Sensitization to Polyethylene Glycols (Carbowaxes®)

Strauss, Maurice J.

doi:10.1001/archderm.1950.01530100064008

Cited by 14 publications

(5 citation statements)

References 6 publications

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“…Incidentally, concurrent immediate‐ and delayed‐type PEG hypersensitivity has yet to be described; among 15 instances of reported delayed‐type PEG hypersensitivity, none investigate for simultaneous immediate‐type hypersensitivity. Of note, all delayed‐type cases involve application of PEG on broken skin, often in combination with known sensitizers such as nitrofurazone . In contrast to immediate‐type hypersensitivity, low molecular weight PEGs were more commonly associated with delayed‐type HSRs, likely a reflection of their comparatively greater cutaneous absorption and prevalence in topical products .…”

Section: Literature Review Of Immediate‐type Hypersensitivity To Pegsmentioning

confidence: 99%

Immediate‐type hypersensitivity to polyethylene glycols: a review

Wenande

Garvey

2016

Clin Experimental Allergy

307

384

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Polyethylene glycols (PEGs) or macrogols are polyether compounds widely used in medical and household products. Although generally considered biologically inert, cases of mild to life-threatening immediate-type PEG hypersensitivity are reported with increasing frequency. Nevertheless, awareness of PEG's allergenic potential remains low, due to a general lack of suspicion towards excipients and insufficient product labelling. Information on immediate-type reactions to PEG is limited to anecdotal reports, and the potential for PEG sensitization and cross-sensitization to PEGylated drugs and structurally related derivatives is likely underestimated. Most healthcare professionals have no knowledge of PEG and thus do not suspect PEG's as culprit agents in hypersensitivity reactions. In consequence, patients are at risk of misdiagnosis and commonly present with a history of repeated, severe reactions to a range of unrelated products in hospital and at home. Increased awareness of PEG prevalence, PEG hypersensitivity, and improved access to PEG allergy testing, should facilitate earlier diagnosis and reduce the risk of inadvertent re-exposure. This first comprehensive review provides practical information for allergists and other healthcare professionals by describing the clinical picture of 37 reported cases of PEG hypersensitivity since 1977, summarizing instances where PEG hypersensitivity should be considered and proposing an algorithm for diagnostic management.

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Section: Literature Review Of Immediate‐type Hypersensitivity To Pegsmentioning

confidence: 99%

Immediate‐type hypersensitivity to polyethylene glycols: a review

Wenande

Garvey

2016

Clin Experimental Allergy

307

384

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“…Cases of allergic contact dermatitis (ACD) from PEGs (27–30), from diethyleneglycol ethers (31–34), and from various ethoxylated non‐ionic surfactants and emulsifiers are reported in literature (35). The ethoxylated alkylphenolic compounds (nonoxynols) are examples of ethoxylated non‐ionic surfactants that have caused ACD (36–39).…”

Section: Discussionmentioning

confidence: 99%

Allergenic activity of an air‐oxidized ethoxylated surfactant

Karlberg

Bodin²,

Matura

2003

Contact Dermatitis

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Ethoxylated surfactants are used in household and industrial cleaners, topical pharmaceuticals, cosmetics and laundry products. Polyethers, e.g. ethoxylated surfactants and polyethylene glycols, are oxidized by atmospheric oxygen (autoxidized) when stored and handled. We have previously shown that a chemically well-defined non-ionic surfactant, the ethoxylated alcohol penta-ethylene glycol mono-n-dodecyl ether (C 12 E 5 ), forms a complex mixture of autoxidation products when exposed to air. Predictive testing in guinea pigs showed that the surfactant itself is a nonsensitizer, but that oxidation products formed are skin sensitizers. The aim of this study was to investigate the sensitizing capacity of a total oxidation mixture of C 12 E 5 obtained after autoxidation. The allergenic activity of different oxidation products is discussed as well as the clinical importance of the findings. This study shows that the non-ionic surfactant C 12 E 5 containing 20% oxidation products is a sensitizing mixture. The result accords with what is observed for other compounds that are unstable when in contact with air, e.g. limonene and linalool, major fragrance terpenes. Studies regarding the clinical relevance of our findings should be performed. However, it is already clear from this study that precautions must be taken in handling and storage of ethoxylated surfactants to avoid formation of allergenic mixtures.

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“…In industry the PEGs are used as solvents for nitrocellulose, as wetting agents in epoxy hardeners and as plasticizers for glue and casein. Although allergic contact dermatitis from PEG is uncommon, several cases have been reported (13–16). According to the literature, it is principally the low molecular weight (MW) PEGs from 200 to 400 that may evoke an allergic reaction, whereas those with higher MWs are not contact sensitizers (14).…”

Section: Discussionmentioning

confidence: 99%

Identification and allergenic activity of hydroxyaldehydes – a new type of oxidation product from an ethoxylated non‐ionic surfactant

et al. 2001

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Ethoxylated alcohols, which are widely used as surfactants, are susceptible to oxidation on air exposure. A complex mixture of oxidation products is formed, among which alkylated aldehydes, alkylated formates, formaldehyde and peroxides have previously been identified by our group. In the present study, we have identified a new class of oxidation product from the nonionic ethoxylated surfactant C12E5. These oxidation products are highly water-soluble hydroxyaldehydes with the general formula HO(CH2CH2O)nCH2CHO, n=1-4. To facilitate the identification of the hydroxyaldehydes in oxidized C12E5, reference compounds were synthesized. The sensitizing potential of 1 of the identified hydroxyaldehydes, HO(CH2CH2O)3CH2CHO, was studied in guinea pigs and was found to be weak. A significant cross-reactivity between this aldehyde and the next shorter homologue, HO(CH2CH2O)2CH2CHO, was observed. Irritant components, present in the oxidation mixture, facilitate the skin penetration of allergens, which further accentuates the importance of controlling the conditions of storage and handling of ethoxylated surfactants, to reduce the formation of allergenic and irritant oxidation products.

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Sensitization to Polyethylene Glycols (Carbowaxes®)

Cited by 14 publications

References 6 publications

Immediate‐type hypersensitivity to polyethylene glycols: a review

Immediate‐type hypersensitivity to polyethylene glycols: a review

Allergenic activity of an air‐oxidized ethoxylated surfactant

Identification and allergenic activity of hydroxyaldehydes – a new type of oxidation product from an ethoxylated non‐ionic surfactant

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