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The prevalence of sensitization to formaldehyde releasers (FRs) differs according to geographic area and has changed over time. Several factors may influence prevalence, including different patch test systems or concentrations or the allergen selection in different baseline patch test series, habits of the populations, and regulations and legal concentration limits in cosmetics. 1,2 Quaterium-15 had been SANZ-SÁNCHEZ ET AL. 173

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7. Durmischev AL, Davidoff MS. Depigmentation effect of hydroquinone monomethyl ether. Dermatol Monatsschr. 1976;162:306-311. 8. Becker H, Vogel H. The role of hydroquinone monomethyl ether in the stabilization of acrylic acid. Chem Eng Tecnol. 2006;29:1227-1231. 9. Chivers CP. Two cases of occupational leucoderma following contact with hydroquinone monomethyl ether. Br J Ind Med. 1972;29:105-107. 10. Frenk E, Ott F. Evaluation of the toxicity of the monoethyl ether of hydroquinone for mammalian melanocytes and melanoma cells. The prevalence of formaldehyde sensitization differs between regions. The concentration of formaldehyde used in the patch test has been controversial, but the latest European recommendations 1 suggest that formaldehyde 2% aq. is the optimal concentration because clinically relevant contact allergy to formaldehyde may be missed by testing with formaldehyde 1% aq. For this reason, the Spanish baseline series was updated by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC), and the concentration of formaldehyde increased to 2% aq. in 2016. 2 The aims of this descriptive one-year prospective study were to determine the prevalence of sensitization to formaldehyde and assess the features of patients with sensitization to formaldehyde in Spain. METHODS In 14 Spanish hospitals, 2971 patients were patch tested in 2017 with the Spanish baseline series. Formaldehyde 2% aq. was supplied by 458 SANZ-SÁNCHEZ ET AL. Chemotechnique Diagnostics (Vellinge, Sweden) in 7 hospitals and AllergEAZE (Calgary, Canada) in the other 7. Readings were done on day (D) 2 and D4 and graded according to International Contact Dermatitis Research Group evaluation criteria (+, ++, and +++ as positive). We compared the demographic characteristics of the patients according to the MOAHLFA index. RESULTS Of the 2971 patients tested with formaldehyde 2% aq., 113 patients (3.80%) reacted positively, and only four irritant reactions were recorded. The demographic data obtained in our study show that a higher percentage of women (men: 26.6%), younger people (age > 40 years: 21.2%), atopic patients (27.5%), and people with leg dermatitis (46.8%) are allergic to formaldehyde compared to the overall study population. Twelve occupational cases were observed, mostly in women (health care workers and hairdressers), and the hands were the most frequently involved areas. DISCUSSIONIn this study, the frequency of sensitization to formaldehyde was found to be higher (3.80%) than in previous studies in Spain (ranging from 2.58 to 1.38). 3-5 This higher yield may be due to the fact that formaldehyde 2% aq. detects more contact allergies to formaldehyde than 1% aq., while only a few cases are considered irritant reactions. These data are in accordance with previously published European studies. 1,6The demographic data are similar to those in other studies, 3 except for a higher percentage of patients with leg dermatitis than in other studies. 3,6 As an explanation for this, previous dermatitis could be a risk factor for the ...