nickel release with cooking/boiling time higher with unused pots, at low pH…

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Guarneri F1, Costa C2, Cannavò SP3, Catania S4, Bua GD4, Fenga C2, Dugo G4.     Release of nickel and chromium in common foods during cooking in 18/10 (grade 316) stainless steel pots.     Contact Dermatitis. 2016 Nov 1. doi: 10.1111/cod.12692. [Epub ahead of print]

Abstract
BACKGROUND:
Literature data on the release of nickel and chromium from stainless steel cookware during food preparation are contrasting, have often been obtained with uncommon foods and/or procedures, and are thus not widely applicable.
OBJECTIVES:
To assess the release of nickel and chromium from 18/10 (grade 316) stainless steel pots in cooking conditions that are common in an urban lifestyle.
METHODS:
Tomato sauce and lemon marmalade were cooked for 1 h, alone or with added EDTA, in used or unused stainless steel pots from different manufacturers. Additionally, aqueous solutions at pH 2.3, 7.7 and 9 were boiled for 1 h in the same pots. Metal release was assessed with inductively coupled plasma mass spectrometry.
RESULTS:
The release of nickel and chromium increased with cooking/boiling time, was higher with unused pots, at low pH or with EDTA, and was sometimes remarkably different between manufacturers. In all experiments, the amounts released were below known allergy-triggering thresholds.
CONCLUSIONS:
Under common conditions, the use of 18/10 stainless steel pots is considered to be safe for the majority of nickel-allergic and/or chromium-allergic subjects. However, the total amount of nickel contained in foods and released from pots may exceed the individual threshold for triggering allergy, potentially causing problems for highly sensitive patients, or, conversely, contribute to induction of immunotolerance by oral low-dose exposure.

https://www.ncbi.nlm.nih.gov/pubmed/27804135

Pre-Emptive Avoidance Strategy Update

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Brankov N1, Jacob SE2.

Pre-Emptive Avoidance Strategy (P.E.A.S) 2016: Update on Pediatric Contact Dermatitis Allergens.

Expert Rev Clin Immunol. 2016 Nov 18. [Epub ahead of print]
The New Pre-Emptive Avoidance Strategy (P.E.A.S.) Update is published.
New PEAS:

1. Fragrance Mix 1 and 2/Balsam of Peru (and derivatives)
2. Neomycin/Bacitracin
3. Wool wax/Amerchol/lanolin
4. Formaldehyde/bronopol/Q15
5. MCI and MI
6. Propylene glycol
7. Cocamidopropyl betaine
8. Glucosides
9. Propolis
10. Compositae
Simple and Free is in the process of updating the products to reflect the new P.E.A.S.
https://www.dermatitisacademy.com/nickel-immediate-reactions/

Nickel reactions within minutes to hours – confirmed by prick testing.

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https://www.dermatitisacademy.com/nickel-immediate-reactions/

OLYMPUS DIGITAL CAMERA

This is a most important work by Dr. Doug Powell’s group, which highlights non-delayed type hypersensitivity immune activation to nickel (nickel immediate reactions).  In our practice we see patients with atopic dermatitis that flare in response to nickel exposure.  This is an area in need of further investigation.  Article will be in print this month!


Saluja SS1, Davis CL, Chong TA, Powell DL.  Contact Urticaria to Nickel: A Series of 11 Patients Who Were Prick Test Positive and Patch Test Negative to Nickel Sulfate 2.5% and 5.0. Dermatitis. 2016 Sep-Oct;27(5):282-7. doi: 10.1097/DER.0000000000000211.

BACKGROUND:
Nickel is the most common allergen found by patch testing; however, not all cases of nickel allergy are type 4 (delayed) allergies. Contact urticaria (CU) to nickel (immediate reaction) has been reported; however, few seem to evaluate it as per a recent published survey of American Contact Dermatitis Society members.
OBJECTIVE:
The aim of the study was to present a series of patients who had clinical histories suggestive of nickel allergy and yet were patch test negative but prick test positive to nickel, thus demonstrating CU.
METHODS:
We reviewed the charts of 11 patients who were patch test negative but prick test positive.
RESULTS:
All 11 patients demonstrated evidence of CU by prick testing (or closed chamber test in 1). None were patch test positive to nickel 2.5% or 5.0%. Four patients’ histories mentioned reactions to various jewelry/earrings within minutes, whereas 2 histories mentioned reacting within a few hours. These histories are consistent with CU. Others (except 1 patient) recalled reacting to jewelry/earrings but did not recall a time frame.
CONCLUSIONS:
Our series suggests that CU to nickel may be far more common than anticipated and should be evaluated with prick testing when patients’ history suggests nickel allergy and yet they are patch test negative.

 

Learn more about nickel immediate reactions this month!!!

pediatric patch test

Free Access for 30d! Inaugural Pediatric Contact Dermatitis Registry Data.

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New Today – 10 years in collaborative effort!  The inaugural data paper from the Pediatric Contact Dermatitis Registry (PCDR).   In the not too distant past it was believed that contact dermatitis (allergic) in children was rare, we now know that not to be the case as in fact it is an common in patch tested children as adults.  This study discusses the evaluation of more than 1000 US children who presented for evaluation of contact dermatitis.  The  reported here through a collaborative effort of more than 80 providers!  65% of the cases had a positive allergen and 48% were able to find at least on relevant source – remove the allergen and improve the dermatitis!!!

Goldenberg A1, Mousdicas N, Silverberg N, Powell D, Pelletier JL, Silverberg JI, Zippin J, Fonacier L, Tosti A, Lawley L, Wu Chang M, Scheman A, Kleiner G, Williams J, Watsky K, Dunnick CA, Frederickson R, Matiz C, Chaney K, Estes TS, Botto N, Draper M, Kircik L, Lugo-Somolinos A, Machler B, Jacob SE.  Pediatric Contact Dermatitis Registry Inaugural Case Data.  Dermatitis. 2016 Sep-Oct;27(5):293-302.

Abstract
BACKGROUND:
Little is known about the epidemiology of allergic contact dermatitis (ACD) in US children. More widespread diagnostic confirmation through epicutaneous patch testing is needed.
OBJECTIVE:
The aim was to quantify patch test results from providers evaluating US children.
METHODS:
The study is a retrospective analysis of deidentified patch test results of children aged 18 years or younger, entered by participating providers in the Pediatric Contact Dermatitis Registry, during the first year of data collection (2015-2016).
RESULTS:
One thousand one hundred forty-two cases from 34 US states, entered by 84 providers, were analyzed. Sixty-five percent of cases had one or more positive patch test (PPT), with 48% of cases having 1 or more relevant positive patch test (RPPT). The most common PPT allergens were nickel (22%), fragrance mix I (11%), cobalt (9.1%), balsam of Peru (8.4%), neomycin (7.2%), propylene glycol (6.8%), cocamidopropyl betaine (6.4%), bacitracin (6.2%), formaldehyde (5.7%), and gold (5.7%).
CONCLUSIONS:
This US database provides multidisciplinary information on pediatric ACD, rates of PPT, and relevant RPPT reactions, validating the high rates of pediatric ACD previously reported in the literature. The registry database is the largest comprehensive collection of US-only pediatric patch test cases on which future research can be built. Continued collaboration between patients, health care providers, manufacturers, and policy makers is needed to decrease the most common allergens in pediatric consumer products.

Full free access to the article for 30 days:

http://journals.lww.com/dermatitis/Abstract/2016/09000/Pediatric_Contact_Dermatitis_Registry_Inaugural.10.aspx

European Society CD Meeting – highlights

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This week marked the Manchester UK, European Society of Contact Dermatitis Meeting 14-17 September 2016…  There was so much top notch research presented  by international researchers.

Poster P016: Octylisothiazolinone is a relevant nonoccupational contact allergen in leather goods and may show cross-reactivity to methyisothiazolinone.   J. Leysen et al.

Poster P020: Airborne bullous allergic contact dermatitis from MI contained in a glass shower screen cleaning spray.  M.A Pastor-Nieto et al.

Poster P021: Allergic contact dermatitis from nickel is prevented using a novel barrier cream.  Niklasson B and Isaksson M.  New nickel prevention cream!  “We present a male worker with ACD due to exposure to nickel-containing tools and where an active barrier cream containing a strong metal chelating agent helped solved the problem.   … The leather gloves were analyzed for the release of nickel ions: one glove released 0.4ug nickel cm2 and the other 0.2ug nickel cm2. … The barrier cream, NIK-L-BLOKTM (Chemotechnique), captures the nickel ions using a strong chelating agent, diethylenetriaminepentaacetic acid, in a special formulation that immobilizes the nickel ions (as well as cobalt and chromium ions), thereby preventing allergic contact dermatitis.”

Poster P022 The methyisothiazolinone epidemic: a pan- European prospective study JF Schewensen et al. “Patients were exposed to the following products containing MI (and could be exposed to more than one category): dish-washing liquids (n=32), shampoo (n=30), bath/shower gel (n=22).  … Thirteen experienced an allergic reaction in newly painted rooms: ACD [skin] (n=11), rhinitis [nose] (n=2) and conjuncitivitis [eye] (n=1).  Eight (4.7%) experienced reactions to other airborne exposures than paint, for example cleaning agents… EFFECTIVE REGULATION OF MI IN COSMETIC AND OCCUPATIONAL PRODUCTS IS NOT YET IN PLACE.  The current data demonstrate the URGENT need for PREVENTIVE actions.”

These poster abstracts are printed and the articles are forthcoming.  It is critical to work with manufacturers, consumers, patient advocates (medical providers) and legislators to protect!!!

Free Article- Cosmetic Contact Allergens by An Goossens!

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This is a FREE open access article that discusses common and not so common allergens in cosmetics.  Section  3.2.2. discusses preservatives:

“Shifts in frequency of positive patch-test reactions have occurred over the years [6 ], but more

recently methylisothiazolinone (MI), in particular … weaker sensitizer… less efficient …

hence larger use concentrations … severe skin lesions and atypical clinical

symptoms, leading to a delay in the correct diagnosis (e.g., [8 ]), and respiratory …”

“The incidence of positive reactions to formaldehyde—”

3.21. discusses fragrances:

“Myroxylon pereirae (balsam of Peru), colophonium, hydroperoxides of limonene and linalool, terpene compounds that act as prehaptens…”

 

Cosmetic Contact Allergens

By An Goossens

“This article presents trends in the frequency of cosmetics as causal factors of allergic contact dermatitis during a 26-year period in 14,911 patients patch-tested between 1990 and 2014, and discusses the cosmetic allergens identified during the last six years (2010–2015) in 603 patients out of 3105 tested. The data were retrieved from, and evaluated with, a patient database developed in-house. The results show the increasing importance of cosmetic allergies, up to 25% of the patients tested during the last five-year period. As expected, fragrance materials, preservatives, and hair dyes were the most frequent culprits, but a great variety of other allergenic ingredients were involved as well. This underlines the need of additional and extensive patch testing with the patient’s products used and their ingredients.”

 

To read more click on this link:

http://www.mdpi.com/2079-9284/3/1/5

and download FREE pdf.
To learn more about contact dermatitis visit us at:

 http://www.dermatitisacademy.com

The conifer – balsam of Peru connection discussed – Systemic Contact Dermatitis

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Systemic contact dermatitis is a systemic response to an allergen in a previously sensitized individual.  This article presents a case of a woman with ‘dyshidrotic hand eczema’ who developed blisters after eating chocolate.  She also had fever and an elevated immune cell count.  This patient benefited from a BOP-reduced diet.

…”many of the components of BP can be present as unrecognized, ‘‘hidden’’ allergens in different food items.” … ” Patients with BP contact allergy are often allergic to colophonium, balsam of Tolu, wood tar, turpentine, styrax or propolis, all of which can contain similar or related allergens.”

Conifers (evergreens, pine trees) are sources of colophonium.

http://medicaljournals.se/acta/content/download.php?doi=10.1080/00015550310016599

For more information on the balsam of Peru diet visit us at:

https://www.dermatitisacademy.com/bop-diet/

 

SNAS – 700 patients evaluated

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This is important work from the Italians… 700 patients evaluated with the systemic nickel allergy syndrome having both skin and GI symptoms.  Patch testing helped confirm the diagnosis.

Tammaro A1, Romano I1, De Marco G1, Parisella FR2, Pigliacelli F1, D’Arino A1, Persechino F3, Gaspari AA2, Persechino S1.

Effects of TIO NICKEL in patients with ACD and SNAS: experience on 700 patients in Italy.

J Eur Acad Dermatol Venereol. 2016 Aug 12. doi: 10.1111/jdv.13916. [Epub ahead of print]
Abstract
The nickel is causes of allergic contact dermatitis (ACD) and of “systemic nickel allergy syndrome” (SNAS). From 2009 to 2015 a very large number of patients with allergies, presented to our Department of Dermatology and Allergology at Sant’Andrea Hospital in Rome; 700 of these showed an allergic reaction to nickel with a double clinical manifestation, skin and gastrointestinal symptoms, between 25 and 60 years old. Regarding the skin manifestation, the diagnosis was confirmed by Patch Test SIDAPA standard series. The results were positive for nickel sulphate with +2 to +3, using the ICDRG scoring system, and also to others allergens (Table 1). This article is protected by copyright. All rights reserved.

 

http://onlinelibrary.wiley.com/doi/10.1111/jdv.13916/pdf

Octylisothiazolinone! Anti-fungal on Leather!

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This is an important article this week, because OIT isn’t just an occupational allergen and it can cross-react with MI.
Contact Dermatitis. 2016 Aug 19. doi: 10.1111/cod.12670. [Epub ahead of print]

Octylisothiazolinone, an additional cause of allergic contact dermatitis caused by leather: case series and potential implications for the study of cross-reactivity with methylisothiazolinone.

Abstract

BACKGROUND:

Octylisothiazolinone (OIT) (CAS no. 26530-20-1) is used as an antifungal agent by the leather industry.

OBJECTIVES:

To show sensitization to OIT from leather, and to highlight the potential implications when cross-reactivity between OIT and methylisothiazolinone (MI) is studied.

METHODS:

Two patients with allergic contact dermatitis caused by a leather belt and shoes, respectively, were patch tested with methylchloroisothiazolinone (MCI)/MI, MI, MCI, OIT, and benzisothiazolinone (BIT). High-performance liquid chromatography with ultraviolet detection (HPLC-UV) was used to detect isothiazolinone derivatives in leather goods. Additionally, files of OIT-sensitized patients, observed at the KU Leuven department during the period 1990-2015, were retrospectively analysed.

RESULTS:

Both patients had been primarily sensitized to OIT, but the diagnosis in 1 of them could be achieved only when a higher patch test concentration of OIT (1000 ppm pet.) was used. HPLC-UV confirmed the presence of OIT in their leather goods. Non-relevant sensitization to MI was noted in both cases. Four additional cases of OIT sensitization from leather could be retrieved from the KU Leuven database.

CONCLUSIONS:

Non-occupational sensitization to OIT from leather may occur. Patch test concentrations of >250 ppm pet. may be necessary for diagnosis, and to show cross-reactivity with MI. Safer use limits for OIT in the leather industry may be needed.

© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

KEYWORDS:

CAS no. 26530-20-1; allergic contact dermatitis; biocide; cross-reaction; fungicide; high-performance liquid chromatography; leather; methylisothiazolinone; octylisothiazolinone; shoes

For more information:
http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1600-0536/earlyview

 

 

Test your Colophony savvy

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