Quantification of aluminium release from Finn chambers under different in vitro test conditions of relevance for patch testing

Hedberg, Yolanda; Wei, Zheng; Matura, Mihály

doi:10.1111/cod.13629

Cited by 4 publications

(15 citation statements)

References 21 publications

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“…Aluminum has been found in toothpaste, antiperspirants, tattoos, eardrops, cosmetic skincare products, and some sunscreens, but the bioavailability of different aluminum compounds is not well investigated. 17 Interestingly, Veien et al 18 reported two patients who may have had a systemically aggravated contact dermatitis at previous vaccination sites caused by a small amount of aluminum oxide in toothpaste. It was postulated that aluminum was systemically absorbed by the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

“…3,14 One case report suggested testing patients with aluminum chloride hexahydrate 10% in petrolatum if a false negative to 2% is suspected. 19 Hedberg et al 17 found that the amount of aluminum released from Finn chambers ® corresponds to a skin dose of 0.03% to 0.5% of aluminum chloride hexahydrate applied in plastic chambers. In one study of 37 children who were patch tested, aluminum allergy was found in 8 patients with 10% aluminum chloride hexahydrate and in only three patients with 2% aluminum chloride hexahydrate.…”

Section: Discussionmentioning

confidence: 99%

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Widespread cutaneous eruption after aluminum‐containing vaccination: A case report and review of current literature

Mistry

DeKoven

2021

Pediatric Dermatology

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Aluminum salts are adjuvants found in many vaccines. Although rare, patients have reported cutaneous reactions to aluminum salts including persistent pruritic subcutaneous nodules at the injection site. We report the case of an 11-year-old male who at the age of 5 years developed a generalized pruritic cutaneous eruption after receiving the aluminum-containing Quadracel ® vaccination. Patch testing at that time was positive to aluminum salts and again on repeat patch testing 6 years later.Our case highlights a delayed systemic cutaneous reaction to a vaccine containing aluminum salts. We review cutaneous allergic reactions to vaccines containing aluminum salts and vaccination advice for patients with aluminum contact allergy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Widespread cutaneous eruption after aluminum‐containing vaccination: A case report and review of current literature

Mistry

DeKoven

2021

Pediatric Dermatology

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“…11 New chemical analyses from Hedberg et al show, however, that various patch test preparations can induce Al release from Finn chambers in vitro due to Al corrosion. 12 In the study, different batches of FC and FCA were investigated with 32 different baseline preparations. These were exposed to artificial sweat containing 5.0 g/L NaCl, 1.0 g/L urea, 1.0 g/L lactic acid, with the pH adjusted to 6.5.…”

mentioning

confidence: 99%

“…These were exposed to artificial sweat containing 5.0 g/L NaCl, 1.0 g/L urea, 1.0 g/L lactic acid, with the pH adjusted to 6.5. 12 It was found that sodium tetrachloropalladate hydrate (Na-Pd) 3% pet. and caine mix II (CM II), 10% pet.…”

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confidence: 99%

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Patch testing with aluminium Finn Chambers could give false‐positive reactions in patients with contact allergy to aluminium

et al. 2021

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Background: Earlier laboratory studies have shown that sodium tetrachloropalladate, Myroxylon pereirae, caine mix II, and palladium chloride trigger the release of aluminium (Al) from Finn Chambers (FC).Objectives: To investigate whether aluminium realease from FC could influence the diagnostic outcome of patch testing with FC.Method: A retrospective analysis of patch test results from 2010 to 2019 was performed. A two-sided Fisher's exact test was used to calculate any overrepresentation of contact allergy to Al among patients with positive reactions to sodium tetrachloropalladate, Myroxylon pereirae, caine mix II, and palladium chloride.Results: A total of 5446 patients had been tested with FC during the study period.There was a significant overrepresentation of contact allergy to Al among patients with positive reactions to sodium tetrachloropalladate, Myroxylon pereirae, caine mix II, and palladium chloride. Patients with a strong Al allergy had significantly higher amounts of concomitant reactions to sodium tetrachloropalladate, Myroxylon pereirae, caine mix II, and palladium chloride compared to patients with weak Al allergy. These results were not seen for patients tested with Finn Chambers AQUA. Conclusion:In patients with contact allergy to Al, patch testing with Finn chambers could give false-positive reactions to sodium tetrachloropalladate, Myroxylon pereirae, caine mix II, and palladium chloride.aluminium corrosion, caine mix II, contact allergy to aluminium, Finn chambers, Myroxylon pereirae, palladium chloride, sodium tetrachloropalladate | INTRODUCTIONPatch testing is an in vivo test considered to be the gold standard in the diagnosis of contact allergy. Patch testing needs to be performed under standardized procedures, and taking into consideration all practical aspects from storage and purity of test substances, through loading and applying the chambers, to reading the results. [1][2][3][4][5][6][7] The European Society of Contact Dermatitis recommends optimal dosing for Finn chambers (aluminium chambers; SmartPractice, Phoenix, Arizona), Van der Bend chambers (plastic chambers; Van der Bend Medical Supplies, Brielle, Netherlands), and IQ chambers (plastic chambers; Chemotechnique Diagnostics, Vellinge, Sweden), which are the three most commonly used test chamber systems. 7 Finn chambers (FCs) are made of aluminium (Al), which is normally a passive (non-corroding)

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Aluminum—Allergen of the Year 2022

Bruze¹,

Netterlid²,

Siemund³

2022

Dermatitis

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Exposure to elemental aluminum and its salts is unavoidable. Aluminum as a metal is present in transport, construction, packaging, and electronic equipment. Aluminum salts are present in consumer products, food items and drinking water, vaccines, drugs, and antiperspirants. Aluminum in vaccines and preparations for allergen-specific immunotherapy are the major sensitization sources. The predominent clinical manifestations of aluminum allergy are pruritic subcutaneous nodules and eczematous dermatitis. Patch testing shall be performed with aluminum chloride hexahydrate (ACH) in petrolatum. The preparation with ACH 10% detects substantially more aluminum allergy than ACH 2%. A patch test with elemental aluminum, for example, an empty Finn Chamber, is only positive when there is a strong aluminum allergy. A patch test reading should be performed 1 week after the application so as not to miss 15% to 20% of aluminum allergy. Aluminum should be included in any baseline patch test series for children and investigated for a possible inclusion in baseline series for adults. Aluminum test chambers can interfere with the testing resulting in both false-negative and false-positive patch test reactions to nonaluminum contact sensitizers.A luminum has within the periodic system the symbol Al and atom number 13. Its weight is 26.98. Aluminum is the third most abundant element in the Earth's crust; approximately 8% of the crust consists of aluminum. It is rare to find aluminum in its elemental form because it is too reactive. Pure aluminum virtually always forms compounds by bonding to other elements, oxygen being a favorite. In our environment, aluminum is present as oxides. EXPOSUREAluminum is widely used and contact with its elemental form or its salts is unavoidable. The metal form of aluminum has many advantages because it is soft, nonmagnetic, light, corrosion resistant, and recyclable. Aluminum as a metal is, therefore, used in applications such as in transport, packaging, construction, electronic equipment, household goods, and as alloys in medicine and dentistry. Aluminum as a trivalent metal cation, Al 3+ , can be found in many different aluminum salts with various properties. These salts are, therefore, used in industry, cosmetics, sunscreens, dental restorations, food, and medicine. [1][2][3] Aluminum is also found in drinking water. 3 Examples of the use of aluminum salts include aluminum sulfate, which is used in water purification and paper production. Aluminum acetate and aluminum acetotartrate are used as astringents in solutions. Aluminum chloride hexahydrate (ACH) and aluminum chlorohydrate are used in antiperspirants. In antacids, aluminum hydroxide can be used. Aluminum hydroxide and aluminum phosphate are added to many vaccines to enhance the immune response in the treated individuals. Aluminum may also be found in tattoo pigments. 4

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Quantification of aluminium release from Finn chambers under different in vitro test conditions of relevance for patch testing

Cited by 4 publications

References 21 publications

Widespread cutaneous eruption after aluminum‐containing vaccination: A case report and review of current literature

Widespread cutaneous eruption after aluminum‐containing vaccination: A case report and review of current literature

Patch testing with aluminium Finn Chambers could give false‐positive reactions in patients with contact allergy to aluminium

Aluminum—Allergen of the Year 2022

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