Influence of a detergent on skin response to methyldibromo glutaronitrile in sensitized individuals

Abstract

The present study was undertaken to evaluate the combined effect of the preservative methyldibromo glutaronitrile (MDBGN) and sodium lauryl sulfate (SLS) on the elicitation response of allergic contact dermatitis. 20 volunteers with contact allergy to MDBGN were patch tested with 5 concentrations (10, 50, 100, 500 and 1000 p.p.m.) of MDBGN alone and in combination with 0.25% SLS on the upper arms for 24 h. Skin reactions were evaluated by clinical scoring, and data were evaluated by logistic dose-response models. Additionally, evaluation of skin reactions was performed by measurement of transepidermal water loss (TEWL) and skin colour. Measurements were obtained at baseline and at D3 and D7. As evaluated by clinical assessment, allergic reactions to MDBGN were elicited at lower concentrations when applied in combination with SLS than when applied alone. The response was augmented by a factor of 6.4. An increased response to combined exposure to SLS and MDBGN as compared with MDBGN alone was confirmed by TEWL and colour measurements. Effects of exposure time and concentration of the detergent are discussed. In conclusion, an augmented response was found after concurrent application of MDBGN and SLS. The response was augmented by a factor of 6.4, with confidence limits of 2.8-14.6 (P < 0.0001). This result is important in relation to the determination of threshold values and the risk assessment of contact allergens in consumer and industrial products, where allergens are often present in combination with surfactants.

Contact allergy to methyldibromo glutaronitrile – data from a ‘front line’ network

“…The risk of induction also depends on the number of exposures within a certain time frame (11). The combination of MDBGN and detergents such as those in liquid soaps has been shown to enhance skin reactions in sensitized individuals by a factor of 6.4 (12), which is in accordance with the concept of ‘danger’ signals produced by irritancy (13). Rinse‐off products, e.g.…”

Current knowledge on biomarkers for contact sensitization and allergic contact dermatitis

“…As stated before, an impaired skin barrier function will necessarily increase the risk of sensitization and elicitation of ACD. In line with this, combined exposure to irritants and sensitizers is known to significantly augment the response as assessed by measurement of TEWL and erythema .…”

Quantitative repeated open application testing with a rinse‐off product in methyldibromo glutaronitrile‐sensitive patients: results of the IVDK

“…Jensen et al (36) have shown, for instance, that 0.04% MDBGN once daily or 0.01% MDBGN four times daily had approximately equal capabilities of provoking allergic contact dermatitis. In contrast, a further aggravating influence on elicitation relating to the used product itself, namely concomitant exposure to potentially irritating detergents (37), was considered in this study, as the preparations used were based on commercial washing liquids. Zachariae et al described that the hand eczema ‘improved or cleared within 6 months' following identification of the contact allergen.…”