. Thus, we overview known, newly identified and hypothesized mechanisms of metal-specific T cell activation and discuss current knowledge on cross-reactivity.
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Affiliation(s)
- Franziska Riedel
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
- Institute of Pharmacy, Freie Universität Berlin, Königin-Luise-Straße 2, 14195 Berlin, Germany
| | - Marina Aparicio-Soto
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Caterina Curato
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Hermann-Josef Thierse
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Katherina Siewert
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Andreas Luch
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
- Institute of Pharmacy, Freie Universität Berlin, Königin-Luise-Straße 2, 14195 Berlin, Germany
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de Wijs LEM, van der Waa JD, Nijsten T, Silverberg JI, Kunkeler ACM, Hijnen DJ. Effects of dupilumab treatment on patch test reactions: A retrospective evaluation. Clin Exp Allergy 2021; 51:959-967. [PMID: 33960047 PMCID: PMC8362223 DOI: 10.1111/cea.13892] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/13/2021] [Accepted: 04/23/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Linde E M de Wijs
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - José D van der Waa
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | | | - Amalia C M Kunkeler
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Dirk J Hijnen
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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Hedberg YS. Chromium and leather: a review on the chemistry of relevance for allergic contact dermatitis to chromium. JOURNAL OF LEATHER SCIENCE AND ENGINEERING 2020. [DOI: 10.1186/s42825-020-00027-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
As other causes decline in importance, chromium-tanned leather has become a more important source for chromium allergy, which affects around 1% of the general population. The aim of this review is to give suggestions on how to minimize the risk of leather-related allergic contact dermatitis, which can be elicited in chromium-allergic persons by hexavalent and trivalent chromium released from leather. Hexavalent chromium is the more potent chromium form and requires a lower skin dose to elicit allergic reactions. It is formed on the surface of some, antioxidant-free, leathers at dry conditions (< 35% relative humidity) and is influenced by the tanning process and other conditions, such as UV irradiation, contact with alkaline solutions, and leather age. Trivalent chromium is the dominant form released from chromium-tanned leather and its released amount is sufficient to elicit allergic reactions in some chromium-allergic individuals when they are exposed repetitively and over longer time (days – months). A low initial test result (< 3 mg/kg) for hexavalent chromium with the current standard test (ISO 17075) does not guarantee a low release of chromium from the leather or a low release of hexavalent chromium under typical exposure conditions during the service life of the leather. Information, labels, and certificates regarding leather products are often insufficient to protect chromium-allergic individuals. Correct labelling and information on the possible content of different allergens, as well as different tanning alternatives for certain leather products, are crucial.
Graphical abstract
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10
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Contact Allergy-Emerging Allergens and Public Health Impact. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072404. [PMID: 32244763 PMCID: PMC7177224 DOI: 10.3390/ijerph17072404] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 02/07/2023]
Abstract
Contact allergy (sensitisation) and allergic contact dermatitis (ACD) resulting from it have a considerable public health impact. For the present review, all pertinent articles were systematically searched via Medline and Web of Science™; additionally, all available issues of the journals "Contact Dermatitis" and "Dermatitis" were manually searched, covering the years 2018-2019, thereby extending and re-focusing a previous similar review. New allergens, or previously described allergens found in a new exposure context or of other current importance, are described in sections according to substance classes, e.g., metals, preservatives, fragrances. As a common finding in many investigations, a lack of information on product composition has been noted, for instance, regarding a newly described allergen in canvas shoes (dimethylthiocarbamylbenzothiazole sulfide) and, most notably, absence of co-operation from manufacturers of glucose-monitoring devices and insulin pumps, respectively. These latter devices have been shown to cause severe ACD in a considerable number of diabetic patients caused by the liberation of isobornyl acrylate and N,N'-dimethylacrylamide, respectively, as demonstrated by an international collaboration between dermatologists and chemists. Improved and complete ingredient labelling for all types of products, and not just cosmetics, must be put on the legislative agenda.
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Veverka KK, Davis MDP. Dubiously Doubtful: An Exploration of the Literature Concerning Doubtful, Macular Erythema, “?+,” and “+/−” Patch Test Reactions. Dermatitis 2020; 31:36-41. [DOI: 10.1097/der.0000000000000533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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van Amerongen CCA, Ofenloch R, Dittmar D, Schuttelaar MLA. New positive patch test reactions on day 7-The additional value of the day 7 patch test reading. Contact Dermatitis 2019; 81:280-287. [PMID: 31116435 PMCID: PMC6771944 DOI: 10.1111/cod.13322] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/15/2019] [Accepted: 05/21/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Not performing a day (D) 7 patch test reading might result in positive patch test reactions being missed. OBJECTIVES To investigate the added value of the D7 patch test reading for individual allergens, and to identify patient characteristics and allergen groups associated with new positive D7 reactions. METHODS Data from patients patch tested between 2008 and 2018 with the extended European baseline series were analysed. Patch test readings were performed on D3 and D7. Positive reactions were categorized into positive on D3 or new positive on D7. RESULTS A total of 3292 patients were consecutively patch tested with at least 43 allergens of the TRUE Test panels 1 and 2 supplemented with investigator-loaded allergens. In total, 447 (13.6%) patients showed new positive D7 reactions. In univariable regression analysis, age between 18 and 30 years showed a negative association with new positive D7 reactions. Significantly more D7 positive reactions were seen for topicals (odds ratio [OR] 2.60, 95% confidence interval [CI]: 1.92-3.51) and corticosteroids (OR 1.87, 95%CI: 1.09-3.21). No associations were found between sex, atopic dermatitis and occupational dermatitis and a new positive D7 reaction. CONCLUSION A D7 reading to identify new positive patch test reactions is of added value, especially for topicals and corticosteroids.
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Affiliation(s)
- Cynthia C. A. van Amerongen
- Department of DermatologyUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
| | - Robert Ofenloch
- Department of Social Medicine, Occupational and Environmental DermatologyUniversity of HeidelbergHeidelbergGermany
| | - Daan Dittmar
- Department of DermatologyUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
| | - Marie L. A. Schuttelaar
- Department of DermatologyUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
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Oosterhaven JAF, Voorberg AN, Romeijn GLE, de Bruin-Weller MS, Schuttelaar MLA. Effect of dupilumab on hand eczema in patients with atopic dermatitis: An observational study. J Dermatol 2019; 46:680-685. [PMID: 31187925 PMCID: PMC6771665 DOI: 10.1111/1346-8138.14982] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/21/2019] [Indexed: 12/30/2022]
Abstract
Systemic treatment options for chronic hand eczema are limited. Dupilumab is used in atopic dermatitis (AD) but is not licensed for (isolated) hand eczema. In this observational prospective study we aimed to determine the response of hand eczema to dupilumab in patients with AD. Adult patients with hand eczema and AD received dupilumab s.c. at a 600 mg loading dose, followed by 300 mg every 2 weeks. Primary outcome was a minimum improvement of 75% on the Hand Eczema Severity Index after 16 weeks (HECSI‐75). Secondary outcomes were severity, measured using the Photographic guide; quality of life improvement as patient‐reported outcome, measured using the Dermatology Life Quality Index (DLQI); and AD severity, measured using the Eczema Area and Severity Index (EASI). Forty‐seven patients were included (32 males; mean age, 45 years). HECSI‐75 was achieved by 28 (60%). Mean HECSI score reduction was 49.2 points (range, 0–164; 95% within‐subject confidence interval, 46.4–52.0), which was already significantly decreased after 4 weeks (P < 0.001). DLQI score mean improvement was 8.8 points (standard deviation [SD], 6.0) or 70.0% decrease (SD, 26.4) (P < 0.001). Eighteen patients (38%) were classified as responders on the Photographic guide. There was no difference in response between chronic fissured and recurrent vesicular clinical subtypes. Similar percentages of patients achieving EASI‐75 and HECSI‐75 were seen after 16 weeks. In conclusion, this study shows a favorable response of hand eczema to dupilumab in patients with AD. This raises the question whether a response will also be seen in isolated hand eczema.
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Affiliation(s)
- Jart A F Oosterhaven
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Angelique N Voorberg
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Geertruida L E Romeijn
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Marie L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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