Kaija Lammintausta

Patch test reactions to cosmetic allergens in 1995–1997 and 2000–2002 in Finland – a multicentre study

Contact sensitivity to cosmetics is common, but the sensitizing chemicals vary between countries and study periods. The present survey aimed at revealing the recent trends in patch test sensitivity with cosmetic chemicals in Finland. We report a retrospective multicentre survey of patch test reactions focusing on cosmetic‐related substances and comparing the test results in 1995–97 with those in 2000–02. The most striking increases in the frequency of the patch test sensitivity were found with balsam of Peru and propolis from 4.0% to 6.2% (P < 0.001) and from 0.5% to 1.4% (P < 0.001), respectively, whereas the most prominent decreases were found with methylchloro/methylisothiazolinone and chlorhexidine diglugonate from 2.4% to 1.3% (P < 0.001) and from 1.2% to 0.5% (P < 0.001), respectively. The level of patch test sensitivity to methyldibromo glutaronitrile increased, although not significantly, from 1.0% to 1.5%. An increasing tendency was also found with hair dye chemicals 4‐aminophenol and toluene‐2,5‐diamine or toluene‐2,5‐diamine sulfate from 1.3% to 3.8% and from 1.4% to 5.2%, respectively, while such a tendency was not found among permanent wave chemicals. The sensitivity level of fragrance mix remained the same (6% − 7%). We conclude that surveys revealing the state of sensitivity to cosmetic chemicals should be performed periodically in different countries.

Contact sensitization to methylisothiazolinone in Finland--a multicentre study.

Background. Antimicrobials constitute the second most common cause of contact allergy to cosmetics. Methylisothiazolinone (MI), previously always used together with methylchloroisothiazolinone (MCI), has recently been approved in the EU for use on its own in cosmetics and also various industrial products. MCI has been classified as an extreme–strong and MI as a strong–moderate sensitizer.

The relevance of chlorhexidine contact allergy

Background. Chlorhexidine is used for disinfection of skin and mucosae in medicine and dentistry. Prolonged exposure may lead to contact sensitization and allergic contact dermatitis or stomatitis.

Oral challenge in patients with suspected cutaneous adverse drug reactions: findings in 784 patients during a 25-year-period.

The aim of this study was to analyse the usefulness of oral challenge test with different drugs in confirming cutaneous adverse drug reactions in routine clinical practice. During the years 1975-2000 a total of 1,001 challenges were carried out in 784 patients. Patients with serious drug reactions were excluded and those with positive skin test reactions were challenged only in dubious cases. Of 1,001 challenges, 136 (13%) patients developed a positive challenge reaction. Antimicrobial drugs were most commonly suspected, accounting for 67% of challenges and 66% of the positive reactions. Exanthema was the most common skin reaction (72%), followed by fixed drug eruption (16%) and urticaria (12%). One serious challenge reaction with salazosulfapyridine was seen. We conclude that the challenge test is most useful as a tolerance test or to exclude drug hypersensitivity. It may be useful to complete studies of adverse drug reactions in patients with a history of exanthema, if other diagnostic methods are not available or if other diagnostic tests yield negative results. Out-patient protocol can be used in most cases.

An epidemic of contact allergy to methylisothiazolinone in Finland

Kaija Lammintausta1, Kristiina Aalto-Korte2, Leena Ackerman3, Kristiina Alanko3, Päivikki Berry4, Taina Hasan5, Renata Kaminska6, Laura Korhonen5, Arja Laukkanen7, Jussi Liippo1, Maria Pesonen2, Tapio Rantanen8, Riita Riekki9 and Katri Suuronen2 1Department of Dermatology, Turku University Hospital, 20521 Turku, Finland, 2Department of Dermatology, Finnish Institute of Occupational Health, Control of Hypersensitivity Diseases, 00250 Helsinki, Finland, 3Department of Dermatology, Skin and Allergy Hospital, 00290 Helsinki University Central Hospital, Helsinki, Finland, 4Department of Dermatology, Allergy Centre, North Carelia Central Hospital, 80210, Joensuu, Finland, 5Department of Dermatology, Tampere University Hospital, 33521 Tampere, Finland, 6Department of Dermatology, Central Hospital of Keski-Pohjanmaa, 67200 Kokkola, UK, 7Department of Dermatology, Kuopio Unievrsity Hospital, 70211 Kuopio, Finland, 8Department of Dermatology, Central Hospital, Päijät-Häme Social and Health Care Group, 15850 Lahti, Finland, and 9Department of Dermatology, Oulu University Hospital, 90029 Helsinki, Finland

An epidemic of furniture-related dermatitis: searching for a cause

Background  Sitting in new chairs or sofas has elicited dermatitis in numerous patients in Finland and in the U.K. since autumn 2006. The cause of the dermatitis seemed to be an allergen in the furniture materials.

Rapid systemic valaciclovir reaction subsequent to aciclovir contact allergy

Keywords: aciclovir; valaciclovir; allergic contact dermatitis; famciclovir; cutaneous adverse drug reactions; antivirals; oral challenge; systemic contact dermatitis; cross-sensitivity; medicaments; cetearyl alcohol

Is it possible to improve the prognosis in nickel contact dermatitis

A questionnaire was sent to 143 patients who had shown a positive patch test reaction to nickel sulfate more than 10 years earlier. 91 patients returned the questionnaire, revealing that after the testing, 73 had suffered from dermatitis, 61 especially from hand dermatitis, 37 of these patients were clinically examined and patch tested with standard series and in addition, 12 patients were tested with nickel sulfate and nickel chloride with different occlusion times. At the clinic visit, 23 patients had dermatitis, 16 hand dermatitis, and 11 were symptom‐free, 26 of the patients had metal items close to their skin and 21 of them had current dermatitis, 14 hand dermatitis. Of the 11 patients who had no metal exposure, 9 were symptom‐free. The association of dermatitis with exposure to metal objects was statistically significant (p < 0.001). Those patients who had current dermatitis had also developed multiple allergies and reacted to nickel with shorter application times in patch tests, as compared to those who were symptom‐free. It seemed possible that the prognosis for nickel dermatitis could be improved if nickel‐allergic patients would strictly avoid metal contact, especially in clothing and jewelry.

Lupin allergy and lupin sensitization among patients with suspected food allergy

BACKGROUND Lupin, a legume with good nutritional value, is used in food production today, most often in bakery products. Lupin sensitization is often seen among patients with reactions to legumes, but the number of reports describing lupin anaphylaxis is also increasing. OBJECTIVE To investigate the occurrence of lupin sensitization, cross-reactivity, and lupin allergy among patients with suspected food allergy in Finland, where lupin is a labeled ingredient in few products. METHODS The occurrence of positive skin prick test (SPT) reactions to lupin seed flour was studied among 1522 patients with suspected food allergy from November 1, 2005, through December 31, 2007. Clinical histories and diagnostic SPT results were analyzed among patients with positive SPT results to lupin. For 1 patient, ImmunoSpot and lupin radioallergosorbent test inhibition methods were used. RESULTS Lupin sensitization was shown in 25 of 1522 patients (1.6%), and probable lupin allergy was diagnosed in 7 of 25 patients, in whom the clinical symptoms varied from anaphylaxis and respiratory symptoms to contact urticaria and itchy mouth. Cross-reactions or concurrent reactions to other legumes were seen in 18 of 25 patients. CONCLUSIONS Clinically relevant lupin allergy often occurs in patients without atopic background or other food allergies, although lupin sensitization most commonly seems to represent cross-reactivity to other legumes. The occurrence of lupin allergy in a country where lupin has not been traditionally used is surprisingly common, suggesting that short-term use of modest amounts of lupin can cause serious allergic reactions.

Contact sensitization to 4,4'-diaminodiphenylmethane and to isocyanates among general dermatology patients.

Background:  Diisocyanates and 4,4′‐diaminodiphenylmethane (MDA) are industrial sensitizers. Occupational asthma is a risk among workers exposed to diisocyanates. Exposure may also lead to contact sensitization and allergic contact dermatitis.