Recent trends in epidemiology, sensitization and legal requirements of selected relevant contact allergens

ABSTRACT

Numerous studies have focused on emerging allergens causing contact allergy and allergic contact dermatitis in eczema populations and the general population, whereas only a few European multicenter studies systematically manage to detect prevalence rates of various contact allergies over time in eczema populations. Contact allergy is a life-time condition, which may lead to allergic contact dermatitis in individuals who do not manage to avoid exposure to the ascertained allergen in question. It is therefore of utmost importance that clinicians and dermatologists have sufficient knowledge on common allergens causing contact allergies in the general and working population. This review aimed to highlight the newest knowledge of frequent allergens of clinical importance. Literature was sought from the Pubmed™ database, Google™ scholar and textbooks. On the basis of the literature within the last 5 years, a comprehensive review of methylisothiazolinone, chromium, cobalt, rubber accelerators and fragrance ingredients were conducted. Of each allergen we discuss in detail the temporal trend of prevalence, source of exposure, clinical manifestation of allergic contact dermatitis and legislative measurements on how to regulate the exposure.

KEYWORDS:

• Allergic contact dermatitis
• carbamates
• contact allergy
• chromium
• cobalt
• fragrances
• methylisothiazolinone
• rubber accelerators
• thiurams

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

Key issues

• The use of the comprehensive and updated guideline for diagnostic patch testing by the European Society of Contact Dermatitis is essential for surveillance data across European countries.

• The use of the preservative methylisothiazolinone (MI) has resulted in an unprecedented increase of patients with contact allergy to MI. In both cosmetic and industrial chemical products, restrictions are much needed.

• The 2015 EU Leather Regulation is an important intervention on regulating the exposure to chromium (VI) in leather products.

• Mandatory ingredient labeling of rubber accelerators in rubber-protective gloves is advisable.

• The use of fragrance substances will continue and appropriate risk management of fragrance substances must constantly be done.