Evaluation of Patients With Positive Patch Test Reactions to Rubber Additives: A Retrospective Study From Turkey Between 1996 and 2023

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12 8月 2025

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Author : 伤口世界

Evaluation of Patients With Positive Patch Test Reactions to Rubber Additives: A Retrospective Study From Turkey Between 1996 and 2023

İbrahim Halil Aydoğdu | Esen Özkaya Department of Dermatology and Venereology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey

Correspondence: İbrahim Halil Aydoğdu (该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。)

Received: 26 April 2025 | Revised: 14 June 2025 | Accepted: 30 June 2025

Funding: The authors received no specific funding for this work.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2025 The Author(s). Contact Dermatitis published by John Wiley & Sons Ltd.

ABSTRACT

Background: Rubber additives are common causes of allergic contact dermatitis (ACD) worldwide, yet data from Turkey remain

Objectives: To evaluate the prevalence of rubber additive sensitisation and its clinical/occupational relevance in a tertiary re ferral centre.

Methods: A retrospective study on 2687 consecutively patch-tested patients with rubber additives at our allergy unit between 1996 and 2023.

Results: Rubber sensitisation was found in 10.6%, with a slight increase after 2010. Male predominance was noted (female: male=1:2.3). Thiurams and carbamates were the most frequent sensitizers. ACD was diagnosed in 7.9%, primarily caused by gloves (85.5%). Hands were most commonly affected (94.4%). Logistic regression analysis showed that thiuram and carba mate sensitisation was significantly associated with hand eczema, while benzothiazole derivatives were linked to foot eczema. Airborne ACD occurred in 4.2%, mainly in healthcare workers. Hand eczema with and without wrist extension was observed with similar frequency. Occupational ACD accounted for 79.3% of cases, especially among construction (56.8%) and healthcare workers (14.8%), with a relative increase in the latter group after 2015.

Conclusions: The high prevalence of sensitisation from rubber gloves is concerning. Legal measures are urgently needed, includ ing safer additives and clearer glove labelling. Patch testing remains essential, even without the classic glove-pattern distribution.

1 | Introduction

Rubber additives such as thiurams are well-recognised culprits of rubber-induced allergic contact dermatitis (ACD) worldwide. The most commonly implicated products in sensitisation to rub ber additives include gloves, shoes and laundry elastics [1–4]. Rubber-induced occupational ACD (OACD) is particularly com mon, especially among construction workers and healthcare professionals, with gloves serving as a major source [5]. The aim of this study was to evaluate the prevalence of contact sensitisation to rubber additives and examine their clinical and

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Evaluation of Patients With Positive Patch Test Reactions to Rubber Additives: A Retrospective Study From Turkey Between 1996 and 2023 2025-08-12 00:00

İbrahim Halil Aydoğdu | Esen Özkaya Department of Dermatology and Venereology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey

Correspondence: İbrahim Halil Aydoğdu (该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。)

Received: 26 April 2025 | Revised: 14 June 2025 | Accepted: 30 June 2025

Funding: The authors received no specific funding for this work.

Keywords: allergic contact dermatitis | carbamate | epidemiology | glove | mercapto | nonoccupational | occupational | patch test | rubber additives | thiuram

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2025 The Author(s). Contact Dermatitis published by John Wiley & Sons Ltd.

ABSTRACT

Background: Rubber additives are common causes of allergic contact dermatitis (ACD) worldwide, yet data from Turkey remain

Objectives: To evaluate the prevalence of rubber additive sensitisation and its clinical/occupational relevance in a tertiary re ferral centre.

Methods: A retrospective study on 2687 consecutively patch-tested patients with rubber additives at our allergy unit between 1996 and 2023.

Results: Rubber sensitisation was found in 10.6%, with a slight increase after 2010. Male predominance was noted (female: male=1:2.3). Thiurams and carbamates were the most frequent sensitizers. ACD was diagnosed in 7.9%, primarily caused by gloves (85.5%). Hands were most commonly affected (94.4%). Logistic regression analysis showed that thiuram and carba mate sensitisation was significantly associated with hand eczema, while benzothiazole derivatives were linked to foot eczema. Airborne ACD occurred in 4.2%, mainly in healthcare workers. Hand eczema with and without wrist extension was observed with similar frequency. Occupational ACD accounted for 79.3% of cases, especially among construction (56.8%) and healthcare workers (14.8%), with a relative increase in the latter group after 2015.

Conclusions: The high prevalence of sensitisation from rubber gloves is concerning. Legal measures are urgently needed, includ ing safer additives and clearer glove labelling. Patch testing remains essential, even without the classic glove-pattern distribution.
European Society of Contact Dermatitis guideline for diagnostic patch testing – recommendations on best practice 2025-08-11 00:00

Jeanne D. Johansen1, Kristiina Aalto-Korte2, Tove Agner3, Klaus E. Andersen4, Andreas Bircher5, Magnus Bruze6, Alicia Cannavó7, Ana Giménez-Arnau8, Margarida Gonçalo9, An Goossens10, Swen M. John11, Carola Lidén12, Magnus Lindberg13, Vera Mahler14, Mihály Matura15, Thomas Rustemeyer16, Jørgen Serup3, Radoslaw Spiewak17, Jacob P. Thyssen1, Martine Vigan18, Ian R. White19, Mark Wilkinson20 and Wolfgang Uter21

1 Department of Dermato-Allergology, National Allergy Research Centre, Gentofte Hospital, University of Copenhagen, 2900 Hellerup, Denmark,

2 Occupational Medicine, Finnish Institute of Occupational Health, 00250 Helsinki, Finland, 3Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, 2400 Copenhagen, Denmark, 4Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, 5000 Odense, Denmark, 5Allergy Unit, Department of Dermatology, University Hospital and University of Basel, 4031 Basel, Switzerland, 6Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, SE-20502 Malmö, Sweden, 7Hospital Municipal de Vicente López ‘Profesor Bernard Houssay’, Buenos Aires, Argentina, 8Department of Dermatology, Hospital del Mar, Universitat Autónoma de Barcelona, 08003 Barcelona, Spain, 9Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal, 10Contact Allergy Unit, Department of Dermatology, University Hospital K. U. Leuven, B-3000 Leuven, Belgium, 11Department of Dermatology, Environmental Medicine, Health Theory, University of Osnabrueck, D-49069 Osnabrueck, Germany, 12Institute of Environmental Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden, 13Department of Dermatology, University Hospital Örebro, SE-70185 Örebro, Sweden, 14Allergy Unit, Department of Dermatology, University Hospital Erlangen, 91054 Erlangen, Germany, 15Unit of Occupational and Environmental Dermatology, Centre for Occupational and Environmental Medicine, SLSO, SE-11365 Stockholm, Sweden, 16Department of Dermatology, VU University Medical Centre, 1081 HV Amsterdam, The Netherlands, 17Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, 30-688 Krakow, Poland, 18Department of Dermatology, CHRU Besançon, 25030 Besançon Cedex, France, 19Department of Cutaneous Allergy, St John’s Institute of Dermatology, St Thomas’ Hospital, London, SE1 7EH UK, 20Spire Hospital, Leeds, LS8 1NT UK, and 21Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, 91054 Erlangen, Germany doi:10.1111/cod.12432 Correspondence: Jeanne D. Johansen, Department of Dermato-allergology, Gentofte Hospital, 2900 Hellerup, Denmark. Tel: +4538677301. E-mail: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 Conflicts of interests: KAK, JDJ, AC, CL, ML, MM, JS, IRW: No conflicts. TA: Giving talks at meetings arranged by Leo Pharma and GlaxoSmithKline; KEA: Advisor to SmartPractice, Hillerød. Medical Director for Dermatological Investigation (DIS). Research support from IFRA and RIFM; AB: Educational grants from Novartis, GSK, Vifor; MB: member of the REXPAN, collaboration with SmartPractice on metal allergens; AGA: Medical Advisor for Uriach Pharma, Genentech, Novartis research grants by Intendis – Bayer, Uriach Pharma, Novartis, educational activities sponsored by Uriach Pharma, Novartis, Genentech, Menarini, GSK, MSD, Almirall; MG: Participated in the EDEN study on fragrance allergy. Since January 2014 participatation in the National Advisory Board for NOVARTIS (omalizumab for urticaria). Lectures on immunology of psoriasis for Portuguese dermatologists paid by Janssen (2012/13); AG: Departmental service (contact allergy website) financially supported by cosmetic and a few pharmaceutical companies; lecture on allergic contact dermatitis from cosmetics for GSK; lectures to pharmacists and dermatologists on dermatological preparations (contact allergy, irritancy) for Fagron; SMJ: Lecture fees from Almirall, Biogen-Idec, Galderma; VM: Has received lecturing fees from SmartPractice, Almirall Hermal, GlaxoSmithKline, Basilea; TR: Grants for the department from Almirall, Novartis, Zilverlon, Stallergenes; RS: Shareholder and scientific adviser of the Polish representative of Chemotechnique Diagnostics; JPT: Sold a cobalt spot test to Smart Health, Az, USA; MV: Grants from GlaxoSmithKline, Unilever, l’ARCAA; MW: Attended a drug advisory board meeting for GlaxoSmithKline; WU: Accepted travel reimbursement and partly honorarium for presentations given to cosmetic industry (associations) by them. Lecture fee from Almirall Hermal for educational lectures on contact allergy. Accepted for publication 6 May 2015

Summary

The present guideline summarizes all aspects of patch testing for the diagnosis of contact allergy in patients suspected of suffering, or having been suffering, from allergic contact dermatitis or other delayed-type hypersensitivity skin and mucosal conditions. Sections with brief descriptions and discussions of different pertinent topics are followed by a highlighted short practical recommendation. Topics comprise, after an introduction with important definitions, materials, technique, modifications of epicutaneous testing, indi vidual factors influencing the patch test outcome or necessitating special considerations, children, patients with occupational contact dermatitis and drug eruptions as special groups, patch testing of materials brought in by the patient, adverse effects of patch testing, and the final evaluation and patient counselling based on this judgement. Finally, short reference is made to aspects of (continuing) medical education and to electronic collection of data for epidemiological surveillance.

Key words: contact allergy; guideline; patch testing; review.
Influence of Cosmetic Skincare Products with pHal Evaluation 2025-08-08 00:00

Ciska Janssens‑Böcker · Claudia Doberenz · Marta Monteiro · Marta de Oliveira Ferreira

C. Janssens‑Böcker (*) · C. Doberenz MedSkin Solutions Dr. Suwelack AG, Billerbeck, Germany e-mail: ciska.janssens-boecker@medskin-suwelack. com M. Monteiro · M. de Oliveira Ferreira Inovapotek, Pharmaceutical Research & Development, Porto, Portugal

Received: September 10, 2024 / Accepted: November 27, 2024 / Published online: December 21, 2024 © The Author(s) 2024

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1007/s13555-024-01321-x.

ABSTRACT

Introduction:

The human skin acts as a pro‑ tective barrier against external pathogens and hosts a diverse microbiome consisting of bacte‑ ria, fungi, viruses, and archaea. Disruptions to the skin microbiome can impact immune func‑ tion, leading to inflammatory and autoimmune conditions. The importance of pH for the micro‑ biome is paramount. Cosmetic skincare prod‑ ucts interact with the skin microbiome and skin pH, playing a key role in maintaining microbial balance. Research suggests that products with non-physiological pH levels may disrupt the skin microbiota. Our clinical study aimed to evaluate the effects of low-pH cosmetic products (pH<5) on the skin microbiome, contributing to improved skin health.

Methods: The clinical study focused on evalu‑

ating the skin microbiome diversity following

the application for 28 days of four different low

pH cosmetic products (vitamin C, resveratrol, a

collagen mask, and a native algae mask) on the

forearms of post-menopausal women with skin

pH>5.5.

Results:

The diversity of the natural skin microbiome increased consistently through‑ out the study, evident in both the untreated area and after the application of the Vitamin C Concentrate, Resveratrol Concentrate, Colla‑ gen Mask, and Native Algae Mask, as indicated by Shannon’s diversity index. The native algae mask notably reduced the Corynebacterium genus and significantly lowered the pH. The skin pH changes corresponded with microbiota stability.

Conclusions:

In conclusion, enhanced diver‑ sity of the natural skin microbiome was observed over the study duration. None of the investi‑ gational products caused significant disruption to the skin microbiome diversity, as evidenced by the stable Shannon’s diversity index and relative abundance of specific genera. Notably, the native algae mask significantly decreased the presence of the opportunistic pathogenic Corynebacterium genus, which is likely attribut‑ able to a minor reduction in skin pH following extended product use. The findings suggest that the use of low-pH skincare products, like the native algae mask, do not disrupt skin micro‑ biome diversity and may have the potential to positively impact skin microbiome diversity and health by reducing certain pathogenic microbial

Keywords: Human skin; Microbiome; Skincare; Cosmetics; pH

Key Summary Points

Why carry out this study?

This study investigated the intricate relation‑ ship between cosmetic skincare products, the skin microbiome, and skin health. It evaluated the impact of low-pH skincare products on skin microbiome diversity and skin barrier function.

What was learned from this study?

The diversity of the skin microbiome increased following the application of vita‑ min C concentrate, resveratrol concentrate, a collagen mask, and a native algae mask, as demonstrated by Shannon’s diversity index. The native algae mask notably decreased the genus Corynebacterium and lowered the pH, with the pH changes aligning with micro‑ biota stability. Low-pH skincare products maintain skin microbiome diversity and health by reducing pathogenic microbial populations, promot‑ ing a positive impact on skin microbiome health.

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