Photopatch testing: recommendations for a European photopatch test baseline series

Gonçalo, Margarida; Ferguson, J.; Bonevalle, Annie; Bruynzeel, Derk P.; Giménez‐Arnau, Ana; Goossens, An; Kerr, Alastair; Lecha, M; Neumann, Norbert; Niklasson, Bo; Pigatto, Paolo D.; Rhodes, Lesley E.; Rustemeyer, Thomas; Sarkany, Robert; Thomas, Pierre; Wilkinson, S. M.

doi:10.1111/cod.12037

Cited by 127 publications

(97 citation statements)

References 18 publications

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“…All patients were tested with the European baseline 30 and additional series, according to the tasks they developed. Allergens from Chemotechnique (Chemotechnique Diagnostics ® , Vellinge, Sweden) or Trolab allergens ® (Almirall GmbH, Germany) were applied for 48h on the back using Finn Chambers ® (Epitest Ld, Almirall) or IQ Chambers ® (Chemotechnique Diagnostics ® , Vellinge, Sweden) and readings were performed at day (D)2-3 and D4-7, according to ESCD guidelines.…”

Section: Methodsmentioning

confidence: 99%

“…Allergens from Chemotechnique (Chemotechnique Diagnostics ® , Vellinge, Sweden) or Trolab allergens ® (Almirall GmbH, Germany) were applied for 48h on the back using Finn Chambers ® (Epitest Ld, Almirall) or IQ Chambers ® (Chemotechnique Diagnostics ® , Vellinge, Sweden) and readings were performed at day (D)2-3 and D4-7, according to ESCD guidelines. [30][31][32] Only 1+ or more intense reactions were considered. Occasionally, semi-open testing was performed with rinse-off products from the workplace.…”

Section: Methodsmentioning

confidence: 99%

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Dermatite de Contacto Alérgica em Profissionais de Saúde

Pinheiro

Pestana

Marques

et al. 2017

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RESUMO -Introdução: A dermatite de contacto alérgica (DCA) constitui patologia profissional particularmente frequente em profissionais de saúde. Os alergénios responsáveis podem variar ao longe do tempo, com a exposição ocupacional e com o tipo de trabalho. Objectivos e Métodos: Com o objetivo de avaliar a realidade local, foi feita uma análise retrospetiva dos profissionais de saúde que realizaram testes epicutâneos no Serviço de Dermatologia do Centro Hospitalar e Universitário de Coimbra (CHUC), num período de 6 anos (2010)(2011)(2012)(2013)(2014)(2015), por suspeita de dermatite de contacto alérgica. Os doentes foram todos testados com uma Série Básica e com séries complementares orientadas pela história clínica. Resultados: Dos 1858 doentes testados, 125 (6,7%) eram profissionais de saúde, 114 de género feminino/11 masculino, idade média de 39,26±12,5 anos, maioritariamente enfermeiras (56), assistentes técnicos (48) e médicos (21), 71 com dermatite das mãos (56.8%), 22 com dermatite atópica e/ou outros sinais de atopia (17,6%). Noventa (72%) revelaram pelo menos um patch test (PT) positivo, 47 dos quais (52,2%) com relevância profissional. Doentes com dermatite das mãos tiveram mais frequentemente PT positivo (76,1%). Os metais causaram maior número de PT positivos (total 51; Ni-41, maioritariamente com relevância passada, Co-8; Cr-2), seguidos das fragrâncias (total 30; mistura de fragrâncias (FM)-I-10; Myroxylon pereirae-8; lyral-5; FM-II-4; citronellol-3), conservantes (total 29, dos quais 20 à metilisotiazolinona (MI) e/ou clorometilisotiazolinona/MI (MCI/MI)), borrachas (24; P-fenilenodiamina (PPD)/Isopropil-PPD-9) e medicamentos tópicos (total 14; iodopovidona 5). As principais causas da DCA profissional foram os desinfetantes/sabonetes líquidos e produtos de higiene dos doentes (15), borracha das luvas/calçado (12) e medicamentos sistémicos ou tópicos (8 antissépticos e 3 antibióticos parentéricos). Os principais alergénios com relevância profissional foram a MI e/ou MCI/MI (15), lanolina (9), formaldeído e/ou libertadores (7), iodopovidona (5), carbamatos (4), FM-I (3), cefalosporinas (3) e acrilatos (3 dentistas e/ou assistentes dentários). Em 37 dos 42 casos avaliados, houve uma melhoria franca ou resolução da DCA, após evicção do alergénio causal, nomeadamente o conservante MCI/ MI contido num sabonete líquido sob a designação de "Acticide ® MV". Conclusões: A dermatite das mãos, a principal apresentação da DCA em profissionais de saúde, não mostrou relação com atopia e foi mais frequentemente associada a PT positivos. PT positivos a isotiazolinonas e libertadores de formaldeído foram mais frequentes entre profissionais de saúde do que na população geral estudada, muito provavelmente devido à exposição cumulativa, pessoal e profissional, a estes conservantes em sabonetes líquidos de uso pessoal e hospitalar. O PT foi crucial para orientar individualmente os doentes e para alertar a comunidade hospitalar para a presença de alergénios no local de trabalho e estabelecer medidas preventivas mais ade...

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Dermatite de Contacto Alérgica em Profissionais de Saúde

Pinheiro

Pestana

Marques

et al. 2017

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“…Recently, recommendations for diagnostic patch testing have been issued by the European Society of Contact Dermatitis (ESCD), 22 and in a cooperative effort of the ESCD and European Society of Photodermatology (ESPD), an agreement was not only reached regarding standardized protocols for photo-patch testing, 23 but also on the list of 20 allergens to be included in the European baseline photo-patch tests series and an additional extended series including certain classical photo-allergens. 24 Last but not least, photo-patch tests with all the patient's own topical products and systemic photosensitizers to which the patients is exposed are strongly recommended as well, since the outcome may further contribute to the relevance of positive reactions observed, or avoid "false"-negative reactions obtained by testing standardized allergens only. 24 …”

Section: This Number Of the Revista Da Sociedade Portuguesa Dementioning

confidence: 99%

“…24 Last but not least, photo-patch tests with all the patient's own topical products and systemic photosensitizers to which the patients is exposed are strongly recommended as well, since the outcome may further contribute to the relevance of positive reactions observed, or avoid "false"-negative reactions obtained by testing standardized allergens only. 24 …”

Section: This Number Of the Revista Da Sociedade Portuguesa Dementioning

confidence: 99%

Patch and Photo-Patch Testing are Important in Patients with Idiopathic Photodermatoses

Goossens

Gonçalo

2018

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This number of the Revista da Sociedade Portuguesa de Dermatologia e Venereologia contains two articles dedicated to idiopathic photodermatoses, for which autoimmune reactions to an unknown endogenous chromophore are suspected to be involved – polymorphous light eruption, actinic prurigo, hydroa vacciniforme, chronic actinic dermatitis, and solar urticarial.1,2 Many of these and other photodermatoses have a very clear clinical presentation, while others may mimic allergic contact dermatitis (ACD) or photo-allergic contact dermatitis (PhACD), a classical T cell-mediated or delayed type IV hypersensitivity reaction to an exogenous chromophore applied on the skin in the presence of, or followed by exposure to ultraviolet (UV) or visible light.3,4 Allergic contact reactions can be followed by persistent photosensitivity and chronic actinic dermatitis, such as in cases of chronic ACD from certain plants, e.g., Compositae that are rich in sesquiterpene lactones,5 fragrances, lichens, and colophony,4 or in PhACD or photo-aggravated ACD from drugs like ketoprofen, etofenamate, and chlorproethazine, or even other contact allergens, such as tosylamide/formaldehyde resin, fragrances, and thiourea derivatives.4The long persistence of these chemicals in the epidermis (for up to at least 17 days in the case of ketoprofen),6 or the formation of endogenous photosensitizers might perhaps explain the progression to chronic actinic dermatitis.4In patients with idiopathic photodermatoses the use of sunscreens is mandatory, however, the sensitization risk from these chemicals may be enhanced by the previous skin inflammation and the need for repeated application for long periods.7 UV filters, which are chromophores that capture UV light, are among the most frequent causes of PhACD,8-11 namely benzophenones, dibenzoylmethane derivatives, octocrylene, and cinammates.9,10,12-14 Although more recent UV filters seem to be more photostable and less prone to induce PhACD,3 a few cases have been described,9 for example, from polysilicone-15 (Parsol®SLX).15 With regard to methylene bis-benzotriazolyl tetramethylbutylphenol (syn. bisoctrizole or Tinosorb® M), ACD from it is due to the surfactant decyl glucoside, in particular, which is added in order to stabilize the sunscreen molecule.16,17Topical drugs, such as the non-steroidal anti-inflammatory ketoprofen, piketoprofen, suprofen, etofenamate, piroxicam, and benzydamine,18 as well as phenothiazine derivatives, i.e., promethazine or chlorproethazine, and isothipendyl chlorhydrate19 are frequent causes of ACD/PhACD, either by direct application or by transfer from other individuals in close contact (consort or connubial dermatitis). Moreover, some of these chemicals, particularly ketoprofen, exhibit cross-reactions with UV filters, i.e., benzophenone(s) and octocrylene, the latter containing benzophenone residues. Also fenofibrate, a systemic drug, shares the benzophenone ring and can cross react with ketoprofen and related molecules.3,20 Furthermore, patients with PhACD from ketoprofen present with concomitant reactions to the perfume ingredient cinnamic alcohol, reactions that at present are difficult to explain by cross-reactivity.21Therefore, patch and photo-patch testing are highly recommended in patients with idiopathic and autoimmune photodermatoses, as well as in all other diseases aggravated by sunlight, in order to detect and avoid exposure to possible aggravating factors, and particularly to UV filters. Recently, recommendations for diagnostic patch testing have been issued by the European Society of Contact Dermatitis (ESCD),22 and in a cooperative effort of the ESCD and European Society of Photodermatology (ESPD), an agreement was not only reached regarding standardized protocols for photo-patch testing,23 but also on the list of 20 allergens to be included in the European baseline photo-patch tests series and an additional extended series including certain classical photo-allergens.24 Last but not least, photo-patch tests with all the patient’s own topical products and systemic photosensitizers to which the patients is exposed are strongly recommended as well, since the outcome may further contribute to the relevance of positive reactions observed, or avoid “false”- negative reactions obtained by testing standardized allergens only.24

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“…The recommended European baseline photopatch test series includes many drugs, namely, ketoprofen, etofenamate, piroxicam and benzydamine and also piketoprofen, dexketoprofen, ibuprofen, diclofenac, fenofi brate and chlorpromazine in the extended series (Gonçalo et al 2013 ). Any other topical or systemic drug suspected of causing photosensitivity may be tested according to the general standardized procedures of photopatch testing.…”

Section: Diagnostic Procedures In Drug Photosensitivitymentioning

confidence: 99%