Amber Reck Atwater1, Amy J Petty2, Beiyu Liu3, Cynthia L Green3, Jonathan I Silverberg4, Joel G DeKoven5, Donald V Belsito6, Margo J Reeder7, Denis Sasseville8, James S Taylor9, Howard I Maibach10, Matthew J Zirwas11, James G Marks12, Kathryn A Zug13, Joseph F Fowler14, Melanie D Pratt15, Vincent A DeLeo16, Erin M Warshaw17. 1. Department of Dermatology, Duke University Medical Center, Durham, North Carolina. Electronic address: atwat012@gmail.com. 2. Duke University School of Medicine, Durham, North Carolina. 3. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina. 4. Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC. 5. Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. 6. Department of Dermatology, Columbia University Medical Center, New York, New York. 7. Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. 8. Division of Dermatology, McGill University Health Centre, Montréal General Hospital, Montréal, Canada. 9. Department of Dermatology, Cleveland Clinic, Cleveland, Ohio. 10. Department of Dermatology, University of California Medical School, San Francisco, California. 11. Probity Medical Research, Dermatologists of the Central States, Columbus, Ohio. 12. Department of Dermatology, Penn State College of Medicine, Hershey, Pennsylvania. 13. Department of Dermatology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire. 14. Division of Dermatology, University of Louisville, Louisville, Kentucky. 15. Division of Dermatology, University of Ottawa, The Ottawa Hospital, Ottawa, Canada. 16. Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California. 17. Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota; Department of Dermatology, University of Minnesota, Minneapolis, Minnesota.
Abstract
BACKGROUND: Preservatives are often necessary components of commercial products. Large-scale North American studies on preservative allergy are limited. OBJECTIVE: To evaluate demographics, positive patch test reactions (PPTRs), clinical relevance, and trends for preservatives tested by the North American Contact Dermatitis Group. METHODS: We conducted a retrospective cross-sectional analysis of North American Contact Dermatitis Group patch testing results of preservatives from 1994 through 2016. RESULTS: A total of 50,799 patients were tested; 11,338 (22.3%) had a PPTR to at least 1 preservative. The most frequent reactions were to methylisothiazolinone 0.2% aqueous (aq) (12.2%), formaldehyde 2% aq (7.8%), formaldehyde 1% aq (7.8%), quaternium-15 2% petrolatum (pet) (7.7%), and methyldibromo glutaronitrile/phenoxyethanol 2% pet (5.1%). Paraben mix 12% pet (1%), iodopropynyl butylcarbamate 0.1% pet (0.4%), benzyl alcohol 1% pet (0.3%), and phenoxyethanol 1% pet (0.2%) had the lowest PPTRs. Linear regression analysis of preservatives tested showed that only methylchloroisothiazolinone/methylisothiazolinone 0.01% aq (parameter estimate, 0.42; 95% CI, 0.17-0.66; P < .005) had a significant increase in PPTRs over time. LIMITATIONS: Collected variables are dependent on clinical judgment. Results may be prone to referral selection bias. CONCLUSIONS: This large North American study provides insight on preservative PPTRs and trends from 1994 through 2016.
BACKGROUND: Preservatives are often necessary components of commercial products. Large-scale North American studies on preservative allergy are limited. OBJECTIVE: To evaluate demographics, positive patch test reactions (PPTRs), clinical relevance, and trends for preservatives tested by the North American Contact Dermatitis Group. METHODS: We conducted a retrospective cross-sectional analysis of North American Contact Dermatitis Group patch testing results of preservatives from 1994 through 2016. RESULTS: A total of 50,799 patients were tested; 11,338 (22.3%) had a PPTR to at least 1 preservative. The most frequent reactions were to methylisothiazolinone 0.2% aqueous (aq) (12.2%), formaldehyde 2% aq (7.8%), formaldehyde 1% aq (7.8%), quaternium-15 2% petrolatum (pet) (7.7%), and methyldibromo glutaronitrile/phenoxyethanol 2% pet (5.1%). Paraben mix 12% pet (1%), iodopropynyl butylcarbamate 0.1% pet (0.4%), benzyl alcohol 1% pet (0.3%), and phenoxyethanol 1% pet (0.2%) had the lowest PPTRs. Linear regression analysis of preservatives tested showed that only methylchloroisothiazolinone/methylisothiazolinone 0.01% aq (parameter estimate, 0.42; 95% CI, 0.17-0.66; P < .005) had a significant increase in PPTRs over time. LIMITATIONS: Collected variables are dependent on clinical judgment. Results may be prone to referral selection bias. CONCLUSIONS: This large North American study provides insight on preservative PPTRs and trends from 1994 through 2016.
Authors: A M Giménez-Arnau; G Deza; A Bauer; G A Johnston; V Mahler; M-L Schuttelaar; J Sanchez-Perez; J F Silvestre; M Wilkinson; W Uter Journal: J Eur Acad Dermatol Venereol Date: 2017-01-17 Impact factor: 6.166
Authors: Ivan J Boyer; Bart Heldreth; Wilma F Bergfeld; Donald V Belsito; Ronald A Hill; Curtis D Klaassen; Daniel C Liebler; James G Marks; Ronald C Shank; Thomas J Slaga; Paul W Snyder; F Alan Andersen Journal: Int J Toxicol Date: 2013 Nov-Dec Impact factor: 2.032
Authors: Joel G DeKoven; Erin M Warshaw; Kathryn A Zug; Howard I Maibach; Donald V Belsito; Denis Sasseville; James S Taylor; Joseph F Fowler; C G Toby Mathias; James G Marks; Melanie D Pratt; Matthew J Zirwas; Vincent A DeLeo Journal: Dermatitis Date: 2018 Nov/Dec Impact factor: 4.845