Results of patch testing 2-hydroxyethyl methacrylate (HEMA) in the European baseline series: A 4-year retrospective study

BACKGROUND

2-Hydroxyethyl methacrylate (HEMA) was added to the European baseline series (EBS) in 2019. Few recent data are available on the frequency and relevance of positive reactions to this hapten.

OBJECTIVES

To investigate the frequency and relevance of positive patch tests to HEMA in the EBS in a university hospital in Amsterdam, The Netherlands.

PATIENTS AND METHODS

Retrospective study in patients with positive patch tests to HEMA investigated between June 2019 and August 2023.

RESULTS

Of 2927 consecutive patients, 88 (79 women and 9 men; 3.0%) had a positive reaction to HEMA. The prevalence in women was 3.9%, in men 1.0%. Forty-three (49%) reactions were judged to be of current clinical relevance and 21 (24%) of past relevance. In this group of 64 patients with relevant reactions, 18 (28%) had occupational contact with (meth)acrylate-containing products, of who 11 (61%) were nail stylists. In 46 patients with non-occupational allergic contact dermatitis, 31 (67%) had allergic reactions to nail cosmetics. Glues and glue-containing products accounted for 22% of the materials causing allergic contact dermatitis and dental products for 8%.

CONCLUSIONS

Allergic reactions to HEMA are very frequent in women investigated in Amsterdam. Nearly two thirds of cases were caused by nail cosmetics.

Contact allergy caused by acrylates in nail cosmetics: A pilot study from Greece

BACKGROUND

The growing popularity of nail techniques based on acrylates has led to a higher frequency of sensitization in both nail technicians and users.

OBJECTIVES

The study aimed to assess cases of allergic contact dermatitis (ACD) caused by acrylates in individuals with occupational or non-occupational exposure to nail techniques.

METHODS

A preliminary study was conducted on 30 patients with ACD caused by acrylates in nail techniques, who were patch tested from September 2022 to March 2023 at the First Department of Dermatology and Venereology of Andreas Syggros Hospital, Athens, Greece.

RESULTS

Thirty female patients with ACD to acrylates were documented (15 users and 15 nail technicians and users). The most common allergens were: 2-hydroxyethyl methacrylate (HEMA), 2-hydroxypropyl methacrylate (HPMA) and ethyleneglycol dimethacrylate (EGDMA), which tested positive in all 30 patients (100.0%). Twenty patients (66.7%) had been exposed to dental procedures involving acrylates, before the onset of ACD. Nail technicians exhibited extensive skin lesions, 40.0% experienced ACD within the first year of work and 13.3% during their professional practice. Three of them (20.0%) had to discontinue their work.

CONCLUSION

Acrylates have been identified as potent allergens, necessitating the implementation of safety measures for the use of these chemicals in nail techniques.

Contact allergy to acrylate-containing nail cosmetics: A retrospective 8-year study

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.

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

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.

2-Hydroxyethyl methacrylate (HEMA): A clinical review of contact allergy and allergic contact dermatitis-Part 1. Introduction, epidemiology, case series and case reports

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.

Patients' awareness of the prevention and treatment of the selected podiatry diseases

BACKGROUND

The lower limbs are an essential element of the structure of our body, bearing the weight and responsible for the correct motor skills. Defects in the functioning of the lower limbs and nails or foot skin can significantly affect the quality of life and limit full mobility. Due to the multitude of causes of podiatry changes, we consider their prevention and treatment interdisciplinary.

AIMS

This study aimed to examine the patient's awareness of selected podiatry units' prevention and treatment methods.

PATIENTS/METHODS

The study was an anonymous questionnaire consisting of 23 questions. The survey was carried out from November 4, 2020, to March 3, 2021. 516 questionnaires were collected.

RESULTS

The results indicate that pain in the area of the feet is common. It was shown that patients do not have enough awareness and knowledge about proper foot care, yet the vast majority, mainly using Internet sources, try to solve the problem independently. In turn, a definite minority uses the services of a professional (eg, podiatrist) in this matter. The most commonly observed biological conditions are corns, cracked heels, ingrown toenails, and calluses.

CONCLUSION

Patients, despite low awareness of proper care and the risk of complications, rarely decide to seek the help of a specialist in the field of podiatry diseases, even though appropriate care constantly improves foot motor skills. This problem is significant among people chronically ill with somatic diseases that often cause symptoms in the feet and thus reduce the patient's quality of life.

Psoriasiform Onychodystrophy Induced by Photobonded Acrylic Nails

Multiple cases have reported onychodystrophy secondary to acrylic nails. We present a case of onychodystrophy with psoriasiform nail changes, including onycholysis, splinter hemorrhages, hyperkeratosis, and nail plate thinning, caused by gel manicures. Histopathological analysis of the nail plate and subungual debris revealed neutrophils in the absence of fungal elements. Although the presence of neutrophils in the nail plate material in conjunction with characteristic psoriatic nail changes suggested a diagnosis of psoriasis, certain key features of nail psoriasis, including oil spots, salmon patches, and pitting, were notably absent. The development of these nail changes following gel manicure and pedicure application and the improvement of the onychodystrophy with topical and intralesional steroids support the diagnosis of psoriasiform onychodystrophy.

The effect of various primers improving adhesiveness of gel polish hybrids on pH, TOWL and overall nail plates condition

BACKGROUND

Hybrid manicure is now a popular method of nail care and nail art, which is associated with its durability. Unfortunately, it has an adverse effect on pH, TOWL and overall nail plates condition and has not been investigated in detail so far.

AIMS

The aim of this study was to compare the pH and TOWL of the hand nails after using different primers. The effect of application time, breaks between applications and the method of curing and removal on those parameters and overall nail plates condition were evaluated.

PATIENTS/METHODS

An evaluation survey was conducted among 116 women. pH and TOWL measurements of the nail plate in 35 women were taken using the Courage & Khazaka. Clinical photos were made using the Fotomedicus system.

RESULTS

The measured pH values of the nail plate in the test group with gel polish hybrid on the nails were from 5.50 to 6.65, while after removal of the gel polish hybrid, the values ranged from 5.63 to 6.68. TOWL of the nail plate covered with gel polish hybrid ranged from 2.9 to 33.2 g/m² /h, whereas after removal of hybrids-from 1.9 to 45.7 g/m² /h.

CONCLUSION

Different forms of acid-free primers maintain a lower pH of the nail plate covered with a gel polish hybrid, while the acidic primer maintains higher values of the nail plate pH. The significant decrease in the nail plate TOWL following the application of gel polish hybrid indicates a reduced loss of water from the surface of the nail to the atmosphere.