Formaldehyde 2% is not a useful means of detecting allergy to formaldehyde releasers— results of the ESSCA network, 2015‐2018. (16th October 2020)

• Record Type: Journal Article
• Authors: Whitehouse, Heather; Uter, Wolfgang; Geier, Johannes; Ballmer‐Weber, Barbara; Bauer, Andrea; Cooper, Susan; Czarnecka‐Operacz, Magdalena; Dagmar, Simon; Dickel, Heinrich; Fortina, Anna Belloni; Gallo, Rosella; Giménez‐Arnau, Ana M.; Johnston, Graham A.; Filon, Francesca Laresse; Mahler, Vera; Pesonen, Maria; Rustemeyer, Thomas; Schuttelaar, Marie L. A.; Valiukevičienė, Skaidra; Weisshaar, Elke; Werfel, Thomas; Wilkinson, Mark
• Is Part Of: Contact dermatitis. Volume 84:Number 2(2021)
• Page Start: 95
• Page End: 102
• Publication Date: 2020-10-16
• Subjects: 2‐bromo‐2‐nitropropane‐1, 3‐diol -- contact allergy -- cosmetics -- formaldehyde formaldehyde releasers -- diazolidinyl urea -- DMDM hydantoin -- imidazolidinyl urea -- quaternium‐15; Contact dermatitis -- Periodicals; 616.51
• DOI: 10.1111/cod.13691
• Languages: English
• ISSNs: 0105-1873

Abstract

Abstract: Background: Studies suggest that patch testing with formaldehyde releasers (FRs) gives significant additional information to formaldehyde 1% aq. and should be considered for addition to the European baseline series (EBS). It is not known if this is also true for formaldehyde 2% aq. Objectives: To determine the frequency of sensitization to formaldehyde 2% aq. and co‐reactivity with FRs. To establish whether there is justification for including FRs in the EBS. Materials and Methods: A 4‐year, multi‐center retrospective analysis of patients with positive patch test reactions to formaldehyde 2% aq. and five FRs. Results: A maximum of 15 067 patients were tested to formaldehyde 2% aq. and at least one FR. The percentage of isolated reactions to FR, without co‐reactivity to, formaldehyde 2% aq. for each FR were: 46.8% for quarternium‐15 1% pet.; 67.4% imidazolidinyl urea 2% pet.; 64% diazolidinyl urea 2% pet.; 83.3% 1, 3‐dimethylol‐5, 5‐dimethyl hydantoin (DMDM) hydantoin 2% pet. and 96.3% 2‐bromo‐2‐nitropropane‐1, 3‐diol 0.5% pet. This demonstrates that co‐reactivity varies between FRs and formaldehyde, from being virtually non‐existent in 2‐bromo‐2‐nitropropane‐1, 3‐diol 0.5% pet. (Cohen's kappa: 0, 95% confidence interval [CI] −0.02 to 0.02)], to only weak concordance for quaternium‐15 [Cohen's kappa: 0.22, 95%CI 0.16 to 0.28)], where Cohen's kappa value of 1 would indicate full concordance. Conclusions: Formaldehyde 2% aq. is an inadequate screen for contact allergy to the formaldehyde releasers, which should be considered for inclusion in any series dependant on the frequency of reactions to and relevance of each individual allergen. Abstract : Formaldehyde‐releasers (FRs) with the highest sensitization prevalences were quarternium‐15 1% pet. 0.71%, diazolidinyl urea 2% pet. 0.61%, 2‐bromo‐2‐nitropropane‐1, 3‐diol 0.5% pet. 0.49%, imidazolidinyl urea 2% pet. 0.42%, and DMDM hydantoin 2% pet.0.42% Quaternium‐15 (Cohen's kappa: 0.22, 95%CI 0.16 to 0.28) is the formaldehyde releaser showing the most co‐reactivity with formaldehyde 2% aq. (a Cohen's kappa value of 1 would indicate full concordance.) The percentage of additional positive reactions detected by FRs above the use of formaldehyde 2%. ranged from 0.22% for imidazolidinyl urea 2% pet to 0.44% for 2‐bromo‐2‐nitro‐1, 3‐propanediol 0.5% pet.