Quantitative patch and repeated open application testing in methyldibromo glutaronitrile‐sensitive patients

Schnuch, Axel; Kelterer, D.; Bauer, Andrea; Schuster, Christian; Aberer, Werner; Mahler, Vera; Katzer, K.; Rakoski, J.; Jappe, Uta; Krautheim, Andrea; Bircher, Andreas J.; Koch, Patrick; Worm, Margitta; Löffler, Harald; Hillen, Uwe; Frosch, Peter J.; Uter, Wolfgang

doi:10.1111/j.0105-1873.2005.00529.x

Cited by 47 publications

(30 citation statements)

References 48 publications

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“…Among the biocides, MDBGN ranks as a top allergen. Together with other evidence (15, 16), its ban in leave‐on products is thus well substantiated. However, also in rinse‐off product (BS‐) positive patients, a significantly elevated proportion of MDBGN sensitized can be noted.…”

Section: Discussionmentioning

confidence: 62%

Patch testing with patients' own cosmetics and toiletries – results of the IVDK*, 1998–2002

et al. 2005

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Patch test results with products brought in by the patients collected by the members of the Information Network of Departments of Dermatology (IVDK) between 1998 and 2002 were analysed. 5911 patients were patch tested with their own cosmetics and toiletries during this period. The 34 082 single test preparations applied to these 5911 patients were manually assigned to 1 of 26 categories, based on the EU Classification Annex I to 76/768/EEC, which had been further refined. The leave-on product category most commonly tested was 'creams, emulsions, lotions, gels and oils for the skin' (n = 3621 tested, n = 312 positive). The rinse-off product type most commonly tested was 'bath and shower preparations' (n = 1333 tested, n = 71 positive). In one-third of patients tested positive to these products, no other positive test result was observed. In the remainder, positive reactions to the fragrance mix, Myroxylon pereirae resin, methyldibromo glutaronitrile, (chloro-)methylisothiazolinone, 2-bromo-2-nitropropane-1,3-diole and further ingredients of cosmetics and toiletries were more common than in product-negative patients. However, in view of the potential for false-positive reactions mainly to rinse-off products, the results must be interpreted with caution. In conclusion, testing of patients' own products can be regarded as efficient and safe, if in accordance with current recommendations.

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Section: Discussionmentioning

confidence: 62%

Patch testing with patients' own cosmetics and toiletries – results of the IVDK*, 1998–2002

et al. 2005

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“…Indeed it has been shown that following repeated applications of radiolabelled PPD to rat skin, followed by washing off (as would occur in the use of a hair dye), there is progressive accumulation of PPD 9 . In addition, when allergic individuals were tested with methyldibromoglutaronitrile in a ROAT at 50 parts per million (0·005%), positive responses were obtained in a third of the allergic subjects 10 …”

Section: Discussionmentioning

confidence: 99%

“…There are clear data that potent sensitizers such as DNCB or diphencyprone can induce a dose‐dependent augmentation in reactivity after high‐dose exposure; for example after application of high sensitizing doses (142 μg cm −2 ) individuals will give positive responses to challenges with as little as 0·8 μg of DNCB 1,2 . However, ingredients in personal products such as fragrances (oak moss) or antimicrobials, mostly regarded as weak sensitizers, are present at low concentrations (< 0·1%) but can induce what has been called very strong sensitization 10–12 . There has been a debate as to whether this indicates that these compounds are actually potent sensitizers or whether repeated exposure to low concentrations somehow potentiates their sensitizing potency 13,14 .…”

Section: Discussionmentioning

confidence: 99%

Repeated low-dose skin exposure is an effective sensitizing stimulus, a factor to be taken into account in predicting sensitization risk

Paramasivan

Lai

Pickard

et al. 2009

British Journal of Dermatology

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Background Contact sensitization by ingredients in personal products is an important clinical problem. It is not clear how sensitization is induced by the generally low concentrations at which they occur but it might be the result of repeated exposure.Objectives To compare the strength of contact sensitization induced by a single exposure to 2,4-dinitrochlorobenzene (DNCB) (60 lg cm )2 ) or three repeated exposures to a subsensitizing dose (10 lg cm )2 ). Methods Two groups (n = 10) of healthy adult volunteers were randomized to receive either a single patch of DNCB 60 lg cm )2 or three once-weekly applications to the same site of 10 lg cm )2 DCNB. Four weeks after the last application, sensitization was quantified by measurement of responses (skinfold thickness) to a graded series of four challenge doses. Results All the volunteers were sensitized and the strength of the responses was virtually identical between the groups. Conclusions The same degree of sensitization was induced by three exposures to DNCB 10 lg cm )2 as by one exposure to 60 lg cm )2 of DNCB. Thus repeated exposure to low doses of contact sensitizers may increase the sensitizing potency. This must be taken into account in future risk assessments.

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“…However, the frequency of these reactions is not an accurate indication of the frequency of incidents in which geraniol has been established as the direct cause of contact dermatitis resulting from the use of consumer products and other everyday environmental contact. A recent publication [107] relative to the testing of methyldibromo-glutaronitrile-sensitive patients has discussed another aspect of patch testing. The use of patch-test concentrations that are too high (as the current levels used for geraniol may well be) decreases specifi city without greatly affecting sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Is There Evidence that Geraniol Causes Allergic Contact Dermatitis?

Hostýnek¹,

Maibach²

2004

Exog Dermatol

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The fragrance material geraniol has been cited as a frequent cause of allergic contact dermatitis. A review of the literature shows that when the underlying clinical and experimental data are analyzed, a clear cause-effect relationship has infrequently or rarely been established. On the basis of the generally weak sensitizing potential of this substance coupled with its generally low exposure conditions, the prevalence of clinical cases would not be expected to be particularly high. This is not to say that geraniol is a frequent inducer of type IV allergy in members of the public. It remains to be seen, however, how often such allergy, once established, is responsible for any of the cases of allergic contact dermatitis commonly ascribed in the literature. Indeed, in some cases, patch-test conditions may not be optimal for differentiating between clinically relevant and irrelevant allergy to geraniol. Because of the numerous publications on geraniol-positive patch-test publications, a future effort to ascertain how many of these represent clinical intolerance is indicated. This will also permit determination of the NOEL (no observed effect level) in patch and use testing.

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Quantitative patch and repeated open application testing in methyldibromo glutaronitrile‐sensitive patients

Cited by 47 publications

References 48 publications

Patch testing with patients' own cosmetics and toiletries – results of the IVDK*, 1998–2002

Patch testing with patients' own cosmetics and toiletries – results of the IVDK*, 1998–2002

Repeated low-dose skin exposure is an effective sensitizing stimulus, a factor to be taken into account in predicting sensitization risk

Is There Evidence that Geraniol Causes Allergic Contact Dermatitis?

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