Wolfgang Uter1, S Mark Wilkinson2, Olivier Aerts3, Andrea Bauer4, Leopoldo Borrego5, Timo Buhl6, Susan M Cooper7, Heinrich Dickel8, Rosella Gallo9, Ana M Giménez-Arnau10, Swen M John11,12, Alexander A Navarini13, Maria Pesonen14, Györgyi Pónyai15, Thomas Rustemeyer16, Sibylle Schliemann17, Steffen Schubert18, Marie-Louise A Schuttelaar19, Skaidra Valiukevičienė20, Nicola Wagner21, Elke Weisshaar22, Margarida Gonçalo23. 1. Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander Universität Erlangen/Nürnberg, Erlangen, Germany. 2. Dermatology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK. 3. Department of Dermatology, University Hospital Antwerp (UZA) and Research group Immunology, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium. 4. Department of Dermatology, University Allergy Centre, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany. 5. Complejo Hospitalario Universitario Insular Materno Infantil. Universidad de las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. 6. Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany. 7. Department of Dermatology, Oxford University Hospitals NHS Trust, Oxford, UK. 8. Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany. 9. Clinica Dermatologica, Department of Health Sciences, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. 10. Department of Dermatology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain. 11. Department of Dermatology and Environmental Medicine, Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany. 12. Lower Saxony Institute for Occupational Dermatology (NIB), Osnabrück, Germany. 13. Department of Biomedicine, University Hospital Basel, Basel, Switzerland. 14. Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland. 15. Department of Dermatology, Venerology and Dermatooncology, Semmelweis University, Budapest, Hungary. 16. Department of Dermatology-Allergology, Amsterdam University Medical Centers, Amsterdam, The Netherlands. 17. Department of Dermatology, University Hospital Jena, Jena, Germany. 18. Information Network of Departments of Dermatology, Institute at the University Medical Centre Göttingen, Göttingen, Germany. 19. Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 20. Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania. 21. Department of Dermatology, University Hospital of Erlangen, University of Erlangen-Nuremberg (FAU), Erlangen, Germany. 22. Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany. 23. Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Abstract
BACKGROUND: In 2019, a number of allergens (haptens), henceforth, "the audit allergens," were considered as potential additions to the European Baseline Series (EBS), namely, sodium metabisulfite, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, imidazolidinyl urea, Compositae mix II (2.5% or 5% pet), linalool hydroperoxides (lin-OOH), limonene hydroperoxides (lim-OOH), benzisothiazolinone (BIT), octylisothiazolinone (OIT), decyl glucoside, and lauryl glucoside; Evernia furfuracea (tree moss), was additionally tested by some departments as well. OBJECTIVES: To collect further data on patch test reactivity and clinical relevance of the audit allergens in consecutive patients across Europe. METHODS: Patch test data covering the audit allergens in 2019 and 2020 were collected by those departments of the European Surveillance System on Contact Allergies testing these, as well as further collaborators from the EBS working group of the European Society of Contact Dermatitis (ESCD), and the Spanish Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea. As patch test outcome, reactions between day (D) 3 and D5 were considered. RESULTS: Altogether n = 12 403 patients were tested with any of the audit allergen. Positive reactions were most common to lin-OOH 1% pet. (8.74% [95%CI: 8.14-9.37%]), followed by lin-OOH 0.5% pet., and lim-OOH 0.3% pet (5.41% [95% CI: 4.95-5.89%]). Beyond these terpene hydroperoxides, BIT 0.1% pet. was the second most common allergen with 4.72% (95% CI: 4.2-5.28%), followed by sodium metabisulfite 1% pet. (3.75% [95%CI: 3.32-4.23%]) and Compositae mix 5% pet. (2.31% [95% CI: 1.84-2.87%]). For some allergens, clinical relevance was frequently difficult to ascertain. CONCLUSIONS: Despite many positive patch test reactions, it remains controversial whether lin- and lim-OOH should be tested routinely, while at least the two preservatives BIT and sodium metabisulfite appear suitable. The present results are a basis for further discussion and ultimately decision on their implementation into routine testing among the ESCD members.
BACKGROUND: In 2019, a number of allergens (haptens), henceforth, "the audit allergens," were considered as potential additions to the European Baseline Series (EBS), namely, sodium metabisulfite, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, imidazolidinyl urea, Compositae mix II (2.5% or 5% pet), linalool hydroperoxides (lin-OOH), limonene hydroperoxides (lim-OOH), benzisothiazolinone (BIT), octylisothiazolinone (OIT), decyl glucoside, and lauryl glucoside; Evernia furfuracea (tree moss), was additionally tested by some departments as well. OBJECTIVES: To collect further data on patch test reactivity and clinical relevance of the audit allergens in consecutive patients across Europe. METHODS: Patch test data covering the audit allergens in 2019 and 2020 were collected by those departments of the European Surveillance System on Contact Allergies testing these, as well as further collaborators from the EBS working group of the European Society of Contact Dermatitis (ESCD), and the Spanish Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea. As patch test outcome, reactions between day (D) 3 and D5 were considered. RESULTS: Altogether n = 12 403 patients were tested with any of the audit allergen. Positive reactions were most common to lin-OOH 1% pet. (8.74% [95%CI: 8.14-9.37%]), followed by lin-OOH 0.5% pet., and lim-OOH 0.3% pet (5.41% [95% CI: 4.95-5.89%]). Beyond these terpene hydroperoxides, BIT 0.1% pet. was the second most common allergen with 4.72% (95% CI: 4.2-5.28%), followed by sodium metabisulfite 1% pet. (3.75% [95%CI: 3.32-4.23%]) and Compositae mix 5% pet. (2.31% [95% CI: 1.84-2.87%]). For some allergens, clinical relevance was frequently difficult to ascertain. CONCLUSIONS: Despite many positive patch test reactions, it remains controversial whether lin- and lim-OOH should be tested routinely, while at least the two preservatives BIT and sodium metabisulfite appear suitable. The present results are a basis for further discussion and ultimately decision on their implementation into routine testing among the ESCD members.