Frequency and trends of contact allergy to and iatrogenic contact dermatitis caused by topical drugs over a 25-year period

Gilissen, Liesbeth; Goossens, An

doi:10.1111/cod.12621

Cited by 48 publications

(48 citation statements)

References 40 publications

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“…Interesting, but difficult to explain, is a considerable decrease in the percentage of hand and leg dermatitis, while the percentage of patients with face dermatitis remained largely constant, possibly driven by the epidemic of MI contact allergy often affecting the face due to cosmetic exposures . At least the decrease in contact allergy to topical drugs (and thus, e.g., of leg dermatitis) is consistent with findings from other departments . Interdepartmental differences in the percentage of patients with at least one positive reaction to the (European) baseline series have been noted throughout all ESSCA analyses, including Hegewald et al .…”

Section: Discussionsupporting

confidence: 56%

European Surveillance System on Contact Allergies (ESSCA): results with the European baseline series, 2013/14

Uter

Amario-Hita

Balato

et al. 2017

Acad Dermatol Venereol

114

111

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Section: Discussionsupporting

confidence: 56%

European Surveillance System on Contact Allergies (ESSCA): results with the European baseline series, 2013/14

Uter

Amario-Hita

Balato

et al. 2017

Acad Dermatol Venereol

114

111

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“…This was reflected in our data, with fragrance mix I, tixocortol pivalate, neomycin, imidazolidinyl urea, and lanolin allergy more likely in AD patients, although formaldehyde itself did not reach the threshold of significance. Overall prevalence of sensitisation to neomycin has decreased in several countries in recent years, possibly due to availability being more restricted . Although other formaldehyde‐releasers aside from imidazolidinyl urea showed adjusted ORs of >1 (2‐bromo‐2‐nitropropane‐1, 3‐diol: 1.41; diazolidinyl urea: 1.38), this was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…Overall prevalence of sensitisation to neomycin has decreased in several countries in recent years, possibly due to availability being more restricted. 17 Although other formaldehyde-releasers aside from imidazolidinyl urea showed adjusted ORs of >1 (2-bromo- (Continues) statistically significant. Imidazolidinyl urea was previously shown to have been present in many cosmetic products in both Europe and the USA, 18 with a reported rise in prevalence of contact allergy to it in the United Kingdom between 2000 and 2004-2005, 19 from 0.5% to 0.9%.…”

Section: Discussionmentioning

confidence: 99%

Allergic contact dermatitis in atopic individuals: Results of a 30‐year retrospective study

et al. 2019

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Background: The association between atopic dermatitis (AD) and contact allergy, remains unclear, with studies to date showing conflicting results.Objectives: To investigate the prevalence of contact allergy in AD individuals compared to those without AD.Methods: Results of 46 250 patients patch tested in a single centre over a span of 30 years were reviewed, comparing those with AD with those without AD. Collected data were analysed with corrections for multiple confounding variables, including date of patch testing to account for changes in allergens tested over the period.Results: Nine allergens showed a statistically significant difference between the two groups. Contact allergy to nickel, cobalt and primin was less likely to arise in those with AD, whilst substances found in topical dermatological products were more likely to be associated with AD.Conclusions: This is the largest single centre study of contact sensitization in atopy reported to date. The previously reported association between contact allergy to sesquiterpene lactone and AD is reinforced. The decreased incidence of metal allergy suggests distinct immunological effector mechanisms in sensitization to these allergens. In keeping with previous publications, exposure to topical treatments for AD can result in sensitisation and contact allergy and clinicians should consider patch testing in AD individuals who report worsening of their skin despite continued treatment with topical medicaments.

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“…The sensitizing potential of aminoglycosides is well known and neomycin is the most commonly reported contact allergen . We report a case of systemic allergic dermatitis related to the use of topical gentamicin.…”

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confidence: 99%

Systemic allergic dermatitis due to gentamicin

et al. 2019

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were applied on the upper part of the patient's back. The readings on day (D) 2, D4, and D7, according to ESCD guidelines, 2 showed a positive reaction only to the Gentamicin cream (++/+++/+++). During patch testing the patient developed a widespread flare of itchy eczematous dermatitis involving the whole body except the face ( Figure 1B-D). Systemic corticosteroids were prescribed and healing of the eczema and of the burn wound was achieved. Six weeks later, a semiopen test with gentamicin 25% pet. on the right arm was performed, which showed a positive, localized reaction on D2 and D4 readings. Systemic allergic dermatitis due to gentamicin was diagnosed.Systemic allergic dermatitis is an eczematous reaction occurring in individuals previously sensitized by contact after subsequent systemic re-exposure to the same or cross-reacting substance. The related pathomechanism is probably a T-cell-mediated, delayed hypersensitivity reaction to an allergen that reaches the skin through hematogenous transport. Systemic symptoms may be associated, including headaches, fever, arthralgia, and diarrhea. 3In our patient we recognized gentamicin cream as the causal agent of the widespread eczematous dermatitis. As recommended in the literature we waited 6 weeks after the resolution of the dermatitis before testing gentamicin as standardized test preparation. 4 A semiopen test was preferred to avoid massive drug absorption.Most cases of allergic contact dermatitis due to gentamicin reported in the literature are related to its topical use. 5 Rare cases of systemic allergic dermatitis due to gentamicin are also described: all these cases were due to intravenous administration or related to gentamicin-loaded arthroplasty implants. 6-8 Although numerous cases of contact dermatitis due to gentamicin arise from crosssensitivity to neomycin, in this case the patient appears to have been sensitized only to gentamicin. Broken skin and multiple, occlusive application for several days could have favored drug absorption, accumulation in the skin, and sensitization. CONFLICTS OF INTERESTThe authors declare no potential conflict of interest. ORCID Monica Corazza

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Frequency and trends of contact allergy to and iatrogenic contact dermatitis caused by topical drugs over a 25-year period

Abstract: With a prevalence of 17.4% of consecutive patients, iatrogenic contact dermatitis is a frequent diagnosis in patients attending a general patch test clinic, involving one-third of the patients with at least one positive reaction.

Cited by 48 publications

References 40 publications

European Surveillance System on Contact Allergies (ESSCA): results with the European baseline series, 2013/14

European Surveillance System on Contact Allergies (ESSCA): results with the European baseline series, 2013/14

Allergic contact dermatitis in atopic individuals: Results of a 30‐year retrospective study

Systemic allergic dermatitis due to gentamicin

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