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Dascalu J, Polansky S, Khamaysi Z, Avitan-Hersh E, Nevet MJ. Is the Use of the Extended (Meth)acrylate Series - Nails Justified? Characterization of Nail Acrylate Allergy in a Tertiary Medical Centre. Acta Derm Venereol 2024; 104:adv41079. [PMID: 39530709 PMCID: PMC11571230 DOI: 10.2340/actadv.v104.41079] [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: 07/13/2024] [Accepted: 10/10/2024] [Indexed: 11/16/2024] Open
Abstract
Methacrylate allergy is a common cause of allergic contact dermatitis, and its incidence has surged over the past decade. Consequently, the primary sensitizing agent, 2-hydroxyethyl methacrylate, was recently added to the European Baseline Series of contact allergens. This study aimed to assess the added value of testing for allergens included in the (Meth)Acrylate Series - Nails, in addition to 2-hydroxyethyl methacrylate, as well as to characterize patients who may benefit from more extensive testing. A retrospective analysis of medical records of patch-tested patients was conducted between June 2013 and July 2022. Among the 3,828 patients who underwent patch testing, 396 were tested with the (Meth)Acrylate Series - Nails; 153 (38.6%) of those patients tested positive for at least 1 acrylate. The most common hapten was 2-hydroxyethyl methacrylate (85.6%), followed by hydroxypropyl methacrylate (85.0%) and ethylene glycol dimethacrylate (80.4%). In our study, 22/153 patients (14.4%) would have been missed if tested only for 2-hydroxyethyl methacrylate. The analysis showed that including hydroxypropyl methacrylate and ethylene glycol dimethacrylate improved detection rate to 98%, rendering the use of the entire tray unnecessary in most cases.
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Affiliation(s)
- Joel Dascalu
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
| | - Sophia Polansky
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
| | - Ziad Khamaysi
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Emily Avitan-Hersh
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Mariela J Nevet
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
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Keskinkaya Z, Işık Mermutlu S, Kaya Ö, Çakır H. Artificial nail modelling systems in healthcare workers: An emerging risk of contact sensitization to a well-known occupational allergen in an alternative way. Contact Dermatitis 2024; 91:38-44. [PMID: 38561321 DOI: 10.1111/cod.14548] [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: 01/16/2024] [Revised: 02/26/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Artificial nail modelling systems (ANMS) pose a significant risk for nail stylists and their clients regarding acrylate sensitization, which might jeopardize the use of acrylate-containing medical devices. OBJECTIVES To evaluate the frequency of artificial nail practices among female healthcare workers (HCWs) compared with controls and assess ANMS-related side effects. METHODS In this comparative, cross-sectional, single-centre study, a face-to-face interview with 200 female HCWs and 200 age-matched female dermatology patients (controls) was conducted regarding the use of ANMS between March and November 2023. RESULTS Among 400 participants (median age: 25), 85 (21.3%) have applied ANMS at least once. The prevalence of ANMS application was significantly higher in HCWs (n = 54/200, 27%) compared with controls (n = 31/200, 15.5%) (p < 0.05). Long-lasting nail polish was the most commonly preferred technique (n = 82/85, 96.5%). ANMS were mainly performed in nail studios by nail stylists (n = 79/85, 92.9%), while three participants were using home kits. Nail brittleness was the most frequently reported side effect (n = 19/85, 22.4%). No case of allergic contact dermatitis (ACD) was detected. CONCLUSIONS The popularity of ANMS among young female HCWs is growing. This striking trend might further put these individuals not only at risk of medical device-related adverse events but also occupational ACD.
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Affiliation(s)
- Zeynep Keskinkaya
- Department of Dermatology and Venereology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Selda Işık Mermutlu
- Department of Dermatology and Venereology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Özge Kaya
- Department of Dermatology and Venereology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Haile Çakır
- Department of Dermatology and Venereology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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Steunebrink IM, de Groot A, Rustemeyer T. Contact allergy to acrylate-containing nail cosmetics: A retrospective 8-year study. Contact Dermatitis 2024; 90:262-265. [PMID: 38093676 DOI: 10.1111/cod.14475] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/03/2023] [Accepted: 11/28/2023] [Indexed: 02/13/2024]
Abstract
BACKGROUND Over the last 10 years, allergic contact dermatitis (ACD) from acrylate-containing nail cosmetics (acrylic nails, gel nails, gel nail polish) has been reported repeatedly. OBJECTIVES To investigate the frequency and clinical features of ACD in nail cosmetics in a university hospital in Amsterdam, The Netherlands. PATIENTS AND METHODS A retrospective study in patients diagnosed with ACD from acrylate-containing nail cosmetics at the Amsterdam University Medical Centers between January 2015 and August 2023. RESULTS Sixty-seven patients, all women, were diagnosed with ACD from nail cosmetics, representing 1.6% of all individuals and 2.3% of all women patch tested in this period. Sixty-five of sixty-seven (97%) subjects had a positive patch test to 2-hydroxyethyl methacrylate (HEMA). Forty-nine patients (73%) were consumers and 18 (27%) were professional nail stylists. The sites most frequently affected with dermatitis were the fingers (79%), hands (40%) and the head and/or neck. Avoidance of contact with acrylate-containing products resulted in complete clearing of dermatitis in 80% of patients. CONCLUSIONS ACD from acrylate-containing nail cosmetics is frequent in women patch tested in Amsterdam. Nearly all were identified by a positive patch test to 2-hydroxyethyl methacrylate in the (meth)acrylate series or the European baseline series.
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Affiliation(s)
| | - Anton de Groot
- Dermato-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Dermato-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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de Groot AC, Rustemeyer T. 2-Hydroxyethyl methacrylate (HEMA): A clinical review of contact allergy and allergic contact dermatitis. Part 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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Johnson W, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Marks JG, Peterson LA, Shank RC, Slaga TJ, Snyder PW, Fiume M, Heldreth B. Methacrylate Ester Monomers. Int J Toxicol 2023; 42:61S-73S. [PMID: 37794531 DOI: 10.1177/10915818231204572] [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] [Indexed: 10/06/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed newly available studies since their original assessment in 2005, along with updated information regarding product types and concentrations of use, and confirmed that these 22 methacrylate ester monomers are safe as used in nail enhancement products in the practices of use and concentration as described in this report, when skin contact is avoided.
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Affiliation(s)
- Wilbur Johnson
- Cosmetic Ingredient Review Former Senior Scientific Analyst/Writer
| | | | | | | | | | | | - James G Marks
- Expert Panel for Cosmetic Ingredient Safety Former Member
| | | | - Ronald C Shank
- Expert Panel for Cosmetic Ingredient Safety Former Member
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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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Kalenge S, Kirkham TL, Nguyen LV, Holness DL, Arrandale VH. Skin Exposure to Acrylates in Nail Salons. Ann Work Expo Health 2021; 65:162-166. [PMID: 32737502 DOI: 10.1093/annweh/wxaa063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/30/2020] [Accepted: 06/07/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The nail salon industry has seen significant growth in recent years. Nail technicians provide manicures, pedicures and apply artificial nails; tasks that expose them to chemicals, including acrylates that are known skin and respiratory sensitizers. This paper reports on potential skin exposure to acrylates among nail technicians in Toronto, Canada. METHODS Hand skin wipes were collected after (i) the application of artificial nails, (ii) the application of ultraviolet cured gel nail polish, and (iii) deliberate contact with nail polish. Surface wipes were collected from work areas and surfaces contaminated with known products. Wipe samples were analysed for eight acrylates: methyl acrylate (MA), ethyl acrylate (EA), methyl methacrylate (MMA), ethyl methacrylate (EMA), 2-hydroxyethyl acrylate (HEA), 2-hydroxyethyl methacrylate (HEMA), 2-hydroxypropyl methacrylate (HPMA), and ethylene glycol dimethacrylate (EGDMA) by gas chromatography with mass spectrometry. RESULTS Thirty-five wipe samples were collected. No acrylates were detected in skin samples (n = 8) or work surfaces (n = 6). However, MMA, EMA, EA, HEMA, and HPMA were detected in the samples of surfaces contaminated with known products. MMA was detected in 28% of products tested. HEMA and HPMA were detected where deliberate contact with nail polish occurred. CONCLUSIONS These results confirm that acrylates are present in nail products. However, no acrylates were detected in skin wipes. MMA, a chemical prohibited for use in cosmetics in Canada, was detected in nail polishes. Nail technicians should continue to employ safe work practices that reduce the probability of skin contact with acrylates and other chemicals.
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Affiliation(s)
- Sheila Kalenge
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Tracy L Kirkham
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Linh V Nguyen
- Department of Physical and Environmental Sciences, University of Toronto, 1065 Military Trail Toronto, Ontario, Canada
| | - D Linn Holness
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,St Michael's Hospital, Unity Health, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, Canada
| | - Victoria H Arrandale
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Aalto-Korte K, Suuronen K. Ten years of contact allergy from acrylic compounds in an occupational dermatology clinic. Contact Dermatitis 2020; 84:240-246. [PMID: 33184864 DOI: 10.1111/cod.13739] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Contact allergy from acrylic compounds is a "hot topic". Knowledge on the exact chemical composition of acrylic products is superficial. AIMS To retrospectively describe patients with allergic reactions to acrylic compounds. METHODS We included patients who had been tested with acrylate patch test series and displayed allergic reactions to at least one acrylic compound. Chemical analyses were often performed when safety data sheets of implicated products failed to reveal acrylic compounds to which the patient tested positive. RESULTS In 2010-2019 a total of 55 patients met the inclusion criteria. Eight cases of allergic contact dermatitis were due to anaerobic sealants, seven to dental products, three to windscreen glues, seven to eyelash glues and/or nail products in the beauty sector, three to UV-cured printing inks, two to paints/lacquers, and one to polyester resin system. The origin of these contact allergies was occupational with the exception of four beauty sector workers who had developed eyelid symptoms from eyelash extensions glued onto their own eyelashes. We invariably detected methacrylate monomers in 15 chemical analyses of 12 different anaerobic sealants. CONCLUSIONS Safety data sheets of anaerobic sealants often lack warnings for skin sensitization, although these products regularly contain sensitizing methacrylates.
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Affiliation(s)
- Kristiina Aalto-Korte
- Finnish Institute of Occupational Health (FIOH), Occupational Health Unit, Helsinki, Finland
| | - Katri Suuronen
- Finnish Institute of Occupational Health (FIOH), Occupational Health Unit, Helsinki, Finland
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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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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: 26] [Impact Index Per Article: 5.2] [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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