North American Contact Dermatitis Group Patch Test Results

2015-2016

Joel G. DeKoven, Erin M. Warshaw, Kathryn A. Zug, Howard I. Maibach, Donald V. Belsito, Denis Sasseville, James S. Taylor, Joseph F. Fowler, C. G.Toby Mathias, James Marks, Melanie D. Pratt, Matthew J. Zirwas, Vincent A. DeLeo

Research output: Contribution to journalReview article

20 Citations (Scopus)

Abstract

Background Patch testing is an important diagnostic tool for the assessment of allergic contact dermatitis (ACD). Objective This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2015, to February 28, 2017. Methods At 13 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ 2 test. Results A total of 5597 patients were tested. There were 3725 patients (66.6%) who had at least 1 positive reaction, and 2798 patients (50.2%) were ultimately determined to have a primary diagnosis of ACD. A total of 572 patients (10.2%) had occupationally related skin disease. There were 10,983 positive allergic reactions. Nickel remained the most commonly detected allergen (17.5%). Methylisothiazolinone, which was added to the screening series for the 2013-2014 cycle, had the second highest positive reaction rate of allergens tested (13.4%). Compared with the previous reporting periods (2013-2014) and (2005-2014), positive reaction rates for the top 35 screening allergens statistically increased for only 1 allergen: hydroxyethyl methacrylate (3.4%; risk ratios, 1.24 [confidence interval, 1.00-1.54] and 1.46 [confidence interval, 1.23-1.73]). Three newly added allergen preparations-ammonium persulfate (1.7%), chlorhexidine (0.8%), and hydroquinone (0.3%)-all had a reaction rate of less than 2%. Twenty-Three percent of the tested patients had at least 1 relevant allergic reaction to an allergen not on the NACDG series; 12% of these were occupationally related. T.R.U.E. Test (SmartPractice Denmark, Hillerød, Denmark) would have hypothetically missed one quarter to almost 40% of reactions detected by the NACDG screening series. Conclusions These results confirm that the epidemic of sensitivity to methylisothiazolinone has continued in North America. Patch testing with allergens beyond a screening tray is necessary for a complete evaluation of occupational and nonoccupational ACD.

Original languageEnglish (US)
Pages (from-to)297-309
Number of pages13
JournalDermatitis
Volume29
Issue number6
DOIs
StatePublished - Nov 1 2018

Fingerprint

Patch Tests
Contact Dermatitis
Allergens
Allergic Contact Dermatitis
Denmark
North America
Hypersensitivity
Confidence Intervals
Chlorhexidine
Nickel
Skin Diseases
Odds Ratio
Databases

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Dermatology

Cite this

DeKoven, J. G., Warshaw, E. M., Zug, K. A., Maibach, H. I., Belsito, D. V., Sasseville, D., ... DeLeo, V. A. (2018). North American Contact Dermatitis Group Patch Test Results: 2015-2016. Dermatitis, 29(6), 297-309. https://doi.org/10.1097/DER.0000000000000417
DeKoven, Joel G. ; Warshaw, Erin M. ; Zug, Kathryn A. ; Maibach, Howard I. ; Belsito, Donald V. ; Sasseville, Denis ; Taylor, James S. ; Fowler, Joseph F. ; Mathias, C. G.Toby ; Marks, James ; Pratt, Melanie D. ; Zirwas, Matthew J. ; DeLeo, Vincent A. / North American Contact Dermatitis Group Patch Test Results : 2015-2016. In: Dermatitis. 2018 ; Vol. 29, No. 6. pp. 297-309.
@article{0e4d23fc7fb0424ba684167839000d94,
title = "North American Contact Dermatitis Group Patch Test Results: 2015-2016",
abstract = "Background Patch testing is an important diagnostic tool for the assessment of allergic contact dermatitis (ACD). Objective This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2015, to February 28, 2017. Methods At 13 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ 2 test. Results A total of 5597 patients were tested. There were 3725 patients (66.6{\%}) who had at least 1 positive reaction, and 2798 patients (50.2{\%}) were ultimately determined to have a primary diagnosis of ACD. A total of 572 patients (10.2{\%}) had occupationally related skin disease. There were 10,983 positive allergic reactions. Nickel remained the most commonly detected allergen (17.5{\%}). Methylisothiazolinone, which was added to the screening series for the 2013-2014 cycle, had the second highest positive reaction rate of allergens tested (13.4{\%}). Compared with the previous reporting periods (2013-2014) and (2005-2014), positive reaction rates for the top 35 screening allergens statistically increased for only 1 allergen: hydroxyethyl methacrylate (3.4{\%}; risk ratios, 1.24 [confidence interval, 1.00-1.54] and 1.46 [confidence interval, 1.23-1.73]). Three newly added allergen preparations-ammonium persulfate (1.7{\%}), chlorhexidine (0.8{\%}), and hydroquinone (0.3{\%})-all had a reaction rate of less than 2{\%}. Twenty-Three percent of the tested patients had at least 1 relevant allergic reaction to an allergen not on the NACDG series; 12{\%} of these were occupationally related. T.R.U.E. Test (SmartPractice Denmark, Hiller{\o}d, Denmark) would have hypothetically missed one quarter to almost 40{\%} of reactions detected by the NACDG screening series. Conclusions These results confirm that the epidemic of sensitivity to methylisothiazolinone has continued in North America. Patch testing with allergens beyond a screening tray is necessary for a complete evaluation of occupational and nonoccupational ACD.",
author = "DeKoven, {Joel G.} and Warshaw, {Erin M.} and Zug, {Kathryn A.} and Maibach, {Howard I.} and Belsito, {Donald V.} and Denis Sasseville and Taylor, {James S.} and Fowler, {Joseph F.} and Mathias, {C. G.Toby} and James Marks and Pratt, {Melanie D.} and Zirwas, {Matthew J.} and DeLeo, {Vincent A.}",
year = "2018",
month = "11",
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doi = "10.1097/DER.0000000000000417",
language = "English (US)",
volume = "29",
pages = "297--309",
journal = "Dermatitis",
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DeKoven, JG, Warshaw, EM, Zug, KA, Maibach, HI, Belsito, DV, Sasseville, D, Taylor, JS, Fowler, JF, Mathias, CGT, Marks, J, Pratt, MD, Zirwas, MJ & DeLeo, VA 2018, 'North American Contact Dermatitis Group Patch Test Results: 2015-2016', Dermatitis, vol. 29, no. 6, pp. 297-309. https://doi.org/10.1097/DER.0000000000000417

North American Contact Dermatitis Group Patch Test Results : 2015-2016. / DeKoven, Joel G.; Warshaw, Erin M.; Zug, Kathryn A.; Maibach, Howard I.; Belsito, Donald V.; Sasseville, Denis; Taylor, James S.; Fowler, Joseph F.; Mathias, C. G.Toby; Marks, James; Pratt, Melanie D.; Zirwas, Matthew J.; DeLeo, Vincent A.

In: Dermatitis, Vol. 29, No. 6, 01.11.2018, p. 297-309.

Research output: Contribution to journalReview article

TY - JOUR

T1 - North American Contact Dermatitis Group Patch Test Results

T2 - 2015-2016

AU - DeKoven, Joel G.

AU - Warshaw, Erin M.

AU - Zug, Kathryn A.

AU - Maibach, Howard I.

AU - Belsito, Donald V.

AU - Sasseville, Denis

AU - Taylor, James S.

AU - Fowler, Joseph F.

AU - Mathias, C. G.Toby

AU - Marks, James

AU - Pratt, Melanie D.

AU - Zirwas, Matthew J.

AU - DeLeo, Vincent A.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background Patch testing is an important diagnostic tool for the assessment of allergic contact dermatitis (ACD). Objective This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2015, to February 28, 2017. Methods At 13 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ 2 test. Results A total of 5597 patients were tested. There were 3725 patients (66.6%) who had at least 1 positive reaction, and 2798 patients (50.2%) were ultimately determined to have a primary diagnosis of ACD. A total of 572 patients (10.2%) had occupationally related skin disease. There were 10,983 positive allergic reactions. Nickel remained the most commonly detected allergen (17.5%). Methylisothiazolinone, which was added to the screening series for the 2013-2014 cycle, had the second highest positive reaction rate of allergens tested (13.4%). Compared with the previous reporting periods (2013-2014) and (2005-2014), positive reaction rates for the top 35 screening allergens statistically increased for only 1 allergen: hydroxyethyl methacrylate (3.4%; risk ratios, 1.24 [confidence interval, 1.00-1.54] and 1.46 [confidence interval, 1.23-1.73]). Three newly added allergen preparations-ammonium persulfate (1.7%), chlorhexidine (0.8%), and hydroquinone (0.3%)-all had a reaction rate of less than 2%. Twenty-Three percent of the tested patients had at least 1 relevant allergic reaction to an allergen not on the NACDG series; 12% of these were occupationally related. T.R.U.E. Test (SmartPractice Denmark, Hillerød, Denmark) would have hypothetically missed one quarter to almost 40% of reactions detected by the NACDG screening series. Conclusions These results confirm that the epidemic of sensitivity to methylisothiazolinone has continued in North America. Patch testing with allergens beyond a screening tray is necessary for a complete evaluation of occupational and nonoccupational ACD.

AB - Background Patch testing is an important diagnostic tool for the assessment of allergic contact dermatitis (ACD). Objective This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2015, to February 28, 2017. Methods At 13 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ 2 test. Results A total of 5597 patients were tested. There were 3725 patients (66.6%) who had at least 1 positive reaction, and 2798 patients (50.2%) were ultimately determined to have a primary diagnosis of ACD. A total of 572 patients (10.2%) had occupationally related skin disease. There were 10,983 positive allergic reactions. Nickel remained the most commonly detected allergen (17.5%). Methylisothiazolinone, which was added to the screening series for the 2013-2014 cycle, had the second highest positive reaction rate of allergens tested (13.4%). Compared with the previous reporting periods (2013-2014) and (2005-2014), positive reaction rates for the top 35 screening allergens statistically increased for only 1 allergen: hydroxyethyl methacrylate (3.4%; risk ratios, 1.24 [confidence interval, 1.00-1.54] and 1.46 [confidence interval, 1.23-1.73]). Three newly added allergen preparations-ammonium persulfate (1.7%), chlorhexidine (0.8%), and hydroquinone (0.3%)-all had a reaction rate of less than 2%. Twenty-Three percent of the tested patients had at least 1 relevant allergic reaction to an allergen not on the NACDG series; 12% of these were occupationally related. T.R.U.E. Test (SmartPractice Denmark, Hillerød, Denmark) would have hypothetically missed one quarter to almost 40% of reactions detected by the NACDG screening series. Conclusions These results confirm that the epidemic of sensitivity to methylisothiazolinone has continued in North America. Patch testing with allergens beyond a screening tray is necessary for a complete evaluation of occupational and nonoccupational ACD.

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DO - 10.1097/DER.0000000000000417

M3 - Review article

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DeKoven JG, Warshaw EM, Zug KA, Maibach HI, Belsito DV, Sasseville D et al. North American Contact Dermatitis Group Patch Test Results: 2015-2016. Dermatitis. 2018 Nov 1;29(6):297-309. https://doi.org/10.1097/DER.0000000000000417