Christoffer Kursawe Larsen, Mikkel Bak Jensen, Jakob F. B. Schwensen
{"title":"连续贴片测试的丹麦湿疹患者对 N-异丙基-N'-苯基对苯二胺的接触过敏:2013 年至 2023 年历史数据的观察性研究。","authors":"Christoffer Kursawe Larsen, Mikkel Bak Jensen, Jakob F. B. Schwensen","doi":"10.1111/cod.14629","DOIUrl":null,"url":null,"abstract":"<p><i>N</i>-isopropyl-<i>N</i>′-phenyl-paraphenylenediamine (IPPD) is used as antioxidant in industrial black rubber items such as tyres and domestic rubber products such as sport watches<span><sup>1, 2</sup></span> IPPD may cause allergic contact dermatitis known as “Volkswagen dermatitis.”<span><sup>3</sup></span> The European baseline series (EBS) contains IPPD (0.1% in pet.).<span><sup>4</sup></span> The prevalence of contact allergy (CA) to IPPD is low in many studies (<1%).<span><sup>5</sup></span> IPPD is considered a screening allergen in favour of black rubber mix (IPPD), <i>N</i>-cyclohexyl-<i>N</i>-phenyl-4-phenylenediamine (CPPD) and <i>N</i>,<i>N</i>′-diphenyl-p-phenylenediamine (DPPD) that was removed from the EBS in 1992 as CPPD and DPPD were in short supply.<span><sup>6</sup></span> Though, testing with IPPD alone may result in underdiagnosing.<span><sup>7</sup></span> New surveillance data on IPPD are needed. [Correction added on 4 September 2024, after first online publication: The heading ‘BACKGROUND’ has been removed in this version.]</p><p>The objective of this study is to investigate the epidemiology of CA to IPPD from 2013 to 2023.</p><p>An observational study using historical data from the Allergen Database at Gentofte Hospital, Denmark, was conducted. We included patients ≥18 years old being consecutively patch tested with IPPD (0.1% in pet.). at Gentofte Hospital from 2013 to 2023. Patch testing was performed and interpreted as previously.<span><sup>8</sup></span> Patients patch tested several times during our study period were likewise handled as previously.<span><sup>8</sup></span> Information on patch test results, current clinical relevance,<span><sup>8</sup></span> the MOAHLFA-index (Male/Occupational dermatitis/Atopic dermatitis/Hand dermatitis/Leg dermatitis/Facial dermatitis/Age >40), and occupation was extracted.<span><sup>8</sup></span> Time trends were assessed using the Cochrane-Armitage test for trend. Associations between IPPD CA and the MOAHLFA-index were assessed by binary logistic regressions adjusting for sex, age >40/≤40, and atopic dermatitis. Further, crude odds ratios were calculated.</p><p>As sub-analysis, patch test results on patients tested with CPPD, DPPD or <i>N</i>,<i>N</i>-di-2-naphthyl-4-phenylenediamine (all 1% in pet.) as part of the specialised rubber series from 2013 to 2023 were extracted.</p><p>A <i>p</i>-value <0.05 was considered significant. SPSS Statistics-25 and R-version-2023.12.0 were used for statistical analysis. The study is approved under the umbrella project (p-2023-14 475), <i>Region Hovedstaden - Forskningsjuras</i> internal directory of active research projects.</p><p>A total of 7575 unique patients were consecutively patch tested with IPPD from 2013 to 2023. The overall prevalence of CA to IPPD was 0.41% (31/7575) and a significantly decreasing trend was identified from 2013 to 2023 (Cochrane-Armitage <i>p</i> < 0.05) (Figure 1). The current clinical relevance was 20% (6/30).</p><p>No significant associations were found between IPPD CA and any variable from the MOAHLFA-index (Table 1).</p><p>The occupations among those with IPPD CA and occupational dermatitis were: Worker in food industry (<i>n</i> = 2); cleaner (<i>n</i> = 1), healthcare worker (<i>n</i> = 1); lab work (<i>n</i> = 1); warehouse work (<i>n</i> = 1); unemployed (<i>n</i> = 1).</p><p>Of patients tested with CPPD, DPPD, or <i>N</i>,<i>N</i>-di-2-naphthyl-4-phenylenediamine, 0.76% (15/1975) had positive reaction to CPPD, 0.40% (8/1978) to DPPD, and 0% (0/1978) to <i>N</i>,<i>N</i>-di-2-naphthyl-4-phenylenediamine. Co-testing with IPPD and DPPD or CPPD showed that of patients reacting to IPPD, 92.3% (12/13) and 46.2% (6/13) also reacted to CPPD or DPPD, respectively. Further, all patients reacting to CPPD or DPPD also reacted to IPPD (Tables S1 and S2).</p><p>In this study, we investigated the epidemiology of CA to IPPD from 2013 to 2023. The found prevalence (0.41%) is lower than reported from European Surveillance System on Contact Allergy 2019/2020 data (0.79%).<span><sup>9</sup></span> No associations with the MOAHLFA-index were identified even though IPPD CA previously has been associated with occupational dermatitis.<span><sup>10</sup></span> IPPD proved to be a well-screening allergen for the components of black rubber mix. The importance of IPPD in the EBS may nevertheless be questioned considering the low prevalence of IPPD CA, the decreasing trend, low clinical relevance, and lack of relevant occupations. Data used in this study are from a specialised tertiary hospital and only severe cases are included. In Demark, IPPD CA may therefore be caught elsewhere, for example, private dermatologists and departments of occupational medicine. Further surveillance data should evaluate the relevance of IPPD in the EBS.</p><p>\n <b>Christoffer Kursawe Larsen:</b> Conceptualization; methodology; formal analysis; investigation; writing – original draft. <b>Mikkel Bak Jensen:</b> Conceptualization; investigation; methodology; formal analysis; writing – review and editing. <b>Jakob F. B. Schwensen:</b> Writing – review and editing; supervision.</p><p>This work is supported by the Danish Environmental Protection Agency under the Ministry of Environment of Denmark.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.14629","citationCount":"0","resultStr":"{\"title\":\"Contact allergy to N-isopropyl-N′-phenyl paraphenylenediamine in consecutively patch tested Danish eczema patients: An observational study with historical data from 2013 to 2023\",\"authors\":\"Christoffer Kursawe Larsen, Mikkel Bak Jensen, Jakob F. B. Schwensen\",\"doi\":\"10.1111/cod.14629\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><i>N</i>-isopropyl-<i>N</i>′-phenyl-paraphenylenediamine (IPPD) is used as antioxidant in industrial black rubber items such as tyres and domestic rubber products such as sport watches<span><sup>1, 2</sup></span> IPPD may cause allergic contact dermatitis known as “Volkswagen dermatitis.”<span><sup>3</sup></span> The European baseline series (EBS) contains IPPD (0.1% in pet.).<span><sup>4</sup></span> The prevalence of contact allergy (CA) to IPPD is low in many studies (<1%).<span><sup>5</sup></span> IPPD is considered a screening allergen in favour of black rubber mix (IPPD), <i>N</i>-cyclohexyl-<i>N</i>-phenyl-4-phenylenediamine (CPPD) and <i>N</i>,<i>N</i>′-diphenyl-p-phenylenediamine (DPPD) that was removed from the EBS in 1992 as CPPD and DPPD were in short supply.<span><sup>6</sup></span> Though, testing with IPPD alone may result in underdiagnosing.<span><sup>7</sup></span> New surveillance data on IPPD are needed. [Correction added on 4 September 2024, after first online publication: The heading ‘BACKGROUND’ has been removed in this version.]</p><p>The objective of this study is to investigate the epidemiology of CA to IPPD from 2013 to 2023.</p><p>An observational study using historical data from the Allergen Database at Gentofte Hospital, Denmark, was conducted. We included patients ≥18 years old being consecutively patch tested with IPPD (0.1% in pet.). at Gentofte Hospital from 2013 to 2023. Patch testing was performed and interpreted as previously.<span><sup>8</sup></span> Patients patch tested several times during our study period were likewise handled as previously.<span><sup>8</sup></span> Information on patch test results, current clinical relevance,<span><sup>8</sup></span> the MOAHLFA-index (Male/Occupational dermatitis/Atopic dermatitis/Hand dermatitis/Leg dermatitis/Facial dermatitis/Age >40), and occupation was extracted.<span><sup>8</sup></span> Time trends were assessed using the Cochrane-Armitage test for trend. Associations between IPPD CA and the MOAHLFA-index were assessed by binary logistic regressions adjusting for sex, age >40/≤40, and atopic dermatitis. Further, crude odds ratios were calculated.</p><p>As sub-analysis, patch test results on patients tested with CPPD, DPPD or <i>N</i>,<i>N</i>-di-2-naphthyl-4-phenylenediamine (all 1% in pet.) as part of the specialised rubber series from 2013 to 2023 were extracted.</p><p>A <i>p</i>-value <0.05 was considered significant. SPSS Statistics-25 and R-version-2023.12.0 were used for statistical analysis. The study is approved under the umbrella project (p-2023-14 475), <i>Region Hovedstaden - Forskningsjuras</i> internal directory of active research projects.</p><p>A total of 7575 unique patients were consecutively patch tested with IPPD from 2013 to 2023. The overall prevalence of CA to IPPD was 0.41% (31/7575) and a significantly decreasing trend was identified from 2013 to 2023 (Cochrane-Armitage <i>p</i> < 0.05) (Figure 1). The current clinical relevance was 20% (6/30).</p><p>No significant associations were found between IPPD CA and any variable from the MOAHLFA-index (Table 1).</p><p>The occupations among those with IPPD CA and occupational dermatitis were: Worker in food industry (<i>n</i> = 2); cleaner (<i>n</i> = 1), healthcare worker (<i>n</i> = 1); lab work (<i>n</i> = 1); warehouse work (<i>n</i> = 1); unemployed (<i>n</i> = 1).</p><p>Of patients tested with CPPD, DPPD, or <i>N</i>,<i>N</i>-di-2-naphthyl-4-phenylenediamine, 0.76% (15/1975) had positive reaction to CPPD, 0.40% (8/1978) to DPPD, and 0% (0/1978) to <i>N</i>,<i>N</i>-di-2-naphthyl-4-phenylenediamine. Co-testing with IPPD and DPPD or CPPD showed that of patients reacting to IPPD, 92.3% (12/13) and 46.2% (6/13) also reacted to CPPD or DPPD, respectively. Further, all patients reacting to CPPD or DPPD also reacted to IPPD (Tables S1 and S2).</p><p>In this study, we investigated the epidemiology of CA to IPPD from 2013 to 2023. The found prevalence (0.41%) is lower than reported from European Surveillance System on Contact Allergy 2019/2020 data (0.79%).<span><sup>9</sup></span> No associations with the MOAHLFA-index were identified even though IPPD CA previously has been associated with occupational dermatitis.<span><sup>10</sup></span> IPPD proved to be a well-screening allergen for the components of black rubber mix. The importance of IPPD in the EBS may nevertheless be questioned considering the low prevalence of IPPD CA, the decreasing trend, low clinical relevance, and lack of relevant occupations. Data used in this study are from a specialised tertiary hospital and only severe cases are included. In Demark, IPPD CA may therefore be caught elsewhere, for example, private dermatologists and departments of occupational medicine. 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Schwensen:</b> Writing – review and editing; supervision.</p><p>This work is supported by the Danish Environmental Protection Agency under the Ministry of Environment of Denmark.</p><p>The authors declare no conflicts of interest.</p>\",\"PeriodicalId\":10527,\"journal\":{\"name\":\"Contact Dermatitis\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2024-06-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.14629\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Contact Dermatitis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/cod.14629\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Contact Dermatitis","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cod.14629","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}
Contact allergy to N-isopropyl-N′-phenyl paraphenylenediamine in consecutively patch tested Danish eczema patients: An observational study with historical data from 2013 to 2023
N-isopropyl-N′-phenyl-paraphenylenediamine (IPPD) is used as antioxidant in industrial black rubber items such as tyres and domestic rubber products such as sport watches1, 2 IPPD may cause allergic contact dermatitis known as “Volkswagen dermatitis.”3 The European baseline series (EBS) contains IPPD (0.1% in pet.).4 The prevalence of contact allergy (CA) to IPPD is low in many studies (<1%).5 IPPD is considered a screening allergen in favour of black rubber mix (IPPD), N-cyclohexyl-N-phenyl-4-phenylenediamine (CPPD) and N,N′-diphenyl-p-phenylenediamine (DPPD) that was removed from the EBS in 1992 as CPPD and DPPD were in short supply.6 Though, testing with IPPD alone may result in underdiagnosing.7 New surveillance data on IPPD are needed. [Correction added on 4 September 2024, after first online publication: The heading ‘BACKGROUND’ has been removed in this version.]
The objective of this study is to investigate the epidemiology of CA to IPPD from 2013 to 2023.
An observational study using historical data from the Allergen Database at Gentofte Hospital, Denmark, was conducted. We included patients ≥18 years old being consecutively patch tested with IPPD (0.1% in pet.). at Gentofte Hospital from 2013 to 2023. Patch testing was performed and interpreted as previously.8 Patients patch tested several times during our study period were likewise handled as previously.8 Information on patch test results, current clinical relevance,8 the MOAHLFA-index (Male/Occupational dermatitis/Atopic dermatitis/Hand dermatitis/Leg dermatitis/Facial dermatitis/Age >40), and occupation was extracted.8 Time trends were assessed using the Cochrane-Armitage test for trend. Associations between IPPD CA and the MOAHLFA-index were assessed by binary logistic regressions adjusting for sex, age >40/≤40, and atopic dermatitis. Further, crude odds ratios were calculated.
As sub-analysis, patch test results on patients tested with CPPD, DPPD or N,N-di-2-naphthyl-4-phenylenediamine (all 1% in pet.) as part of the specialised rubber series from 2013 to 2023 were extracted.
A p-value <0.05 was considered significant. SPSS Statistics-25 and R-version-2023.12.0 were used for statistical analysis. The study is approved under the umbrella project (p-2023-14 475), Region Hovedstaden - Forskningsjuras internal directory of active research projects.
A total of 7575 unique patients were consecutively patch tested with IPPD from 2013 to 2023. The overall prevalence of CA to IPPD was 0.41% (31/7575) and a significantly decreasing trend was identified from 2013 to 2023 (Cochrane-Armitage p < 0.05) (Figure 1). The current clinical relevance was 20% (6/30).
No significant associations were found between IPPD CA and any variable from the MOAHLFA-index (Table 1).
The occupations among those with IPPD CA and occupational dermatitis were: Worker in food industry (n = 2); cleaner (n = 1), healthcare worker (n = 1); lab work (n = 1); warehouse work (n = 1); unemployed (n = 1).
Of patients tested with CPPD, DPPD, or N,N-di-2-naphthyl-4-phenylenediamine, 0.76% (15/1975) had positive reaction to CPPD, 0.40% (8/1978) to DPPD, and 0% (0/1978) to N,N-di-2-naphthyl-4-phenylenediamine. Co-testing with IPPD and DPPD or CPPD showed that of patients reacting to IPPD, 92.3% (12/13) and 46.2% (6/13) also reacted to CPPD or DPPD, respectively. Further, all patients reacting to CPPD or DPPD also reacted to IPPD (Tables S1 and S2).
In this study, we investigated the epidemiology of CA to IPPD from 2013 to 2023. The found prevalence (0.41%) is lower than reported from European Surveillance System on Contact Allergy 2019/2020 data (0.79%).9 No associations with the MOAHLFA-index were identified even though IPPD CA previously has been associated with occupational dermatitis.10 IPPD proved to be a well-screening allergen for the components of black rubber mix. The importance of IPPD in the EBS may nevertheless be questioned considering the low prevalence of IPPD CA, the decreasing trend, low clinical relevance, and lack of relevant occupations. Data used in this study are from a specialised tertiary hospital and only severe cases are included. In Demark, IPPD CA may therefore be caught elsewhere, for example, private dermatologists and departments of occupational medicine. Further surveillance data should evaluate the relevance of IPPD in the EBS.
Christoffer Kursawe Larsen: Conceptualization; methodology; formal analysis; investigation; writing – original draft. Mikkel Bak Jensen: Conceptualization; investigation; methodology; formal analysis; writing – review and editing. Jakob F. B. Schwensen: Writing – review and editing; supervision.
This work is supported by the Danish Environmental Protection Agency under the Ministry of Environment of Denmark.
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".