New data regarding Wet Wipe Allergens from the North American Contact Dermatitis Group!

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New data regarding Wet Wipe Allergens from the North American Contact Dermatitis Group!

There have been several case reports of wipe-associated contact dermatitis, however, the aim of this study was to determine the prevalence of wipe-associated contact dermatitis in a larger population This study looked at 9037 patients patch tested from 2011-2014 to determine the prevalence of wet wipes as a source of contact allergy.

What did they find?

79(0.9%) had a positive patch test to an allergen associated with a wet-wipe source. Anal/genital dermatitis was 15 times more likely in those with a wet-wipe allergy!

What were the most associated allergens

Preservatives and fragrance:

  1. Methylisothiazolinone (59.0%)
  2. Methychloroisothiazolinone (MCI)/MI (35.6%)
  3. Bronopol (2-bromo-2-nitropropane-1,3-diol) (27.4%)
  4. Iodopropynyl butylcarbamate (12.3%)
  5. Fragrance (combined) represented (12.3%)

What was their conclusion?

Although uncommon (0.9%), Wet wipes are an important source of contact allergy to consider with anal/genital dermatitis. Preservatives such as Isothiazolinones are an especially important source to consider!

 

Warshaw EM, Aschenbeck KA, Zug KA, Belsito DV, Zirwas MJ, Fowler JF Jr, Taylor

JS, Sasseville D, Fransway AF, DeLeo VA, Marks JG Jr, Pratt MD, Maibach HI,

Mathias CG, DeKoven JG. Wet Wipe Allergens: Retrospective Analysis From the North

American Contact Dermatitis Group 2011-2014. Dermatitis. 2017

Jan/Feb;28(1):64-69

Nickel allergy and wheat sensitivity – Free access article

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Contact Dermatitis Due to Nickel Allergy in Patients Suffering from Non-Celiac Wheat Sensitivity 

Original article:

Alberto D’ Alcamo, Pasquale Mansueto, Maurizio Soresi, Rosario Iacobucci, Francesco La Blasca, Girolamo Geraci, Francesca Cavataio, Francesca Fayer, Andrea Arini, Laura Di Stefano, Giuseppe Iacono, Liana Bosco & Antonio Carrocio. Contact Dermatitis Due to Nickel Allergy in Patients Suffering from Non-Celiac Wheat Sensitivity.Nutrients, 2017; Vol. 9(2):103  

Reviewed by Sue Min S. Kwon, BS, MSI and Annelise Rasmussen BS, MSII, Loma Linda University.

  • As gluten allergy becomes more prevalent and widely-knownin society, patients with cutaneous or gastrointestinal symptoms following wheat ingestion may self-report gluten/wheat allergies, though they do not in fact have celiac disease. Almaco et al. suggested the term “non-celiac wheat sensitivity” (NCWS) to describe patients presenting with these symptoms, rather than non-celiac gluten sensitivity (NCGS), as it is not known which component of wheat causes the symptoms.
  • Non-celiac wheat sensitivity (NCWS) is a relatively new clinical finding associated with gluten-related diseases. Wheat contains nickel, a known contact allergen, which may produce systemic nickel allergy syndrome (SNAS) symptoms. Nickel is the most frequent cause of contact allergy in tested populations.
  • NCWS can mimic irritable bowel syndrome (IBS). 
  • Almacoet al. conducted a double-blind placebo-controlled (DBPC) experiment in order to evaluate the frequency of contact dermatitis due to nickel allergy.

o   NCWS patients suffering from nickel allergy were compared with a control group of NCWS patients who did not report nickel allergy.

o   NCWS patients with nickel allergy had a significantly higher percentage of atopic disease manifestations than those with irritable bowel syndrome (IBS) and NCWS patients without nickel allergy.

  • Nickel allergy (diagnosed by a confirmatory epicutaneouspatch test) may manifest with both cutaneous and gastrointestinal symptoms.

o   All NCWS patients with nickel allergy exhibited cutaneous erythema.

o   Less than 10% of NCWS patients without nickel allergy exhibited such symptoms.

  • Causes may include dietary short-chain carbohydrate load, autoimmune disorders, and non-immunoglobulin E – mediated wheat allergies.
  • This study did not allow for evaluation of the frequency of nickel allergy in NCWS; nickel patch testing was only performed on patients who self-reported contact dermatitis. Nickel allergy could have been present in patients who did not report nickel allergy.
  • Selection bias was a result of patients referred to tertiary centers.
  • Alcamo et al. suggest that patients with NCWS who exhibit cutaneous erythema should be tested for nickel allergy.

http://www.mdpi.com/2072-6643/9/2/103