Contact sensitization in patients with suspected cosmetic intolerance: results of the <scp>IVDK</scp> 2006–2011

Dinkloh, A.; Worm, Margitta; Geier, Johannes; Schnuch, Axel; Wollenberg, Andreas

doi:10.1111/jdv.12750

Cited by 45 publications

(43 citation statements)

References 54 publications

(91 reference statements)

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“…This is of special relevance if type IV allergy to ingredients of emollients has been diagnosed by classical patch tests. Emulsifiers, fragrances and preservatives are the main causes of contact allergy to cosmetics …”

Section: General Measures and Avoidance Strategiesmentioning

confidence: 99%

Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I

Wollenberg

Barbarot

Bieber³

et al. 2018

Acad Dermatol Venereol

Self Cite

837

1,014

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This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus-based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This first part of the guideline covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy, whereas the second part covers antimicrobial therapy, systemic treatment, allergen-specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions. Management of AE must consider the individual clinical variability of the disease; highly standardized treatment rules are not recommended. Basic therapy is focused on treatment of disturbed barrier function by hydrating and lubricating topical treatment, besides further avoidance of specific and unspecific provocation factors. Topical anti-inflammatory treatment based on glucocorticosteroids and calcineurin inhibitors is used for flare management and for proactive therapy for long-term control. Topical corticosteroids remain the mainstay of therapy, whereas tacrolimus and pimecrolimus are preferred in sensitive skin areas and for long-term use. Topical phosphodiesterase inhibitors may be a treatment alternative when available. Adjuvant therapy includes UV irradiation, preferably with UVB 311 nm or UVA1. Pruritus is targeted with the majority of the recommended therapies, but some patients may need additional antipruritic therapy. Antimicrobial therapy, systemic anti-inflammatory treatment, immunotherapy, complementary medicine and educational intervention will be addressed in part II of the guideline.

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Section: General Measures and Avoidance Strategiesmentioning

confidence: 99%

Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I

Wollenberg

Barbarot

Bieber³

et al. 2018

Acad Dermatol Venereol

Self Cite

837

1,014

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“…Therefore, patch testing is recommended in AD patients with recalcitrant disease, atypical localization or aggravation without known cause, especially when systemic intervention is considered . Emulsifiers, fragrances, preservatives, corticosteroids and other components of topical treatment preparations are the most relevant substances to be tested . Children with AD who have long‐lasting hand and/or foot dermatitis should always be patch tested to evaluate if they have a relevant contact allergy and allergic contact dermatitis …”

Section: Avoidance Strategies On the Basis Of Allergy Diagnosismentioning

confidence: 99%

“…44 Emulsifiers, fragrances, preservatives, corticosteroids and other components of topical treatment preparations are the most relevant substances to be tested. 43,45 Children with AD who have long-lasting hand and/or foot dermatitis should always be patch tested to evaluate if they have a relevant contact allergy and allergic contact dermatitis. 46 AD patients run a significant risk of developing occupational contact dermatitis.…”

Section: Contact Allergymentioning

confidence: 99%

ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients

Wollenberg

Oranje²,

Deleuran

et al. 2016

Acad Dermatol Venereol

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358

488

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Atopic dermatitis (AD) is a clinically defined, highly pruritic, chronic inflammatory skin disease of children and adults. The diagnosis is made using evaluated clinical criteria. Disease activity is best measured with a composite score assessing both objective signs and subjective symptoms, such as SCORAD. The management of AD must consider the clinical and pathogenic variabilities of the disease and also target flare prevention. Basic therapy includes hydrating topical treatment, as well as avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment of visible skin lesions is based on topical glucocorticosteroids and the topical calcineurin inhibitors tacrolimus and pimecrolimus. Topical calcineurin inhibitors are preferred in sensitive locations. Tacrolimus and mid-potent steroids are proven for proactive therapy, which is long-term intermittent anti-inflammatory therapy of the frequently relapsing skin areas. Systemic anti-inflammatory or immunosuppressive treatment is indicated for severe refractory cases. Biologicals targeting key mechanisms of the atopic immune response are promising emerging treatment options. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Systemic antihistamines (H1R-blockers) may diminish pruritus, but do not have sufficient effect on lesions. Adjuvant therapy includes UV irradiation, preferably UVA1 or narrow-band UVB 311 nm. Dietary recommendations should be patient specific and elimination diets should only be advised in case of proven food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Psychosomatic counselling is recommended to address stress-induced exacerbations. 'Eczema school' educational programmes have been proven to be helpful for children and adults.

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“…In six studies in groups of patients suspected of having cosmetic or fragrance allergy, [66][67][68][69][70][71] frequencies of sensitization ranged from 9.4% to 19.6%. Relevance was mentioned in one study only (95%), but this investigation had certain weaknesses.…”

Section: Relevance and Causative Productsmentioning

confidence: 99%

Myroxylon pereiraeresin (balsam of Peru) – A critical review of the literature and assessment of the significance of positive patch test reactions and the usefulness of restrictive diets

Groot¹

2019

Contact Dermatitis

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In this article, contact allergy to Myroxylon pereirae resin (MP) (balsam of Peru) is reviewed. The topics presented include the uses, the chemical composition, the frequency of sensitization, the relevance of positive reactions, the MP-containing products causing allergic contact dermatitis, co-reactivity with other fragrance and nonfragrance materials, the sensitizers, the usefulness of MP as a "marker" of fragrance allergy, and the effectiveness of, and indications for, "balsam-restrictive" diets. Sensitization to MP occurs in 4% to 8% of patients routinely tested for suspected contact dermatitis. There are few adequate data on relevance. Topical pharmaceuticals were formerly, but are not today, important sources of sensitization. Cosmetics and foods or drinks are hardly ever products responsible for sensitization to MP. Positive patch test reactions in the large majority probably result from previous sensitization to MP constituents because of their presence in fragrances and fragranced products, MP thereby acting as marker (or "indicator") of fragrance allergy. However, fragrance mix I is a more sensitive marker, and the added diagnostic value of testing with MP is unknown. The allergenic ingredients of MP include isoeugenol, eugenol and cinnamyl alcohol, but there are other-largely unknown-chemicals that are responsible for contact allergy. Suggestions are given for further research to address questions thus far unanswered and to improve patient care. K E Y W O R D Sbalsam of Peru, balsam-restrictive diet, chemical composition, eugenol, cinnamyl alcohol, coniferyl benzoate, fragrance, isoeugenol, Myroxylon pereirae resin, perfume, fragrance marker, contact allergy

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Contact sensitization in patients with suspected cosmetic intolerance: results of the IVDK 2006–2011

Abstract: True allergic reactions to cosmetic ingredients are rarer than generally assumed. Limitation of exposure to MI in leave-on cosmetics and body care products is urgently needed.

Cited by 45 publications

References 54 publications

Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I

Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I

ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients

Myroxylon pereiraeresin (balsam of Peru) – A critical review of the literature and assessment of the significance of positive patch test reactions and the usefulness of restrictive diets

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