Patch test results with rubber series in the European Surveillance System on Contact Allergies (ESSCA), 2013/14

Abstract

Additional testing with a dedicated rubber series, containing break-down single ingredients of mixes from the baseline series and additional rubber allergens, is warranted in patients with suspected contact allergy to rubber, to avoid false-negative results.

Patch testing with rubber series inEurope: a critical review and recommendation

“…However, the present, albeit limited, results obtained with single thiurams tested at 1% pet. do not show a greater concordance with the mix . Thus, it seems warranted to further study the clinical implications of thiuram mix reactions supported by positive reactions to a single constituent or single constituents as compared with isolated reactions to the mix.…”

“…Recent data have shown 0.32% positive results in patch testing with Ziram in cases of suspected rubber allergy (n = 625). However, there is no literature in the last 15 years regarding its relevance in rubber allergy, and it probably represents historical relevance only.…”

“…For this purpose, the following approaches were used: The database of the European Surveillance System on Contact Allergies (ESSCA) ( www.essca‐dc.org), containing patch test results obtained since 2002 and information on the patch test series used to obtain these, was searched to identify rubber series allergens. The results of this search from 2013 to 2014 are reported in a separate publication , detailing the frequencies of reactions to individual allergens. Members of the StanDerm (COST action TD1206) consortium ( www.standerm.eu), which provides nearly complete geographical coverage of Europe, were requested by e‐mail to fill in a simple electronic questionnaire (spreadsheet) listing the allergens used locally in their rubber series. …”

European Surveillance System on Contact Allergies (ESSCA): results with the European baseline series, 2013/14

“…The present data show some decline of contact allergy to thiuram mix [1.9% (95% CI: 1.8–2.1%) vs. 2.6% (95% CI: 2.3–2.9%) in 2004], while the other rubber additives remained largely stable. It has to be noted that diagnostic work‐up of patients with suspected rubber‐related allergic contact dermatitis should not solely rely on these four EBS allergens, because as many as 40% with eventually diagnosed contact allergy to rubber additives will be missed if further rubber additives and mix breakdowns are not additionally tested . An in‐depth discussion of adequate patch test diagnosis of rubber contact allergy is found in a recent review .…”

“…Hegewald et al ,. lately also including more in‐depth views on different groups of allergens from the EBS, such as fragrances, metals, preservatives, rubber chemicals or topical therapeutics and excipients . Following the main approach of providing a concise overview of the full range of EBS allergens as in Hegewald et al .…”