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Johannes Geier - One of the best experts on this subject based on the ideXlab platform.
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Contact Sensitization in dental technicians with occupational Contact dermatitis data of the information network of departments of dermatology ivdk 2001 2015
Contact Dermatitis, 2018Co-Authors: Annice Heratizadeh, Thomas Werfel, Steffen Schubert, Johannes GeierAbstract:Background Dental technicians (DTs) are at increased risk for allergic Contact Sensitization. Objectives To assess the current spectrum of occupational Sensitization in DTs with occupational Contact dermatitis (OCD). Methods A retrospective analysis of Information Network of Departments of Dermatology patch test data from the years 2001-2015 concerning DTs with OCD was performed. Results Patients of the study group (226 DTs with OCD) were significantly more often diagnosed with allergic Contact dermatitis (37.6% versus 18.5%; p = 0.0002) than patients of the control group (124 DTs without OCD). In the study group, positive reactions were most frequently observed to methacrylates and/or acrylates (n = 67). Of these, 61 patients showed positive reactions to at least one of the five most frequent allergens in this group, namely 2-hydroxyethyl methacrylate, 2-hydroxypropyl methacrylate, methyl methacrylate, ethyl methacrylate, and/or ethylene glycol dimethacrylate. In contrast, no positive reactions to diurethane dimethacrylate (DUDMA) occurred. Among allergens of the German Contact Dermatitis Research Group series 'dental metals', positive reactions were less frequent and were mainly to palladium chloride (n = 6). Conclusions The present data analysis showed that the Sensitization spectrum and spectrum of cross-reactivity are largely unchanged as compared with the 1990s. It can be concluded that test recommendations are still valid and useful, except for the methacrylate DUDMA, which could be omitted.
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Contact Sensitization in patients with suspected textile allergy data of the information network of departments of dermatology ivdk 2007 2014
Contact Dermatitis, 2017Co-Authors: Annice Heratizadeh, Johannes Geier, Sonja Molin, Thomas WerfelAbstract:SummaryBackground Textile dyes, rubber, elements or textile resins carry the risk of inducing allergic Contact Sensitization. Objectives To assess clinical data and patch test results for dermatitis patients with suspected textile allergy. Methods A retrospective analysis of Information Network of Departments of Dermatology data of the years 2007–2014 of patients patch tested because of suspected textile allergy was performed. Results Patients of the study group (n = 3207) suffered more frequently from leg, trunk and generalized dermatitis than patients of the control group (n = 95210). Among the allergens of the textile dye series, the highest frequency of positive reactions was observed for p-aminoazobenzene (5.1%) and p-phenylenediamine (PPD) (4.5%), followed by Disperse Orange 3 (3.1%), Disperse Blue 124 (2.3%), Disperse Blue 106 (2.0%), Disperse Red 17 (1.1%), and Disperse Yellow 3 (1.1%), partly with concomitant reactions. Patch testing with the patients' own textiles was performed in 315 patients, with positive reactions in 18 patients. These were mostly elicited by blue or black textiles with tight skin Contact. Only 2 of these patients also reacted to textile dyes from the German Contact Dermatitis Research Group series. Conclusions For the comprehensive diagnosis of Contact Sensitization in patients with suspected textile dermatitis, combined patch testing is indicated, with (i) PPD and a textile dye series and (ii) patients' own clothing.
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the current spectrum of Contact Sensitization in patients with chronic leg ulcers or stasis dermatitis new data from the information network of departments of dermatology ivdk
Contact Dermatitis, 2017Co-Authors: Cornelia Erfurtberge, Johannes Geier, Vera MahlerAbstract:SummaryBackground Patients with lower leg dermatitis, chronic venous insufficiency or chronic leg ulcers have a high prevalence of Contact Sensitization. Objectives To identify the current spectrum of Contact allergens in these patients. Patients and methods Data of the Information Network of Departments of Dermatology on 5264 patients with the above diagnoses from the years 2003 to 2014 (study group) were compared with data on 4881 corresponding patients from 1994 to 2003 (historical control group) and with a current control group without these diagnoses (n = 55 510). Results Allergic Contact dermatitis was diagnosed less frequently in the study group than in the historical control group (25.9% versus 16.9%; p < 0.001), and Contact Sensitization to most allergens had declined. The allergen spectrum, however, was largely unchanged. Important allergens are Myroxylon pereirae (balsam of Peru) (14.8% positive reactions), fragrance mix I (11.4%), lanolin alcohol (7.8%), colophonium (6.6%), neomycin sulfate (5.0%), cetearyl alcohol (4.4%), oil of turpentine (3.1%), and paraben mix (2.6%). Patch testing with additional series showed Sensitization to Amerchol L-101 (9.7%), tert-butyl hydroquinone (8.7%), framycetin sulfate (5.0%), and gentamicin sulfate (3.1%). Conclusions Topical preparations for treating the above-mentioned conditions should not contain fragrances, Myroxylon pereirae, and colophonium. The special allergen spectrum has to be considered in patch testing.
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The current spectrum of Contact Sensitization in patients with chronic leg ulcers or stasis dermatitis - new data from the Information Network of Departments of Dermatology (IVDK).
Contact Dermatitis, 2017Co-Authors: Cornelia Erfurt-berge, Johannes Geier, Vera MahlerAbstract:SummaryBackground Patients with lower leg dermatitis, chronic venous insufficiency or chronic leg ulcers have a high prevalence of Contact Sensitization. Objectives To identify the current spectrum of Contact allergens in these patients. Patients and methods Data of the Information Network of Departments of Dermatology on 5264 patients with the above diagnoses from the years 2003 to 2014 (study group) were compared with data on 4881 corresponding patients from 1994 to 2003 (historical control group) and with a current control group without these diagnoses (n = 55 510). Results Allergic Contact dermatitis was diagnosed less frequently in the study group than in the historical control group (25.9% versus 16.9%; p
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Contact Sensitization in prurigo patients.
Contact dermatitis, 2016Co-Authors: Elke Weisshaar, Sonja Molin, Ulf Darsow, Johannes GeierAbstract:Summary Background There are no studies on Contact allergy in patients with prurigo. With itch being important in the pathophysiology of prurigo diseases and being a symptom of allergic Contact dermatitis, we aimed to investigate Contact allergy in patients suffering from prurigo. Objectives Exploratory analysis of patch test results in prurigo patients. Materials and methods A retrospective analysis of data of the Information Network of Departments of Dermatology, 2005–2014, was performed. Results Of 116 744 patch tested patients, 639 (0.55%) were diagnosed with prurigo. The median age was 61 years, 286 (45%) were pensioners, and 252 (39.5%) had generalized prurigo. The indication for patch testing was exclusion of Contact allergy in 412 patients (64.5%), and 223 patients (35%) had at least one positive patch test reaction. There was no distinctive pattern of Sensitization. Prurigo patients had significantly more (and stronger) reactions to the irritant control patch test with sodium lauryl sulfate than a control group (27.6% versus 21.0%). Conclusions Although prurigo is not a typical clinical manifestation of Contact Sensitization, our results indicate that patch testing in these patients may be helpful.
Jacob P. Thyssen - One of the best experts on this subject based on the ideXlab platform.
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Association between atopic dermatitis and Contact Sensitization: A systematic review and meta-analysis
Journal of the American Academy of Dermatology, 2017Co-Authors: Carsten R. Hamann, Jeanne D. Johansen, Dathan Hamann, Alexander Egeberg, Jonathan I. Silverberg, Jacob P. ThyssenAbstract:Background It is unclear whether patients with atopic dermatitis (AD) have an altered prevalence or risk for Contact Sensitization. Increased exposure to chemicals in topical products together with impaired skin barrier function suggest a higher risk, whereas the immune profile suggests a lower risk. Objective To perform a systematic review and meta-analysis of the association between AD and Contact Sensitization. Methods The PubMed/Medline, Embase, and Cochrane databases were searched for articles that reported on Contact Sensitization in individuals with and without AD. Results The literature search yielded 10,083 citations; 417 were selected based on title and abstract screening and 74 met inclusion criteria. In a pooled analysis, no significant difference in Contact Sensitization between AD and controls was evident (random effects model odds ratio [OR] = 0.891; 95% confidence interval [CI] = 0.771-1.03). There was a positive correlation in studies that compared AD patients with individuals from the general population (OR 1.50, 95% CI 1.23-1.93) but an inverse association when comparing with referred populations (OR 0.753, 95% CI 0.63-0.90). Limitations Included studies used different tools to diagnose AD and did not always provide information on current or past disease. Patch test allergens varied between studies. Conclusion No overall relationship between AD and Contact Sensitization was found. We recommend that clinicians consider patch testing AD patients when allergic Contact dermatitis is suspected.
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the multiple factors affecting the association between atopic dermatitis and Contact Sensitization
Allergy, 2014Co-Authors: Jacob P. Thyssen, James P. Mcfadden, Ian KimberAbstract:Atopic dermatitis and allergic Contact dermatitis are both common skin diseases having an immune pathogenesis. There has been considerable interest about their inter-relationships with regard to altered susceptibility. Recent investigations have shed new light on this important question, and in this article, we explore whether there is evidence that atopic dermatitis affects the risk of Contact Sensitization and allergic Contact dermatitis. The use of topical products to treat xerotic and inflamed skin in atopic dermatitis often results in a higher prevalence of Sensitization to, for example, fragrances and other ingredients in emollients. Moreover, the prevalence of metal allergy seems to be increased, probably due to compromised chelation of the metals in the stratum corneum of patients with atopic dermatitis. However, conversely, the T-helper cell 2 bias that characterizes immune responses in atopic dermatitis appears to lower the risk of Contact Sensitization compared to healthy controls. Based on these observations, we conclude that multiple factors affect the association between atopic dermatitis and Contact Sensitization, and that these need to be appreciated in the clinical management of atopic dermatitis patients.
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Xerosis is associated with atopic dermatitis, hand eczema and Contact Sensitization independent of filaggrin gene mutations.
Acta dermato-venereologica, 2013Co-Authors: Jacob P. Thyssen, Torkil Menné, Jeanne D. Johansen, Claus Zachariae, Allan LinnebergAbstract:Atopic dermatitis, hand eczema and Contact Sensitization are prevalent disorders, and may, in many cases, be secondary to skin barrier abnormality. The aim of this study was to investigate the association between self-reported generalized xerosis, atopic dermatitis, hand eczema and Contact Sensitization, taking filaggrin gene mutations into account. Questionnaire data were collected from a cross-sectional study performed in a general population in Copenhagen. A total of 3,460 18-69-year-olds were patch-tested and 3,335 were genotyped for the 2282del4 and R501X mutations in the filaggrin gene. Atopic dermatitis and hand eczema were significantly associated with generalized xerosis, whereas Contact Sensitization (not nickel) showed only a borderline significant association. These results suggest that generalized xerosis may increase the risk of common skin disorders.
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The role of glutathione S-transferase and claudin-1 gene polymorphisms in Contact Sensitization: a cross-sectional study.
The British journal of dermatology, 2013Co-Authors: Katrine Ross-hansen, Allan Linneberg, Torkil Menné, Jeanne D. Johansen, L.-g. Hersoug, Charlotte Brasch-andersen, Jacob P. ThyssenAbstract:Summary Background Contact Sensitization is frequent in the general population and arises from excessive or repeated skin exposure to chemicals and metals. However, little is known about its genetic susceptibility. Objectives To determine the role of polymorphisms of glutathione S-transferase (GST) genes and the claudin-1 gene (CLDN1) on the risk of Contact Sensitization, taking common filaggrin gene (FLG) mutations into account. Methods In total, 3471 adult Danes from the general population were standard patch tested and filled out a questionnaire on their general health. They were genotyped for the following polymorphisms: GSTM1 and GSTT1 deletion, GSTP1 single nucleotide polymorphism (SNP) rs1695, four CLDN1 SNPs (rs893051, rs9290927, rs9290929 and rs17501010) and the FLG null mutations R501X and 2282del4. Results In individuals without ear piercings, a higher prevalence of nickel Sensitization was found in those with the minor allele of CLDN1 SNP rs9290927 (Ptrend = 0·013). For CLDN1 rs17501010, Contact Sensitization to organic compounds was associated with the major allele (Ptrend = 0·031). The risk pattern was also identified for self-reported nickel dermatitis (Ptrend = 0·011). The fragrance Sensitization prevalence differed in a pairwise comparison of the CLDN1 rs893051 SNP genotypes (P = 0·022), with the minor allele being associated with a higher prevalence. The associations were confirmed in logistic regression analyses. Conclusions The CLDN1 polymorphisms rs9290927, rs893051 and rs17501010 were associated, respectively, with nickel Contact Sensitization in individuals without ear piercings, Contact Sensitization to fragrances, and with both organic compounds and nickel Contact dermatitis. We could not find associations between GST gene polymorphisms and Contact Sensitization. FLG mutations did not affect the observed associations.
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Filaggrin mutations are strongly associated with Contact Sensitization in individuals with dermatitis
Contact dermatitis, 2013Co-Authors: Jacob P. Thyssen, Allan Linneberg, Torkil Menné, Katrine Ross-hansen, Berit C. Carlsen, Michael Meldgaard, Pal B. Szecsi, Steen Stender, Jeanne D. JohansenAbstract:Background. Although heterozygous filaggrin gene (FLG) mutation carriers seem to have an increased risk of atopic, irritant and allergic nickel dermatitis, it remains unclear whether the risk of Contact Sensitization to allergens other than nickel is also elevated in FLG mutation carriers. Objectives. We hypothesized that heterozygous FLG mutation carriers who suffer from dermatitis will have strongly reduced or even absent filaggrin levels during episodes of inflammation, potentially increasing the penetration of Contact allergens, and hence the risk of becoming sensitized. Materials and methods. During 2006–2008, 3335 randomly invited 18–69-year-old adult Danes participated in a general health examination, filled out a questionnaire, and were genotyped for the R501X and 2282del4 mutations in FLG. Results. A logistic regression analysis restricted to individuals who reported atopic dermatitis and frequent episodes of hand eczema showed a strong association between FLG mutations and Contact Sensitization to allergens other than nickel (odds ratio 5.71; 95% confidence interval 1.31–24.94). In participants without dermatitis, no association was found between Contact Sensitization and FLG mutations. Conclusion. FLG mutation carriers with self-reported dermatitis have an increased risk of Contact Sensitization to substances other than nickel, whereas FLG mutations alone may not, or may only slightly, increase the risk of Sensitization.
Allan Linneberg - One of the best experts on this subject based on the ideXlab platform.
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Xerosis is associated with atopic dermatitis, hand eczema and Contact Sensitization independent of filaggrin gene mutations.
Acta dermato-venereologica, 2013Co-Authors: Jacob P. Thyssen, Torkil Menné, Jeanne D. Johansen, Claus Zachariae, Allan LinnebergAbstract:Atopic dermatitis, hand eczema and Contact Sensitization are prevalent disorders, and may, in many cases, be secondary to skin barrier abnormality. The aim of this study was to investigate the association between self-reported generalized xerosis, atopic dermatitis, hand eczema and Contact Sensitization, taking filaggrin gene mutations into account. Questionnaire data were collected from a cross-sectional study performed in a general population in Copenhagen. A total of 3,460 18-69-year-olds were patch-tested and 3,335 were genotyped for the 2282del4 and R501X mutations in the filaggrin gene. Atopic dermatitis and hand eczema were significantly associated with generalized xerosis, whereas Contact Sensitization (not nickel) showed only a borderline significant association. These results suggest that generalized xerosis may increase the risk of common skin disorders.
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The role of glutathione S-transferase and claudin-1 gene polymorphisms in Contact Sensitization: a cross-sectional study.
The British journal of dermatology, 2013Co-Authors: Katrine Ross-hansen, Allan Linneberg, Torkil Menné, Jeanne D. Johansen, L.-g. Hersoug, Charlotte Brasch-andersen, Jacob P. ThyssenAbstract:Summary Background Contact Sensitization is frequent in the general population and arises from excessive or repeated skin exposure to chemicals and metals. However, little is known about its genetic susceptibility. Objectives To determine the role of polymorphisms of glutathione S-transferase (GST) genes and the claudin-1 gene (CLDN1) on the risk of Contact Sensitization, taking common filaggrin gene (FLG) mutations into account. Methods In total, 3471 adult Danes from the general population were standard patch tested and filled out a questionnaire on their general health. They were genotyped for the following polymorphisms: GSTM1 and GSTT1 deletion, GSTP1 single nucleotide polymorphism (SNP) rs1695, four CLDN1 SNPs (rs893051, rs9290927, rs9290929 and rs17501010) and the FLG null mutations R501X and 2282del4. Results In individuals without ear piercings, a higher prevalence of nickel Sensitization was found in those with the minor allele of CLDN1 SNP rs9290927 (Ptrend = 0·013). For CLDN1 rs17501010, Contact Sensitization to organic compounds was associated with the major allele (Ptrend = 0·031). The risk pattern was also identified for self-reported nickel dermatitis (Ptrend = 0·011). The fragrance Sensitization prevalence differed in a pairwise comparison of the CLDN1 rs893051 SNP genotypes (P = 0·022), with the minor allele being associated with a higher prevalence. The associations were confirmed in logistic regression analyses. Conclusions The CLDN1 polymorphisms rs9290927, rs893051 and rs17501010 were associated, respectively, with nickel Contact Sensitization in individuals without ear piercings, Contact Sensitization to fragrances, and with both organic compounds and nickel Contact dermatitis. We could not find associations between GST gene polymorphisms and Contact Sensitization. FLG mutations did not affect the observed associations.
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Filaggrin mutations are strongly associated with Contact Sensitization in individuals with dermatitis
Contact dermatitis, 2013Co-Authors: Jacob P. Thyssen, Allan Linneberg, Torkil Menné, Katrine Ross-hansen, Berit C. Carlsen, Michael Meldgaard, Pal B. Szecsi, Steen Stender, Jeanne D. JohansenAbstract:Background. Although heterozygous filaggrin gene (FLG) mutation carriers seem to have an increased risk of atopic, irritant and allergic nickel dermatitis, it remains unclear whether the risk of Contact Sensitization to allergens other than nickel is also elevated in FLG mutation carriers. Objectives. We hypothesized that heterozygous FLG mutation carriers who suffer from dermatitis will have strongly reduced or even absent filaggrin levels during episodes of inflammation, potentially increasing the penetration of Contact allergens, and hence the risk of becoming sensitized. Materials and methods. During 2006–2008, 3335 randomly invited 18–69-year-old adult Danes participated in a general health examination, filled out a questionnaire, and were genotyped for the R501X and 2282del4 mutations in FLG. Results. A logistic regression analysis restricted to individuals who reported atopic dermatitis and frequent episodes of hand eczema showed a strong association between FLG mutations and Contact Sensitization to allergens other than nickel (odds ratio 5.71; 95% confidence interval 1.31–24.94). In participants without dermatitis, no association was found between Contact Sensitization and FLG mutations. Conclusion. FLG mutation carriers with self-reported dermatitis have an increased risk of Contact Sensitization to substances other than nickel, whereas FLG mutations alone may not, or may only slightly, increase the risk of Sensitization.
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The association between Contact Sensitization and atopic disease by linkage of a clinical database and a nationwide patient registry.
Allergy, 2012Co-Authors: Jacob P. Thyssen, Allan Linneberg, Torkil Menné, Jeanne D. Johansen, Kaare EngkildeAbstract:Background Experimental studies have shown that individuals with atopic dermatitis are likely to have suppressed Contact sensitivity secondary to their disease whereas some clinical and epidemiological studies have shown that individuals with atopic dermatitis might have a higher prevalence of Contact Sensitization than controls. The objective was to study the association between Contact Sensitization and, respectively, atopic dermatitis and asthma using clinical databases. Methods Record linkage of two different registers was performed: (i) a tertiary hospital register of dermatitis patient's patch tested for Contact sensitivity and (ii) the Danish National Patient Register containing nationwide hospital discharge diagnoses and outpatient Contacts. Results An inverse association was found between Contact Sensitization and, respectively, presumed severe atopic dermatitis (OR, 0.70; 95% CI, 0.61–0.81) and asthma (OR, 0.61; 95% CI, 0.42–0.90) when linkage was performed. Inverse associations were found for all groups of chemicals and metals except for Sensitization to fragrances and topical drugs where positive associations were identified. A significant positive association between fragrance Sensitization and presumed mild–moderate atopic dermatitis was also found when data from hospital register only were used, suggesting an overall higher prevalence of fragrance Sensitization in patients with atopic dermatitis. Conclusions Our findings support that patients with severe atopic dermatitis and asthma have an overall lower prevalence of Contact Sensitization when compared with controls, whereas mild-to-moderate disease does not suppress Contact Sensitization. The prevalence of Contact Sensitization to fragrance chemicals was higher in patients with atopic dermatitis. Patients should be instructed to avoid scented moisturizers and products containing highly sensitizing substances.
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Contact Sensitization to common haptens is associated with atopic dermatitis: new insight
The British journal of dermatology, 2012Co-Authors: Jacob P. Thyssen, Allan Linneberg, Kaare Engkilde, Torkil Menné, Jeanne D. JohansenAbstract:Summary Background It has been much debated whether atopic dermatitis (AD) is associated with Contact Sensitization as past findings have been conflicting. A positive association might change our clinical practice. Objectives To investigate the association between AD and Contact Sensitization taking the likely route of allergen exposure into account. Methods Questionnaire and clinical data from a cross-sectional study performed in a general population in Copenhagen. In total, 3202 adults aged 18–69 years were patch tested, filaggrin genotyped for 2282del4 and R501X and questioned about AD. Results The variable ‘Contact Sensitization to at least one allergen, but not nickel and thimerosal’ was significantly associated with AD (odds ratio 2·53, 95% confidence interval 1·59–4·04). The higher prevalence of Contact Sensitization was driven mainly by fragrance chemicals. In a subanalysis in nonpierced women, a positive association was also found for nickel Sensitization. Nickel and thimerosal Sensitization may introduce bias in data analysis as these allergies often develop following skin piercing where the skin compartments are bypassed. Conclusions We suspect that individuals with self-reported AD from this study mainly had mild disease. However, clinicians should be aware of increased levels of Contact Sensitization in individuals with AD. Patch testing should therefore be considered at an early point in individuals with a history of AD and active disease. The fundamental relationship between atopic disease and environmental chemical exposure may be of a more complex and intimate nature than previously supposed.
Axel Schnuch - One of the best experts on this subject based on the ideXlab platform.
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Contact Sensitization in patients with suspected cosmetic intolerance: Results of the IVDK 2006-2011
Journal of the European Academy of Dermatology and Venereology, 2015Co-Authors: A. Dinkloh, Axel Schnuch, Johannes Geier, Margitta Worm, Andreas WollenbergAbstract:BACKGROUND: Ingredients of leave-on cosmetics and body care products may sensitize. However, not every case of cosmetic intolerance is due to Contact Sensitization. OBJECTIVE: To describe the frequency of Contact Sensitization due to cosmetics in a large clinic population, and a possible particular allergen pattern. METHODS: Retrospective analysis of data from the Information Network of Departments of Dermatology, 2006-2011. RESULTS: Of 69 487 patients tested, 'cosmetics, creams, sunscreens' was the only suspected allergen source category in 10 124 patients (14.6%). A final diagnosis 'allergic Contact dermatitis' was stated in 2658 of these patients (26.3%).Compared to a control group, there were significantly more reactions to fragrance mixes I and II, balsam of Peru, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and lanolin alcohols. No special pattern of fragrance Sensitization could be identified. Among the preservatives, MI was by far the leading allergen, while Sensitization to other widely used compounds like parabens or phenoxyethanol was rare. CONCLUSIONS: True allergic reactions to cosmetic ingredients are rarer than generally assumed. Limitation of exposure to MI in leave-on cosmetics and body care products is urgently needed.
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Contact Sensitization to cobalt multifactorial analysis of risk factors based on long term data of the information network of departments of dermatology
Contact Dermatitis, 2014Co-Authors: Wolfgang Uter, Johannes Geier, Olaf Gefeller, Axel SchnuchAbstract:Summary Background Cobalt Contact Sensitization in consecutively tested patients is common. The sources of exposure, and thus clinical relevance, are mostly unclear. Objective To examine (i) long-term time trends of Sensitization, (ii) risk factors that may point to relevant exposures, and (iii) coupling with nickel Sensitization. Methods Data of all patients patch tested with cobalt(II) chloride hexahydrate (1% pet.) between 1992 and 2012 (n = 185 050) in the Information Network of Departments of Dermatology (IVDK, www.ivkd.org) were subjected to descriptive stratified and Poisson regression analysis. Results The overall prevalence of positive patch test reactions was 5.23% (95% confidence interal 5.13–5.33%). Regarding time trends, there were significant increases for males aged 18–44 years and for females aged ≥45 years, and a significant variation of co-reactivity with nickel over time. Female sex almost doubled the risk of Sensitization; age ≥45 years was associated with a 30% decrease in the risk of positive patch test reactions to cobalt, and atopic eczema with an approximately 20% increase. Conclusions Notwithstanding some diagnostic difficulties with the test preparation, a persistent, notable proportion of cobalt Sensitization, isolated or coupled with nickel allergy, can be observed. This warrants further in-depth research into causative exposures, both at the workplace and in consumers.
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Contact Sensitization in patients with suspected cosmetic intolerance: results of the IVDK 2006–2011
Journal of the European Academy of Dermatology and Venereology : JEADV, 2014Co-Authors: A. Dinkloh, Axel Schnuch, Johannes Geier, Margitta Worm, Andreas WollenbergAbstract:Background Ingredients of leave-on cosmetics and body care products may sensitize. However, not every case of cosmetic intolerance is due to Contact Sensitization. Objective To describe the frequency of Contact Sensitization due to cosmetics in a large clinic population, and a possible particular allergen pattern. Methods Retrospective analysis of data from the Information Network of Departments of Dermatology, 2006–2011. Results Of 69 487 patients tested, ‘cosmetics, creams, sunscreens’ was the only suspected allergen source category in 10 124 patients (14.6%). A final diagnosis ‘allergic Contact dermatitis’ was stated in 2658 of these patients (26.3%).Compared to a control group, there were significantly more reactions to fragrance mixes I and II, balsam of Peru, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and lanolin alcohols. No special pattern of fragrance Sensitization could be identified. Among the preservatives, MI was by far the leading allergen, while Sensitization to other widely used compounds like parabens or phenoxyethanol was rare. Conclusions True allergic reactions to cosmetic ingredients are rarer than generally assumed. Limitation of exposure to MI in leave-on cosmetics and body care products is urgently needed.
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risk factors associated with methylisothiazolinone Contact Sensitization
Contact Dermatitis, 2013Co-Authors: Wolfgang Uter, Andrea Bauer, Johannes Geier, Axel SchnuchAbstract:SummaryBackground The preservative methylisothiazolinone (MI) has become an important allergen, with a dramatic increase in Sensitization prevalence being seen over the last few years. Objective To examine risk factors associated with MI Sensitization, in order to identify targets of prevention aimed at curtailing the present epidemic. Methods On the basis of Contact allergy surveillance data collected by the Information Network of Departments of Dermatology (www.ivkd.org), 2009–2012, in the course of 28 922 patch tests with MI, 500 ppm in water, included in a series of cosmetic preservatives, logistic regression analysis was employed to quantify the risk associated with a number of putative risk factors. Results The prevalence of MI Sensitization increased from 1.94% in 2009 to 6.02% in 2012, the increase being mainly driven by female patients aged ≥ 40 years, patients with face dermatitis, and the use of cosmetics. Adjusted multifactorial analysis additionally identified several occupations (e.g. painters and beauticians) and ano-genital dermatitis as risk factors for MI Sensitization. Conclusions The present use concentrations of MI, both cosmetic and industrial, are too high; (self-)regulatory action is urgently needed. MI should be added to the baseline series.
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self testing for Contact Sensitization to hair dyes scientific considerations and clinical concerns of an industry led screening programme
Contact Dermatitis, 2012Co-Authors: Jacob P. Thyssen, Axel Schnuch, Wolfgang Uter, J P Mcfadden, Ana Gimenezarnau, Thomas Rustemeyer, Heidi Sosted, M Vigan, Berit Granum, Jonathan M L WhiteAbstract:The cosmetic industry producing hair dyes has, for many years, recommended that their consumers perform ‘a hair dye allergy self-test' or similar prior to hair dyeing, to identify individuals who are likely to react upon subsequent hair dyeing. This review offers important information on the requirements for correct validation of screening tests, and concludes that, in its present form, the hair dye self-test has severe limitations: (i) it is not a screening test but a diagnostic test; (ii) it has not been validated according to basic criteria defined by scientists; (iii) it has been evaluated in the wrong population group; (iv) skin reactions have been read by dermatologists and not by the targeted group (consumers and hairdressers); (v) hair dyes contain strong and extreme sensitizers that are left on the skin in high concentrations, potentially resulting in active Sensitization; and (vi) recommendations and instructions on how to perform the hair dye self-test vary greatly even among products from the same company, again suggesting that the basis for safe use of the test has not been determined. If the use of a hair dye self-test to predict Contact Sensitization becomes widespread, there is severe risk that a tool has been marketed that may cause morbidity in European consumers.
Jeanne D. Johansen - One of the best experts on this subject based on the ideXlab platform.
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Association between atopic dermatitis and Contact Sensitization: A systematic review and meta-analysis
Journal of the American Academy of Dermatology, 2017Co-Authors: Carsten R. Hamann, Jeanne D. Johansen, Dathan Hamann, Alexander Egeberg, Jonathan I. Silverberg, Jacob P. ThyssenAbstract:Background It is unclear whether patients with atopic dermatitis (AD) have an altered prevalence or risk for Contact Sensitization. Increased exposure to chemicals in topical products together with impaired skin barrier function suggest a higher risk, whereas the immune profile suggests a lower risk. Objective To perform a systematic review and meta-analysis of the association between AD and Contact Sensitization. Methods The PubMed/Medline, Embase, and Cochrane databases were searched for articles that reported on Contact Sensitization in individuals with and without AD. Results The literature search yielded 10,083 citations; 417 were selected based on title and abstract screening and 74 met inclusion criteria. In a pooled analysis, no significant difference in Contact Sensitization between AD and controls was evident (random effects model odds ratio [OR] = 0.891; 95% confidence interval [CI] = 0.771-1.03). There was a positive correlation in studies that compared AD patients with individuals from the general population (OR 1.50, 95% CI 1.23-1.93) but an inverse association when comparing with referred populations (OR 0.753, 95% CI 0.63-0.90). Limitations Included studies used different tools to diagnose AD and did not always provide information on current or past disease. Patch test allergens varied between studies. Conclusion No overall relationship between AD and Contact Sensitization was found. We recommend that clinicians consider patch testing AD patients when allergic Contact dermatitis is suspected.
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Xerosis is associated with atopic dermatitis, hand eczema and Contact Sensitization independent of filaggrin gene mutations.
Acta dermato-venereologica, 2013Co-Authors: Jacob P. Thyssen, Torkil Menné, Jeanne D. Johansen, Claus Zachariae, Allan LinnebergAbstract:Atopic dermatitis, hand eczema and Contact Sensitization are prevalent disorders, and may, in many cases, be secondary to skin barrier abnormality. The aim of this study was to investigate the association between self-reported generalized xerosis, atopic dermatitis, hand eczema and Contact Sensitization, taking filaggrin gene mutations into account. Questionnaire data were collected from a cross-sectional study performed in a general population in Copenhagen. A total of 3,460 18-69-year-olds were patch-tested and 3,335 were genotyped for the 2282del4 and R501X mutations in the filaggrin gene. Atopic dermatitis and hand eczema were significantly associated with generalized xerosis, whereas Contact Sensitization (not nickel) showed only a borderline significant association. These results suggest that generalized xerosis may increase the risk of common skin disorders.
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The role of glutathione S-transferase and claudin-1 gene polymorphisms in Contact Sensitization: a cross-sectional study.
The British journal of dermatology, 2013Co-Authors: Katrine Ross-hansen, Allan Linneberg, Torkil Menné, Jeanne D. Johansen, L.-g. Hersoug, Charlotte Brasch-andersen, Jacob P. ThyssenAbstract:Summary Background Contact Sensitization is frequent in the general population and arises from excessive or repeated skin exposure to chemicals and metals. However, little is known about its genetic susceptibility. Objectives To determine the role of polymorphisms of glutathione S-transferase (GST) genes and the claudin-1 gene (CLDN1) on the risk of Contact Sensitization, taking common filaggrin gene (FLG) mutations into account. Methods In total, 3471 adult Danes from the general population were standard patch tested and filled out a questionnaire on their general health. They were genotyped for the following polymorphisms: GSTM1 and GSTT1 deletion, GSTP1 single nucleotide polymorphism (SNP) rs1695, four CLDN1 SNPs (rs893051, rs9290927, rs9290929 and rs17501010) and the FLG null mutations R501X and 2282del4. Results In individuals without ear piercings, a higher prevalence of nickel Sensitization was found in those with the minor allele of CLDN1 SNP rs9290927 (Ptrend = 0·013). For CLDN1 rs17501010, Contact Sensitization to organic compounds was associated with the major allele (Ptrend = 0·031). The risk pattern was also identified for self-reported nickel dermatitis (Ptrend = 0·011). The fragrance Sensitization prevalence differed in a pairwise comparison of the CLDN1 rs893051 SNP genotypes (P = 0·022), with the minor allele being associated with a higher prevalence. The associations were confirmed in logistic regression analyses. Conclusions The CLDN1 polymorphisms rs9290927, rs893051 and rs17501010 were associated, respectively, with nickel Contact Sensitization in individuals without ear piercings, Contact Sensitization to fragrances, and with both organic compounds and nickel Contact dermatitis. We could not find associations between GST gene polymorphisms and Contact Sensitization. FLG mutations did not affect the observed associations.
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Filaggrin mutations are strongly associated with Contact Sensitization in individuals with dermatitis
Contact dermatitis, 2013Co-Authors: Jacob P. Thyssen, Allan Linneberg, Torkil Menné, Katrine Ross-hansen, Berit C. Carlsen, Michael Meldgaard, Pal B. Szecsi, Steen Stender, Jeanne D. JohansenAbstract:Background. Although heterozygous filaggrin gene (FLG) mutation carriers seem to have an increased risk of atopic, irritant and allergic nickel dermatitis, it remains unclear whether the risk of Contact Sensitization to allergens other than nickel is also elevated in FLG mutation carriers. Objectives. We hypothesized that heterozygous FLG mutation carriers who suffer from dermatitis will have strongly reduced or even absent filaggrin levels during episodes of inflammation, potentially increasing the penetration of Contact allergens, and hence the risk of becoming sensitized. Materials and methods. During 2006–2008, 3335 randomly invited 18–69-year-old adult Danes participated in a general health examination, filled out a questionnaire, and were genotyped for the R501X and 2282del4 mutations in FLG. Results. A logistic regression analysis restricted to individuals who reported atopic dermatitis and frequent episodes of hand eczema showed a strong association between FLG mutations and Contact Sensitization to allergens other than nickel (odds ratio 5.71; 95% confidence interval 1.31–24.94). In participants without dermatitis, no association was found between Contact Sensitization and FLG mutations. Conclusion. FLG mutation carriers with self-reported dermatitis have an increased risk of Contact Sensitization to substances other than nickel, whereas FLG mutations alone may not, or may only slightly, increase the risk of Sensitization.
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The association between Contact Sensitization and atopic disease by linkage of a clinical database and a nationwide patient registry.
Allergy, 2012Co-Authors: Jacob P. Thyssen, Allan Linneberg, Torkil Menné, Jeanne D. Johansen, Kaare EngkildeAbstract:Background Experimental studies have shown that individuals with atopic dermatitis are likely to have suppressed Contact sensitivity secondary to their disease whereas some clinical and epidemiological studies have shown that individuals with atopic dermatitis might have a higher prevalence of Contact Sensitization than controls. The objective was to study the association between Contact Sensitization and, respectively, atopic dermatitis and asthma using clinical databases. Methods Record linkage of two different registers was performed: (i) a tertiary hospital register of dermatitis patient's patch tested for Contact sensitivity and (ii) the Danish National Patient Register containing nationwide hospital discharge diagnoses and outpatient Contacts. Results An inverse association was found between Contact Sensitization and, respectively, presumed severe atopic dermatitis (OR, 0.70; 95% CI, 0.61–0.81) and asthma (OR, 0.61; 95% CI, 0.42–0.90) when linkage was performed. Inverse associations were found for all groups of chemicals and metals except for Sensitization to fragrances and topical drugs where positive associations were identified. A significant positive association between fragrance Sensitization and presumed mild–moderate atopic dermatitis was also found when data from hospital register only were used, suggesting an overall higher prevalence of fragrance Sensitization in patients with atopic dermatitis. Conclusions Our findings support that patients with severe atopic dermatitis and asthma have an overall lower prevalence of Contact Sensitization when compared with controls, whereas mild-to-moderate disease does not suppress Contact Sensitization. The prevalence of Contact Sensitization to fragrance chemicals was higher in patients with atopic dermatitis. Patients should be instructed to avoid scented moisturizers and products containing highly sensitizing substances.