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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: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [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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Alves VM, Borba JVB, Braga RC, Korn DR, Kleinstreuer N, Causey K, Tropsha A, Rua D, Muratov EN. PreS/MD: Predictor of Sensitization Hazard for Chemical Substances Released From Medical Devices. Toxicol Sci 2022; 189:250-259. [PMID: 35916740 PMCID: PMC9516038 DOI: 10.1093/toxsci/kfac078] [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] [Indexed: 11/14/2022] Open
Abstract
In the United States, a pre-market regulatory submission for any medical device that comes into contact with either a patient or the clinical practitioner must include an adequate toxicity evaluation of chemical substances that can be released from the device during its intended use. These substances, also referred to as extractables and leachables, must be evaluated for their potential to induce sensitization/allergenicity, which traditionally has been done in animal assays such as the guinea pig maximization test (GPMT). However, advances in basic and applied science are continuously presenting opportunities to employ new approach methodologies, including computational methods which, when qualified, could replace animal testing methods to support regulatory submissions. Herein, we developed a new computational tool for rapid and accurate prediction of the GPMT outcome that we have named PreS/MD (predictor of sensitization for medical devices). To enable model development, we (1) collected, curated, and integrated the largest publicly available dataset for GPMT results; (2) succeeded in developing externally predictive (balanced accuracy of 70%-74% as evaluated by both 5-fold external cross-validation and testing of novel compounds) quantitative structure-activity relationships (QSAR) models for GPMT using machine learning algorithms, including deep learning; and (3) developed a publicly accessible web portal integrating PreS/MD models that can predict GPMT outcomes for any molecule of interest. We expect that PreS/MD will be used by both industry and regulatory scientists in medical device safety assessments and help replace, reduce, or refine the use of animals in toxicity testing. PreS/MD is freely available at https://presmd.mml.unc.edu/.
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Affiliation(s)
- Vinicius M Alves
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Joyce V B Borba
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | | | - Daniel R Korn
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Nicole Kleinstreuer
- National Toxicology Program, Interagency Center for the Evaluation of Alternative Toxicological Methods, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina 27560, USA
| | - Kevin Causey
- Predictive, LLC, Research Triangle Park, North Carolina, USA
| | - Alexander Tropsha
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Predictive, LLC, Research Triangle Park, North Carolina, USA
| | - Diego Rua
- Division of Biology, Chemistry, and Materials Science, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland 20993, USA
| | - Eugene N Muratov
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
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Tramontana M, Hansel K, Bianchi L, Marietti R, Stingeni L. Use of self-applied sculptured gel nails may increase the risk of allergy to (meth)acrylates in children and adolescents. J Eur Acad Dermatol Venereol 2021; 35:e765-e767. [PMID: 34062011 DOI: 10.1111/jdv.17429] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/07/2021] [Accepted: 05/21/2021] [Indexed: 11/29/2022]
Affiliation(s)
- M Tramontana
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - K Hansel
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - L Bianchi
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - R Marietti
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - L Stingeni
- Dermatology Section, Department of Medicine and Surgery, 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: 10] [Impact Index Per Article: 2.5] [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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Foti C, Bonamonte D, Romita P, Guarneri F, Patruno C, Angelini G. Common Allergens. CLINICAL CONTACT DERMATITIS 2021:437-497. [DOI: 10.1007/978-3-030-49332-5_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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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: 0.6] [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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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: 1.2] [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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