The authors declare no conflict of interest.

Contact DermatitisVolume 83, Issue 4 p. 326-328 CONTACT POINTS Allergic contact dermatitis from carbomers: two case report Florence Castelain, Florence Castelain orcid.org/0000-0003-0334-8486 Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France Contribution: Conceptualization, Data curation, ​Investigation, Methodology, Resources, Supervision, Validation, Visualization, Writing - review & editingSearch for more papers by this authorStefan Kerre, Stefan Kerre Dermatologist, Dermatology Clinic, Aarschot, Belgium Contribution: Data curation, Formal analysis, Methodology, Resources, Supervision, Validation, Writing - original draft, Writing - review & editingSearch for more papers by this authorClémentine Carlet, Clémentine Carlet Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France Contribution: Conceptualization, Data curation, Formal analysis, ​Investigation, Methodology, Writing - review & editingSearch for more papers by this authorAn Goossens, An Goossens Department of Dermatology, University Hospitals, KU Leuven, Leuven, Belgium Contribution: Supervision, Validation, Visualization, Writing - original draft, Writing - review & editingSearch for more papers by this authorPascal Girardin, Pascal Girardin Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France Contribution: Conceptualization, Data curation, Resources, Validation, Writing - review & editingSearch for more papers by this authorFabien Pelletier, Fabien Pelletier Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France Dermatology Clinic, University of Franche-Comté, Inserm U1098 RIGHT, Besançon, France Contribution: Conceptualization, Formal analysis, Methodology, Validation, Writing - review & editingSearch for more papers by this authorFrancois Aubin, Corresponding Author Francois Aubin francois.aubin@univ-fcomte.fr orcid.org/0000-0002-1421-4996 Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France Dermatology Clinic, University of Franche-Comté, Inserm U1098 RIGHT, Besançon, France Correspondence Francois Aubin, Department of Dermatology, University Hospital of Besançon, 3 boulevard Alexander Fleming, F25030 Besançon, France. Email: francois.aubin@univ-fcomte.fr Contribution: Formal analysis, ​Investigation, Visualization, Writing - original draft, Writing - review & editingSearch for more papers by this author Florence Castelain, Florence Castelain orcid.org/0000-0003-0334-8486 Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France Contribution: Conceptualization, Data curation, ​Investigation, Methodology, Resources, Supervision, Validation, Visualization, Writing - review & editingSearch for more papers by this authorStefan Kerre, Stefan Kerre Dermatologist, Dermatology Clinic, Aarschot, Belgium Contribution: Data curation, Formal analysis, Methodology, Resources, Supervision, Validation, Writing - original draft, Writing - review & editingSearch for more papers by this authorClémentine Carlet, Clémentine Carlet Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France Contribution: Conceptualization, Data curation, Formal analysis, ​Investigation, Methodology, Writing - review & editingSearch for more papers by this authorAn Goossens, An Goossens Department of Dermatology, University Hospitals, KU Leuven, Leuven, Belgium Contribution: Supervision, Validation, Visualization, Writing - original draft, Writing - review & editingSearch for more papers by this authorPascal Girardin, Pascal Girardin Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France Contribution: Conceptualization, Data curation, Resources, Validation, Writing - review & editingSearch for more papers by this authorFabien Pelletier, Fabien Pelletier Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France Dermatology Clinic, University of Franche-Comté, Inserm U1098 RIGHT, Besançon, France Contribution: Conceptualization, Formal analysis, Methodology, Validation, Writing - review & editingSearch for more papers by this authorFrancois Aubin, Corresponding Author Francois Aubin francois.aubin@univ-fcomte.fr orcid.org/0000-0002-1421-4996 Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France Dermatology Clinic, University of Franche-Comté, Inserm U1098 RIGHT, Besançon, France Correspondence Francois Aubin, Department of Dermatology, University Hospital of Besançon, 3 boulevard Alexander Fleming, F25030 Besançon, France. Email: francois.aubin@univ-fcomte.fr Contribution: Formal analysis, ​Investigation, Visualization, Writing - original draft, Writing - review & editingSearch for more papers by this author First published: 20 May 2020 https://doi.org/10.1111/cod.13616Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. CONFLICTS OF INTEREST The authors declare no conflict of interests. Citing Literature Volume83, Issue4October 2020Pages 326-328 RelatedInformation

Patent Blue V (PBV), also called E131 or Acid Blue 3 (CAS no. 3536-49-0), is commonly used in pharmacology, cosmetology, aesthetics, and food products. Hypersensitivity to this dye has been mainly described during sentinel lymph node procedures in patients with cancer. Hypersensitivity reactions include urticaria, “blue hives,” pruritus or generalized rash, extracutaneous lesions such as angioedema, bronchospasm, or cardiovascular symptoms. These are usually triggered after intravenous or subcutaneous exposure to PBV. Herein, we report, to the best of our knowledge, the first case of immediate hypersensitivity to PBV occurring after oral intake.

BackgroundEyelids are frequent sites of contact dermatitis. No prospective study focused on eyelid allergic contact dermatitis (EACD) has yet been published, and this topic has never been studied in French patients.ObjectivesTo prospectively evaluate the usefulness of an eyelid series in French patients patch tested because of EACD, and to describe these patients.MethodsWe prospectively analysed standardized data for all patients referred to our departments between September 2014 and August 2016 for patch testing for suspected EACD as the main reason. All patients were patch tested with an eyelid series, the European baseline series (EBS), the French additional series, and their personal products. Patch testing with additional series and repeated open application tests (ROATs) or open tests were performed if necessary. A standardized assessment of the relevance was used, and the analysis of the results was focused on patients having positive test results with a current certain relevance.ResultsTwo‐hundred and sixty‐four patients (238 women and 26 men) were included. Three‐hundred and twenty‐two tests gave positive results in 167 patients, 84 of whom had currently relevant reactions: 56 had currently relevant positive test reactions to the EBS, 16 had currently relevant positive test reactions to their personal products, 8 had currently relevant positive test reactions to the French additional series, and 4 had currently relevant positive test reactions to the eyelid series. Sixty‐seven per cent of all relevant cases were related to cosmetic products. The most frequent allergens with current relevance were methylisothiazolinone (10.2%), fragrance mix I (3%), nickel (2.7%), hydroxyperoxides of linalool (2.7%) and limonene (2.3%), and Myroxylon pereirae (2.3%). Current atopic dermatitis was found in 9.5% of patients. The duration of dermatitis was shorter (23.2 vs 34.2 months; P = .035) in patients with currently relevant test reactions. The percentage of currently relevant tests remained the same when atopic patients or dermatitis localized only on the eyelids were taken into account.ConclusionIn French patients, testing for EACD with the extended baseline series and personal products, also including ROATs and use tests, appears to be adequate, considering the currently relevant positive test reactions. The regular addition of an eyelid series does not seem to be necessary.

Polyurethane resins, developed by the addition of diisocyanates and polyol, have many industrial applications, especially as filling foam (automobile, building and furniture industries). The diisocyanates of which these foams are composed can be irritating and sensitizing during their manufacturing process and use. They are particularly responsible for respiratory manifestations, and less frequently for urticaria or allergic contact dermatitis.

Background: Iodinated and gadolinium-based contrast media (ICM; GBCM) induce immediate hypersensitivity (IH) reactions. Differentiating allergic from non-allergic IH is crucial; allergy contraindicates the culprit agent for life. We studied frequency of allergic IH among ICM or GBCM reactors. Methods: Patients were recruited in 31 hospitals between 2005 and 2009. Clinical symptoms, plasma histamine and tryptase concentrations and skin tests were recorded. Allergic IH was diagnosed by intradermal tests (IDT) with the culprit CM diluted 1:10, “potentially allergic” IH by positive IDT with pure CM, and non-allergic IH by negative IDT. Findings: Among 245 skin-tested patients (ICM = 209; GBCM = 36), allergic IH to ICM was identified in 41 (19.6%) and to GBCM in 10 (27.8%). Skin cross-reactivity was observed in 11 patients with ICM (26.8%) and 5 with GBCM (50%). Allergy frequency increased with clinical severity and histamine and tryptase concentrations (p < 0.0001). Cardiovascular signs were strongly associated with allergy. Non-allergic IH was observed in 152 patients (62%) (ICM:134; GBCM:18). Severity grade was lower (p < 0.0001) and reaction delay longer (11.6 vs 5.6 min; p < 0.001). Potentially allergic IH was diagnosed in 42 patients (17.1%) (ICM:34; GBCM:8). The delay, severity grade, and mediator release were intermediate between the two other groups. Interpretation: Allergic IH accounted for <10% of cutaneous reactions, and >50% of life-threatening ones. GBCM and ICM triggered comparable IH reactions in frequency and severity. Cross-reactivity was frequent, especially for GBCM. We propose considering skin testing with pure contrast agent, as it is more sensitive than the usual 1:10 dilution criteria.

Airborne allergic contact dermatitis caused by paints containing isothiazolinones has been recognized as a health hazard.

Elisabeth Aberer, Graz, Austria Z. Meltem Akkurt, Diyarbakir, Turkey Víctor Alegre de Miquel, Valencia, Spain Lacy M. Alexander, University Park, Pa., USA Sharique A. Ali, Bhopal, India Nawaf Al-Mutairi, Kuwait, Kuwait Augustin Alomar, Barcelona, Spain Wim Annaert, Leuven, Belgium Richard Joseph Antaya, New Haven, Conn., USA Ercan Arca, Ankara, Turkey Giuseppe Argenziano, Naples, Italy Aimée H. Arits, Maastricht, The Netherlands Nicola Balato, Naples, Italy Robert Baran, Cannes, France Barouyr Baroudjian, Paris, France Veronique Bataille, London, UK Jaideep Bhat, Birmingham, UK Wolf-Henning Boehncke, Geneva, Switzerland Roland Boeni, Zurich, Switzerland Yong Chool Boo, Daegu, Republic of Korea Jean-David Bouaziz, Paris, France Lise Boussemart, Paris, France Ralph-Peter Braun, Zurich, Switzerland Leena Bruckner-Tuderman, Münster, Germany Dianne Campbell, Sydney, N.S.W., Australia Caterina Campisi, Genoa, Italy Mollie Carruthers, Columbus, Ohio, USA Annamaria Cesinario, Modena, Italy Wah Cheuk, Hong Kong, SAR, China Wei-Sheng Chong, Singapore, Singapore Olivier Chosidow, Créteil, France Arnon D. Cohen, Tel Aviv, Israel Rafael Contreras-Galindo, Ann Arbor, Mich., USA Monica Corazza, Ferrara, Italy Luisa Costa, Naples, Italy Diona L. Damian, Camperdown, N.S.W., Australia Esteban Dauden, Madrid, Spain Claire Dauphin, Clermont-Ferrand, France David de Berker, Bristol, UK

Background: Currently used antimalarial drugs (AM) are hydroxychloroquine and chloroquine, which are prescribed for many autoimmune disorders. The value of skin tests on cutaneous adverse drug reactions (CADR) with AM remains unknown. Objective: The main objective of this retrospective study is to know whether skin tests for AM are useful and how to manage the recovery of AM therapy in these patients. Methods: All patients referred for suspected CADR secondary to AM between 2001 and 2014 in eight French dermatology centers were retrospectively reviewed. Results: We report herein a retrospective series of 20 patients with CADR and AM involvement. Skin tests, performed in 14/20 patients, were negative in all cases. Six patients had an oral provocation test with recurrence of CADR in 1 case. Conclusion: We encourage dermatologists to perform oral provocation tests in nonsevere CADR in order to allow AM rechallenge at progressive doses.

Contact DermatitisVolume 74, Issue 1 p. 55-56 Contact Point Anaphylactic reaction to povidone in a skin antiseptic Florence Castelain, Florence Castelain Allergology Unit, Department of Dermatology, University Hospital, 25030, Besançon, FranceSearch for more papers by this authorPascal Girardin, Corresponding Author Pascal Girardin Allergology Unit, Department of Dermatology, University Hospital, 25030, Besançon, FranceCorrespondence: Pascal Girardin, Department of Dermatology, University Hospital of Besancon, 3 Boulevard Alexander Fleming, F25030 Besancon, France. Tel: +33 3 81218060; Fax: +33 3 81218163. E-mail: pgirardin@chu-besancon.frSearch for more papers by this authorLaurianne Moumane, Laurianne Moumane Allergology Unit, Department of Dermatology, University Hospital, 25030, Besançon, FranceSearch for more papers by this authorFrançois Aubin, François Aubin Allergology Unit, Department of Dermatology, University Hospital, 25030, Besançon, France EA3181, SFR FED 4234 IBCT, University of Franche-Comté, Besançon, FranceSearch for more papers by this authorFabien Pelletier, Fabien Pelletier Allergology Unit, Department of Dermatology, University Hospital, 25030, Besançon, France Inserm U1098, SFR FED 4234 IBCT, University of Franche-Comté, 25030, Besançon, FranceSearch for more papers by this author Florence Castelain, Florence Castelain Allergology Unit, Department of Dermatology, University Hospital, 25030, Besançon, FranceSearch for more papers by this authorPascal Girardin, Corresponding Author Pascal Girardin Allergology Unit, Department of Dermatology, University Hospital, 25030, Besançon, FranceCorrespondence: Pascal Girardin, Department of Dermatology, University Hospital of Besancon, 3 Boulevard Alexander Fleming, F25030 Besancon, France. Tel: +33 3 81218060; Fax: +33 3 81218163. E-mail: pgirardin@chu-besancon.frSearch for more papers by this authorLaurianne Moumane, Laurianne Moumane Allergology Unit, Department of Dermatology, University Hospital, 25030, Besançon, FranceSearch for more papers by this authorFrançois Aubin, François Aubin Allergology Unit, Department of Dermatology, University Hospital, 25030, Besançon, France EA3181, SFR FED 4234 IBCT, University of Franche-Comté, Besançon, FranceSearch for more papers by this authorFabien Pelletier, Fabien Pelletier Allergology Unit, Department of Dermatology, University Hospital, 25030, Besançon, France Inserm U1098, SFR FED 4234 IBCT, University of Franche-Comté, 25030, Besançon, FranceSearch for more papers by this author First published: 22 December 2015 https://doi.org/10.1111/cod.12473Citations: 15 Conflicts of interests: The authors declare no conflict of interests. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume74, Issue1January 2016Pages 55-56 RelatedInformation

This study has two purposes:--to know whether the European standard series is still the key reference when it comes to contact dermatitis, i.e., are its components still the most frequently involved allergens in contact dermatitis nowadays?--to assess the results of the European standard series among French and Belgian dermatologists/allergists as, so far, most of them have failed to provide statistical data within the European community of allergists/dermatologists. 18 participants from 2 dermatology and allergy centres in Belgium and 11 centres in France collected their results from 3,073 patients tested in 2011. They assessed the relevance of some tests as well as that of the standard series and additional series to establish an etiological diagnosis of contact dermatitis. These results, together with the history of the European standard series, have shown that some allergens are obsolete and that others should be included in a new standard series for which we are making a few suggestions.

Dear Sir, We read with great interest the recent report by Matthieu et al. (1) on their experience in phototesting patients with suspected contact dermatitis to ketoprofen (KP). The authors found a high frequency (69%) of contact allergy to fragrance mix. They discussed the already suggested hypothesis (2) that the presence of an aldehyde function in KP and cinnamic aldehyde (Cald) (component of fragrance mix) may explain this cross-sensitivity. As there is no mechanistic nor structural evidence that cinnamic derivatives and KP can activate the same T lymphocytes subpopulation, the term cross-sensitivity is probably not adequate and requires further investigations. But for practical reasons, we will still use it in the following discussion. There is no true aldehyde function on KP molecule, but the oxygen group close to the benzene ring resembles that found in Cald when it is folded into itself by carbonic double link. However, the authors did not test the different components of fragrance mix and their data could not support this. Cross-sensitization between KP and fragrance mix has been already reported by Pigatto et al. (2). Among 123 patients with allergic reactions to topical arylpropionic anti-inflammatory drugs, they observed 26 contact and 25 photocontact sensitivity to KP cases, and 39 patients (32%) demonstrated positive reaction to fragrance mix as compared to the total prevalence of positivity to fragrance mix (12%) in the outpatient clinic data (2401 cases). When tested with components of fragrance mix, 33 patients out of 39 reacted to Cald. However, no data for reaction to cinnamic alcohol (Calc) were given. The authors concluded that reactions to KP and fragrance mix were not due to chance. They suggested that an aldehyde group near a benzene ring could induce sensitization and cross-reactions between KP and fragrance mix. More recently, Frosch et al. (3) observed that 8.3% out of 1069 patients were positive to fragrance mix. Among them, 11% were positive to Cald. In a previous study in 18 patients with contact photallergy to KP (4), we also found a high frequency of contact allergy to fragrance mix (83%). 8 positive patients were then tested with the different components of fragrance mix, including Calc and Cald (unpublished data). All patients demonstrated positive reaction with Calc and only 5 patients reacted to Cald. We do not have any clear explanation for the low reactivity to Cald observed in our study as compared to those found by Pigatto et al. (2) and Frosch et al. (3). Both Calc and Cald have been reported to cause allergic contact dermatitis in humans, with Cald a more potent skin sensitizer than Calc. However, in man, Calc is almost as frequent a cause of allergic contact dermatitis as is Cald (5). In addition, unexplained interindividual differences and cross-reactivities/cosensitization to these compounds in the clinic have been observed. Cutaneous sensitization to Cald may be dependent not only upon skin absorption kinetics but also upon the effectiveness of toxification/detoxification by cutaneous enzymes, which may demonstrate interindividual variations (6–8). Furthermore, the weak sensitization potential of Calc and the limited cutaneous conversion of Calc to Cald may be overcome by a higher degree of exposure to Calc. Indeed, Calc is a component of cinnamon spice, which is widely used in the food and fragrance industry. Our results thus do not support the role of the aldehyde function in cross-reaction between KP and fragrance mix. In contrast, we postulate that Calc may be an independent antigen that does not necessarily require transformation into Cald to be a sensitizer. The mechanisms involved in this strong association between positive patch test to cinnamic derivatives, in particular Calc and KP are still unknown. Besides the immunological pathway of cross-sensitization, an enzymatic susceptibility for either toxification or detoxification of molecules may also be involved. However, we believe that the mechanism may involve the high reactivity induced by the association of a benzene ring with an oxygen group (4). Indeed, several molecules, including KP, Calc, Cald, benzophenone-3, fenofibrate, tiaprofenic acid and several unexpected and non-relevant allergens (4), share this chemical combination and are involved in cross-association. There are few available clinical data to confirm this demonstration, which to be true, requires that all patients with positive patch test to fragrance mix and cinnamic derivatives should also react to KP. However, such an investigation (photopatch test to KP in patients with positive patch test to cinnamic derivatives) as the retest method (KP on previously positive patch test to cinnamic derivatives and cinnamic derivatives on previously positive patch test to KP+ irradiation with ultraviolet radiation) is restricted for ethical reasons. In conclusion, on the basis of strong correlation between sensitization to cinnamic derivatives and KP, we suggested that cutaneous reactivity to cinnamic derivatives may represent a risk factor of KP sensitization. Furthermore, exposure to the sun may facilitate the direct transformation making sensitization and cross-sensitization occur more rapidly (2). For this reason, we recommend to test the patients positive to fragrance mix with the different components, in particular the cinnamic derivatives, and then to inform patients positive to cinnamic derivatives of the risk of sensitization to KP.

Euxyl K400 is a biocide used in cosmetics. It is composed of phenoxyethanol and dibromodicyanobutane. From January of 1988 to October of 1994, 1,217 patients with contact dermatitis were tested with Euxyl K400, 2% petrolatum. This study had three aims: to monitor and record the evolution of the rate of sensitization, to study the sensitized population, to determine the sensitizing compound present in Euxyl K400. The rate of sensitization increased; animal studies were not able to predict this sensitization; this fact shows the interest of "active cosmetovigilance". Dibromodicyanobutane is the main allergen in Euxyl K400 but it is not the only one.