Live Blog: Allergens of the Year – Not Just Names, but Real Cases. Faculty: Sharon Jacob, MD
In this live blog from the Annual SDPA Fall Conference in Orlando, FL, Sharon Jacob, MD, presented a lecture called, “Allergens of the Year – Not Just Names, but Real Cases.” Here are some of the highlights.
Dr. Jacob spoke on the “allergens of the year” between 2000 and 2015 (the list can be found below) and presented real cases that have been seen related to common allergens. Dr. Jacobs detailed creative and critical methods for determining the source of an allergen breakout in patients and listed popular and common products where these allergens can be found.
Dr. Jacob shared that beginning in the year 2000 the FDA developed an “Allergen of the Year” in order to draw attention to the agents causing the most significant clinical allergen effects. These allergens are often under-recognized, have become obsolete or have exposure patterns that have changed. While the original intent was academic in nature, the annually awarded allergen also plays a key role in increasing public awareness.
The allergen of 2015 is formaldehyde. Formaldehyde is primarily used to prevent contamination in personal hygiene products and for tissue preservation. Formaldehyde can be found in shampoos, body washes and hand soaps, lotions and creams, baby wipes, nail polish, mascara, disinfectants, fabric softeners, topical wart remedies, adhesives, Brazilian Blowout treatments, wrinkle-free fabrics and tissue specimen preservation solutions.
Dr. Jacob shared that formaldehyde has been found in products such as moisturizers and alcohol swabs that are not labeled to include formaldehyde. Therefore, it is important to test all products that might be the source for a patient’s dermatitis regardless if formaldehyde is not found on the label.
A pearl Dr. Jacob shared is that if you know a patient has a formaldehyde allergy, make sure they also avoid aspartame, which shares some allergen triggers with formaldehyde.
An additional pearl to consider when treating patients with allergens is polysensitization. Polysensitization is when a patient has a positive patch test reaction to three or more unrelated allergens. When antibiotics (and steroids for that matter) are used to treat dermatitis (atopic, irritant, allergic dermatitis), the patient can become sensitized to an increasing number of allergens.
Below is the list of the sixteen Allergens of the Year and some supporting pearls.
Methylisothiazolinone Pearl— MI is found in leather cleaning wipes popularly used to wipe leather furniture.
Acrylate Pearl— found in Plexiglas, dental fillers and nail cosmetics, Nitrile gloves have shown to better protect people exposed to acrylate than vinyl or latex gloves.
2011 Dimethyl fumarate
2009 Mixed dialkyl thioureas
Mixed dialkyl thioureas Pearl— Because the thiourea allergy may be missed by screening only with mixed dialkyl thiourea, it is recommended that the patch testing with a component of the patients neoprene product be considered.
Nickel Pearl— Increasing reports of ACD to nickel containing electronics – cell phones, laptops, & iPhones.
Corticosteriods Pearl— While ACD to steroids is well reported, 2014 marked the first report of a bullous systemic contact dermatitiss after a routine corticosteroid injection for chronic joint pain.
2004 Cocamidopropyl betaine
Cocamidopropyl betaine Pearl— Zhao and Li studied the frequency of contact sensitization to a European cosmetic series of allergens in a Beijing population, and found the top three leading allergens to be thimerosal, shellac and CAPB.
Thimerosal Pearl— In Mexico, mercury is prohibited for use in cosmetic products; yet, phenyl mercury & thimerosal are allowed as preservatives in eye make-up.
2000 Disperse Dyes