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Stingeni L, Bianchi L, Caroppo ES, Belloni Fortina A, Caroppo F, Corazza M, Borghi A, Gallo R, Trave I, Ferrucci SM, Beretta A, Guarneri F, Martina E, Napolitano M, DE Lucia M, Patruno C, Bennardo L, Romita P, Foti C, Tramontana M, Marietti R, Argenziano G, Hansel K. The new Italian SIDAPA Baseline Series for patch testing (2023): an update according to the new regulatory pathway for contact allergens. Ital J Dermatol Venerol 2024; 159:83-104. [PMID: 38650492 DOI: 10.23736/s2784-8671.24.07733-8] [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: 04/25/2024]
Abstract
Allergic contact dermatitis (ACD) is a common inflammatory skin disease caused by delayed hypersensitivity to chemical and biotic contact allergens. ACD significantly affects the patients' quality of life negatively impacting both occupational and non-occupational settings. Patch testing is the gold standard diagnostic in vivo test to precise the ACD etiology and to correctly perform prevention. According to the Italian Medicines Agency (AIFA) legislative decree no. 178 of 29th May 1991, allergens are defined as medicines and therefore they are subject to strict regulation. In 2017, AIFA (decree no. 2130/2017) started a procedure to regulate contact allergens on the Italian market and actually the contact allergens temporarily authorized are reported in AIFA decree no. 98/2022, valid until November 2023. The availability on the market of contact allergens to diagnose ACD and continuous updating on the basis of new epidemiological trends are mandatory, jointly with the continuous update of the baseline and integrative series for patch testing. For this reason, the scientific community represented in Italy by the Skin Allergies Study Group of SIDeMaST (Italian Society of Dermatology and Venereology) and SIDAPA (Italian Society of Allergological, Occupational and Environmental Dermatology) are constantly working, in close relationship with the European scientific communities with large expertise in this important sector of the modern Dermatology. Herein, we report the setting up of regulatory legislation by AIFA and the new Italian Adult Baseline Series for patch testing.
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Affiliation(s)
- Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy -
| | - Leonardo Bianchi
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elena S Caroppo
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | | | - Monica Corazza
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Borghi
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Rosella Gallo
- Division of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Ilaria Trave
- Division of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Silvia M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Beretta
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabrizio Guarneri
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Emanuela Martina
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mario DE Lucia
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Cataldo Patruno
- Section of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Luigi Bennardo
- Section of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Marta Tramontana
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Rossella Marietti
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, "Luigi Vanvitelli" University of Campania, Naples, Italy
| | - Katharina Hansel
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Tramontana M, Hansel K, Bianchi L, Sensini C, Malatesta N, Stingeni L. Advancing the understanding of allergic contact dermatitis: from pathophysiology to novel therapeutic approaches. Front Med (Lausanne) 2023; 10:1184289. [PMID: 37283623 PMCID: PMC10239928 DOI: 10.3389/fmed.2023.1184289] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/18/2023] [Indexed: 06/08/2023] Open
Abstract
Allergic contact dermatitis (ACD) is a common inflammatory skin disease that, especially when the condition becomes chronic, has a high impact on the quality of life and represents a significant disease burden. ACD represents a type IV delayed-type hypersensitivity reaction that is triggered by contact with an allergen in previously sensitized individuals through the activation of allergen-specific T cells. In the acute phase, it is characterized by eczematous dermatitis, which presents with erythema, edema, vesicles, scaling, and intense itch. Non-eczematous clinical forms are also described (lichenoid, bullous, and lymphomatosis). Lichenification is the most common clinical picture in the chronic phase if the culprit allergen is not found or eliminated. ACD can be associated with both occupational and non-occupational exposure to allergens, representing approximately 90% of occupational skin disorders along with irritant contact dermatitis. Patch testing with suspected allergens is required for a diagnosis. Metals, especially nickel, fragrance mix, isothiazolinones, and para-phenylenediamine, are the most commonly positive allergens in patients patch tested for suspected ACD. The treatment goal is to avoid contact with the culprit agent and use topical and/or systemic corticosteroid therapy.
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Contact Dermatitis in the Inpatient Hospital Setting–an Updated Review of the Literature. CURRENT DERMATOLOGY REPORTS 2022. [DOI: 10.1007/s13671-022-00366-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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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: 6] [Impact Index Per Article: 2.0] [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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Moshirfar M, Bundogji N, Tukan AN, Huynh R. Intraocular Acrylic Allergy: Is it Something to Sneeze at? Ophthalmol Ther 2021; 10:393-396. [PMID: 34260041 PMCID: PMC8319285 DOI: 10.1007/s40123-021-00374-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/01/2021] [Indexed: 01/01/2023] Open
Abstract
Cataract surgery is most commonly performed with acrylic intraocular lens (IOL) implantation. To date, there have been no reported cases of intraocular acrylic allergy despite increasing rates of acrylic-induced contact dermatitis elsewhere in the body. Concern regarding acrylate sensitization is gaining traction in the ophthalmology community. This commentary explores the lack of intraocular atopy and whether an acrylic allergy necessitates extensive preoperative consideration.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St., Ste.200, Draper, UT, 84020, USA.
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA.
- Utah Lions Eye Bank, Murray, UT, USA.
| | - Nour Bundogji
- University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA
| | - Alyson N Tukan
- University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA
| | - Rachel Huynh
- University of Utah School of Medicine, Salt Lake City, UT, USA
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Tramontana M, Bianchi L, Hansel K, Agostinelli D, Stingeni L. Nickel Allergy: Epidemiology, Pathomechanism, Clinical Patterns, Treatment and Prevention Programs. Endocr Metab Immune Disord Drug Targets 2021; 20:992-1002. [PMID: 31994473 DOI: 10.2174/1871530320666200128141900] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/10/2019] [Accepted: 04/04/2019] [Indexed: 01/19/2023]
Abstract
Nickel is the most common cause of contact allergy in the general population and the most frequently detected allergen in patients patch tested for suspected allergic contact dermatitis (ACD). ACD from nickel is a typical type IV hypersensitivity. Nickel allergy is mostly caused by nonoccupational exposure, such as jewelry and clothing decorations, metal tools, medical devices (mainly orthopedic and orthodontic implants, cardiovascular prosthesis), eyeglasses, utensils, keys, pigment for paint, cosmetics, and food (mainly legumes, chocolate, salmon, peanuts). Occupational exposure can involve several workers (mechanics, metalworkers, platers, hairdressers, jewelers, workers in the constructions and electronic industries), classically involving hands and forearms. The classic clinical pattern of ACD caused by nickel is characterized by eczematous dermatitis involving the sites of direct contact with the metal. Non-eczematous-patterns are reported, including lichenoid dermatitis, granuloma annulare, vitiligo-like lesions, dyshidrosiform dermatitis, and vasculitis. In the case of systemic exposure to nickel, sensitized patients could develop systemic contact dermatitis. Patch testing represents the gold standard for the diagnosis of ACD from nickel. Treatment includes avoidance of contact with products containing nickel and the patient's education about the possible use of alternative products. A recent EU nickel directive, regulating the content and release of nickel from products, has caused a decrease of nickel contact allergy in some European countries. Nickel allergy is a relevant issue of public health with significant personal, social, and economic impact. This review summarizes epidemiology, pathomechanism, clinical patterns, treatment, and prevention programs.
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Affiliation(s)
- Marta Tramontana
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Leonardo Bianchi
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Katharina Hansel
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Daniela Agostinelli
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Luca Stingeni
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
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So SP, Yoon JY, Kim JW. Postoperative contact dermatitis caused by skin adhesives used in orthopedic surgery: Incidence, characteristics, and difference from surgical site infection. Medicine (Baltimore) 2021; 100:e26053. [PMID: 34011120 PMCID: PMC8137005 DOI: 10.1097/md.0000000000026053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/03/2021] [Indexed: 01/05/2023] Open
Abstract
Skin adhesives are used to close clean surgical wounds. We aimed to investigate the incidence of skin adhesive-related contact dermatitis and the characteristics that differentiate it from a surgical site infection.We retrospectively analyzed patients whose surgical wound was closed using a liquid skin adhesive (Dermabond Prineo skin closure system, Ethicon, NJ) by a single surgeon between March 2018 and June 2020. Medical records were reviewed to evaluate complications indicating contact dermatitis, including wound infections and hematomas.We included 143 patients (men, 59; women, 84; mean age, 60.8 years). No patient had an early surgical site infection or wound dehiscence, but 4 (2.8%) developed postoperative contact dermatitis (week 7, 1; week 4, 2; day 9, 1). Manifestations included eczema and pruritus, without local heat or wound discharge. All cases resolved without complications, including infection.Contact dermatitis occurred in 2.8% of patients who received liquid skin adhesive, and the symptoms differed from those of surgical site infection. Patients should be informed about the risk of contact dermatitis before applying a liquid skin adhesive.
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Affiliation(s)
- Sang Pil So
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea
| | - Jae Youn Yoon
- Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Ji Wan Kim
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea
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Castelain F, Kerre S, Carlet C, Goossens A, Girardin P, Pelletier F, Aubin F. Allergic contact dermatitis from carbomers: two case report. Contact Dermatitis 2020; 83:326-328. [DOI: 10.1111/cod.13616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Florence Castelain
- Department of Dermatology, Allergology Unit University Hospital of Besançon Besançon France
| | - Stefan Kerre
- Dermatologist, Dermatology Clinic Aarschot Belgium
| | - Clémentine Carlet
- Department of Dermatology, Allergology Unit University Hospital of Besançon Besançon France
| | - An Goossens
- Department of Dermatology University Hospitals, KU Leuven Leuven Belgium
| | - Pascal Girardin
- Department of Dermatology, Allergology Unit University Hospital of Besançon Besançon France
| | - Fabien Pelletier
- Department of Dermatology, Allergology Unit University Hospital of Besançon Besançon France
- Dermatology Clinic University of Franche‐Comté, Inserm U1098 RIGHT Besançon France
| | - Francois Aubin
- Department of Dermatology, Allergology Unit University Hospital of Besançon Besançon France
- Dermatology Clinic University of Franche‐Comté, Inserm U1098 RIGHT Besançon France
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Corazza M, Mantovani L, Zedde P, Forconi R, Scuderi V, Borghi A. A case of allergic contact dermatitis to (meth)acrylates in electrocardiogram electrodes. Contact Dermatitis 2020; 83:152-154. [DOI: 10.1111/cod.13570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/14/2020] [Accepted: 04/17/2020] [Indexed: 01/24/2023]
Affiliation(s)
- Monica Corazza
- Section of Dermatology, Department of Medical Sciences University of Ferrara Ferrara Italy
| | - Lucia Mantovani
- Section of Dermatology, Department of Medical Sciences University of Ferrara Ferrara Italy
| | - Pierantonia Zedde
- Section of Dermatology, Department of Medical Sciences University of Ferrara Ferrara Italy
| | - Riccardo Forconi
- Section of Dermatology, Department of Medical Sciences University of Ferrara Ferrara Italy
| | - Valeria Scuderi
- Section of Dermatology, Department of Medical Sciences University of Ferrara Ferrara Italy
| | - Alessandro Borghi
- Section of Dermatology, Department of Medical Sciences University of Ferrara Ferrara Italy
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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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Hansel K, Foti C, Nettis E, Lopalco A, Tramontana M, Bianchi L, Brozzi J, Romita P, Ambrogio F, Stingeni L. Acrylate and methacrylate allergy: When is patch testing with acrylic acid recommended? Contact Dermatitis 2020; 82:231-233. [DOI: 10.1111/cod.13440] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 11/02/2019] [Accepted: 11/26/2019] [Indexed: 01/03/2023]
Affiliation(s)
- Katharina Hansel
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human OncologyUniversity of Bari Bari Italy
| | - Eustachio Nettis
- Department of Emergency and Organ TransplantationSchool of Allergology and Clinical Immunology, University of Bari Bari Italy
| | - Antonio Lopalco
- Department of Pharmacy‐Drug SciencesUniversity of Bari Bari Italy
| | - Marta Tramontana
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Leonardo Bianchi
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Jacopo Brozzi
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Science and Human OncologyUniversity of Bari Bari Italy
| | - Francesca Ambrogio
- Section of Dermatology, Department of Biomedical Science and Human OncologyUniversity of Bari Bari Italy
| | - Luca Stingeni
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
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Hansel K, Tramontana M, Bianchi L, Cerulli E, Patruno C, Napolitano M, Stingeni L. Contact sensitivity to electrocardiogram electrodes due to acrylic acid: A rare cause of medical device allergy. Contact Dermatitis 2019; 82:118-121. [DOI: 10.1111/cod.13403] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 09/16/2019] [Accepted: 09/22/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Katharina Hansel
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Marta Tramontana
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Leonardo Bianchi
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Emilia Cerulli
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Cataldo Patruno
- Section of Dermatology, Department of Health SciencesUniversity Magna Graecia of Catanzaro Catanzaro Italy
| | - Maddalena Napolitano
- Section of Dermatology, Department of Health SciencesUniversity of Molise Campobasso Italy
| | - Luca Stingeni
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
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van Amerongen CCA, Dahlin J, Isaksson M, Schuttelaar MLA. Allergic contact dermatitis caused by 1,6-hexanediol diacrylate in a hospital wristband. Contact Dermatitis 2019; 81:446-449. [PMID: 31392731 PMCID: PMC6899871 DOI: 10.1111/cod.13378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 11/30/2022]
Abstract
Background 1,6‐Hexanediol diacrylate (1,6‐HDDA) is a multifunctional acrylate and a potent sensitizer. Objectives To report a case of allergic contact dermatitis caused by 1,6‐HDDA in a hospital wristband. Methods A male patient presented with eczema on his wrist where he had worn a hospital wristband. Patch testing was performed with our extended European baseline series, additional series, and pieces of the hospital wristband. Thin‐layer chromatography (TLC) was performed with extracts from the wristband and gas chromatography‐mass spectrometry was used for chemical analysis. Results Positive reactions were found to pieces of the wristband, including adhesive rim (+++), inside (+++), and outside (++); to multiple allergens in the (meth)acrylates series; and to extracts of the wristband in acetone and ethanol. Chemical analysis of the ethanol extract showed presence of lauryl acrylate and 1,6‐HDDA. Patch testing with TLC strips and subsequent chemical analysis showed that the substance causing the strongest reaction was 1,6‐HDDA, to which the patient had a confirmed positive patch test reaction. Conclusion 1,6‐HDDA was identified as the culprit allergen responsible for allergic contact dermatitis caused by the hospital wristband.
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Affiliation(s)
- Cynthia C A van Amerongen
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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