Patch Test Results to European Baseline Series in Turkey: A Prospective and Multicenter Study

Abstract

Background: Patch testing with the European Baseline Series (EBS) is an essential diagnostic tool for the assessment of allergic contact dermatitis.Objective: The aims of the study were to describe the most common contact allergens identified with patch testing in Turkey and to establish the distribution of contact allergens among different regions in Turkey.Patients and Methods: Twelve centers consisting of tertiary health care institutions were included in the study. A total of 1169 patients were patch tested with the EBS from 2015 to 2017.Results: A total of 596 patients (51.0%) had 1 or more positive patch test reactions to the EBS. A total of 30.2% (n = 353) of those tested had clinical relevance. Contact sensitivity was more common in young patients. The most common 10 allergens were nickel sulfate (20.4%), followed by textile dye mix (8.6%), cobalt chloride (8.3%), potassium dichromate (8.0%), p-phenylenediamine base (4.5%), balsam of Peru (4.3%), methylchloroisothiazolinone/methylisothiazolinone (3.8%), thiuram mix (3.6%), fragrance mix I (3.0%), and methylisothiazolinone (2.9%).Conclusions: This study provides a comprehensive profile of patch test results with the EBS in Turkey. An ongoing decrease in contact allergy to methylchloroisothiazolinone/methylisothiazolinone and methylisothiazolinone was observed. Textile dye mix and p-phenylenediamine are beginning to pose a new risk in Turkey.

Patterns of Allergic Contact Dermatitis in African Americans in a Major Metropolitan Area Over a 10-Year Period

“…Previous studies suggest that PPD should not be considered as a screening agent for textile dye mix contact allergy, and simultaneous reactivity to PPD has been reported in 30%-60% of textile dye mix-positive patients. 12,13 It should also be noted that contact allergy to PPD has shown to be a better indicator of self-reported skin reactions to textiles than textile dye mix. 14 Upon investigating the possibility of cross-elicitation of textile dye mix with PPD, we found that all textile dye reactors were African American and all but one also reacted to PPD.…”

“…In addition, rates of sensitization to textile dyes have been increasing, and disperse dyes are the most common and most known textile-related contact sensitizer. 13 Differences in rates of sensitization have often been hypothesized to likely rise from exposure patterns, but this question has not been explored. Our study uniquely evaluated this and found personal care products as the overwhelmingly most common source of all positive patch tests in both groups.…”

“…African American patients reacted with greater frequency to both allergens. Previous studies suggest that PPD should not be considered as a screening agent for textile dye mix contact allergy, and simultaneous reactivity to PPD has been reported in 30%–60% of textile dye mix–positive patients 12,13 . It should also be noted that contact allergy to PPD has shown to be a better indicator of self-reported skin reactions to textiles than textile dye mix 14 …”

“…Thus, this could have direct relevance as true allergy to disperse blue. In addition, rates of sensitization to textile dyes have been increasing, and disperse dyes are the most common and most known textile-related contact sensitizer 13 …”

Analysis of patch testing results in patients with contact dermatitis in Istanbul, Turkey, from 2012 to 2022

“…Therefore, the European baseline series (EBS) is used in all studies conducted in Turkey to report patch test results in patients with ACD. [1][2][3][4][5][6][7][8][9][10] The thin-layer rapid-use epicutaneous (T.R.U.E.) test is a ready-to-use patch test containing 35 allergens.…”