Contact allergy induced by bisphenol A diglycidyl ether leachables from aluminium tubes for pharmaceutical use

BACKGROUND

Aluminium tubes for pharmaceutical use are internally lacquered with epoxy resins (ER) based on bisphenol A diglycidyl ether (BADGE). Recently, it was shown that remnants of ER polymerization like BADGE are extractable from epoxy-based coatings of commercially available tubes and may leach into semi-solid drug preparations. We aimed to evaluate the safety of BADGE-contaminated macrogol ointments in individuals sensitized to ER based on BADGE by use tests.

METHODS

Repeated open application testing (ROAT) in 11 patients sensitized to ER based on BADGE with BADGE in macrogol ointments (3 mg/kg; 30 mg/kg, equivalent to BADGE concentration determined in macrogol ointment after storage in a commercially available tube; 300 mg/kg).

RESULTS

The 30 mg/kg BADGE ointment elicited reactions in three patients, and another three patients reacted to 300 mg/kg BADGE ointment. No reactions to the vehicle control and 3 mg/kg BADGE were observed.

CONCLUSIONS

Elevated BADGE concentrations in ER-coated aluminium tubes pose a risk of developing contact dermatitis to patients sensitized to ER based on BADGE. Quality standards are deemed necessary for the production of ER-coated aluminium tubes intended for pharmaceutical use and should consider the results of the present ROAT study.

Air-oxidized linalool elicits eczema in allergic patients - a repeated open application test study

BACKGROUND

Linalool is a commonly used fragrance terpene that forms potent sensitizers upon oxidation. In a recent multicentre study, we found that 7% of 2900 patients showed positive patch test reactions to oxidized linalool at 6.0%. No elicitation studies have been performed.

OBJECTIVE

To identify threshold concentrations for elicitation of allergic contact dermatitis caused by oxidized linalool in allergic individuals with repeated exposures.

METHODS

Repeated open application tests were performed in 6 participants previously diagnosed with contact allergy to oxidized linalool. Creams containing 3.0%, 1.0% and 0.30% oxidized linalool (corresponding to 0.56%, 0.19% and 0.056% linalool hydroperoxides, respectively) and 'fine fragrance' containing 1.0%, 0.30% and 0.10% oxidized linalool (corresponding to 0.19%, 0.056% and 0.019% linalool hydroperoxides, respectively) were used twice daily for up to 3 weeks. Patch testing with a dilution series of oxidized linalool was performed.

RESULTS

Five of 6 participants reacted to the cream containing 3% oxidized linalool. With 1% oxidized linalool, a reaction was seen in 3 (cream) and 4 (fine fragrance) participants, respectively. With 0.3% oxidized linalool, 2 (cream) and 1 (fine fragrance) participants reacted.

CONCLUSION

Repeated exposure to low concentrations of oxidized linalool can elicit allergic contact dermatitis in previously sensitized individuals.

The impact of surface loading and dosing scheme on the skin uptake of fragrances

This study compared the skin uptake of γ-undecalactone, decanol, and dodecyl acetate in an in vitro, un-occluded penetration assay in which they were applied to porcine skin at different finite loadings and application schemes. The pattern of fractional uptake differed between the chemicals and did not show the often assumed inverse correlation with surface loading. Furthermore, the mass uptake of identical cumulative amounts of the chemicals was not always additive. These results show that the uptake of fragrances in absence of occlusion and at finite loadings is chemical-specific and depends on the surface loading, the application scheme, and most probably, on the effects of the chemicals on the skin barrier efficiency. The observed lack of additivity might explain some of the differences in the responses observed in patch and repeated open application tests, and the boosting of the allergic state in sensitized individuals by sub-clinical exposures.