Positive relationship – intensity of response to p‐phenylenediamine on patch testing and cross‐reactions with related allergens. (22nd May 2014)

• Record Type: Journal Article
• Authors: Thomas, Bjorn R.; White, Ian R.; McFadden, John P.; Banerjee, Piu
• Is Part Of: Contact dermatitis. Volume 71:Number 2(2014:Aug.)
• Page Start: 98
• Page End: 101
• Publication Date: 2014-05-22
• Subjects: Contact dermatitis -- Periodicals; 616.51
• DOI: 10.1111/cod.12255
• Languages: English
• ISSNs: 0105-1873

Abstract

<abstract abstract-type="main" id="cod12255-abs-0001"> <title>Summary</title> <sec id="cod12255-sec-0001" sec-type="section"> <title>Background</title> <p id="cod12255-para-0001">Hair dye exposure is the most common cause of sensitization to <italic>p</italic>‐phenylenediamine (PPD). Cross‐reactions with structurally related allergens occur.</p> </sec> <sec id="cod12255-sec-0001a" sec-type="section"> <title>Objectives</title> <p id="cod12255-para-0001a">It is suggested that a stronger patch test reaction (3+ rather than 1+) to PPD (usually tested as 1% petrolatum) is associated with an increased propensity for cross‐reactions. In this article we will demonstrate this association.</p> </sec> <sec id="cod12255-sec-0002" sec-type="section"> <title>Methods</title> <p id="cod12255-para-0002">Of 230 patients with allergic reactions to PPD on patch testing identified during 2007–2012 from clinical records, notes for 221 were available for review. Data were collected regarding age, sex, and grade of reaction [International Contact Dermatitis Research Group (ICDRG) criteria] to PPD. Cross‐reactions with the following allergens, found in our baseline series, were recorded: Disperse Yellow 3, <italic>N</italic>‐isopropyl‐<italic>N</italic><italic>′</italic>‐phenyl‐<italic>p</italic>‐phenylenediamine (IPPD), and caine mix. Having excluded 23 doubtful reactions, the reactions from 198 patients were further considered.</p> </sec> <sec id="cod12255-sec-0003" sec-type="section"> <title>Results</title> <p id="cod12255-para-0003">Of the patients, 75.3% (n = 149) were female, and the mean age was 48.6 years (12–82 years). Of the patients allergic to PPD, 16.6% (n = 33) showed cross‐reactions with one or more related allergens. Cross‐reactions were seen in 16% with a grade of 1+, 14.5% with a grade of 2+, 28.6% with a grade of 3+ when PPD was tested 1% pet., and 50.0% when PPD was tested at 0.1–0.001%, arbitrarily considered to be 4+ (<italic>p</italic> = 0.02; Cramér's <italic>V</italic> = 0.23).</p> </sec> <sec id="cod12255-sec-0004" sec-type="section"> <title>Conclusion</title> <p id="cod12255-para-0004">An increasing likelihood of reactions to Disperse Yellow 3, IPPD or caine mix was seen with increasing strength of patch test reaction to PPD. The clinical relevance of these cross‐reactions is unclear.</p> </sec> </abstract>