{"title":"Outbreak of contact allergy to dicyclohexylcarbodiimide in a biotechnology laboratory","authors":"Linas Griguola, Kestutis Cerniauskas, Laura Malinauskiene, Kotryna Linauskiene, Justina Rudyte, Anzelika Chomiciene","doi":"10.1111/cod.14715","DOIUrl":"10.1111/cod.14715","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dicyclohexylcarbodiimide (DCC) is known to cause occupational allergic contact dermatitis in biotechnology laboratory workers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to assess the prevalence of DCC sensitization among workers of one biosynthesis laboratory and to determine the optimal DCC concentration for patch testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>23 laboratory workers frequently exposed to DCC of whom 21 suffered from dermatitis and 11 controls were enrolled into the study. All participants underwent skin patch testing with different concentrations of DCC and other substances used in the work environment. Statistical analysis was conducted to compare results between active and control groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 23 workers tested, 56.5% showed positive reactions to DCC. All of them had dermatitis. Morpholine also elicited positive reactions in 26.1% of workers who were all sensitized to DCC. Dimethylformamide and chloroform yielded negative results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dicyclohexylcarbodiimide was a major cause of contact dermatitis in the active group indicating an outbreak of contact allergy to DCC in the company necessitating preventive measures. Both DCC 0.1% ac. and DCC 0.05% pet. should both be used for patch testing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 2","pages":"145-151"},"PeriodicalIF":4.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Contact dermatitis secondary to povidone-iodine: A systematic review","authors":"Harriet Kennedy","doi":"10.1111/cod.14712","DOIUrl":"10.1111/cod.14712","url":null,"abstract":"<p>Cutaneous reactions to povidone (PVP)-iodine are widely reported; however, distinction between allergic and irritant reactions can be challenging. Free iodine is responsible for irritant reactions and is released when PVP-iodine is in a liquid state. The aim of this study was to review the clinical presentation and results of patch testing in patients with PVP-iodine contact dermatitis. A systematic review was conducted by searching Pubmed, MEDLINE, and Google Scholar databases for reports of contact dermatitis secondary to PVP-iodine. Data were collated including study design, patient age and gender identity, iodine exposure, skin biopsy findings, and patch test methodology and results. The search revealed 187 reports with 38 eligible studies; 30 case reports/case series and 8 retrospective cohort studies. Overall, there were 223 patients with PVP-iodine contact dermatitis. The commonest reaction was irritant contact dermatitis (51%), followed by allergic contact dermatitis (40%) and contact dermatitis not further specified (9%). Irritant reactions were characterised by burn-like morphology and, when due to surgical skin disinfectant, were often distant from the surgical incision site. Patch testing was most often performed with a 10% PVP-iodine aqueous solution; however, irritant reactions in controls occur. Various testing methods including iodine in petrolatum, ethanol, dried powder, and open application testing were described. Most reactions to PVP-iodine are irritant and patch testing using a closed-chamber method yields inconsistent results due to risk of irritation from free iodine release over the 2-day occlusion time. Surgeons should be aware of the risk of prolonged skin contact with wet iodine solution.</p>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 1","pages":"2-8"},"PeriodicalIF":4.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.14712","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aaron I. Moore, Ana S. P. Moreira, Inês M. S. Guerra, Laura Goracci, Pedro Domingues, Tânia Melo, M. Rosário Domingues, Niamh M. O'Boyle
{"title":"A lipidomic approach towards identifying the effects of fragrance hydroperoxides on keratinocytes","authors":"Aaron I. Moore, Ana S. P. Moreira, Inês M. S. Guerra, Laura Goracci, Pedro Domingues, Tânia Melo, M. Rosário Domingues, Niamh M. O'Boyle","doi":"10.1111/cod.14711","DOIUrl":"10.1111/cod.14711","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Limonene and linalool are used in cosmetic products for their floral scents, but their oxidation products are strong contact allergens whose mechanisms of action are still not fully understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The effects of limonene hydroperoxide (Lim-2-OOH) and linalool hydroperoxides (Lin-6/7-OOH) on the lipid profile of a human keratinocyte cell line (HaCaT) were evaluated. 2,4-Dinitrofluorobenzene (DNFB) was also included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Lim-2-OOH and Lin-6/7-OOH were synthesised according to previous methods. HaCaT cells were treated with allergens (10 μM) for 24 h and the cellular lipid extracts were analysed by C18 liquid chromatography with tandem mass spectrometry (LC–MS/MS). Data analysis was performed using Lipostar software. Statistical analysis was carried out using Metaboanalyst and R software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All three sensitisers used caused significant changes in the lipidome of HaCaT cells in a similar trend. There was an upregulation in several plasmanyl/plasmenyl phospholipids (O-/P-phosphatidylcholines [PC] and O-/P-phosphatidylethanolamines [PE]), sphingolipids (HexCer) and triacylglycerol lipid species, and a decrease in some polyunsaturated fatty acids-containing phospholipid (PE and PC) species suggesting oxidative stress and inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study is the first to evaluate the plasticity of the HaCaT cell lipidome in response to allylic hydroperoxide allergens Lim-2-OOH and Lin-6/7-OOH, together with the experimental contact allergen DNFB. These allergens are able to upregulate and downregulate certain lipid classes to a varying degree.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 3","pages":"176-186"},"PeriodicalIF":4.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.14711","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yasemin Topal Yüksel, Henrik Thoning, Lotte Seiding Larsen, Lucine Lehmann, Rob Arbuckle, Laura Grant, Tove Agner
{"title":"Evaluation of validity, reliability and ability to detect change for the Hand Eczema Severity Index (HECSI) and evaluation of HECSI-75 and HECSI-90 as within-patient responder definitions","authors":"Yasemin Topal Yüksel, Henrik Thoning, Lotte Seiding Larsen, Lucine Lehmann, Rob Arbuckle, Laura Grant, Tove Agner","doi":"10.1111/cod.14699","DOIUrl":"10.1111/cod.14699","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Hand Eczema Severity Index (HECSI) is a Clinician-Reported Outcome measure of the severity of hand eczema (HE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the validity, reliability and ability to detect change of the HECSI, and the HECSI-75 and HECSI-90 as responder definitions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Analyses were performed using data from a sample of <i>n</i> = 258 patients with Chronic Hand Eczema (CHE) from a Phase 2b, randomised, double-blind, vehicle-controlled trial of delgocitinib cream, pooled across treatment groups. The measurement properties of the HECSI were assessed and the adequacy of the HECSI-75 and HECSI-90 as responder definitions was explored through cross-tabulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Inter-item correlations provided support for the scoring, whereby items are grouped by areas of the hand. HECSI demonstrated good test–retest reliability with intra-class correlations >0.70. Construct validity was supported by a logical pattern of correlations with concurrent measures and significant differences in HECSI scores across severity groups (<i>p</i> < 0.001). HECSI was responsive with statistically significant improvements over time and with significant differences (<i>p</i> < 0.001) between improved and stable groups. Data provided support for both HECSI-75 and HECSI-90 as within-patient responder definitions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HECSI has strong validity, reliability and ability to detect change as a measure of CHE severity. HECSI-75 and HECSI-90 are appropriate responder definitions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 1","pages":"51-60"},"PeriodicalIF":4.8,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Pesqué, Nidia Planella-Fontanillas, Leopoldo Borrego, Tatiana Sanz-Sánchez, Violeta Zaragoza-Ninet, Esther Serra-Baldrich, Francisco Javier Miquel-Miquel, Juan Francisco Silvestre-Salvador, Susana Córdoba-Guijarro, Araceli Sánchez-Gilo, Pedro Mercader-García, Francisco José Navarro-Triviño, Francisco Javier Ortiz-de-Frutos, Fátima Tous-Romero, Mercedes Rodríguez-Serna, Gemma Melé-Ninot, Cristina Barrabés-Torrella, Inmaculada Ruiz-González, María Antonia Pastor-Nieto, José Manuel Carrascosa-Carrillo, Enrique Gómez-de-la-Fuente, Paloma Sánchez-Pedreño-Guillén, Javier Sánchez-Pérez, José Juan Pereyra-Rodríguez, María Elena Gatica-Ortega, Ricardo González-Pérez, Ramon Maria Pujol, Miguel Ángel Gallego Descalzo, Ignacio García-Doval, Ana María Giménez-Arnau
{"title":"Patch test results to the Spanish baseline patch test series according to age groups: A multicentric prospective study from 2019 to 2023","authors":"David Pesqué, Nidia Planella-Fontanillas, Leopoldo Borrego, Tatiana Sanz-Sánchez, Violeta Zaragoza-Ninet, Esther Serra-Baldrich, Francisco Javier Miquel-Miquel, Juan Francisco Silvestre-Salvador, Susana Córdoba-Guijarro, Araceli Sánchez-Gilo, Pedro Mercader-García, Francisco José Navarro-Triviño, Francisco Javier Ortiz-de-Frutos, Fátima Tous-Romero, Mercedes Rodríguez-Serna, Gemma Melé-Ninot, Cristina Barrabés-Torrella, Inmaculada Ruiz-González, María Antonia Pastor-Nieto, José Manuel Carrascosa-Carrillo, Enrique Gómez-de-la-Fuente, Paloma Sánchez-Pedreño-Guillén, Javier Sánchez-Pérez, José Juan Pereyra-Rodríguez, María Elena Gatica-Ortega, Ricardo González-Pérez, Ramon Maria Pujol, Miguel Ángel Gallego Descalzo, Ignacio García-Doval, Ana María Giménez-Arnau","doi":"10.1111/cod.14702","DOIUrl":"10.1111/cod.14702","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Patch test results may be influenced by age-related factors. However, there is still discordant evidence between age and patch test results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aim to evaluate the patch test results reflecting skin sensitisation, their relevance and association with clinical features by age group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective multicentric study of all patients patch tested with the Spanish baseline series in participating centres. Age groups were pre-defined as children (0- to 11-years), adolescents (12- to 18-years), young adults (19- to 30-years), middle-aged adults (31- to 65-years) and older adults (≥66-years). Occurrence of sensitisation, relevance and clinical features were compared by age group. Factors associated with skin sensitisation were investigated with multivariate logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 13 368 patients were patch-tested. Differences in positive patch test results and relevance by age were detected with the highest proportion in middle-aged adults. Age-related trend differences were found for nickel, potassium dichromate, caines, colophony, <i>Myroxylon pereirae</i> resin, 2-hydroxyethyl methacrylate and limonene hydroperoxide. The multivariate logistic analysis (adjusted for sex, atopic dermatitis, body location and occupational dermatitis) showed an association between the age group of 31–65 (OR: 1.41, 95% CI: 1.26–1.58) and above 66-years (OR: 1.15, 95% CI: 1.01–1.32) with a higher proportion of positive results, compared with young adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Positive patch test results vary according to age, with the highest occurrence in middle-aged adults. Most haptens did not present age-related differences, reinforcing the use of baseline series regardless of age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 2","pages":"120-130"},"PeriodicalIF":4.8,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11710926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jingfei Fu, Rui Zhao, Yiyang Jiang, Yingyi Chen, Juan Du, Yi Liu, Junji Xu
{"title":"Photobiomodulation suppresses allergic contact dermatitis by inhibiting T-cell activation","authors":"Jingfei Fu, Rui Zhao, Yiyang Jiang, Yingyi Chen, Juan Du, Yi Liu, Junji Xu","doi":"10.1111/cod.14713","DOIUrl":"10.1111/cod.14713","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Allergic contact dermatitis (ACD) is a dermal inflammatory disease caused by allergic reactions to substances that contact the skin. The hyperactivation of T cells plays an important role in its pathogenesis. Photobiomodulation (PBM) is an efficacious therapeutic approach for suppressing inflammatory diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the potentially beneficial role of PBM in ACD models and investigate its possible mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, the ACD model of C57BL/6 mice was produced and treated with PBM, and the number of T cells was evaluated. In an in vitro study, naïve T cells were isolated and intervened with PBM. The markers of T cell activation were detected by flow cytometer. Transforming growth factor-β (TGF-β) and reactive oxygen species (ROS) were detected to investigate the mechanism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PBM effectively inhibited the inflammatory response by impeding the number of T cells in the ACD model. And in vitro studies showed that PBM could directly moderate the activation of naïve T cells and possess the capability to impede T cell activation via TGF-beta signaling pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our finding elucidates the potential mechanism underlying the inhibitory effects of PBM in inflammatory diseases and furnishes a theoretical foundation for its clinical application.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 3","pages":"187-196"},"PeriodicalIF":4.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Delayed presentation of cobalt allergy to a shoulder prosthesis presenting 4 years post-implantation","authors":"James Fuller, Rosemary Nixon","doi":"10.1111/cod.14710","DOIUrl":"10.1111/cod.14710","url":null,"abstract":"","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 2","pages":"152-153"},"PeriodicalIF":4.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Delgado-Prada, M. Valls-Mompo, F. Ferriols Lisart, A. Sastre Sastre, B. Tarrasó-Castillo, A. Morales-Rubio, C. Morales-Rubio
{"title":"Allergic contact dermatitis triggered by castor oil-containing dressings","authors":"A. Delgado-Prada, M. Valls-Mompo, F. Ferriols Lisart, A. Sastre Sastre, B. Tarrasó-Castillo, A. Morales-Rubio, C. Morales-Rubio","doi":"10.1111/cod.14705","DOIUrl":"10.1111/cod.14705","url":null,"abstract":"<p>Castor oil (CO), predominantly composed of ricinoleic acid, is extensively employed in cosmetics and pharmaceuticals. This ubiquity necessitates a thorough investigation into its role as an allergen, particularly in cases of allergic contact dermatitis.</p><p>A 19-year-old male welder developed allergic contact dermatitis from a dressing containing CO. A clinical and chemical study, including epicutaneous testing and gas chromatography–mass spectrometry (GC–MS) analysis of CO and its derivatives, was conducted. Further details of these tests can be found in the Supplementary Material S1. As there are different CO derivatives such as acetylated, hydrogenated, or pegylated, which have previously been described as a possible cause of allergic contact dermatitis,<span><sup>1-3</sup></span> it was proposed to carry out an extended study with the hydrogenated and nonhydrogenated forms of CO of our environment according to Renier et al.<span><sup>4</sup></span> CO contained in Linitul® (Provided by Alfasigma®), nonhydrogenated CO (Cremophor® EL), Hydrogenated CO (Cremophor® RH 60), and commercial CO (Biovène Barcelona®) were studied by GC–MS (Table 1).</p><p>In the clinical study, positive patch test reactions were noted at 48 and 72 h for Linitul® and CO (Alfasigma®), while commercial CO (Biovène Barcelona®) showed a negative reaction. Positive repeated open application tests were observed with the nonhydrogenated compound (Cremophor® EL), but not with the hydrogenated compound. Chromatograms of the four samples revealed that the commercial sample lacked fatty acids found in the Alfasigma® sample. The commercial sample had an unidentified peak at minute 9.5, absent in known compound libraries. GC–MS analysis confirmed that the commercial sample was not a dilution of other samples. Fatty acids in Linitul/Alfasigma® and Cremophor® EL were consistent with other studies.<span><sup>5</sup></span> However, the Cremophor® RH 60 cream lacked the ricinoleic acid signal, likely converted to methyl 12-hydroxystearate during production, a unique compound in the hydrogenated form (Table 1 and Figure 1).</p><p>Our data indicate that ricinoleic acid is the allergen responsible for allergic contact dermatitis from CO. Both, patch tests and chromatographic analysis, consistently identified it as the primary sensitising agent. Hydrogenated CO lacks ricinoleic acid. The hydrogenation process converts ricinoleic acid into 12-hydroxystearic acid, removing the allergenic double bond. GC–MS analysis confirmed the absence of ricinoleic acid in the hydrogenated sample. Our findings show that labelled essential oil products may not contain the claimed ingredients due to adulteration or chemical changes. Chromatographic analysis revealed that the commercial sample studied lacked CO entirely. Besides, the multiplicity of synonyms employed to designate the same substance, coupled with the lack of precision in labelling, renders identification challenging.</p><p>\u0000 <b>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"92 1","pages":"84-85"},"PeriodicalIF":4.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.14705","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}