Comparison of reactivity to a metallic disc and 2% aluminium salt in 366 children, and reproducibility over time for 241 young adults with childhood vaccine‐related aluminium contact allergy

Lidholm, Anette Gente; Inerot, Annica; Gillstedt, Martin; Bergfors, Elisabet; Trollfors, Birger

doi:10.1111/cod.12977

Cited by 20 publications

(26 citation statements)

References 14 publications

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“…This is consistent with our earlier conclusion that metallic aluminium is of very little benefit in patch testing for aluminium contact allergy. 21 In summary, we think that aluminium chloride hexahydrate 2% pet. is sufficient for detection of contact allergy to aluminium in small children, and recommend that the stronger 10% preparation should not be used, because of the risk of unwanted strong allergic reactions to the test.…”

Section: Discussionmentioning

confidence: 97%

“…Our experience of cases such as these was one of the reasons why we considered it unethical to use the 10% preparation in the retest study on the long-term prognosis of aluminium allergy, in which children from the vaccine trial were tested a second time. 5,21 The role of metallic aluminium (eg, an empty Finn Chamber) in patch testing for aluminium allergy has been discussed and questioned lately. 21,22 In our three studies, the diagnosis would have been missed in 10 of 601 cases if we had tested only with the aluminium salt.…”

Section: Discussionmentioning

confidence: 99%

“…5,21 The role of metallic aluminium (eg, an empty Finn Chamber) in patch testing for aluminium allergy has been discussed and questioned lately. 21,22 In our three studies, the diagnosis would have been missed in 10 of 601 cases if we had tested only with the aluminium salt. This is consistent with our earlier conclusion that metallic aluminium is of very little benefit in patch testing for aluminium contact allergy.…”

Section: Discussionmentioning

confidence: 99%

“…Fortunately, and in contrast to previous notions, contact allergy to aluminium acquired in childhood seems to weaken or disappear with time, as shown in follow-up studies on participants in the pertussis vaccine trials by Gente Lidholm; of 241 children with known aluminium allergy, only 55 (23%) remained positive when retested 5 to 9 years after the initial patch test. 5,21 Traditionally in Sweden, contact allergy to aluminium has been diagnosed by patch testing with metallic aluminium (an empty Finn Chamber) and aluminium chloride hexahydrate 2% pet. 22,23 A higher concentration, namely 10% pet., was used by Netterlid et al in a study including 37 children and young adults who had undergone hyposensitization therapy with aluminium-adsorbed antigen extracts.…”

Section: Introductionmentioning

confidence: 99%

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Patch testing children with aluminium chloride hexahydrate in petrolatum: A review and a recommendation

et al. 2019

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Background: According to studies on adults, patch testing with aluminium chloride hexahydrate 2% pet. is insufficient to detect aluminium allergy, and a 10% preparation is recommended. Other studies suggest that a 2% preparation is sufficient for testing children. Objectives: To review three previously published Swedish studies on patch testing children with aluminium chloride hexahydrate 2% pet. Patients/Methods: Altogether, 601 children with persistent itching subcutaneous nodules (granulomas) induced by aluminium-adsorbed vaccines were patch tested with aluminium chloride hexahydrate 2% pet. and metallic aluminium in (a) a pertussis vaccine trial, (b) clinical practice, and (c) a prospective study. Results: Overall, 459 children had positive reactions to the 2% pet. preparation. Another 10 reacted positively only to metallic aluminium. An extreme positive reaction (+++) was seen in 65% of children aged 1 to 2 years as compared with 22% of children aged 7 years. From 8 years onwards, extreme positive reactions were scarce.Conclusions: Aluminium chloride hexahydrate 2% pet. is sufficient to trace aluminium allergy in children. Small children are at risk of extreme reactions. We thus suggest that aluminium chloride hexahydrate 10% pet. should not be used routinely in children before the age of 7 to 8 years. K E Y W O R D S allergic contact dermatitis, aluminium, aluminium-adsorbed vaccines, children, itching subcutaneous granulomas, patch test

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patch testing children with aluminium chloride hexahydrate in petrolatum: A review and a recommendation

et al. 2019

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“…Use of 2% aluminium chloride hexahydrate aq. is more sensitive than metallic aluminium and recommended for children with deep cutaneous inflammatory nodules after vaccination with aluminium-containing vaccines [53,54]. In a French patch test study involving 97 children, using 2% aluminium chloride hexahydrate pet., 21.6% were found sensitised; 8/21 also reacting to metallic aluminium.…”

Section: Metalsmentioning

confidence: 99%

Contact Allergy—Emerging Allergens and Public Health Impact

Uter

Werfel

Lepoittevin

et al. 2020

IJERPH

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Contact allergy (sensitisation) and allergic contact dermatitis (ACD) resulting from it have a considerable public health impact. For the present review, all pertinent articles were systematically searched via Medline and Web of Science™; additionally, all available issues of the journals “Contact Dermatitis” and “Dermatitis” were manually searched, covering the years 2018–2019, thereby extending and re-focusing a previous similar review. New allergens, or previously described allergens found in a new exposure context or of other current importance, are described in sections according to substance classes, e.g., metals, preservatives, fragrances. As a common finding in many investigations, a lack of information on product composition has been noted, for instance, regarding a newly described allergen in canvas shoes (dimethylthiocarbamylbenzothiazole sulfide) and, most notably, absence of co-operation from manufacturers of glucose-monitoring devices and insulin pumps, respectively. These latter devices have been shown to cause severe ACD in a considerable number of diabetic patients caused by the liberation of isobornyl acrylate and N,N’-dimethylacrylamide, respectively, as demonstrated by an international collaboration between dermatologists and chemists. Improved and complete ingredient labelling for all types of products, and not just as we have with cosmetics at present (apart from full listing of fragrance substances) in Europe, must be put on the legislative agenda.

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Contact Allergy to Metals

Thyssen¹,

Ahlström²,

Bruze³

et al. 2020

Contact Dermatitis

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Comparison of reactivity to a metallic disc and 2% aluminium salt in 366 children, and reproducibility over time for 241 young adults with childhood vaccine‐related aluminium contact allergy

Abstract: Aluminium contact allergy can be diagnosed by patch testing without using metallic aluminium.

Cited by 20 publications

References 14 publications

Patch testing children with aluminium chloride hexahydrate in petrolatum: A review and a recommendation

Patch testing children with aluminium chloride hexahydrate in petrolatum: A review and a recommendation

Contact Allergy—Emerging Allergens and Public Health Impact

Contact Allergy to Metals

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