European Society of Contact Dermatitis guideline for diagnostic patch testing - recommendations on best practice.

The present guideline summarizes all aspects of patch testing for the diagnosis of contact allergy in patients suspected of suffering, or having been suffering, from allergic contact dermatitis or other delayed-type hypersensitivity skin and mucosal conditions. Sections with brief descriptions and discussions of different pertinent topics are followed by a highlighted short practical recommendation. Topics comprise, after an introduction with important definitions, materials, technique, modifications of epicutaneous testing, individual factors influencing the patch test outcome or necessitating special considerations, children, patients with occupational contact dermatitis and drug eruptions as special groups, patch testing of materials brought in by the patient, adverse effects of patch testing, and the final evaluation and patient counselling based on this judgement.

Cosmetovigilance: definition, regulation and use "in practice".

Cosmetovigilance is a recent concept. The term itself has just been indexed. It is a form of health public surveillance with a public health objective; it therefore differs from the surveillance carried out by industrialists, who aim at the safety of the product for commercial purposes, and differs from peer surveillance (Revidal-Gerda), whose purpose is medical.

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.

Self-testing for contact sensitization to hair dyes--scientific considerations and clinical concerns of an industry-led screening programme.

The cosmetic industry producing hair dyes has, for many years, recommended that their consumers perform 'a hair dye allergy self-test' or similar prior to hair dyeing, to identify individuals who are likely to react upon subsequent hair dyeing. This review offers important information on the requirements for correct validation of screening tests, and concludes that, in its present form, the hair dye self-test has severe limitations: (i) it is not a screening test but a diagnostic test; (ii) it has not been validated according to basic criteria defined by scientists; (iii) it has been evaluated in the wrong population group; (iv) skin reactions have been read by dermatologists and not by the targeted group (consumers and hairdressers); (v) hair dyes contain strong and extreme sensitizers that are left on the skin in high concentrations, potentially resulting in active sensitization; and (vi) recommendations and instructions on how to perform the hair dye self-test vary greatly even among products from the same company, again suggesting that the basis for safe use of the test has not been determined. If the use of a hair dye self-test to predict contact sensitization becomes widespread, there is severe risk that a tool has been marketed that may cause morbidity in European consumers.

Patch test concentrations (doses in mg/cm2 ) for the 12 non-mix fragrance substances regulated by European legislation.

Background: According to EU legislation, 26 fragrance substance allergens must be labelled on cosmetic products. For 12 of them, the optimal patch test concentration/dose has not been evaluated.

Objectives: To establish the optimal patch test doses in mg/cm2 for the 12 fragrance substances that are not included in fragrance mix I or II in the European baseline patch test series.

The EU Nickel Directive revisited--future steps towards better protection against nickel allergy.

In July 2001, the EU Nickel Directive came into full force to protect European citizens against nickel allergy and dermatitis. Prior to this intervention, Northern European governments had already begun to regulate consumer nickel exposure. According to part 2 of the EU Nickel Directive and the Danish nickel regulation, consumer items intended to be in direct and prolonged contact with the skin were not allowed to release more than 0.

Essential oils: renewal of interest and toxicity.

Essential oils are complex mixtures of substances from vegetable matter, the definition of which is based on their method of extraction. They are characterized by their ambivalence, their ambiguity and their disparity: plant families from which essential oils are extracted are numerous; the composition of each essential oil depends not only on the family but also on the part of the plant from which it is extracted, and sometimes on the soil where the plant grows, or even on the time of the harvest. Gas chromatography is therefore necessary to characterize an essential oil.

Octocrylene, an emerging photoallergen.

Background: Octocrylene is a new emerging photoallergen. We report and discuss 50 cases of photoallergic contact dermatitis from octocrylene use and/or positive photopatch test reactions to this UV filter and draw attention to the unexpected association in adults with a history of photoallergic contact dermatitis from ketoprofen.

Observations: Patients were divided in 3 groups: group A comprised 11 children; group B, 28 adults with a history of photoallergy from sunscreen products; and group C, 14 adults systematically tested with octocrylene because of a history of photoallergy from ketoprofen.

Fragrance allergy: assessing the safety of washed fabrics.

Background: Previously, a quantitative risk assessment suggested there was no risk of induction of fragrance allergy from minor residues of fragrance chemicals on washed fabrics.

Objective: To investigate whether there was any risk of the elicitation of contact allergy from fragrance chemical residues on fabric in individuals who were already sensitized.

Methods: Thirty-six subjects with a positive patch test to isoeugenol (n = 19) or hydroxyisohexyl 3-cyclohexene carboxaldehyde (n = 17) were recruited.

Active sensitization and contact allergy to methyl 2-octynoate.

Background: Methyl 2-octynoate is a synthetic fragrance which was first described to have sensitizing properties in 1935. It is one of the 26 fragrances to be labelled on the ingredient list according to current European cosmetics regulation.

Objectives: To report the experience with patch testing with methyl 2-octynoate 1% and 2% in pet.

Hydrolysed wheat proteins present in cosmetics can induce immediate hypersensitivities.

Cosmetics containing hydrolysed wheat proteins (HWP) can induce rare but severe allergic reactions. 9 patients, all females without common wheat allergy, but with contact urticaria to such cosmetics, were studied. 6 of them also experienced generalized urticaria or anaphylaxis to foods containing HWP.

Allergic contact dermatitis from shellac in mascara.

We report 6 cases of allergic contact dermatitis of the eyelids due to mascara. Allergy occurred in women aged 17-34 years, between September 1999 and June 2001. The main ingredient responsible for allergy was shellac, which gave positive patch test reactions in 5/5 patients.