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Slodownik D, Bar J, Daniely D. Trends in contact sensitization, results, and implications from a contact dermatitis clinic in Israel. Contact Dermatitis 2024; 90:556-565. [PMID: 38368629 DOI: 10.1111/cod.14524] [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: 08/23/2023] [Revised: 12/18/2023] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND The baseline series includes common allergens, evolves over time, and differs by location. Our study aims to characterize allergen sensitization trends among the Israeli population during the last two decades, compare our results to American and European registries, as well as to highlight significant allergens in additional series outside the European baseline series (OEBS). METHODS We analysed patch test results of 2086 patients from a designated contact dermatitis clinic in Tel Aviv between 2019 and 2022, compared them to European and North American registries and to 2156 patch test results conducted in Israel two decades ago. RESULTS 38.6% of patients had at least one positive reaction to an allergen in the European baseline series (EBS), nickel sulphate (14.6%), fragrance mix I (4.6%), and Methylchloroisothiazolinone methylisothiazolinone (MCI/MI; 3.7%) were the most common among them. N-Isopropyl N-Phenyl-4-Phenylenediamine (NIPPD; 0%), Propolis (0.1%), Sesquiterpene lactone mix (0.1%), and Budesonide (0.1%) elicited a sensitization frequency significantly lower than the proposed threshold for baseline inclusion. Chi-square test revealed a statistically significant decrease (p < 0.05) in the sensitization frequency of fragrance mix I, Formaldehyde, Potassium dichromate, Neomycin sulphate, Myroxylon pereirae, Sesquiterpene lactone, and NIPPD during the last two decades. The overall sensitization frequency to the majority of allergens was lower in our cohort in comparison to the North American and European registries. CONCLUSIONS MCI/MI and 2-hydroxyethyl methacrylate-2 (HEMA) are common, relevant allergens, with high SPIN (significance and prevalence index number) and should be better regulated by the authorities. While among the EBS, NIPPD, Propolis, Sesquiterpene lactone, and Budesonide usually do not elicit a positive reaction and therefore should be reconsidered in baseline series, among the OEBS, Chloramphenicol, Quaternium 15, Propyl gallate, and Amerchol L101 have elicited high SPIN values and should be vigilantly examined in the suitable clinical scenario. Significantly lower sensitization frequency to propolis raises the possibility of a protective effect due to early oral exposure among the Israeli population.
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Affiliation(s)
- Dan Slodownik
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan Bar
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
| | - Danny Daniely
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv University, Tel Aviv, Israel
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2
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Navarro-Triviño FJ, Borrego L, Silvestre-Salvador JF, Mercader-García P, Giménez-Arnau AM, Ortiz-de Frutos FJ, Sanz-Sánchez T, Melé-Ninot G, Sánchez-Gilo A, Zaragoza-Ninet V, Serra-Baldrich E, Miquel-Miquel J, Córdoba-Guijarro S, Rodríguez-Serna M, Ruíz-González I, Carrascosa-Carrillo JM, Gómez-de la Fuente E, Pastor-Nieto MA, Heras-Mendaza F, González-Pérez R, Sánchez-Pedreño Guillén P, Sánchez-Pérez J, Gatica-Ortega ME, Fernández-Redondo V, Hervella-Garcés M, Manrique-Martínez P, Guimaraens-Juanena D, García-Gavín J, Giménez-Arnau E, Figueras-Nart I, Curto-Barredo L, Armario-Hita JC. Standard and Expanded Series Patch Testing Update by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC). ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00271-0. [PMID: 38556197 DOI: 10.1016/j.ad.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 04/02/2024] Open
Abstract
After the meeting held by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) back in October 2021, changes were suggested to the Spanish standard series patch testing. Hydroxyethyl methacrylate (2% pet.), textile dye mixt (6.6% pet.), linalool hydroperoxide (1% pet.), and limonene hydroperoxide (0.3% pet.) were, then, added to the series that agreed upon in 2016. Ethyldiamine and phenoxyethanol were excluded. Methyldibromoglutaronitrile, the mixture of sesquiterpene lactones, and hydroxyisohexyl 3-cyclohexene (Lyral) were alo added to the extended Spanish series of 2022.
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Affiliation(s)
- F J Navarro-Triviño
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - L Borrego
- Servicio de Dermatología, Hospital Universitario Insular de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
| | | | - P Mercader-García
- Servicio de Dermatología, Hospital Universitario José María Morales Meseguer, Murcia, España
| | - A M Giménez-Arnau
- Servicio de Dermatología, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, España
| | - F J Ortiz-de Frutos
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - T Sanz-Sánchez
- Servicio de Dermatología, Hospital Universitario Infanta Sofía, Madrid, España
| | - G Melé-Ninot
- Servicio de Dermatología, Hospital Universitari Sagrar Cor, Grupo Quironsalud, Barcelona, España
| | - A Sánchez-Gilo
- Servicio de Dermatología, Hospital Universitario Rey Juan Carlos, Madrid, España
| | - V Zaragoza-Ninet
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - E Serra-Baldrich
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - J Miquel-Miquel
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Valencia, España
| | - S Córdoba-Guijarro
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, España
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - I Ruíz-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - J M Carrascosa-Carrillo
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | | | - M A Pastor-Nieto
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - F Heras-Mendaza
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - R González-Pérez
- Servicio de Dermatología, Hospital Universitario Áraba, Universidad del País Vasco, Vitoria, Álava, España
| | | | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España
| | - M E Gatica-Ortega
- Servicio de Dermatología, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - V Fernández-Redondo
- Servicio de Dermatología, Complejo Hospitalario Universitario de Santiago, Universidad de Santiago, Santiago de Compostela, La Coruña, España
| | - M Hervella-Garcés
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - P Manrique-Martínez
- Servicio de Dermatología, Hospital Universitario Galdakao-Usansolo, Galdakao, Vizcaya, España
| | | | | | - E Giménez-Arnau
- Institut de Chimie CNRS UMR 7177, University of Strasbourg, Estrasburgo, Francia
| | - I Figueras-Nart
- Servicio de Dermatología, Hospital Universitario de Bellvitge, L' Hospitalet de Llobregat, Barcelona, España
| | - L Curto-Barredo
- Servicio de Dermatología, Hospital del Mar, Barcelona, España
| | - J C Armario-Hita
- Servicio de Dermatología, Hospital Universitario Puerto Real, Universidad de Cádiz, Cádiz, España
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3
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Basketter DA. Risk management of skin sensitisers: A commentary. Regul Toxicol Pharmacol 2023; 140:105384. [PMID: 37028500 DOI: 10.1016/j.yrtph.2023.105384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/10/2023] [Accepted: 03/25/2023] [Indexed: 04/09/2023]
Abstract
Historically, allergic contact dermatitis (ACD) to chemicals encouraged hazard identification improvements, more sophisticated risk assessment and implementation of regulatory strategies, including banning of specific sensitising substances. The validation process applied to hazard identification methods demonstrates their accuracy; their use to characterise sensitiser potency facilitates quantitative and transparent risk assessment. Diagnostic patch testing at dermatology clinics worldwide delivers feedback showing where risk assessment/management has been insufficient or did not target the exposure of concern, thereby facilitating improvements. When urgent action to protect human health was required, regulations limited/banned, specific skin sensitisers. This can be seen in practice with the fragrance industry, a known source of ACD, thus requiring risk management, usually restrictions to limit allergy induction, and very rarely specific bans on ingredients. Experience and development of more sophisticated tools, e.g. to assess aggregate exposure from multitude of consumer product types, has led to repeated adaptation of risk assessment and promulgation of updated fragrance use limits. Although targeted control may not always lead to rapid change in the overall clinical picture, it is preferable to a blanket undifferentiated regulatory control of all sensitisers, resulting in unwarranted restrictions for many uses of no health concern, with consequent substantial socio-economic impacts.
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Wilkinson SM, Gonçalo M, Aerts O, Badulici S, Dickel H, Gallo R, Garcia-Abujeta JL, Giménez-Arnau AM, Hamman C, Hervella M, Isaksson M, Johansen JD, Mahler V, Niklasson B, Pigatto P, Ponyai G, Rustemeyer T, Schuttelaar MLA, Spiewak R, Stingeni L, Thyssen JP, Uter W. The European baseline series and recommended additions: 2023. Contact Dermatitis 2023; 88:87-92. [PMID: 36443008 DOI: 10.1111/cod.14255] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/09/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
The European baseline series was last updated in 2019. This article discusses the reasoning behind a further iteration of the series for 2023.
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Affiliation(s)
| | - Margarida Gonçalo
- Clinic of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Olivier Aerts
- University Hospital Antwerp (UZA) and University of Antwerp (UA), Antwerp, Belgium
| | - Sonia Badulici
- Alfa Medical Services, Bucharest, Romania.,Dermato-Aesthetic Institute Dr. Irinel Nedelcu, Bucharest, Romania
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Centre, Ruhr University Bochum, Bochum, Germany
| | - Rosella Gallo
- Clinica Dermatologica-DISSAL-Università di Genova Ospedale Policlinico San Martino, Genova, Italy
| | | | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Pompeu Fabra, Barcelona, Spain
| | - Curt Hamman
- Contact Dermatitis Institute, Phoenix, Arizona, USA
| | - Marcos Hervella
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | | | | | - Paolo Pigatto
- IRCCS Galeazzi Orthopaedic Institute, Milan Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Gyorgyi Ponyai
- Department of Dermatology-Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | | | - Marie L A Schuttelaar
- University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | | | - Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Jacob P Thyssen
- Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen-Nürnberg, Erlangen, Germany
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5
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Lidén C, White IR. Comment on MDBGN/DBDCB, the European baseline series, and EU legislation-Again. Contact Dermatitis 2021; 85:614. [PMID: 34312851 DOI: 10.1111/cod.13949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Carola Lidén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ian R White
- Cutaneous Allergy Team, St. John's Institute of Dermatology, Guy's Hospital, London, UK
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6
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Mercader-García P, Pastor-Nieto MA, Gonzalez-Perez R, Gimenez-Arnau AM, Ruiz-Gonzalez I, Mora-Fernández V, Miquel J, Silvestre-Salvador JF, Sanz-Sanchez T, Perez-Feal P, Sánchez-Pérez J, Heras-Mendaza F, Serra-Baldrich E, Hervella-Garces M, Gatica-Ortega ME, García-Doval I, Borrego L. Arguments in favour of excluding MDBGN from the European baseline series. In response to "Comment on MDBGN/DBDCB, the European baseline series, and EU legislation". Contact Dermatitis 2021; 85:611-613. [PMID: 34268785 DOI: 10.1111/cod.13941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/12/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Pedro Mercader-García
- Dermatology Department, Hospital General Universitario Jose Mª Morales Meseguer, Murcia
| | | | | | | | | | | | - Javier Miquel
- Dermatology Department, Hospital Arnau de Vilanova, Valencia
| | | | | | - Patricia Perez-Feal
- Dermatology Department, Complejo Hospitalario Universitario Santiago de Compostela
| | | | | | | | | | | | - Ignacio García-Doval
- Research Unit. Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid
| | - Leopoldo Borrego
- Complejo Hospitalario Universitario Insular Materno Infantil. Universidad de las Palmas de Gran Canaria
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7
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Lidén C, White IR. Comment on MDBGN/DBDCB, the European baseline series, and EU legislation. Contact Dermatitis 2021; 85:607-610. [PMID: 34250623 DOI: 10.1111/cod.13937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Carola Lidén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ian R White
- Cutaneous Allergy Team, St. John's Institute of Dermatology, Guy's Hospital, London, UK
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