Erin M Warshaw, Malina Yamashita Peterson, Amber R Atwater, Joel G DeKoven, Melanie D Pratt, James S Taylor, Donald V Belsito, Jonathan I Silverberg, Margo J Reeder, Vincent A DeLeo, Marie-Claude Houle, Cory A Dunnick, Jiade Yu, Brandon Adler, Christen Mowad, Nina C Botto
{"title":"Patch Testing to Paraphenylenediamine: The North American Contact Dermatitis Group Experience (1994-2018).","authors":"Erin M Warshaw, Malina Yamashita Peterson, Amber R Atwater, Joel G DeKoven, Melanie D Pratt, James S Taylor, Donald V Belsito, Jonathan I Silverberg, Margo J Reeder, Vincent A DeLeo, Marie-Claude Houle, Cory A Dunnick, Jiade Yu, Brandon Adler, Christen Mowad, Nina C Botto","doi":"10.1089/derm.2023.0140","DOIUrl":null,"url":null,"abstract":"<p><p><u><b><i>Background/Objectives:</i></b></u> Paraphenylenediamine (PPD) is an aromatic amine dye that may cause allergic contact dermatitis. This study examines the epidemiology of allergic patch test reactions to PPD. <u><b><i>Methods:</i></b></u> This retrospective analysis characterizes individuals tested to PPD (1% petrolatum) by the North American Contact Dermatitis Group (1994-2018). Demographics and dermatitis site(s) were compared between PPD-allergic and PPD-negative patients. PPD reactions were analyzed by reaction strength, clinical relevance, occupational relatedness, and source as well as coreactivity with structurally related compounds. <u><b><i>Results:</i></b></u> Of 54,917 patients tested to PPD, 3095 (5.6%) had an allergic patch test reaction. Compared with PPD-negative patients, PPD-allergic patients had significantly greater odds of age >40 years (odds ratio [OR] 1.55 [95% confidence interval; CI 1.43-1.69]) and female gender (OR 1.52 [95% CI 1.41-1.66]), but lower odds of being White (OR 0.66 [95% CI 0.60-0.71]). The most common primary anatomic sites of dermatitis were face (25.5%), hands (21.9%), and scattered/generalized pattern (15.5%). Over half (55.3%) of PPD reactions were ++ or +++ at the final reading and 60.9% were currently relevant. Common exposure sources included hair dye (73.5%) and clothing/shoes/apparel (3.9%). Occupationally related reactions occurred in 8.3%, most commonly in hairdressers/cosmetologists (72.8%). The most common coreactions were benzocaine (11.3%), <i>N</i>-isopropyl-<i>N</i>'-phenyl-<i>p</i>-phenylenediamine (6.7%), disperse dye mix (6.5%), and black rubber mix (5.1%). <u><b><i>Conclusions:</i></b></u> The 24-year percentage of allergic reactions to PPD was 5.6%. PPD allergy was associated with female gender and age >40 years. PPD allergic patients were less likely to be White. Allergic reactions were usually clinically relevant and hair dye was the most frequently identified source.</p>","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":" ","pages":"536-546"},"PeriodicalIF":4.0000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Dermatitis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/derm.2023.0140","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/7/31 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 1
Abstract
Background/Objectives: Paraphenylenediamine (PPD) is an aromatic amine dye that may cause allergic contact dermatitis. This study examines the epidemiology of allergic patch test reactions to PPD. Methods: This retrospective analysis characterizes individuals tested to PPD (1% petrolatum) by the North American Contact Dermatitis Group (1994-2018). Demographics and dermatitis site(s) were compared between PPD-allergic and PPD-negative patients. PPD reactions were analyzed by reaction strength, clinical relevance, occupational relatedness, and source as well as coreactivity with structurally related compounds. Results: Of 54,917 patients tested to PPD, 3095 (5.6%) had an allergic patch test reaction. Compared with PPD-negative patients, PPD-allergic patients had significantly greater odds of age >40 years (odds ratio [OR] 1.55 [95% confidence interval; CI 1.43-1.69]) and female gender (OR 1.52 [95% CI 1.41-1.66]), but lower odds of being White (OR 0.66 [95% CI 0.60-0.71]). The most common primary anatomic sites of dermatitis were face (25.5%), hands (21.9%), and scattered/generalized pattern (15.5%). Over half (55.3%) of PPD reactions were ++ or +++ at the final reading and 60.9% were currently relevant. Common exposure sources included hair dye (73.5%) and clothing/shoes/apparel (3.9%). Occupationally related reactions occurred in 8.3%, most commonly in hairdressers/cosmetologists (72.8%). The most common coreactions were benzocaine (11.3%), N-isopropyl-N'-phenyl-p-phenylenediamine (6.7%), disperse dye mix (6.5%), and black rubber mix (5.1%). Conclusions: The 24-year percentage of allergic reactions to PPD was 5.6%. PPD allergy was associated with female gender and age >40 years. PPD allergic patients were less likely to be White. Allergic reactions were usually clinically relevant and hair dye was the most frequently identified source.
期刊介绍:
Dermatitis is owned by the American Contact Dermatitis Society and is the home journal of 4 other organizations, namely Societa Italiana di Dermatologica Allergologica Professionale e Ambientale, Experimental Contact Dermatitis Research Group, International Contact Dermatitis Research Group, and North American Contact Dermatitis Group.
Dermatitis focuses on contact, atopic, occupational, and drug dermatitis, and welcomes manuscript submissions in these fields, with emphasis on reviews, studies, reports, and letters. Annual sections include Contact Allergen of the Year and Contact Allergen Alternatives, for which papers are chosen or invited by the respective section editor. Other sections unique to the journal are Pearls & Zebras, Product Allergen Watch, and news, features, or meeting abstracts from participating organizations.