What is the optimal duration for a <scp>ROAT</scp>? The experience of the French Dermatology and Allergology group (<scp>DAG</scp>)

Amsler, E.; Assier, Haudrey; Soria, Angèle; Bara, C.; Bouëdec, M.C. Ferrier Le; Barbaud, A.; Milpied, B.; Giordano‐Labadie, F.; Pasteur, Justine; Badaoui, Antoine; Valois, A.; Castelain, Florence; Kurihara, F.; Castagna, J.; Boulard, C.; Bernier, C.; Leleu, C.; Marcant, Pierre; Crépy, M.-N.; Tétart, F.; Raison‐Peyron, Nadia

doi:10.1111/cod.14118

Cited by 11 publications

(5 citation statements)

References 9 publications

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“…To our knowledge, this clinical pattern has not yet been reported in cases of ACD from neem, nor from argan, olive or jojoba oils. Conversely, a papular or follicular reaction is readily observed in repeated open application tests (ROATs), regardless of the product under investigation 12 . Hence, in the present case, the follicular inflammatory pattern on the patient's forearms might even be considered as an ‘unintentional’ ROAT with neem oil.…”

Section: Discussionmentioning

confidence: 77%

Allergic contact dermatitis to neem oil used to treat a flare of atopic dermatitis

Samaran,

Dereure,

Raison‐Peyron

2023

Contact Dermatitis

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The Curasept ® mouthwash is marketed in Italy as a medical device. In this case the presence of MI in the mouthwash was correctly declared in the label by the manufacturer and this facilitated the diagnosis. However, the current regulations concerning medical devices do not require the complete declaration of all the ingredients in the label. 6 A more stringent regulation about the complete declaration would be highly desirable. At the same time a more stringent regulation about MI content in medical devices should be considered, with the aim of reducing the incidence of allergic contact dermatitis due to isothiazolinones in these products.

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Section: Discussionmentioning

confidence: 77%

Allergic contact dermatitis to neem oil used to treat a flare of atopic dermatitis

Samaran,

Dereure,

Raison‐Peyron

2023

Contact Dermatitis

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“…Like the ROAT, the GRAT has the advantage of being a simple and non-invasive test that mimics the usage situation as much as possible to increase the ability of detecting ACD. Concerning the GRAT protocol, we chose a duration of 10 nights because it seemed to be a good compromise between the sensitivity of the test and the adherence of the patients; the Dermato-Allergology Group of the French Society of Dermatology had shown in a recently published study that 98% of positive ROAT occurred within 10 nights of application of the product [18]. Although we minimized the occlusion properties of the test by using a non-adhesive strip and a shorter application time, repetitive application of a new piece of glove for 10 nights could induce innate skin inflammation (skin irritation) in predisposed patients.…”

Section: Discussionmentioning

confidence: 99%

Glove-related contact dermatitis: diagnostic value of a repeated application test

Lamouroux

Potachin

Coste

et al. 2023

Preprint

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Background. Gloves are frequently the cause of occupational hand dermatitis and are responsible for irritant (ICD) and allergic contact dermatitis (ACD). The diagnosis of ACD is based on patch tests to gloves (PTg), semi-open tests to gloves (SOg), and patch tests to glove allergens (PTal). Objective. The aim was to define the contribution of a glove repeated application test (GRAT) in the diagnosis strategy of glove-related contact dermatitis. Methods. This retrospective study included patients with hand eczema who wore gloves and who completed a GRAT in the context of allergological explorations. It consisted of applying a piece of the glove maintained by a non-adhesive strip during 10 consecutive nights on the same area of the anterior face of the forearm. Results. Ten patients were diagnosed with ACD to gloves. This diagnosis was made on positive SOg, PTg, GRAT and PTal for 2 patients, positive PTal and GRAT for 3 patients, positive SOg and GRAT for 2 patients, positive GRAT alone for 2 patients, positive PTal alone for 1 patient. The GRAT had better sensitivity than the other tests. Conclusion. GRAT seems useful in the diagnostic strategy of glove contact dermatitis and could be proposed when the diagnosis of glove-related contact dermatitis is suspected.

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“…After being asymptomatic for 4 months, the patient performed a second ROAT with hydroxyacetophenone 0.6% aq. She was instructed to apply the hydroxyacetophenone preparation with a cotton swab (to avoid passive allergen transfer through contaminated hands to distant body sites) for a period of 3 weeks 5 . Another flare‐up involving the neck (Figure 1F), without reaction on the forearm, again occurred on D5.…”

Section: Case Reportmentioning

confidence: 99%

Allergic contact dermatitis from hydroxyacetophenone in an anti‐wrinkle facial serum with flare‐up reactions triggered by the repeated open application test

2023

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ACD related to the use of metronidazole intravaginal ovules, which was characterized by a symmetrical drug-related intertriginous and flexural exanthema pattern. 6 Cases of ACD in patients using metronidazole gel or cream for rosacea have been described. 7,8 Metronidazole is a nitroimidazole with structural similarities to other imidazole derivatives. A case of cross-reactivity between metronidazole and bifonazole and tioconazole has been described. 9 In other reports, 7,8 patch testing in patients with ACD to metronidazole did not disclose cross-reactions with other imidazoles. Corazza et al. described a patient with vulvovaginal ACD to clotrimazole who had negative patch test reactions to miconazole, metronidazole, and isothiazolinones. 5 A possible cross-reaction between imidazoles and isothiazolinones has also been hypothesized. 10 The diagnosis of iatrogenic ACD should be considered in patients with genital dermatoses and/or symptoms that worse during treatment with topical drugs. We emphasize the importance of performing patch tests with patient's own products in such circumstances.

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What is the optimal duration for a ROAT? The experience of the French Dermatology and Allergology group (DAG)

Cited by 11 publications

References 9 publications

Allergic contact dermatitis to neem oil used to treat a flare of atopic dermatitis

Allergic contact dermatitis to neem oil used to treat a flare of atopic dermatitis

Glove-related contact dermatitis: diagnostic value of a repeated application test

Allergic contact dermatitis from hydroxyacetophenone in an anti‐wrinkle facial serum with flare‐up reactions triggered by the repeated open application test

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