Haudrey Assier

Outbreak of contact sensitization to methylisothiazolinone: an analysis of French data from the REVIDAL‐GERDA network

The preservative methylisothiazolinone (MI) is used in combination with methylchloroisothiazolinone (MCI), but the MCI/MI mixture has been identified as highly allergenic. MI is considered to be less allergenic, and since the mid‐2000s has been widely used alone, but is now clearly identified as a contact allergen. The French Vigilance Network for Dermatology and Allergy of the Study and Research Group on Contact Dermatitis (REVIDAL‐GERDA) added MI to its baseline patch testing series in 2010.

Occupational Contact Dermatitis in 10,582 French Patients Reported between 2004 and 2007: A Descriptive Study

Background: Limited epidemiological data are available in France for occupational contact dermatitis (OCD), a non- infectious inflammatory skin condition arising from direct skin contact with substances used in the workplace. Objective: To estimate the occurrence of, and number of workdays lost to, OCD in France. Methods: Descriptive study of all OCD declared by salaried workers and recognised as occupational disease in France over a 4-year period. Results: 10,582 OCD cases were reported, representing 9.6% of all occupational diseases recognised. The estimated annual incidence of OCD recognised was 15.72/100,000 salaried workers (i.e. 146.87/100,000 employees for all occupational diseases). OCD cases were mainly in the construction and public works industries with 3,057 (36.7%) salaried workers affected. In the services sector, OCD predominantly affected employees aged less than 30 years (41%), particularly hairdressers (69%). OCD accounted for the loss of 395,069 working days. Conclusion: OCD represents a significant public health problem in France, particularly for construction workers and hairdressers.

Cutaneous Adverse Drug Reactions with Antimalarials and Allergological Skin Tests.

Background: Currently used antimalarial drugs (AM) are hydroxychloroquine and chloroquine, which are prescribed for many autoimmune disorders. The value of skin tests on cutaneous adverse drug reactions (CADR) with AM remains unknown. Objective: The main objective of this retrospective study is to know whether skin tests for AM are useful and how to manage the recovery of AM therapy in these patients. Methods: All patients referred for suspected CADR secondary to AM between 2001 and 2014 in eight French dermatology centers were retrospectively reviewed. Results: We report herein a retrospective series of 20 patients with CADR and AM involvement. Skin tests, performed in 14/20 patients, were negative in all cases. Six patients had an oral provocation test with recurrence of CADR in 1 case. Conclusion: We encourage dermatologists to perform oral provocation tests in nonsevere CADR in order to allow AM rechallenge at progressive doses.

Cutaneous Adverse Drug Reaction to Oral Acetazolamide and Skin Tests

Background: Few cases of cutaneous adverse drug reactions (CADR) to oral acetazolamide, a non-antimicrobial sulfonamide, have been previously reported, and the interest of acetazolamide skin tests has never been studied. Objectives: We report a series of ten patients with oral acetazolamide CADR and skin tests. Patients and Methods: The files of ten patients with CADR secondary to oral acetazolamide prescribed for cataract surgery in most cases referred between 2001 and 2011 in four French dermatology and allergy departments were retrospectively reviewed. Skin tests with acetazolamide were performed in nine patients and twelve controls. Other sulfonamides were tested in five of ten patients. Results: Seven patients developed maculopapular exanthema and four had acute generalized exanthematous pustulosis. Patch tests were positive for 8/9 patients, prick tests for 2/4 and intradermal tests for 3/3. Patch and prick or intradermal test results were concordant in 2/3 positive subjects. Patch tests for other sulfonamides were negative, as were patch tests in controls. Conclusions: We report the largest series of CADR to oral acetazolamide (maculopapular exanthema or acute generalized exanthematous pustulosis). A drug eruption after cataract surgery should be investigated for accountability of acetazolamide. In view of this retrospective study, skin tests and particularly intradermal tests appear to be an important contribution to demonstrate accountability.

Airborne allergic contact dermatitis caused by isothiazolinones in water-based paints: a retrospective study of 44 cases

Airborne allergic contact dermatitis caused by paints containing isothiazolinones has been recognized as a health hazard.

Mechanisms that limit proliferative potential of drug-specific LTT in drug-induced severe cutaneous adverse reaction patients

Background / Objective Prior use of “lymphocyte transformation test” (LTT) suggested that it was less often positive in Stevens-Johnson syndrome (SJS), Toxic Epidermal Necrolysis (TEN), than in other cutaneous reactions, with possible dependence on sampling date. We explored the possible role of inhibitory co-receptors in LTT, using well-defined groups of patients who reacted to carbamazepine (CBZ), or lamotrigine (LTG), sulfamethoxazole (SMX) and allopurinol (ALL).

The European Standard Series and its additions: are they of any use in 2013?

This study has two purposes: — to know whether the European standard series is still the key reference when it comes to contact dermatitis, i.e., are its components still the most frequently involved allergens in contact dermatitis nowadays? — to assess the results of the European standard series among French and Belgian dermatologists/allergists as, so far, most of them have failed to provide statistical data within the European community of allergists/dermatologists. 18 participants from 2 dermatology and allergy centres in Belgium and 11 centres in France collected their results from 3,073 patients tested in 2011. They assessed the relevance of some tests as well as that of the standard series and additional series to establish an etiological diagnosis of contact dermatitis. These results, together with the history of the European standard series, have shownthat some allergens are obsolete and that others should be included in a new standard series for which we are making a few suggestions.

Contact dermatitis caused by ascorbyl tetraisopalmitate in a cream used for the management of atopic dermatitis

Conflict of interest: The authors declare no conflict of interests. Financial disclosure: None. Ascorbic acid and its derivatives are usually used as antioxidants. They are present in ‘anti-aging’ cosmetics to stimulate production of skin fibroblast procollagen and for the antioxidant properties. There are few case reports of contact dermatitis caused by vitamin C derivatives in cosmetic creams. We report here a case of severe contact dermatitis caused by ascorbyl tetraisopalmitate, an ester-modified ascorbic acid agent,

First case of contact dermatitis caused by hydroxypropyl tetrahydropyrantriol used in an anti-ageing cream: FIRST CASE OF CONTACT DERMATITIS CAUSED BY HYDROXYPROPYL TETRAHYDROPYRANTRIOL

First case of contact dermatitis caused by hydroxypropyl tetrahydropyrantriol used in an anti-ageing cream Haudrey Assier1, Pierre Wolkenstein1,2 and Olivier Chosidow1,2 1Department of Dermatology, AP-HP, Hôpital Henri-Mondor, 94010 Créteil, France and 2Department of Dermatology, Assistance Publique–Hôpitaux de Paris, Hôpital Henri-Mondor, Université Paris est Créteil Val de Marne et Centre d’Investigation Clinique (CIC) 006, 94010 Créteil, France

Has application of the decree banning the use of cement with a high chromium VI content led to a reduction in occupational cement dermatitis in salaried workers in the construction industries

INTRODUCTION Active employees in the construction industry are particularly exposed to occupational cement eczema (OCE) which affects the hands in 80 to 90% of cases. The importance of OCE in France and the impact of the application of decree n(o). 2005-577 on 26 May 2005 were estimated from data collected by the Occupational risks division of the French national health insurance fund for salaried workers (CNAMTS). This decree prohibits the placing on the market and use of cement (and preparations containing it) with a chromium VI content above 0.0002% in order to reduce its hazardousness. METHODS All cases of OCE reported to and recognized by the CNAMTS between 1 January 2004 and 31 December 2008 among construction workers were selected. The following parameters were noted in each case: age, gender, industrial sector concerned, local French National health insurance agency, causal agent and the number of working days lost. The incidence per 100,000 salaried workers could be determined from the total number of salaried workers followed up by occupational medicine as well as those working in the construction industry. RESULTS For the five years studied, 3698 cases of occupational eczema (OE) were reported in construction workers and this was 17.1% of the total number of cases of OE for all salaried employees (n=12.689). Cement was the causal agent most frequently involved in the construction sector (57.8%, 2139/3698). The annual incidence of OCE decreased from 37.8 to 21.1 new cases per 100,000 employees in the construction industry per year between 2004 and 2008. The total number of days lost from work due to OCE decreased by 39% during the study period. CONCLUSION This descriptive study highlights the importance and socio-economic impact of OCE in the construction industry. Application of decree n(o). 2005-577 on 26 May 2005 may explain a reduction in OCE.