Dermatitis®

Ingredients in nail care products may lead to allergic and/or irritant contact dermatitis.

The aims of this study were to determine frequency of contact dermatitis associated with nail care products, characterize associated body sites, and describe causative allergens.

A retrospective analysis was conducted with the North American Contact Dermatitis Group data between 2001 and 2016.

Of the 38,775 patients tested, 769 (2.0%) had: 1) more than 1 allergic patch test reaction associated with a nail care product (n = 746), 2) irritant contact dermatitis associated with a nail care product (n = 14), or 3) both (n = 9). Primary body sites included the face (43.0%) and hands (27.6%). The top 5 allergens were (2-hydroxyethyl methacrylate (273/482, 56.6%), methyl methacrylate (210/755, 27.8%), ethyl acrylate (190/755, 25.2%), ethyl-2-cyanoacrylate (12/175, 6.9%) and tosylamide (273/755, 36.2%). Frequency of allergy to 2-hydroxyethyl methacrylate (P = 0.0069) and ethyl acrylate (P = 0.0024) significantly increased over the study period, whereas allergy secondary to tosylamide significantly decreased (P < 0.0001).

As long-lasting nail techniques become widespread, the prevalence of contact dermatitis to nail care products is expected to increase. Almost one-fifth of nail care product–associated allergens would have been missed without additional screening allergens beyond the North American Contact Dermatitis Group series, underscoring the need for testing to a broad array of allergens.

Patch testing is the criterion standard for diagnosis of allergic contact dermatitis (ACD).

The aim of the study was to report the trends of patch testing results with the standard series at Massachusetts General Hospital from January 1, 2007, to December 31, 2016, compared with previous data from 1998 to 2006 and from 1990 to 2006 and those reported by the North American Contact Dermatitis Group.

Data were collected and analyzed from retrospective chart reviews, focusing on 50 allergens in our standard series.

A total of 2373 patients were patch tested. One or more positive reactions were observed in 1428 patients (60.2%), and 1153 patients (48.6%) had a final primary diagnosis of ACD. Top 5 allergens were nickel (19.8%), fragrance mix I (14.6%), Myroxylon pereirae (balsam of Peru) (13.5%), neomycin (9.4%), and bacitracin (7.7%). Sensitization frequencies statistically increased over time for 3 allergens: nickel, neomycin, and propylene glycol, and decreased for 5 allergens: formaldehyde, paraben mix, thiuram mix, n-isopropyl-N-phenyl-4-phenylenediamine, and epoxy resin (P ≤ 0.001).

Surveillance of ACD trends is essential to detect emerging sensitizers. Patch testing is an important diagnostic tool for detection of ACD to commonly encountered and potential allergens.

Although many generic dermatological quality-of-life (QoL) instruments exist, none have been specifically designed for patients with allergic contact dermatitis (ACD). In the preceding publication—Validating a Quality-of-Life Instrument for Allergic Contact Dermatitis—we developed and validated a QoL instrument specific to the ACD population.

The aim of this study was to assess whether this ACD-specific QoL instrument appropriately captures change in QoL after patch testing in ACD patients.

One hundred individuals completed the previously validated 17-item QoL survey plus 2 global questions and the Skindex-29 before patch testing. Two months after patch testing and allergen avoidance, the participants repeated the same questionnaires. We used statistical methods to evaluate the capacity of the ACD questionnaire to measure change in QoL in comparison with the Skindex-29.

The novel ACD-specific questionnaire was more sensitive to change in QoL than the generic Skindex-29. Eleven of the original 17 items were found to capture change in QoL, and of the 3 domains (emotions, symptoms, functioning), the emotional aspect of the disease was most burdensome and responsive to change 2 months after patch testing. Providers can reliably use this index to assess changes in QoL over time.

Skin colonization by Staphylococcus aureus (SA) correlates with increased severity of atopic dermatitis (AD). The role of nasal SA carriage and coagulase-negative staphylococci (CNSs) in AD is unclear.

The aim of this study was to assess the influence of colonization of lesional/nonlesional skin and the anterior nares by SA and CNSs on AD severity in 63 adult patients.

Disease severity was assessed with SCORAD index. The total immunoglobulin E (IgE) concentration was determined using the enzyme-linked immunosorbent assay method. The prevalence and abundance of staphylococci were assessed with the combination of bacterial culture and mass spectrometry.

The prevalence values of SA within the skin (lesional/nonlesional) and anterior nares were 79.4%/61.9% and 69.8%, respectively (vs 5.6% and 13.9%, respectively in controls, P < 0.0001). The carriage of CNSs in all niches was associated with lower mean IgE concentration (1164.66 ± 1010.36 vs 1762.99 ± 1059.15, P < 0.0213; 1166.9 ± 1006.4 vs 2152.7 ± 759.2, P < 0.0063; 1022 ± 1100 vs 1925 ± 880.8, P < 0.0044, respectively). The abundance of SA correlated with the extent of skin lesions and total IgE (ρ = 0.42, P = 0.0007; ρ = 0.488, P < 0.0001; ρ = 0.312, P < 0.2; and ρ = 0.402, P = 0.0007; ρ = 0.403, P < 0.002; ρ = 0.287, P < 0.03, respectively).

Atopic dermatitis severity correlates with both cutaneous and nasal colonization by SA. Staphylococcus aureus seems to promote T_H2-type response, whereas CNS probably limits this process. Preventive measures within the anterior nares should be considered for AD patients.

The impact of pediatric atopic dermatitis (AD) on families is largely hidden from view, and AD is commonly misunderstood as a minor skin condition. Few studies have examined the full burden of AD from the family perspective.

The aim of the study was to assess the burden of AD on children and families using a caregiver-centered survey.

A 72-item anonymous online survey was posted on social media sites targeted to or composed of parents of children with AD. It explored the following 9 domains of impact: sleep, social isolation, time requirements, life decisions, family relationship dynamics, energy/fatigue, mental health impacts, and unmet treatment needs. Atopic dermatitis severity was reported by respondents using the Patient-Oriented Eczema Measure. Statistical analyses were conducted using R 3.6.0.

Two hundred thirty-five individuals completed the survey during the 1-month period that it was promoted via social media. Caregivers reported frequent sleep disturbance, exhaustion, worry, and social isolation related to their child’s AD.

Results highlight the need for psychosocial support and respite care for caregivers of children with AD.