David Bregnbak

Chromium allergy and dermatitis: prevalence and main findings

The history of chromium as an allergen goes back more than a century, and includes an interventional success with national legislation that led to significant changes in the epidemiology of chromium allergy in construction workers. The 2015 EU Leather Regulation once again put a focus on chromium allergy, emphasizing that the investigation of chromium allergy is still far from complete. Our review article on chromium focuses on the allergens chemical properties, its potential exposure sources, and the allergens interaction with the skin, and also provides an overview of the regulations, and analyses the epidemiological pattern between nations and across continents. We provide an update on the allergen from a dermatological point of view, and conclude that much still remains to be discovered about the allergen, and that continued surveillance of exposure sources and prevalence rates is necessary.

Chromium(VI) release from leather and metals can be detected with a diphenylcarbazide spot test

Along with chromium, nickel and cobalt are the clinically most important metal allergens. However, unlike for nickel and cobalt, there is no validated colorimetric spot test that detects chromium. Such a test could help both clinicians and their patients with chromium dermatitis to identify culprit exposures.

Characteristics of chromium‐allergic dermatitis patients prior to regulatory intervention for chromium in leather: a questionnaire study

Chromium‐tanned leather articles currently constitute the most important cause of contact allergy to chromium in Denmark. A regulation on the content of hexavalent chromium in leather was adopted in November 2013 by the EU member states.

Association between cobalt allergy and dermatitis caused by leather articles – a questionnaire study

Cobalt is a strong skin sensitizer and a prevalent contact allergen. Recent studies have recognized exposure to leather articles as a potential cause of cobalt allergy.

Failure of total hip implants: metals and metal release in 52 cases.

The pathogenesis of total joint replacement failure is multifactorial. One hypothesis suggests that corrosion and wear of alloys result in metal ion release, which may then cause sensitization and even implant failure, owing to the acquired immune reactivity.

Five cases of severe chronic dermatitis caused by isothiazolinones

Preservatives used in both industrial and consumer products are well-known and important causes of contact allergy (1). The allergens relevant for this article are the preservatives methylchloroisothiazolinone (MCI) (CAS: 26172-55-4), methylisothiazolinone (MI) (CAS: 268220-4), and benzisothiazolinone (BIT) (CAS: 2634-33-5). MCI/MI (3:1) has been used as a preservative in cosmetics and household products such as cleaning agents, as well as in industrial products, since the early 1980s. Since the beginning of the millennium, MI has been available on its own for industrial products, and in 2005 its use in cosmetic products was permitted (2). In cosmetics, MCI/MI has been limited to a concentration of 15 ppm, whereas MI alone is limited to 100 ppm. BIT is used in both industrial and household products, such as cleaning and impregnating agents, paints, polishes, and printing inks (3), but was recently rejected by the Scientific Committee on Consumer Safety for use in cosmetic product, owing to the negative experiences with MI concerning contact allergy (4). From 2009 to 2011, the prevalence of MI contact allergy increased dramatically (5, 6). In 2011, the first 2 cases of airborne allergic contact dermatitis caused by MI in paint were published (7), and it was recently shown that 3 of 4 of MI-allergic patients with relevant exposure to paint had signs of airborne allergic contact dermatitis (6). In 2012, the first case of systemic allergic dermatitis caused by airborne exposure to BIT was published (8). The entity systemic contact dermatitis can present with clinically characteristic features or be clinically indistinguishable from other types of contact dermatitis (9). The clinical features include

Airborne sensitization to isothiazolinones observed in a 3-month-old boy.

A case study is presented of sensitisation to methylchloroisothiazolinone and methylisothiazolinone in a baby.

Recent trends in epidemiology, sensitization and legal requirements of selected relevant contact allergens

ABSTRACT Numerous studies have focused on emerging allergens causing contact allergy and allergic contact dermatitis in eczema populations and the general population, whereas only a few European multicenter studies systematically manage to detect prevalence rates of various contact allergies over time in eczema populations. Contact allergy is a life-time condition, which may lead to allergic contact dermatitis in individuals who do not manage to avoid exposure to the ascertained allergen in question. It is therefore of utmost importance that clinicians and dermatologists have sufficient knowledge on common allergens causing contact allergies in the general and working population. This review aimed to highlight the newest knowledge of frequent allergens of clinical importance. Literature was sought from the Pubmed™ database, Google™ scholar and textbooks. On the basis of the literature within the last 5 years, a comprehensive review of methylisothiazolinone, chromium, cobalt, rubber accelerators and fragrance ingredients were conducted. Of each allergen we discuss in detail the temporal trend of prevalence, source of exposure, clinical manifestation of allergic contact dermatitis and legislative measurements on how to regulate the exposure.

Experimental skin deposition of chromium on the hands following handling of samples of leather and metal

Chromium is an important skin sensitizer. Exposure to it has been regulated in cement, and recently in leather. Studies on the deposition of chromium ions on the skin as a result of handling different chromium‐containing materials are sparse, but could improve the risk assessment of contact sensitization and allergic contact dermatitis caused by chromium.

Assessment of chromium(VI) release from 848 jewellery items by use of a diphenylcarbazide spot test

Keywords: allergic chromium dermatitis; chromium; chromium allergy; dermatitis; metals; potassium dichromate; screening; spot test