Contact allergy to haptens in the Swedish baseline series: Results from the Swedish Patch Test Register (2010 to 2017)

Abstract

Background Allergic contact dermatitis has considerable public health impact and causative haptens vary over time. Objectives To report the prevalence of contact allergy to allergens in the Swedish baseline series 2010 to 2017, as registered in the Swedish Patch Test Register. Methods Results and demographic information for patients tested with the Swedish baseline series in 2010 to 2017 were analysed. Results Data for 21 663 individuals (females 69%) were included. Females had significantly more positive patch tests (54% vs 40%). The reaction prevalence rates were highest for nickel sulfate (20.7%), fragrance mix I (7.1%), Myroxylon pereirae (6.9%), potassium dichromate (6.9%), cobalt chloride (6.8%), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI; 6.4%), MI (3.7%), colophonium (3.5%), fragrance mix II (3.2%), and formaldehyde (3.2%). Myroxylon pereirae reaction prevalence increased from 5% in 2010 to 9% in 2017 and that for methyldibromo glutaronitrile from 3.1% to 4.6%. MCI/MI and MI reactions decreased in prevalence after 2014. Nickel reaction prevalence decreased among females aged 10 to 19 years. Conclusions Nickel remains the most common sensitizing agent, with reaction prevalence decreasing among females younger than 20 years. The changes in MCI/MI and MI reaction prevalence mirrored those in Europe. The register can reveal changes in contact allergy prevalence over time among patients patch tested in Sweden.

Contact allergy to and allergic contact dermatitis from formaldehyde and formaldehyde releasers: A clinical review and update

“…In a recent Swedish study, the number of positive reactions to FA increased significantly following the use of the 2.0% test concentration instead of the 1.0%, that is, almost doubled from a mean of 2.2% (2010–2013) to a mean of 4.1% (2014–2017) 73 …”

“…(2010-2013) to a mean of 4.1% (2014-2017). 73 Hence, in the past, clinically relevant patch-test reactions have been potentially missed and contributed to the lower sensitization rates observed. This may also depend on the patch-test system used, as was shown recently in a study 74 comparing the use of a 2% aq.…”

Preservatives in non‐cosmetic products: Increasing human exposure requires action for protection of health

“…Knowledge about the prevalence and temporal changes of contact allergy to preservatives and other biocides is largely based on monitoring contact allergy in dermatitis patients by diagnostic patch testing 12–18 . Other sources of information are population‐based epidemiological studies, workplace studies, selected patient groups and case reports.…”

“…[9][10][11] Knowledge about the prevalence and temporal changes of contact allergy to preservatives and other biocides is largely based on monitoring contact allergy in dermatitis patients by diagnostic patch testing. [12][13][14][15][16][17][18] Other sources of information are population-based epidemiological studies, workplace studies, selected patient groups and case reports. It should be acknowledged, however, that there is considerable variation in access to dermatology and clinical patch testing services between and within countries.…”

“…15,20 The increase was related to use of methylchloroisothiazolinone/methylisothiazolinone (MCI/MI, CMIT/ MIT), methylchloroisothiazolinone (MI, MIT) and methyldibromo glutaronitrile (MDBGN, DBDCB), then followed by decrease in many EU countries owing to restrictions introduced concerning their use in cosmetics. 16,19,21 Differences in prevalence rates or trends between countries or regions may be explained by commercially available patch test preparations used, accessibility to patch testing, use of certain substances and to differing cosmetics legislations, for example, formaldehyde and formaldehyde releasers, 22 methyldibromo glutaronitrile (MDBGN, DBDCB), 14,18 and iodopropynyl butylcarbamate (IPBC). 21 Common sources of skin exposure and sensitization to preservatives and other biocides are consumer products including cosmetic products, detergents, paints and occupational exposure to chemical products (mixtures) and other products.…”