Daniel Hilewitz, Akiva Trattner, Yehonatan Noyman, Daniel Mimouni, Igor Snast
{"title":"Potassium dichromate sensitivity presenting as tefillin dermatitis: A retrospective cohort study","authors":"Daniel Hilewitz, Akiva Trattner, Yehonatan Noyman, Daniel Mimouni, Igor Snast","doi":"10.1111/cod.14627","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Tefillin are a religious article worn by Jewish men during daily prayer. Tefillin dermatitis secondary to potassium dichromate sensitivity is recognised, but data remain sparse.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>To investigate the prevalence and clinical characteristics of tefillin dermatitis.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Patients who underwent patch testing with the European baseline series in a tertiary dermatology clinic in 2009–2023 and were diagnosed with tefillin dermatitis were identified by file review and their clinical data recorded.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of 1679 consecutive male patients tested, 25 (1.49%) were diagnosed with tefillin dermatitis, accounting for 15.34% of all potassium-dichromate-positive patients (163/1679). Mean pre-symptomatic duration of tefillin use was 38 ± 16.9 years, and mean follow-up time, 3.1 ± 2.9 years. Patients presented with an eczematous rash on body areas in direct contact with the leather box or straps of the tefillin. An id reaction was noted in 32%, and sensitivity to other leather accessories, in 44%. Fourteen patients (56%) switched to chromate-free tefillin: symptoms resolved completely in 11 (79%) and partially in 2.</p>\n </section>\n \n <section>\n \n <h3> Limitations</h3>\n \n <p>Retrospective cohort design.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This is the largest study to date of tefillin dermatitis caused by sensitivity to potassium dichromate used in leather production. Prognosis after switching to chromate-free tefillin was good-to-excellent. Tefillin dermatitis may be more prevalent than previously thought.</p>\n </section>\n </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.14627","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Contact Dermatitis","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cod.14627","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Tefillin are a religious article worn by Jewish men during daily prayer. Tefillin dermatitis secondary to potassium dichromate sensitivity is recognised, but data remain sparse.
Objective
To investigate the prevalence and clinical characteristics of tefillin dermatitis.
Methods
Patients who underwent patch testing with the European baseline series in a tertiary dermatology clinic in 2009–2023 and were diagnosed with tefillin dermatitis were identified by file review and their clinical data recorded.
Results
Of 1679 consecutive male patients tested, 25 (1.49%) were diagnosed with tefillin dermatitis, accounting for 15.34% of all potassium-dichromate-positive patients (163/1679). Mean pre-symptomatic duration of tefillin use was 38 ± 16.9 years, and mean follow-up time, 3.1 ± 2.9 years. Patients presented with an eczematous rash on body areas in direct contact with the leather box or straps of the tefillin. An id reaction was noted in 32%, and sensitivity to other leather accessories, in 44%. Fourteen patients (56%) switched to chromate-free tefillin: symptoms resolved completely in 11 (79%) and partially in 2.
Limitations
Retrospective cohort design.
Conclusion
This is the largest study to date of tefillin dermatitis caused by sensitivity to potassium dichromate used in leather production. Prognosis after switching to chromate-free tefillin was good-to-excellent. Tefillin dermatitis may be more prevalent than previously thought.
期刊介绍:
Contact Dermatitis is designed primarily as a journal for clinicians who are interested in various aspects of environmental dermatitis. This includes both allergic and irritant (toxic) types of contact dermatitis, occupational (industrial) dermatitis and consumers" dermatitis from such products as cosmetics and toiletries. The journal aims at promoting and maintaining communication among dermatologists, industrial physicians, allergists and clinical immunologists, as well as chemists and research workers involved in industry and the production of consumer goods. Papers are invited on clinical observations, diagnosis and methods of investigation of patients, therapeutic measures, organisation and legislation relating to the control of occupational and consumers".