The prevalence and relevance of patch testing with textile dyes

Abstract

Background Textile dye mix (TDM) is included in the European baseline series (EBS), but it is unknown if TDM identifies all patients with a textile dye allergy. Objectives To assess the added value of performing patch testing with individual textile dyes in addition to TDM. Methods Two hundred and nine patients suspected to have a contact allergy to textile dyes were patch tested between January 2015 and December 2021 with the EBS, as well as an individual textile dye test series containing textile dyes part of TDM (TDM‐dyes) and outside the scope of TDM (non‐TDM dyes). Results Fifty‐four patients (25.8%) tested positive for TDM or an individual textile dye. Disperse Orange 3 (9.6%) followed by Disperse Blue 106 (4.8%) were the most common individual textile dyes causing a positive patch test reaction. Of the 54 dye positive patients, 28 (51.9%) had a clinically relevant reaction. No clinically relevant reactions were seen in patients that solely tested positive for non‐TDM dyes. Conclusions It is beneficial to test individual textile dyes in addition to TDM in patients suspected of having a textile dye allergy. Otherwise, 46.3% of the dye positive patients and 35.7% of the patients with a clinically relevant reaction would have been missed.

Sensitization to textile dyes in Spain: Epidemiological situation (2019–2022)

“…The research of Stingeni et al 11 is the only one with a low proportion of concomitant positivity between TDM and PPD (28.5%). The vast majority of studies show that, similar to our results, simultaneous positivity between TDM and PPD is common, as it is between DO 3 and PPD, and vice versa 6–9,11,12,17 . In the study of Isaksson et al, 12 61% of TDM‐allergic patients were also allergic to PPD and 75% to any separate DDs, DO 3 being the most frequent.…”

“…In contrast, Stingeni et al 11 observed a higher clinical relevance of 70%. Concerning studies in selected patients with suspected textile ACD, Nijman et al 17 observed that most cases were linked to clinical relevance in a Dutch sample, as well as Wentworth et al 10 in an American group.…”

“…Linauskiene et al 5 showed that a group of 9 out of 10 TDM‐positive Swedish patients reacted to textile extracts made from synthetic garments which did not contain pure DDs present in TDM 6.6%, probably because of the abovementioned unknown dye substances, DDs metabolites or impurities. However, Nijman et al 17 found that patch‐testing the TDM alone in a Dutch group with suspected textile ACD would involve missing a substantial amount of dye positive and clinically relevant cases. We agree that both the TDM and a specific textile dye series should be patch‐tested in clinical practice in case of suspected textile ACD.…”

“…The vast majority of studies show that, similar to our results, simultaneous positivity between TDM and PPD is common, as it is between DO 3 and PPD, and vice versa. [6][7][8][9]11,12,17 In the study of Isaksson et al, 12 61% of TDMallergic patients were also allergic to PPD and 75% to any separate DDs, DO 3 being the most frequent. In the two cited works by Ryberg et al, 6,7 53%-58% of TDM positive patients were allergic to PPD.…”