Quaternium 15

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Howard I. Maibach - One of the best experts on this subject based on the ideXlab platform.

  • contact dermatitis associated with skin cleansers retrospective analysis of north american contact dermatitis group data 2000 2014
    Dermatitis, 2018
    Co-Authors: Denis Sasseville, Donald V. Belsito, Erin M. Warshaw, Joel G. Dekoven, James S Taylor, Howard I. Maibach, Molly C Goodier, Joseph F Fowler
    Abstract:

    BACKGROUND There is limited information regarding contact dermatitis (CD) associated with skin cleansers (SCs). OBJECTIVE The aim of the study was to evaluate the prevalence of allergic patch test (APT) reactions and irritant CD (ICD) associated with SCs. METHODS A retrospective cross-sectional analysis was performed using North American Contact Dermatitis Group data, 2000-2014. RESULTS Of 32,945 tested patients, 1069 (3.24%) had either APT reaction or ICD associated with SCs. Of these, 692 (64.7%) had APT reaction only, 350 (32.7%) had ICD only, and 27 (2.5%) had both. Individuals with APT reaction and/or ICD were more likely to have occupationally related skin disease (relative risk [RR] = 3.8 [95% confidence interval {CI} = 3.3-4.5] for APT reaction and 10.0 [95% CI = 8.2-12.2] for ICD, respectively, P < 0.0001). As compared with those without APT reaction to SC, individuals with APT reaction had significantly higher frequencies of hand (RR = 2.4 [95% CI = 2.1-2.7]) and arm dermatitis (RR = 1.3 [95% CI = 1.1-1.6], P ≤ 0.001). Irritant CD was strongly associated with hand dermatitis (RR = 6.2 [95% CI = 5.2-7.3], P < 0.0001). More than 50 allergens were associated with SCs including Quaternium-15 (11.2%), cocamidopropyl betaine (9.5%), methylchloroisothiazolinone/methylisothiazolinone (8.4%), coconut diethanolamide (7.9%), fragrance mix I (7.7%), Myroxylon pereirae (5.9%), 4-chloro-3,5-xylenol (5.8%), amidoamine (5.5%), and formaldehyde (4.4%). CONCLUSIONS Many allergens, especially preservatives and surfactants, were associated with SCs. Most cases involved the hands and were occupationally related.

  • north american contact dermatitis group patch test results 2011 2012
    Dermatitis, 2015
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Vincent A. Deleo, C Toby G Mathias, Denis Sasseville, Matthew James Zirwas, Joel G. Dekoven, James S Taylor, Howard I. Maibach, Joseph F Fowler
    Abstract:

    BACKGROUND: Patch testing is an important diagnostic tool for assessment of allergic contact dermatitis (ACD). OBJECTIVE: This study documents the North American Contact Dermatitis Group (NACDG) patch-testing results from January 1, 2011, to December 31, 2012. METHODS: At 12 centers in North America, patients were tested in a standardized manner with a series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends analyzed using χ statistics. RESULTS: Four thousand two hundred thirty-eight patients were tested; of these, 2705 patients (63.8%) had at least 1 positive reaction, and 2029 (48.0%) were ultimately determined to have a primary diagnosis of ACD. Four hundred eight patients (9.6%) had occupationally related skin disease. There were 7532 positive allergic reactions. As compared with previous reporting periods (2009-2010 and 2000-2010), positive reaction rates statistically increased for 6 allergens: methylchloroisothiazolinone/methylisothiazolinone (5.0%; risk ratios [RRs]: 2.01 [1.60-2.52], 1.87 [1.61-2.18]), lanolin alcohol (4.6%; RRs 1.83 [1.45-2.30], 2.10 [1.79-2.47]), cinnamic aldehyde (3.9%; 1.69 [1.32-2.15], 1.53 [1.28-1.82]), glutaral (1.5%; 1.67 [1.13-2.48], 1.31 [1.00-1.71]), paraben mix (1.4%; 1.77 [1.16-2.69], 1.44 [1.09-1.92]), and fragrance mix I (12.1%; RRs 1.42 [1.25-1.61], 1.24 [1.14-1.36]). Compared with the previous decade, positivity rates for all formaldehyde-releasing preservatives significantly decreased (formaldehyde 6.6%; RR, 0.82 [0.73, 0.93]; Quaternium-15 6.4% RR 0.75 [0.66, 0.85]; diazolidinyl urea 2.1%; RR, 0.67 [0.54, 0.84]; imidazolidinyl urea 1.6%, 0.60 [0.47, 0.77]; bronopol 1.6%; RR, 0.60 [0.46, 0.77]; DMDM hydantoin 1.6%; RR, 0.59 [0.54, 0.84]). Approximately a quarter of patients had at least 1 relevant allergic reaction to a non-NACDG allergen. In addition, approximately one-fourth to one-third of reactions detected by NACDG allergens would have been hypothetically missed by T.R.U.E. TEST (SmartPractice Denmark, Hillerod, Denmark). CONCLUSIONS: These data document the beginning of the epidemic of sensitivity to methylisothiazolinones in North America, which has been well documented in Europe. Patch testing with allergens beyond a standard screening tray is necessary for complete evaluation of occupational and nonoccupational ACD.

  • north american contact dermatitis group patch test results for 2007 2008
    Dermatitis, 2013
    Co-Authors: Anthony F Fransway, Robert L Rietschel, Vincent A. Deleo, C Toby G Mathias, Joseph F Fowler, Donald V. Belsito, Melanie D. Pratt, James G. Marks, Howard I. Maibach, Denis Sasseville
    Abstract:

    BACKGROUND: The North American Contact Dermatitis Group (NACDG) tests patients with suspected allergic contact dermatitis to a broad series of screening allergens and publishes periodic reports. OBJECTIVE: The aims of this study were to report the NACDG patch-testing results from January 1, 2007, to December 31, 2008, and to compare results to pooled test data from the previous 2 and 10 years to analyze trends in allergen sensitivity. METHODS AND MATERIALS: Standardized patch testing with 65 allergens was used at 13 centers in North America. χ analysis was used for comparisons. RESULTS: A total of 5085 patients were tested; 11.8% (598) had an occupationally related skin condition, and 65.3% (3319) had at least 1 allergic patch test reaction, which is identical to the NACDG data from 2005 to 2006. The top 15 most frequently positive allergens were nickel sulfate (19.5%), Myroxylon pereirae (11.0%), neomycin (10.1%), fragrance mix I (9.4%), Quaternium-15 (8.6%), cobalt chloride (8.4%), bacitracin (7.9%), formaldehyde (7.7%), methyldibromoglutaronitrile/phenoxyethanol (5.5%), p-phenylenediamine (5.3%), propolis (4.9%), carba mix (4.5%), potassium dichromate (4.1%), fragrance mix II (3.6%), and methylchloroisothiazolinone/methylisothiazolinone (3.6%). There were significant increases in positivity rates to nickel, methylchloroisothiazolinone/methylisothiazolinone, and benzophenone-3. During the same period of study, there were significant decreases in positivity rates to neomycin, fragrance mix I, formaldehyde, thiuram mix, cinnamic aldehyde, propylene glycol, epoxy resin, diazolidinyl urea, amidoamine, ethylenediamine, benzocaine, p-tert-butylphenol formaldehyde resin, dimethylol dimethyl hydantoin, cocamidopropyl betaine, glutaraldehyde, mercaptobenzothiazole, tosylamide formaldehyde resin, budesonide, disperse blue 106, mercapto mix, and chloroxylenol. Twenty-four percent (1221) had a relevant positive reaction to a non-NACDG supplementary allergen; and 180 of these reactions were occupationally relevant. CONCLUSIONS: Periodic analysis, surveillance, and publication of multicenter study data sets document trends in allergen reactivity incidence assessed in the patch test clinic setting and provide information on new allergens of relevance.

  • patch testing with 2 0 0 60 mg cm 2 formaldehyde instead of 1 0 0 30 mg cm 2 detects significantly more contact allergy
    Contact Dermatitis, 2013
    Co-Authors: Ann Ponten, Howard I. Maibach, Jeanne D. Johansen, Klaus Ejner Andersen, Kristiina Aaltokorte, Tove Agner, Ana Gimenezarnau, Margarida Goncalo, An Goossens, Thomas Rustemeyer
    Abstract:

    Summary Background. The currently used patch test concentration for formaldehyde is 1.0% (wt/vol) in water. However, clinical experience and previous studies suggest that 1.0% might be insufficient for detecting an optimized number of clinically relevant cases of contact allergy to formaldehyde. Objectives. To validate earlier patch test results for comparison of 1% (wt/vol) and 2% (wt/vol) formaldehyde in water, and to investigate co-reactivity with Quaternium-15. Materials and methods. In 12 dermatology clinics, 3591 patients were routinely patch tested simultaneously with 2.0% (wt/vol) (0.60 mg/cm 2 ) and 1.0% (wt/vol) (0.30 mg/cm 2 ) formaldehyde. Micropipettes were used for delivering the exact dosage of the allergen. Results. Significantlymorepatientsreactedto2.0%formaldehydethanto1.0%(3.4% versus 1.8%, p< 0.001). Overall, there were no sex differences between those reacting positively to 2.0% and 1.0%. Of 25 Quaternium-15-positive patients, 4 (0.1%) reacted positively without reacting to formaldehyde. Conclusion. On the basis of the results of this multicentre study, as well as of previous studies, it can be suggested that 2.0% (wt/vol) in water formaldehyde should be used in routine patch testing in the baseline series.

  • positive patch test reactions in older individuals retrospective analysis from the north american contact dermatitis group 1994 2008
    Journal of The American Academy of Dermatology, 2012
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Robert L Rietschel, C Toby G Mathias, Joseph F Fowler, Donald V. Belsito, James S Taylor, Howard I. Maibach, Srihari I Raju, Vincent A. Deleo
    Abstract:

    Background Relatively little is known about the epidemiology of allergic contact dermatitis in older individuals. Objectives We sought to determine the frequency of positive and clinically relevant patch test reactions in older individuals (≥65 years old) referred for patch testing, and to compare these results with those of adults (≤64-19 years) and children ( Design This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1994 to 2008. Results A total of 31,942 patients (older n = 5306; adults n = 25,028; children n = 1608) were patch tested. The overall frequency of at least one allergic reaction in older individuals was 67.3% as compared with 66.9% for adults ( P  = .5938) and 47% for children ( P  = .0011). Reaction rates that were statistically higher in older individuals as compared with both adults and children included: Myroxylon pereirae , fragrance mix I, Quaternium-15, formaldehyde, imidazolidinyl urea, diazolidinyl urea, neomycin, bacitracin, methyldibromo glutaronitrile, methyldibromo glutaronitrile/phenoxyethanol, ethyleneurea melamine formaldehyde mix, and carba mix ( P values P values Limitations Referral population was a limitation. Conclusions Older individuals were more likely to have at least one positive patch test reaction as compared with children, but had similar rates to adults. The frequency of positive reactions to specific allergens differed by age group, most likely as a result of exposures.

Donald V. Belsito - One of the best experts on this subject based on the ideXlab platform.

  • contact dermatitis associated with skin cleansers retrospective analysis of north american contact dermatitis group data 2000 2014
    Dermatitis, 2018
    Co-Authors: Denis Sasseville, Donald V. Belsito, Erin M. Warshaw, Joel G. Dekoven, James S Taylor, Howard I. Maibach, Molly C Goodier, Joseph F Fowler
    Abstract:

    BACKGROUND There is limited information regarding contact dermatitis (CD) associated with skin cleansers (SCs). OBJECTIVE The aim of the study was to evaluate the prevalence of allergic patch test (APT) reactions and irritant CD (ICD) associated with SCs. METHODS A retrospective cross-sectional analysis was performed using North American Contact Dermatitis Group data, 2000-2014. RESULTS Of 32,945 tested patients, 1069 (3.24%) had either APT reaction or ICD associated with SCs. Of these, 692 (64.7%) had APT reaction only, 350 (32.7%) had ICD only, and 27 (2.5%) had both. Individuals with APT reaction and/or ICD were more likely to have occupationally related skin disease (relative risk [RR] = 3.8 [95% confidence interval {CI} = 3.3-4.5] for APT reaction and 10.0 [95% CI = 8.2-12.2] for ICD, respectively, P < 0.0001). As compared with those without APT reaction to SC, individuals with APT reaction had significantly higher frequencies of hand (RR = 2.4 [95% CI = 2.1-2.7]) and arm dermatitis (RR = 1.3 [95% CI = 1.1-1.6], P ≤ 0.001). Irritant CD was strongly associated with hand dermatitis (RR = 6.2 [95% CI = 5.2-7.3], P < 0.0001). More than 50 allergens were associated with SCs including Quaternium-15 (11.2%), cocamidopropyl betaine (9.5%), methylchloroisothiazolinone/methylisothiazolinone (8.4%), coconut diethanolamide (7.9%), fragrance mix I (7.7%), Myroxylon pereirae (5.9%), 4-chloro-3,5-xylenol (5.8%), amidoamine (5.5%), and formaldehyde (4.4%). CONCLUSIONS Many allergens, especially preservatives and surfactants, were associated with SCs. Most cases involved the hands and were occupationally related.

  • Cutaneous delayed-type hypersensitivity in patients with atopic dermatitis: Reactivity to topical preservatives
    Journal of the American Academy of Dermatology, 2013
    Co-Authors: Cristin N. Shaughnessy, Dana Malajian, Donald V. Belsito
    Abstract:

    Background Patients with atopic dermatitis (AD) have chronic dry skin to which they frequently apply skin care products containing preservatives, and they are predisposed to developing cutaneous delayed-type hypersensitivity. Objective We sought to compare the rates of positive patch test reactions to allergens on the North American Contact Dermatitis Group (NACDG) standard tray among patients with and without AD and to assess whether atopic patients in our database were more likely to patch test positive to preservatives. Methods A total of 2453 patients underwent patch testing to the NACDG standard screening series. The incidence of positive patch test reaction among patients with AD (n = 342) and without AD (n = 2111) was assessed. Statistical analysis was done using a χ 2 test. Results Compared with nonatopic patients, patients with AD were statistically more likely to have positive patch tests. AD was associated with contact hypersensitivity to Quaternium-15, imidazolidinyl urea, DMDM hydantoin, and 2-bromo-2-nitropropane-1,3-diol but not to parabens, formaldehyde, or diazolidinyl urea. Limitations Only patients suspected of having allergic contact dermatitis were tested. Our population was geographically limited to metropolitan Kansas City, MO, and metropolitan New York City, NY. Conclusions Patients with AD should avoid the use of skin care products preserved with formaldehyde releasers.

  • north american contact dermatitis group patch test results 2009 to 2010
    Dermatitis, 2013
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Vincent A. Deleo, C Toby G Mathias, Denis Sasseville, Donald V. Belsito, Matthew James Zirwas, Joel G. Dekoven, James S Taylor, Joseph F Fowler
    Abstract:

    BACKGROUND: Patch testing is an important diagnostic tool for determination of substances responsible for allergic contact dermatitis. OBJECTIVE: This study reports the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2009, to December 31, 2010. METHODS: At 12 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ2 statistics. RESULTS: A total of 4308 patients were tested. Of these, 2614 (60.7%) had at least 1 positive reaction, and 2284 (46.3%) were ultimately determined to have a primary diagnosis of allergic contact dermatitis. Four hundred twenty-seven (9.9%) patients had occupationally related skin disease. There were 6855 positive allergic reactions. As compared with the previous reporting period (2007-2008), the positive reaction rates statistically decreased for 20 allergens (nickel, neomycin, Myroxylon pereirae, cobalt, formaldehyde, Quaternium 15, methydibromoglutaronitrile/phenoxyethanol, methylchlorisothiazolinone/methylisothiazolinone, potassium dichromate, diazolidinyl urea, propolis, dimethylol dimethylhydantoin, 2-bromo-2-nitro-1,3-propanediol, methyl methacrylate, ethyl acrylate, glyceryl thioglycolate, dibucaine, amidoamine, clobetasol, and dimethyloldihydroxyethyleneurea; P < 0.05) and statistically increased for 4 allergens (fragrance mix II, iodopropynyl butylcarbamate, propylene glycol, and benzocaine; P < 0.05). Approximately one quarter of tested patients had at least 1 relevant allergic reaction to a non-NACDG allergen. Hypothetically, approximately one quarter of reactions detected by NACDG allergens would have been missed by TRUE TEST (SmartPractice Denmark, Hillerod, Denmark). CONCLUSIONS: These results affirm the value of patch testing with many allergens.

  • north american contact dermatitis group patch test results for 2007 2008
    Dermatitis, 2013
    Co-Authors: Anthony F Fransway, Robert L Rietschel, Vincent A. Deleo, C Toby G Mathias, Joseph F Fowler, Donald V. Belsito, Melanie D. Pratt, James G. Marks, Howard I. Maibach, Denis Sasseville
    Abstract:

    BACKGROUND: The North American Contact Dermatitis Group (NACDG) tests patients with suspected allergic contact dermatitis to a broad series of screening allergens and publishes periodic reports. OBJECTIVE: The aims of this study were to report the NACDG patch-testing results from January 1, 2007, to December 31, 2008, and to compare results to pooled test data from the previous 2 and 10 years to analyze trends in allergen sensitivity. METHODS AND MATERIALS: Standardized patch testing with 65 allergens was used at 13 centers in North America. χ analysis was used for comparisons. RESULTS: A total of 5085 patients were tested; 11.8% (598) had an occupationally related skin condition, and 65.3% (3319) had at least 1 allergic patch test reaction, which is identical to the NACDG data from 2005 to 2006. The top 15 most frequently positive allergens were nickel sulfate (19.5%), Myroxylon pereirae (11.0%), neomycin (10.1%), fragrance mix I (9.4%), Quaternium-15 (8.6%), cobalt chloride (8.4%), bacitracin (7.9%), formaldehyde (7.7%), methyldibromoglutaronitrile/phenoxyethanol (5.5%), p-phenylenediamine (5.3%), propolis (4.9%), carba mix (4.5%), potassium dichromate (4.1%), fragrance mix II (3.6%), and methylchloroisothiazolinone/methylisothiazolinone (3.6%). There were significant increases in positivity rates to nickel, methylchloroisothiazolinone/methylisothiazolinone, and benzophenone-3. During the same period of study, there were significant decreases in positivity rates to neomycin, fragrance mix I, formaldehyde, thiuram mix, cinnamic aldehyde, propylene glycol, epoxy resin, diazolidinyl urea, amidoamine, ethylenediamine, benzocaine, p-tert-butylphenol formaldehyde resin, dimethylol dimethyl hydantoin, cocamidopropyl betaine, glutaraldehyde, mercaptobenzothiazole, tosylamide formaldehyde resin, budesonide, disperse blue 106, mercapto mix, and chloroxylenol. Twenty-four percent (1221) had a relevant positive reaction to a non-NACDG supplementary allergen; and 180 of these reactions were occupationally relevant. CONCLUSIONS: Periodic analysis, surveillance, and publication of multicenter study data sets document trends in allergen reactivity incidence assessed in the patch test clinic setting and provide information on new allergens of relevance.

  • positive patch test reactions in older individuals retrospective analysis from the north american contact dermatitis group 1994 2008
    Journal of The American Academy of Dermatology, 2012
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Robert L Rietschel, C Toby G Mathias, Joseph F Fowler, Donald V. Belsito, James S Taylor, Howard I. Maibach, Srihari I Raju, Vincent A. Deleo
    Abstract:

    Background Relatively little is known about the epidemiology of allergic contact dermatitis in older individuals. Objectives We sought to determine the frequency of positive and clinically relevant patch test reactions in older individuals (≥65 years old) referred for patch testing, and to compare these results with those of adults (≤64-19 years) and children ( Design This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1994 to 2008. Results A total of 31,942 patients (older n = 5306; adults n = 25,028; children n = 1608) were patch tested. The overall frequency of at least one allergic reaction in older individuals was 67.3% as compared with 66.9% for adults ( P  = .5938) and 47% for children ( P  = .0011). Reaction rates that were statistically higher in older individuals as compared with both adults and children included: Myroxylon pereirae , fragrance mix I, Quaternium-15, formaldehyde, imidazolidinyl urea, diazolidinyl urea, neomycin, bacitracin, methyldibromo glutaronitrile, methyldibromo glutaronitrile/phenoxyethanol, ethyleneurea melamine formaldehyde mix, and carba mix ( P values P values Limitations Referral population was a limitation. Conclusions Older individuals were more likely to have at least one positive patch test reaction as compared with children, but had similar rates to adults. The frequency of positive reactions to specific allergens differed by age group, most likely as a result of exposures.

Vincent A. Deleo - One of the best experts on this subject based on the ideXlab platform.

  • north american contact dermatitis group patch test results 2011 2012
    Dermatitis, 2015
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Vincent A. Deleo, C Toby G Mathias, Denis Sasseville, Matthew James Zirwas, Joel G. Dekoven, James S Taylor, Howard I. Maibach, Joseph F Fowler
    Abstract:

    BACKGROUND: Patch testing is an important diagnostic tool for assessment of allergic contact dermatitis (ACD). OBJECTIVE: This study documents the North American Contact Dermatitis Group (NACDG) patch-testing results from January 1, 2011, to December 31, 2012. METHODS: At 12 centers in North America, patients were tested in a standardized manner with a series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends analyzed using χ statistics. RESULTS: Four thousand two hundred thirty-eight patients were tested; of these, 2705 patients (63.8%) had at least 1 positive reaction, and 2029 (48.0%) were ultimately determined to have a primary diagnosis of ACD. Four hundred eight patients (9.6%) had occupationally related skin disease. There were 7532 positive allergic reactions. As compared with previous reporting periods (2009-2010 and 2000-2010), positive reaction rates statistically increased for 6 allergens: methylchloroisothiazolinone/methylisothiazolinone (5.0%; risk ratios [RRs]: 2.01 [1.60-2.52], 1.87 [1.61-2.18]), lanolin alcohol (4.6%; RRs 1.83 [1.45-2.30], 2.10 [1.79-2.47]), cinnamic aldehyde (3.9%; 1.69 [1.32-2.15], 1.53 [1.28-1.82]), glutaral (1.5%; 1.67 [1.13-2.48], 1.31 [1.00-1.71]), paraben mix (1.4%; 1.77 [1.16-2.69], 1.44 [1.09-1.92]), and fragrance mix I (12.1%; RRs 1.42 [1.25-1.61], 1.24 [1.14-1.36]). Compared with the previous decade, positivity rates for all formaldehyde-releasing preservatives significantly decreased (formaldehyde 6.6%; RR, 0.82 [0.73, 0.93]; Quaternium-15 6.4% RR 0.75 [0.66, 0.85]; diazolidinyl urea 2.1%; RR, 0.67 [0.54, 0.84]; imidazolidinyl urea 1.6%, 0.60 [0.47, 0.77]; bronopol 1.6%; RR, 0.60 [0.46, 0.77]; DMDM hydantoin 1.6%; RR, 0.59 [0.54, 0.84]). Approximately a quarter of patients had at least 1 relevant allergic reaction to a non-NACDG allergen. In addition, approximately one-fourth to one-third of reactions detected by NACDG allergens would have been hypothetically missed by T.R.U.E. TEST (SmartPractice Denmark, Hillerod, Denmark). CONCLUSIONS: These data document the beginning of the epidemic of sensitivity to methylisothiazolinones in North America, which has been well documented in Europe. Patch testing with allergens beyond a standard screening tray is necessary for complete evaluation of occupational and nonoccupational ACD.

  • north american contact dermatitis group patch test results 2009 to 2010
    Dermatitis, 2013
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Vincent A. Deleo, C Toby G Mathias, Denis Sasseville, Donald V. Belsito, Matthew James Zirwas, Joel G. Dekoven, James S Taylor, Joseph F Fowler
    Abstract:

    BACKGROUND: Patch testing is an important diagnostic tool for determination of substances responsible for allergic contact dermatitis. OBJECTIVE: This study reports the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2009, to December 31, 2010. METHODS: At 12 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ2 statistics. RESULTS: A total of 4308 patients were tested. Of these, 2614 (60.7%) had at least 1 positive reaction, and 2284 (46.3%) were ultimately determined to have a primary diagnosis of allergic contact dermatitis. Four hundred twenty-seven (9.9%) patients had occupationally related skin disease. There were 6855 positive allergic reactions. As compared with the previous reporting period (2007-2008), the positive reaction rates statistically decreased for 20 allergens (nickel, neomycin, Myroxylon pereirae, cobalt, formaldehyde, Quaternium 15, methydibromoglutaronitrile/phenoxyethanol, methylchlorisothiazolinone/methylisothiazolinone, potassium dichromate, diazolidinyl urea, propolis, dimethylol dimethylhydantoin, 2-bromo-2-nitro-1,3-propanediol, methyl methacrylate, ethyl acrylate, glyceryl thioglycolate, dibucaine, amidoamine, clobetasol, and dimethyloldihydroxyethyleneurea; P < 0.05) and statistically increased for 4 allergens (fragrance mix II, iodopropynyl butylcarbamate, propylene glycol, and benzocaine; P < 0.05). Approximately one quarter of tested patients had at least 1 relevant allergic reaction to a non-NACDG allergen. Hypothetically, approximately one quarter of reactions detected by NACDG allergens would have been missed by TRUE TEST (SmartPractice Denmark, Hillerod, Denmark). CONCLUSIONS: These results affirm the value of patch testing with many allergens.

  • north american contact dermatitis group patch test results for 2007 2008
    Dermatitis, 2013
    Co-Authors: Anthony F Fransway, Robert L Rietschel, Vincent A. Deleo, C Toby G Mathias, Joseph F Fowler, Donald V. Belsito, Melanie D. Pratt, James G. Marks, Howard I. Maibach, Denis Sasseville
    Abstract:

    BACKGROUND: The North American Contact Dermatitis Group (NACDG) tests patients with suspected allergic contact dermatitis to a broad series of screening allergens and publishes periodic reports. OBJECTIVE: The aims of this study were to report the NACDG patch-testing results from January 1, 2007, to December 31, 2008, and to compare results to pooled test data from the previous 2 and 10 years to analyze trends in allergen sensitivity. METHODS AND MATERIALS: Standardized patch testing with 65 allergens was used at 13 centers in North America. χ analysis was used for comparisons. RESULTS: A total of 5085 patients were tested; 11.8% (598) had an occupationally related skin condition, and 65.3% (3319) had at least 1 allergic patch test reaction, which is identical to the NACDG data from 2005 to 2006. The top 15 most frequently positive allergens were nickel sulfate (19.5%), Myroxylon pereirae (11.0%), neomycin (10.1%), fragrance mix I (9.4%), Quaternium-15 (8.6%), cobalt chloride (8.4%), bacitracin (7.9%), formaldehyde (7.7%), methyldibromoglutaronitrile/phenoxyethanol (5.5%), p-phenylenediamine (5.3%), propolis (4.9%), carba mix (4.5%), potassium dichromate (4.1%), fragrance mix II (3.6%), and methylchloroisothiazolinone/methylisothiazolinone (3.6%). There were significant increases in positivity rates to nickel, methylchloroisothiazolinone/methylisothiazolinone, and benzophenone-3. During the same period of study, there were significant decreases in positivity rates to neomycin, fragrance mix I, formaldehyde, thiuram mix, cinnamic aldehyde, propylene glycol, epoxy resin, diazolidinyl urea, amidoamine, ethylenediamine, benzocaine, p-tert-butylphenol formaldehyde resin, dimethylol dimethyl hydantoin, cocamidopropyl betaine, glutaraldehyde, mercaptobenzothiazole, tosylamide formaldehyde resin, budesonide, disperse blue 106, mercapto mix, and chloroxylenol. Twenty-four percent (1221) had a relevant positive reaction to a non-NACDG supplementary allergen; and 180 of these reactions were occupationally relevant. CONCLUSIONS: Periodic analysis, surveillance, and publication of multicenter study data sets document trends in allergen reactivity incidence assessed in the patch test clinic setting and provide information on new allergens of relevance.

  • positive patch test reactions in older individuals retrospective analysis from the north american contact dermatitis group 1994 2008
    Journal of The American Academy of Dermatology, 2012
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Robert L Rietschel, C Toby G Mathias, Joseph F Fowler, Donald V. Belsito, James S Taylor, Howard I. Maibach, Srihari I Raju, Vincent A. Deleo
    Abstract:

    Background Relatively little is known about the epidemiology of allergic contact dermatitis in older individuals. Objectives We sought to determine the frequency of positive and clinically relevant patch test reactions in older individuals (≥65 years old) referred for patch testing, and to compare these results with those of adults (≤64-19 years) and children ( Design This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1994 to 2008. Results A total of 31,942 patients (older n = 5306; adults n = 25,028; children n = 1608) were patch tested. The overall frequency of at least one allergic reaction in older individuals was 67.3% as compared with 66.9% for adults ( P  = .5938) and 47% for children ( P  = .0011). Reaction rates that were statistically higher in older individuals as compared with both adults and children included: Myroxylon pereirae , fragrance mix I, Quaternium-15, formaldehyde, imidazolidinyl urea, diazolidinyl urea, neomycin, bacitracin, methyldibromo glutaronitrile, methyldibromo glutaronitrile/phenoxyethanol, ethyleneurea melamine formaldehyde mix, and carba mix ( P values P values Limitations Referral population was a limitation. Conclusions Older individuals were more likely to have at least one positive patch test reaction as compared with children, but had similar rates to adults. The frequency of positive reactions to specific allergens differed by age group, most likely as a result of exposures.

  • patch test results of the north american contact dermatitis group 2005 2006
    Dermatitis, 2009
    Co-Authors: Erin M. Warshaw, C Toby G Mathias, Denis Sasseville, Joseph F Fowler, Melanie D. Pratt, James S Taylor, Howard I. Maibach, Frances J Storrs, Donald L Belsito, Vincent A. Deleo
    Abstract:

    BACKGROUND: The North American Contact Dermatitis Group (NACDG) tests patients who have suspected allergic contact dermatitis with a broad series of screening allergens, and publishes periodic reports of its data. OBJECTIVE: To report the NACDG patch-test results from January 1, 2005, to December 31, 2006, and to compare results to pooled test data from the previous 10 years. METHODS: Standardized patch testing with 65 allergens was used at 13 centers in North America. Chi-square statistics were utilized for comparisons with previous NACDG data. RESULTS: NACDG patch-tested 4,454 patients; 12.3% (557) had an occupation-related skin condition, and 65.3% (2,907) had at least one allergic patch-test reaction. The 15 most frequently positive allergens were nickel sulfate (19.0%), Myroxilon pereirae (balsam of Peru, 11.9%), fragrance mix I (11.5%), Quaternium-15 (10.3%), neomycin (10.0%), bacitracin (9.2%), formaldehyde (9.0%), cobalt chloride (8.4%), methyldibromoglutaronitrile/phenoxyethanol (5.8%), p-phenylenediamine (5.0%), potassium dichromate (4.8%), carba mix (3.9%), thiuram mix (3.9%), diazolidinylurea (3.7%), and 2-bromo-2-nitropropane-1,3-diol (3.4%). As compared to the 1994-2004 data, there were significant increases in rates of positivity to nickel, Quaternium-15, potassium dichromate, lidocaine, and tea tree oil. Of patch-tested patients, 22.9% (1,019) had a relevant positive reaction to a supplementary allergen; 4.9% (219) had an occupationally relevant positive reaction to a supplementary allergen. CONCLUSION: Nickel has been the most frequently positive allergen detected by the NACDG; rates significantly increased in the current study period and most reactions were clinically relevant. Other common allergens were topical antibiotics, preservatives, fragrance mix I and paraphenylenediamine. Testing with an expanded allergen series and supplementary allergens enhances detection of relevant positive allergens.

Joseph F Fowler - One of the best experts on this subject based on the ideXlab platform.

  • contact dermatitis associated with skin cleansers retrospective analysis of north american contact dermatitis group data 2000 2014
    Dermatitis, 2018
    Co-Authors: Denis Sasseville, Donald V. Belsito, Erin M. Warshaw, Joel G. Dekoven, James S Taylor, Howard I. Maibach, Molly C Goodier, Joseph F Fowler
    Abstract:

    BACKGROUND There is limited information regarding contact dermatitis (CD) associated with skin cleansers (SCs). OBJECTIVE The aim of the study was to evaluate the prevalence of allergic patch test (APT) reactions and irritant CD (ICD) associated with SCs. METHODS A retrospective cross-sectional analysis was performed using North American Contact Dermatitis Group data, 2000-2014. RESULTS Of 32,945 tested patients, 1069 (3.24%) had either APT reaction or ICD associated with SCs. Of these, 692 (64.7%) had APT reaction only, 350 (32.7%) had ICD only, and 27 (2.5%) had both. Individuals with APT reaction and/or ICD were more likely to have occupationally related skin disease (relative risk [RR] = 3.8 [95% confidence interval {CI} = 3.3-4.5] for APT reaction and 10.0 [95% CI = 8.2-12.2] for ICD, respectively, P < 0.0001). As compared with those without APT reaction to SC, individuals with APT reaction had significantly higher frequencies of hand (RR = 2.4 [95% CI = 2.1-2.7]) and arm dermatitis (RR = 1.3 [95% CI = 1.1-1.6], P ≤ 0.001). Irritant CD was strongly associated with hand dermatitis (RR = 6.2 [95% CI = 5.2-7.3], P < 0.0001). More than 50 allergens were associated with SCs including Quaternium-15 (11.2%), cocamidopropyl betaine (9.5%), methylchloroisothiazolinone/methylisothiazolinone (8.4%), coconut diethanolamide (7.9%), fragrance mix I (7.7%), Myroxylon pereirae (5.9%), 4-chloro-3,5-xylenol (5.8%), amidoamine (5.5%), and formaldehyde (4.4%). CONCLUSIONS Many allergens, especially preservatives and surfactants, were associated with SCs. Most cases involved the hands and were occupationally related.

  • north american contact dermatitis group patch test results 2011 2012
    Dermatitis, 2015
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Vincent A. Deleo, C Toby G Mathias, Denis Sasseville, Matthew James Zirwas, Joel G. Dekoven, James S Taylor, Howard I. Maibach, Joseph F Fowler
    Abstract:

    BACKGROUND: Patch testing is an important diagnostic tool for assessment of allergic contact dermatitis (ACD). OBJECTIVE: This study documents the North American Contact Dermatitis Group (NACDG) patch-testing results from January 1, 2011, to December 31, 2012. METHODS: At 12 centers in North America, patients were tested in a standardized manner with a series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends analyzed using χ statistics. RESULTS: Four thousand two hundred thirty-eight patients were tested; of these, 2705 patients (63.8%) had at least 1 positive reaction, and 2029 (48.0%) were ultimately determined to have a primary diagnosis of ACD. Four hundred eight patients (9.6%) had occupationally related skin disease. There were 7532 positive allergic reactions. As compared with previous reporting periods (2009-2010 and 2000-2010), positive reaction rates statistically increased for 6 allergens: methylchloroisothiazolinone/methylisothiazolinone (5.0%; risk ratios [RRs]: 2.01 [1.60-2.52], 1.87 [1.61-2.18]), lanolin alcohol (4.6%; RRs 1.83 [1.45-2.30], 2.10 [1.79-2.47]), cinnamic aldehyde (3.9%; 1.69 [1.32-2.15], 1.53 [1.28-1.82]), glutaral (1.5%; 1.67 [1.13-2.48], 1.31 [1.00-1.71]), paraben mix (1.4%; 1.77 [1.16-2.69], 1.44 [1.09-1.92]), and fragrance mix I (12.1%; RRs 1.42 [1.25-1.61], 1.24 [1.14-1.36]). Compared with the previous decade, positivity rates for all formaldehyde-releasing preservatives significantly decreased (formaldehyde 6.6%; RR, 0.82 [0.73, 0.93]; Quaternium-15 6.4% RR 0.75 [0.66, 0.85]; diazolidinyl urea 2.1%; RR, 0.67 [0.54, 0.84]; imidazolidinyl urea 1.6%, 0.60 [0.47, 0.77]; bronopol 1.6%; RR, 0.60 [0.46, 0.77]; DMDM hydantoin 1.6%; RR, 0.59 [0.54, 0.84]). Approximately a quarter of patients had at least 1 relevant allergic reaction to a non-NACDG allergen. In addition, approximately one-fourth to one-third of reactions detected by NACDG allergens would have been hypothetically missed by T.R.U.E. TEST (SmartPractice Denmark, Hillerod, Denmark). CONCLUSIONS: These data document the beginning of the epidemic of sensitivity to methylisothiazolinones in North America, which has been well documented in Europe. Patch testing with allergens beyond a standard screening tray is necessary for complete evaluation of occupational and nonoccupational ACD.

  • north american contact dermatitis group patch test results 2009 to 2010
    Dermatitis, 2013
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Vincent A. Deleo, C Toby G Mathias, Denis Sasseville, Donald V. Belsito, Matthew James Zirwas, Joel G. Dekoven, James S Taylor, Joseph F Fowler
    Abstract:

    BACKGROUND: Patch testing is an important diagnostic tool for determination of substances responsible for allergic contact dermatitis. OBJECTIVE: This study reports the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2009, to December 31, 2010. METHODS: At 12 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ2 statistics. RESULTS: A total of 4308 patients were tested. Of these, 2614 (60.7%) had at least 1 positive reaction, and 2284 (46.3%) were ultimately determined to have a primary diagnosis of allergic contact dermatitis. Four hundred twenty-seven (9.9%) patients had occupationally related skin disease. There were 6855 positive allergic reactions. As compared with the previous reporting period (2007-2008), the positive reaction rates statistically decreased for 20 allergens (nickel, neomycin, Myroxylon pereirae, cobalt, formaldehyde, Quaternium 15, methydibromoglutaronitrile/phenoxyethanol, methylchlorisothiazolinone/methylisothiazolinone, potassium dichromate, diazolidinyl urea, propolis, dimethylol dimethylhydantoin, 2-bromo-2-nitro-1,3-propanediol, methyl methacrylate, ethyl acrylate, glyceryl thioglycolate, dibucaine, amidoamine, clobetasol, and dimethyloldihydroxyethyleneurea; P < 0.05) and statistically increased for 4 allergens (fragrance mix II, iodopropynyl butylcarbamate, propylene glycol, and benzocaine; P < 0.05). Approximately one quarter of tested patients had at least 1 relevant allergic reaction to a non-NACDG allergen. Hypothetically, approximately one quarter of reactions detected by NACDG allergens would have been missed by TRUE TEST (SmartPractice Denmark, Hillerod, Denmark). CONCLUSIONS: These results affirm the value of patch testing with many allergens.

  • north american contact dermatitis group patch test results for 2007 2008
    Dermatitis, 2013
    Co-Authors: Anthony F Fransway, Robert L Rietschel, Vincent A. Deleo, C Toby G Mathias, Joseph F Fowler, Donald V. Belsito, Melanie D. Pratt, James G. Marks, Howard I. Maibach, Denis Sasseville
    Abstract:

    BACKGROUND: The North American Contact Dermatitis Group (NACDG) tests patients with suspected allergic contact dermatitis to a broad series of screening allergens and publishes periodic reports. OBJECTIVE: The aims of this study were to report the NACDG patch-testing results from January 1, 2007, to December 31, 2008, and to compare results to pooled test data from the previous 2 and 10 years to analyze trends in allergen sensitivity. METHODS AND MATERIALS: Standardized patch testing with 65 allergens was used at 13 centers in North America. χ analysis was used for comparisons. RESULTS: A total of 5085 patients were tested; 11.8% (598) had an occupationally related skin condition, and 65.3% (3319) had at least 1 allergic patch test reaction, which is identical to the NACDG data from 2005 to 2006. The top 15 most frequently positive allergens were nickel sulfate (19.5%), Myroxylon pereirae (11.0%), neomycin (10.1%), fragrance mix I (9.4%), Quaternium-15 (8.6%), cobalt chloride (8.4%), bacitracin (7.9%), formaldehyde (7.7%), methyldibromoglutaronitrile/phenoxyethanol (5.5%), p-phenylenediamine (5.3%), propolis (4.9%), carba mix (4.5%), potassium dichromate (4.1%), fragrance mix II (3.6%), and methylchloroisothiazolinone/methylisothiazolinone (3.6%). There were significant increases in positivity rates to nickel, methylchloroisothiazolinone/methylisothiazolinone, and benzophenone-3. During the same period of study, there were significant decreases in positivity rates to neomycin, fragrance mix I, formaldehyde, thiuram mix, cinnamic aldehyde, propylene glycol, epoxy resin, diazolidinyl urea, amidoamine, ethylenediamine, benzocaine, p-tert-butylphenol formaldehyde resin, dimethylol dimethyl hydantoin, cocamidopropyl betaine, glutaraldehyde, mercaptobenzothiazole, tosylamide formaldehyde resin, budesonide, disperse blue 106, mercapto mix, and chloroxylenol. Twenty-four percent (1221) had a relevant positive reaction to a non-NACDG supplementary allergen; and 180 of these reactions were occupationally relevant. CONCLUSIONS: Periodic analysis, surveillance, and publication of multicenter study data sets document trends in allergen reactivity incidence assessed in the patch test clinic setting and provide information on new allergens of relevance.

  • positive patch test reactions in older individuals retrospective analysis from the north american contact dermatitis group 1994 2008
    Journal of The American Academy of Dermatology, 2012
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Robert L Rietschel, C Toby G Mathias, Joseph F Fowler, Donald V. Belsito, James S Taylor, Howard I. Maibach, Srihari I Raju, Vincent A. Deleo
    Abstract:

    Background Relatively little is known about the epidemiology of allergic contact dermatitis in older individuals. Objectives We sought to determine the frequency of positive and clinically relevant patch test reactions in older individuals (≥65 years old) referred for patch testing, and to compare these results with those of adults (≤64-19 years) and children ( Design This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1994 to 2008. Results A total of 31,942 patients (older n = 5306; adults n = 25,028; children n = 1608) were patch tested. The overall frequency of at least one allergic reaction in older individuals was 67.3% as compared with 66.9% for adults ( P  = .5938) and 47% for children ( P  = .0011). Reaction rates that were statistically higher in older individuals as compared with both adults and children included: Myroxylon pereirae , fragrance mix I, Quaternium-15, formaldehyde, imidazolidinyl urea, diazolidinyl urea, neomycin, bacitracin, methyldibromo glutaronitrile, methyldibromo glutaronitrile/phenoxyethanol, ethyleneurea melamine formaldehyde mix, and carba mix ( P values P values Limitations Referral population was a limitation. Conclusions Older individuals were more likely to have at least one positive patch test reaction as compared with children, but had similar rates to adults. The frequency of positive reactions to specific allergens differed by age group, most likely as a result of exposures.

Erin M. Warshaw - One of the best experts on this subject based on the ideXlab platform.

  • contact dermatitis associated with skin cleansers retrospective analysis of north american contact dermatitis group data 2000 2014
    Dermatitis, 2018
    Co-Authors: Denis Sasseville, Donald V. Belsito, Erin M. Warshaw, Joel G. Dekoven, James S Taylor, Howard I. Maibach, Molly C Goodier, Joseph F Fowler
    Abstract:

    BACKGROUND There is limited information regarding contact dermatitis (CD) associated with skin cleansers (SCs). OBJECTIVE The aim of the study was to evaluate the prevalence of allergic patch test (APT) reactions and irritant CD (ICD) associated with SCs. METHODS A retrospective cross-sectional analysis was performed using North American Contact Dermatitis Group data, 2000-2014. RESULTS Of 32,945 tested patients, 1069 (3.24%) had either APT reaction or ICD associated with SCs. Of these, 692 (64.7%) had APT reaction only, 350 (32.7%) had ICD only, and 27 (2.5%) had both. Individuals with APT reaction and/or ICD were more likely to have occupationally related skin disease (relative risk [RR] = 3.8 [95% confidence interval {CI} = 3.3-4.5] for APT reaction and 10.0 [95% CI = 8.2-12.2] for ICD, respectively, P < 0.0001). As compared with those without APT reaction to SC, individuals with APT reaction had significantly higher frequencies of hand (RR = 2.4 [95% CI = 2.1-2.7]) and arm dermatitis (RR = 1.3 [95% CI = 1.1-1.6], P ≤ 0.001). Irritant CD was strongly associated with hand dermatitis (RR = 6.2 [95% CI = 5.2-7.3], P < 0.0001). More than 50 allergens were associated with SCs including Quaternium-15 (11.2%), cocamidopropyl betaine (9.5%), methylchloroisothiazolinone/methylisothiazolinone (8.4%), coconut diethanolamide (7.9%), fragrance mix I (7.7%), Myroxylon pereirae (5.9%), 4-chloro-3,5-xylenol (5.8%), amidoamine (5.5%), and formaldehyde (4.4%). CONCLUSIONS Many allergens, especially preservatives and surfactants, were associated with SCs. Most cases involved the hands and were occupationally related.

  • north american contact dermatitis group patch test results 2011 2012
    Dermatitis, 2015
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Vincent A. Deleo, C Toby G Mathias, Denis Sasseville, Matthew James Zirwas, Joel G. Dekoven, James S Taylor, Howard I. Maibach, Joseph F Fowler
    Abstract:

    BACKGROUND: Patch testing is an important diagnostic tool for assessment of allergic contact dermatitis (ACD). OBJECTIVE: This study documents the North American Contact Dermatitis Group (NACDG) patch-testing results from January 1, 2011, to December 31, 2012. METHODS: At 12 centers in North America, patients were tested in a standardized manner with a series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends analyzed using χ statistics. RESULTS: Four thousand two hundred thirty-eight patients were tested; of these, 2705 patients (63.8%) had at least 1 positive reaction, and 2029 (48.0%) were ultimately determined to have a primary diagnosis of ACD. Four hundred eight patients (9.6%) had occupationally related skin disease. There were 7532 positive allergic reactions. As compared with previous reporting periods (2009-2010 and 2000-2010), positive reaction rates statistically increased for 6 allergens: methylchloroisothiazolinone/methylisothiazolinone (5.0%; risk ratios [RRs]: 2.01 [1.60-2.52], 1.87 [1.61-2.18]), lanolin alcohol (4.6%; RRs 1.83 [1.45-2.30], 2.10 [1.79-2.47]), cinnamic aldehyde (3.9%; 1.69 [1.32-2.15], 1.53 [1.28-1.82]), glutaral (1.5%; 1.67 [1.13-2.48], 1.31 [1.00-1.71]), paraben mix (1.4%; 1.77 [1.16-2.69], 1.44 [1.09-1.92]), and fragrance mix I (12.1%; RRs 1.42 [1.25-1.61], 1.24 [1.14-1.36]). Compared with the previous decade, positivity rates for all formaldehyde-releasing preservatives significantly decreased (formaldehyde 6.6%; RR, 0.82 [0.73, 0.93]; Quaternium-15 6.4% RR 0.75 [0.66, 0.85]; diazolidinyl urea 2.1%; RR, 0.67 [0.54, 0.84]; imidazolidinyl urea 1.6%, 0.60 [0.47, 0.77]; bronopol 1.6%; RR, 0.60 [0.46, 0.77]; DMDM hydantoin 1.6%; RR, 0.59 [0.54, 0.84]). Approximately a quarter of patients had at least 1 relevant allergic reaction to a non-NACDG allergen. In addition, approximately one-fourth to one-third of reactions detected by NACDG allergens would have been hypothetically missed by T.R.U.E. TEST (SmartPractice Denmark, Hillerod, Denmark). CONCLUSIONS: These data document the beginning of the epidemic of sensitivity to methylisothiazolinones in North America, which has been well documented in Europe. Patch testing with allergens beyond a standard screening tray is necessary for complete evaluation of occupational and nonoccupational ACD.

  • north american contact dermatitis group patch test results 2009 to 2010
    Dermatitis, 2013
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Vincent A. Deleo, C Toby G Mathias, Denis Sasseville, Donald V. Belsito, Matthew James Zirwas, Joel G. Dekoven, James S Taylor, Joseph F Fowler
    Abstract:

    BACKGROUND: Patch testing is an important diagnostic tool for determination of substances responsible for allergic contact dermatitis. OBJECTIVE: This study reports the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2009, to December 31, 2010. METHODS: At 12 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ2 statistics. RESULTS: A total of 4308 patients were tested. Of these, 2614 (60.7%) had at least 1 positive reaction, and 2284 (46.3%) were ultimately determined to have a primary diagnosis of allergic contact dermatitis. Four hundred twenty-seven (9.9%) patients had occupationally related skin disease. There were 6855 positive allergic reactions. As compared with the previous reporting period (2007-2008), the positive reaction rates statistically decreased for 20 allergens (nickel, neomycin, Myroxylon pereirae, cobalt, formaldehyde, Quaternium 15, methydibromoglutaronitrile/phenoxyethanol, methylchlorisothiazolinone/methylisothiazolinone, potassium dichromate, diazolidinyl urea, propolis, dimethylol dimethylhydantoin, 2-bromo-2-nitro-1,3-propanediol, methyl methacrylate, ethyl acrylate, glyceryl thioglycolate, dibucaine, amidoamine, clobetasol, and dimethyloldihydroxyethyleneurea; P < 0.05) and statistically increased for 4 allergens (fragrance mix II, iodopropynyl butylcarbamate, propylene glycol, and benzocaine; P < 0.05). Approximately one quarter of tested patients had at least 1 relevant allergic reaction to a non-NACDG allergen. Hypothetically, approximately one quarter of reactions detected by NACDG allergens would have been missed by TRUE TEST (SmartPractice Denmark, Hillerod, Denmark). CONCLUSIONS: These results affirm the value of patch testing with many allergens.

  • positive patch test reactions in older individuals retrospective analysis from the north american contact dermatitis group 1994 2008
    Journal of The American Academy of Dermatology, 2012
    Co-Authors: Erin M. Warshaw, Anthony F Fransway, Robert L Rietschel, C Toby G Mathias, Joseph F Fowler, Donald V. Belsito, James S Taylor, Howard I. Maibach, Srihari I Raju, Vincent A. Deleo
    Abstract:

    Background Relatively little is known about the epidemiology of allergic contact dermatitis in older individuals. Objectives We sought to determine the frequency of positive and clinically relevant patch test reactions in older individuals (≥65 years old) referred for patch testing, and to compare these results with those of adults (≤64-19 years) and children ( Design This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1994 to 2008. Results A total of 31,942 patients (older n = 5306; adults n = 25,028; children n = 1608) were patch tested. The overall frequency of at least one allergic reaction in older individuals was 67.3% as compared with 66.9% for adults ( P  = .5938) and 47% for children ( P  = .0011). Reaction rates that were statistically higher in older individuals as compared with both adults and children included: Myroxylon pereirae , fragrance mix I, Quaternium-15, formaldehyde, imidazolidinyl urea, diazolidinyl urea, neomycin, bacitracin, methyldibromo glutaronitrile, methyldibromo glutaronitrile/phenoxyethanol, ethyleneurea melamine formaldehyde mix, and carba mix ( P values P values Limitations Referral population was a limitation. Conclusions Older individuals were more likely to have at least one positive patch test reaction as compared with children, but had similar rates to adults. The frequency of positive reactions to specific allergens differed by age group, most likely as a result of exposures.

  • patch test results of the north american contact dermatitis group 2005 2006
    Dermatitis, 2009
    Co-Authors: Erin M. Warshaw, C Toby G Mathias, Denis Sasseville, Joseph F Fowler, Melanie D. Pratt, James S Taylor, Howard I. Maibach, Frances J Storrs, Donald L Belsito, Vincent A. Deleo
    Abstract:

    BACKGROUND: The North American Contact Dermatitis Group (NACDG) tests patients who have suspected allergic contact dermatitis with a broad series of screening allergens, and publishes periodic reports of its data. OBJECTIVE: To report the NACDG patch-test results from January 1, 2005, to December 31, 2006, and to compare results to pooled test data from the previous 10 years. METHODS: Standardized patch testing with 65 allergens was used at 13 centers in North America. Chi-square statistics were utilized for comparisons with previous NACDG data. RESULTS: NACDG patch-tested 4,454 patients; 12.3% (557) had an occupation-related skin condition, and 65.3% (2,907) had at least one allergic patch-test reaction. The 15 most frequently positive allergens were nickel sulfate (19.0%), Myroxilon pereirae (balsam of Peru, 11.9%), fragrance mix I (11.5%), Quaternium-15 (10.3%), neomycin (10.0%), bacitracin (9.2%), formaldehyde (9.0%), cobalt chloride (8.4%), methyldibromoglutaronitrile/phenoxyethanol (5.8%), p-phenylenediamine (5.0%), potassium dichromate (4.8%), carba mix (3.9%), thiuram mix (3.9%), diazolidinylurea (3.7%), and 2-bromo-2-nitropropane-1,3-diol (3.4%). As compared to the 1994-2004 data, there were significant increases in rates of positivity to nickel, Quaternium-15, potassium dichromate, lidocaine, and tea tree oil. Of patch-tested patients, 22.9% (1,019) had a relevant positive reaction to a supplementary allergen; 4.9% (219) had an occupationally relevant positive reaction to a supplementary allergen. CONCLUSION: Nickel has been the most frequently positive allergen detected by the NACDG; rates significantly increased in the current study period and most reactions were clinically relevant. Other common allergens were topical antibiotics, preservatives, fragrance mix I and paraphenylenediamine. Testing with an expanded allergen series and supplementary allergens enhances detection of relevant positive allergens.

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