Occupational Chromium Allergy and Contact Dermatitis: 10 Years Evolution

Introduction: Chromium has been responsible for occupational skin disease, both irritant and/or allergic contact dermatitis. In order to minimize this problem, regulatory measures limiting its use have been implemented. The impact of these regulations should be monitored over time. Material and Methods: A retrospective study from 2009 to 2018 was carried out in the Department of Dermatology to assess the temporal trend of chromium sensitization evaluated by patch testing with potassium dichromate 0.5% pet, particularly considering age, sex and its relationship with occupational activity. Results: 3277 individuals were studied, 2369 females (72.29%) and 908 males (27.71%). Of those 621 (18.95%) fulfilled criteria for occupational contact dermatitis. Chromium allergy was found in 118 (3.60%) patients, 64 females (54.4%) and 54 males (45.76%). We found that male patients were significantly more frequent (45.76% vs 27.03%; p<0.001), as well as occupational dermatitis (31.35% vs 18.47%; p<0.001), hand dermatitis (53.54% vs 23.52%; p<0.001) and age above 40 years (70.34% vs 56.76%; p=0.003). Discussion/Conclusion: The results show a high prevalence (3.60%) of chromium positive patch tests. In our study, there has not been a significant decrease in sensitization to chromium over the years. Interestingly cases classically related to this allergy (cement in the building industry) are no longer the main cause of the problem. We found other sources such as leather as a main cause of allergic sensitization, suggesting a change of the panorama.

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Study of the frequency of allergens in cosmetics components in patients with suspected allergic contact dermatitis

Anais Brasileiros de Dermatologia ◽

10.1590/s0365-05962012000200011 ◽

2012 ◽

Vol 87 (2) ◽

pp. 263-268 ◽

Cited By ~ 8

Author(s):

Eliane Aparecida Silva ◽

Marcia Regina Miras Bosco ◽

Érika Mozer

Keyword(s):

Contact Dermatitis ◽

Allergic Contact Dermatitis ◽

Professional Activity ◽

Presumptive Diagnosis ◽

Patch Tests ◽

Occupational Contact Dermatitis ◽

Frequency Of Contact ◽

Allergic Contact ◽

Age Range ◽

Occupational Contact

BACKGROUND: Contact dermatitis to cosmetics is a common dermatosis, especially in adults and professionals who handle them. OBJECTIVE: The objective of this study was to evaluate the frequency of sensitization to cosmetics' components in patients with suspected allergic contact dermatitis and to identify the main sensitizers related to occupational contact dermatitis. METHODS: During the period of January 2008 to June 2010, all the patients with a presumptive diagnosis of allergic contact dermatitis to cosmetics were selected. The patients were submitted to the patch tests of cosmetics series, composed by ten substances. RESULTS: Among the 147 patients studied sensitization to cosmetics components occurred in 31,29% of the cases, 14 of those (19,18%) equally corresponding to BHT and triethanolamine substances, 13 (17,81%) to ammonium thioglycolate, 09 to sorbic acid (12,33%), 08 to tosilamida (10,95%), 06 to germall (8,22%). The other elements tested showed indices of 5% or less. A higher frequency of contact dermatitis to cosmetics was observed in women and the age most affected was concordant with the age range of greatest professional activity of the population. CONCLUSION: Allergic contact dermatitis was more frequently associated with Triethanolamine, BHT and ammonium thioglycolate, and the relation with occupational contact dermatitis was discreet.

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Impact of Allergic Contact Dermatitis on the Quality of Life and Work Productivity

Dermatology Research and Practice ◽

10.1155/2019/3797536 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

H. Kalboussi ◽

I. Kacem ◽

H. Aroui ◽

O. El Maalel ◽

M. Maoua ◽

...

Keyword(s):

Quality Of Life ◽

Contact Dermatitis ◽

Daily Activity ◽

Productivity Loss ◽

Work Productivity ◽

Occupational Activity ◽

Activity Impairment ◽

Allergic Contact ◽

The Impact

Background. Allergic contact dermatitis (ACD) is a common chronic skin disease that generates considerable public-health and socioeconomic costs. This disease affects the quality of life and the occupational activity of patients. Aims. To assess the quality of life (QOL) of patients with ACD and study the impact of this disease on their work productivity. Methods. This is a cross-sectional study carried out from January 2012 to December 2014. All patients diagnosed with ACD in the Dermato-Allergology Unit of the Occupational Medicine Department at Farhat Hached University Hospital, in Sousse, were included. The impact of skin disease on the QOL of affected persons was assessed using the Dermatology Life Quality Index (DLQI). The work productivity was measured using the Work Productivity and Activity Impairment Allergic Specific questionnaire (WPAI: AS). Results. The study population consisted of 150 patients. The average score of DLQI was 6.5. Over the previous 7 days, absenteeism rate was 25.9 ± 15.3%, presenteeism rate was 50.2 ± 32%, overall work productivity loss was 29.6 ± 19.4%, and daily activity impairment was 50.4 ± 32.3%. The DLQI score was significantly associated with atopy (p = 0.03), relapses strictly greater than 10 (p = 0.02), presenteeism (p <10−3), overall work productivity loss (p = 0.01), and daily activity impairment (p = 0.03). Conclusion. The impact of ACD on QOL and occupational activity seems important and requires specific attention from the occupational physician.

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Comparative Study of IQ-Ultra and Finn Chambers Test Methodologies in Detecting 10 Common Standard Allergens that Cause Allergic Contact Dermatitis

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347541201600105 ◽

2012 ◽

Vol 16 (1) ◽

pp. 18-22 ◽

Cited By ~ 5

Author(s):

Joseph Doumit ◽

Melanie Pratt

Keyword(s):

Contact Dermatitis ◽

Allergic Contact Dermatitis ◽

Patch Testing ◽

Potassium Dichromate ◽

Nickel Sulfate ◽

Formaldehyde Resin ◽

Perfect Agreement ◽

Patch Tests ◽

The North ◽

Allergic Contact

Background: Patch testing is routinely used in contact dermatitis clinics because it is the gold standard for the evaluation of potential allergic contact dermatitis. Objective: The study was undertaken to evaluate possible differences in reactivity between the Finn Chamber and IQ-Ultra patch-testing methodologies. Methods: Patients were patch-tested simultaneously with the Finn Chamber and IQ-Ultra patch tests. Ten standard allergens set by the North American Contact Dermatitis Group were used for both techniques. Results: Both patch tests had a significant agreement in detecting all of the allergens. An “almost perfect agreement” was noted for ethylenediamine dihydrochloride, quaternium-15, mercapto mix, black rubber mix, balsam of Peru, and nickel sulfate; “substantial agreement” for formaldehyde, bisphenol A epoxy resin, and 4-tert-butylphenol formaldehyde resin; and “moderate agreement” for potassium dichromate. Conclusion: The Finn Chamber and IQ-Ultra patch tests had a good agreement in the detection of the 10 standard allergens that were tested.

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Clinico-epidemiological study of role of patch test in hand eczema

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20191762 ◽

2019 ◽

Vol 5 (2) ◽

pp. 357

Author(s):

Ashok S. Hogade ◽

P. Anusha

Keyword(s):

Contact Dermatitis ◽

Patch Test ◽

Potassium Dichromate ◽

Hand Eczema ◽

Gold Standard Method ◽

Occupational Contact Dermatitis ◽

International Contact ◽

Contact Allergen ◽

Exogenous Factors ◽

Allergic Contact

Background: Hand eczema is a common distressing condition in different occupational groups caused by various endogenous and exogenous factors. It appears to be the most common occupational skin disease, comprising 80% or more of all occupational contact dermatitis. Patch test at present is the only scientific method to diagnose the contact allergen and in subsequent management of patient.Methods: An observational study of patch test was conducted on 100 patients of hand eczema in the department of DVL, Basaveshwara Teaching and General Hospital, Kalaburagi. After detailed history and complete examination, patch testing was done using Indian Standard Series and graded by International Contact Dermatitis Research Group criteria at 48 hours and 72 hours.Results: Out of 100 patients, there were 28 females and 72 males. The commonest age group seen was 20-40 years followed by 40-60 years. Commonest sensitizers were to potassium dichromate (34%) followed by nickel (18.7%), Parthenium (12.5%), PPD (7.8%), other (26%). Out of 64 patients who were positive, 82.8% were positive to single allergen, 10% to two allergens and 6.2% to multiple allergens.Conclusions: Patch test is considered as gold standard method for diagnosis of allergic contact dermatitis and thus preventing the morbidity of repeated episodes of eczema.

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Alergia de Contacto a Metais num Período de 20 Anos no Centro de Portugal: Implicações das Directivas Europeias

Acta Médica Portuguesa ◽

10.20344/amp.4112 ◽

2014 ◽

Vol 27 (3) ◽

pp. 295 ◽

Cited By ~ 4

Author(s):

Vera Teixeira ◽

Inês Coutinho ◽

Margarida Gonçalo

Keyword(s):

Temporal Trend ◽

Chromium Content ◽

Construction Workers ◽

Occupational Activity ◽

Age Group ◽

Portuguese Population ◽

Patch Tests ◽

Allergic Contact ◽

The Impact ◽

The Eu

Introduction: Metals are a common cause of allergic contact dermatitis. After the introduction of the EU Nickel Directive (1994/27/CE; 2004/96/EC) and, more recently, the Cement Directive (2003/53/EC) there has been a significant decrease in sensitization to metals mainly in the Nordic countries. The applicability of these directives and their impact in the Portuguese population is unknown. Material and Methods: A retrospective study (1992-2011) was carried out in our patch test clinic to assess the temporal trend of metal sensitization (nickel [Ni], cobalt [Co] and chromium [Cr]) along the last 20 years, particularly considering age, sex and its relation with occupational activity. Results: Out of 5 250 consecutively patch-tested patients, 1 626 (31%) were reactive to at least one metal (26.5% to Ni; 10.0% to Co and 7.9% to Cr). Women had a higher prevalence of sensitization to Ni (34.4% vs 8.9%) whereas men were more reactive to Cr (11.5% vs 5.0%). Nickel sensitization did not decrease significantly over the years, although in recent years among women sensitized to nickel the percentage of younger patients (16-30 years-old) is significantly lower (p < 0.001). Chromium sensitization significantly decreased, particularly in men (r = -0.535), and mainly in the construction workers (r = -0.639). Chromium reactivity associated with the shoe dermatitis has remained stable. Discussion: We emphasize the higher and stable percentage of nickel sensitized individuals suggesting, so far, a low impact from the EU Ni directive, although a decreasing percentage in the the younger group among Ni sensitized women may suggest a beneficial effect is becoming evident is this age group. On the contrary, the impact of the directive regarding the modification of Cr in cement seems to be effective. There is now a need to regulate chromium content in leather products, namely in shoes. Conclusions: The regulation of interventional measures related either to the manufacture and trade of adornments or professional use will better protect the population of allergy to metals. Keywords: Dermatitis, Allergic Contact; Chromium; Cobalt; European Union; Metals; Nickel; Patch Tests; Portugal.

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Common allergens in patients with contact dermatitis identified using patch test in a tertiary care centre in North Kerala

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20185054 ◽

2019 ◽

Vol 5 (1) ◽

pp. 78

Author(s):

V. P. K. Gopinath ◽

V. M. Simi ◽

K. Basheer Ahammed ◽

C. M. Ali Rishad ◽

P. M. Farisa

Keyword(s):

Contact Dermatitis ◽

Patch Test ◽

Potassium Dichromate ◽

Tertiary Care ◽

Tertiary Care Centre ◽

Dermatology Department ◽

Patch Tests ◽

Immune Mediated ◽

Allergic Contact ◽

Age Range

Background: Allergic contact dermatitis (ACD) is a disease characterised by an immune mediated response to a substance. The primary prevention remains avoidance of the implicated allergen. This is done with the help of patch test using the Indian Standard series (ISS).Methods: Out of the 246 cases of ACD that came to our Dermatology department, 92 patients were selected and subjected to patch testing using the ISS. Results were read after 48 and 96 hours, interpreted as per ICDRG criteria and were analysed.Results: From 92 patients 59.8% were males and 40.2% were females. Majority of the individuals with ACD who were patch tested belonged to the age range of 21-60 years accounting to 72.8%. The most affected site was the foot. 26.7% showed positivity to Black rubber mix, followed by potassium dichromate 20% and nickel 14.4%. 7.8% produced delayed reactions with positivity revealed at the final reading. One patient gave multiple positive reactions to paraben, PPD and chlorocresol.Conclusions: In the study middle aged males were mostly affected which may be influenced by the sample selected. Black rubber mix was identified as the most frequent sensitizer followed by potassium dichromate which was also implicated as the sensitizer most seen in the unskilled generally. Fragrance mix was responsible for all delayed responses yielding positivity in the second reading. When not considering the negligible left, patch tests’ results could be correlated with the clinical presentations. Patients were treated, educated on ACD and advised to refrain from exposure with suggestions of possible alternatives.

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Recalcitrant Palmoplantar Pustulosis: Have You Considered Allergic Contact Dermatitis?

Revista da Sociedade Portuguesa de Dermatologia e Venereologia ◽

10.29021/spdv.79.2.1313 ◽

2021 ◽

Vol 79 (2) ◽

pp. 173-177

Author(s):

José Neves ◽

A. Brasileiro ◽

P. Mendes-Bastos

Keyword(s):

Contact Dermatitis ◽

Allergic Contact Dermatitis ◽

Cobalt Chloride ◽

Potassium Dichromate ◽

Allergic Sensitization ◽

Response To Treatment ◽

Leather Industry ◽

Palmoplantar Pustulosis ◽

Plaque Type ◽

Allergic Contact

Palmoplantar pustulosis (PPP) is a chronic and relapsing disease of the palms and soles, which tends to be difficult to treat. Classically it was described as a subtype of psoriasis. Nowadays it is regarded as a separate entity, although plaque-type psoriasis affects concomitantly many patients with PPP. A link between allergic contact dermatitis (ACD) and PPP has been described, and the former may encompass a potential to perpetuate the latter. Hereby we report two cases of difficult to treat plantar pustulosis. Underneath the dermatosis’s refractive nature was an allergic sensitization to potassium dichromate and cobalt chloride. Leather shoes and leather insoles were commonly worn, and both allergens are employed by the leather industry. Clinical remission was achieved in both cases with allergen eviction. Patch testing must be considered in cases of PPP without response to treatment. If relevant sensitization is found, allergen eviction measures are mandatory.

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