North American contact dermatitis group patch test results: 2011-2012

Erin M. Warshaw, Howard I. Maibach, James S. Taylor, Denis Sasseville, Joel G. DeKoven, Matthew J. Zirwas, Anthony F. Fransway, C. G Toby Mathias, Kathryn A. Zug, Vincent A. DeLeo, Joseph F. Fowler, James G. Marks, Melanie D. Pratt, Frances Storrs, Donald V. Belsito

Research output: Contribution to journalArticle

97 Citations (Scopus)

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 χ2 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, Hillerød, 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.

Original languageEnglish (US)
Pages (from-to)49-59
Number of pages11
JournalContact Dermatitis
Volume26
Issue number1
DOIs
StatePublished - 2015

Fingerprint

Patch Tests
Contact Dermatitis
Odds Ratio
Allergens
Allergic Contact Dermatitis
Denmark
North America
Formaldehyde
Hypersensitivity
Lanolin
Parabens
Glutaral
Skin Diseases
Alcohols
Databases

ASJC Scopus subject areas

  • Dermatology
  • Immunology and Allergy

Cite this

Warshaw, E. M., Maibach, H. I., Taylor, J. S., Sasseville, D., DeKoven, J. G., Zirwas, M. J., ... Belsito, D. V. (2015). North American contact dermatitis group patch test results: 2011-2012. Contact Dermatitis, 26(1), 49-59. https://doi.org/10.1097/DER.0000000000000097

North American contact dermatitis group patch test results : 2011-2012. / Warshaw, Erin M.; Maibach, Howard I.; Taylor, James S.; Sasseville, Denis; DeKoven, Joel G.; Zirwas, Matthew J.; Fransway, Anthony F.; Mathias, C. G Toby; Zug, Kathryn A.; DeLeo, Vincent A.; Fowler, Joseph F.; Marks, James G.; Pratt, Melanie D.; Storrs, Frances; Belsito, Donald V.

In: Contact Dermatitis, Vol. 26, No. 1, 2015, p. 49-59.

Research output: Contribution to journalArticle

Warshaw, EM, Maibach, HI, Taylor, JS, Sasseville, D, DeKoven, JG, Zirwas, MJ, Fransway, AF, Mathias, CGT, Zug, KA, DeLeo, VA, Fowler, JF, Marks, JG, Pratt, MD, Storrs, F & Belsito, DV 2015, 'North American contact dermatitis group patch test results: 2011-2012', Contact Dermatitis, vol. 26, no. 1, pp. 49-59. https://doi.org/10.1097/DER.0000000000000097
Warshaw EM, Maibach HI, Taylor JS, Sasseville D, DeKoven JG, Zirwas MJ et al. North American contact dermatitis group patch test results: 2011-2012. Contact Dermatitis. 2015;26(1):49-59. https://doi.org/10.1097/DER.0000000000000097
Warshaw, Erin M. ; Maibach, Howard I. ; Taylor, James S. ; Sasseville, Denis ; DeKoven, Joel G. ; Zirwas, Matthew J. ; Fransway, Anthony F. ; Mathias, C. G Toby ; Zug, Kathryn A. ; DeLeo, Vincent A. ; Fowler, Joseph F. ; Marks, James G. ; Pratt, Melanie D. ; Storrs, Frances ; Belsito, Donald V. / North American contact dermatitis group patch test results : 2011-2012. In: Contact Dermatitis. 2015 ; Vol. 26, No. 1. pp. 49-59.
@article{0077d24713f340ae89ea5e2a5ac1706c,
title = "North American contact dermatitis group patch test results: 2011-2012",
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 χ2 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, Hiller{\o}d, 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.",
author = "Warshaw, {Erin M.} and Maibach, {Howard I.} and Taylor, {James S.} and Denis Sasseville and DeKoven, {Joel G.} and Zirwas, {Matthew J.} and Fransway, {Anthony F.} and Mathias, {C. G Toby} and Zug, {Kathryn A.} and DeLeo, {Vincent A.} and Fowler, {Joseph F.} and Marks, {James G.} and Pratt, {Melanie D.} and Frances Storrs and Belsito, {Donald V.}",
year = "2015",
doi = "10.1097/DER.0000000000000097",
language = "English (US)",
volume = "26",
pages = "49--59",
journal = "Contact Dermatitis",
issn = "0105-1873",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - North American contact dermatitis group patch test results

T2 - 2011-2012

AU - Warshaw, Erin M.

AU - Maibach, Howard I.

AU - Taylor, James S.

AU - Sasseville, Denis

AU - DeKoven, Joel G.

AU - Zirwas, Matthew J.

AU - Fransway, Anthony F.

AU - Mathias, C. G Toby

AU - Zug, Kathryn A.

AU - DeLeo, Vincent A.

AU - Fowler, Joseph F.

AU - Marks, James G.

AU - Pratt, Melanie D.

AU - Storrs, Frances

AU - Belsito, Donald V.

PY - 2015

Y1 - 2015

N2 - 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 χ2 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, Hillerød, 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.

AB - 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 χ2 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, Hillerød, 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.

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