Contact allergy in a paediatric population observed in a tertiary referral centre in Belgium

BACKGROUND

Contact allergy is increasingly recognized as being important in children with eczema.

OBJECTIVES

To retrospectively analyse the patch test results in children over the past 10 years, aiming to (1) evaluate demographic characteristics and lesion locations, (2) describe frequencies of positive patch test reactions, and (3) investigate the relationship with atopic dermatitis (AD).

METHODS

A total of 329 children were patch tested between January 2010 and December 2019 with the European (children) baseline series and/or other series, and the personal product(s) used.

RESULTS

A total of 119 (36%) children presented with at least one positive reaction. Children with AD had a higher prevalence of positive reactions compared with the non-AD group (P = .002), but without statistically significant difference regarding sensitization to more than one hapten (P = .39). The face (20.2%), hands (19.3%), feet (16.8%), arms (12.6%), and body folds (10.9%) were the most common sites of primary localizations. The most frequent contact allergens were nickel sulfate and linalool hydroperoxide (both 16%), limonene hydroperoxide (13.5%), and para-phenylenediamine (10.9%). No statistically significant difference for nickel sulfate was found between the AD and non-AD group (P = .20).

CONCLUSIONS

Contact allergy in children with eczema was frequently observed in our tertiary referral centre in Belgium as well, confirming the need for patch testing.

The presence of benzophenone in sunscreens and cosmetics containing the organic UV filter octocrylene: A laboratory study

BACKGROUND

The reason why patients photosensitized to the drug ketoprofen (KP) may develop severe photoallergic skin reactions to octocrylene (OCT), an organic ultraviolet filter in sunscreens and cosmetics, remains largely unknown. OCT can be synthesized by using unsubstituted benzophenone (BP), a possible human carcinogen.

OBJECTIVES

To verify if, and to what extent, BP residues are present in OCT-containing consumer products.

METHODS

The raw material of OCT and 39 skincare products, of which 28 contain OCT, were chemically analysed for the presence of BP by means of liquid chromatography.

RESULTS

In the OCT raw material and in all 28 OCT-containing products the presence of BP could be demonstrated, mostly in concentrations above 10 ppm (0.001%), whereas a majority of OCT-free products (8/11, 73%) did not contain BP. Moreover, BP concentrations significantly increased, in a time- and temperature-dependent manner, likely due to the additional degradation of OCT.

CONCLUSIONS

Photoallergic contact dermatitis from OCT in patients photosensitized to KP might rely on residual BP impurities. Toxicological and ecological studies that evaluate the safety of OCT might also need to consider the concomitant presence of BP.

Iatrogenic allergic contact dermatitis in the (peri)anal and genital area

BACKGROUND

Allergic contact dermatitis (ACD) from topical medication often occurs in occluded areas, for example, with wound treatment, but also in certain body locations, such as the anogenital area.

OBJECTIVES

To investigate the demographics and specific lesion location of patients with ACD from topical drugs applied onto the (peri)anal/genital area, and to identify the respective causal topical pharmaceutical products and ingredients involved.

METHODS

From January 2000 to December 10, 2018, 532 patients were tested with the baseline series, sometimes with additional series, and the topical medication used along with the ingredients. The relevant data were extracted from our electronic databases developed in-house.

RESULTS

Forty-four patients (9%) out of 473 patients suffering from lesions in the (peri)anal/genital area had positive patch test results to topical drug preparations and/or their ingredients, sometimes in association with cosmetics for intimate hygiene. The most frequent sensitizing active principles were local anaesthetics and corticosteroids, while wool alcohols and to a minor extent benzoic acid were the most frequent culprits among the vehicle components and preservative agents, respectively.

CONCLUSIONS

The local conditions (eg, occlusion, sweating, moist) in the anogenital area may favour skin sensitization to topical medication used to treat various skin diseases.

Allergic contact dermatitis caused by acrylic-based medical dressings and adhesives

BACKGROUND

Acrylates and methacrylates are acrylic resin monomers that are known to induce skin sensitization as a result of their presence in different materials, such as nail cosmetics, dental materials, printing inks, and adhesives. Allergic contact dermatitis resulting from the use of modern wound dressings containing them has only rarely been reported.

OBJECTIVES

To describe 2 patients who developed allergic contact dermatitis caused by acrylic-based modern medical dressings and/or adhesives.

METHODS

The medical charts of patients consulting since 1990 were retrospectively reviewed for (meth)acrylate allergy resulting from contact with such materials, and their demographic characteristics and patch test results were analysed.

RESULTS

Two patients were observed in 2014 and 2016 who had presented with positive patch test reactions to several acrylic-based dressings and/or adhesive materials, and to several (meth)acrylates, that is, hydroxyethyl acrylate, hydroxyethyl methacrylate, ethyleneglycol dimethacrylate, bisphenol A-glycidyl methacrylate/epoxy-acrylate, urethane diacrylate, and/or penta-erythritol acrylate.

CONCLUSIONS

Allergic contact dermatitis needs to be considered in patients with eczematous reactions or delayed healing following the use of acrylic-based modern dressings or adhesives. However, identification of the culprit allergen is hampered by poor cooperation from the producers, so adequate labelling of medical devices is an urgent necessity.

Frequency and relevance of positive patch tests to cyclohexylthiophthalimide, a new rubber allergen

Cyclohexylthiophtalimide (CTP) is currently the most widely used vulcanization retarder in the rubber industry. Little is known about sensitization to CTP, although positive tests to it do occur in patients exposed to rubber objects. A retrospective study of 350 patients who were patch tested with the standard rubber chemical series was conducted in two departments of dermatology, one in Nancy, France, and one in Leuven, Belgium. Sixteen (4.6%) out of the 350 patients had clear and 6 (1.7%) had doubtful positive reactions to CTP. Cross-sensitivity with other molecules could not be determined. The source of sensitization in most cases seems to have been protective rubber gloves at work. In the other cases, sensitization was suspected to have been caused by rubber shoes, elastic bands in underwear, or other rubber objects. The determination of the relevance of positive tests remains difficult, especially since little is known about the components of rubber products.

Fluticasone propionate: a rare contact sensitizer

Fluticasone propionate is the first of a new generation of fluorinated corticosteroids that have been synthesized with a view to separating local activity from undesirable side effects. In recent years, contact allergy to the newer topical corticosteroids has received increasing attention. The results of patch testing with fluticasone propionate, even in patients with a known contact allergy to corticosteroids, argue for a low sensitization and cross-sensitization potential.

An update on airborne contact dermatitis

This review is an update of 2 previously published articles on airborne contact dermatoses. Because reports in the literature often omit the term 'airborne', 18 volumes of Contact Dermatitis (April 1991-June 2000), 8 volumes of the American Journal of Contact Dermatitis (1992 1999) and 4 volumes of La Lettre du Gerda (1996-1999) were screened, and the cases cited were classified as to history, lesion locations, sensitization sources, and other factors. Reports on airborne dermatitis are increasingly being published, sometimes in relation to specific occupational areas.