Contact Dermatitis Associated With Skin Cleansers: Retrospective Analysis of North American Contact Dermatitis Group Data 2000–2014. Issue 1 (January 2018)

• Record Type: Journal Article
• Authors: Warshaw, Erin M.; Goodier, Molly C.; DeKoven, Joel G.; Maibach, Howard I.; Taylor, James S.; Sasseville, Denis; Belsito, Donald V.; Fowler, Joseph F.; Fransway, Anthony F.; DeLeo, Vincent A.; Marks, James G.; Pratt, Melanie D.; Mathias, Toby; Zirwas, Matthew J.; Zug, Kathryn A.
• Is Part Of: Dermatitis. Volume 29:Issue 1(2018)
• Publication Date: 2018-01
• Subjects: Skin -- Inflammation -- Periodicals; Skin -- Diseases -- Periodicals; Dermatology -- Periodicals; Dermatitis, Contact -- Periodicals; Dermatitis, Atopic -- Periodicals; Dermatitis, Occupational -- Periodicals; Drug Eruptions -- Periodicals; 616.51
• DOI: 10.1097/DER.0000000000000330
• Languages: English
• ISSNs: 1710-3568

Abstract

Abstract : Background: There is limited information regarding contact dermatitis (CD) associated with skin cleansers (SCs). Objective: The aim of the study was to evaluate the prevalence of allergic patch test (APT) reactions and irritant CD (ICD) associated with SCs. Methods: A retrospective cross-sectional analysis was performed using North American Contact Dermatitis Group data, 2000–2014. Results: Of 32, 945 tested patients, 1069 (3.24%) had either APT reaction or ICD associated with SCs. Of these, 692 (64.7%) had APT reaction only, 350 (32.7%) had ICD only, and 27 (2.5%) had both. Individuals with APT reaction and/or ICD were more likely to have occupationally related skin disease (relative risk [RR] = 3.8 [95% confidence interval {CI} = 3.3–4.5] for APT reaction and 10.0 [95% CI = 8.2–12.2] for ICD, respectively, P < 0.0001). As compared with those without APT reaction to SC, individuals with APT reaction had significantly higher frequencies of hand (RR = 2.4 [95% CI = 2.1–2.7]) and arm dermatitis (RR = 1.3 [95% CI = 1.1–1.6], P ⩽ 0.001). Irritant CD was strongly associated with hand dermatitis (RR = 6.2 [95% CI = 5.2–7.3], P < 0.0001). More than 50 allergens were associated with SCs including quaternium-15 (11.2%), cocamidopropyl betaine (9.5%), methylchloroisothiazolinone/methylisothiazolinone (8.4%), coconut diethanolamide (7.9%), fragrance mix I (7.7%), Myroxylon pereirae (5.9%), 4-chloro-3, 5-xylenol (5.8%), amidoamine (5.5%), and formaldehyde (4.4%). Conclusions: Many allergens, especially preservatives and surfactants, were associated with SCs. Most cases involved the hands and were occupationally related.