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Dermatitis. 2017 May/Jun;28(3):204-209. doi: 10.1097/DER.0000000000000288.

Epidemic of Isothiazolinone Allergy in North America: Prevalence Data From the North American Contact Dermatitis Group, 2013-2014.

Author information

1
From the *Division of Dermatology, The Ohio State University, Columbus; †The University of Minnesota and the Minneapolis VAMC; ‡University of California, San Francisco; §Cleveland Clinic, OH; ∥McGill University Health Centre, Montreal, Canada; ¶University of Toronto, Canada; #Associates in Dermatology, Fort Myers, FL; **Group Health Associates, Cincinnati, OH; ††Dartmouth Medical Center, Lebanon, NH; ‡‡St. Luke's Roosevelt Hospital Center, New York; §§Dermatology Specialists, Louisville, KY; ∥∥Pennsylvania State University, Hershey, PA; ¶¶University of Ottawa, Ontario, Canada; ##Columbia University Medical Center, New York, NY.

Abstract

BACKGROUND:

Preservative sensitivity patterns evolve with changing use patterns in products. During the last decade, the use of methylisothiazolinone (MI) at higher concentrations in both leave-on and rinse-off products has significantly increased. This is the first North American Contact Dermatitis Group reporting cycle that includes both methylchloroisothiazolinone (MCI)/MI and MI data.

OBJECTIVE:

The aim of this study was to report the prevalence of isothiazolinone allergy (MCI/MI and MI) in the North American Contact Dermatitis Group patch-test population from January 1, 2013, to December 31, 2014.

METHODS:

At 13 centers in North America, 4860 patients were patch tested in a standardized manner with a series of 70 allergens, including MCI/MI 0.01% aqueous (aq) and MI 0.2% aq.

RESULTS:

Three hundred five patients (6.3%) had a positive reaction to MCI/MI; this is a significant increase from the previous cycle (5.0%, 2011-2012; P = 0.011). Five hundred twenty-one patients (10.7%) had a positive reaction to MI. These 2 isothiazolinones were among the most common preservative allergens in the 2013 to 2014 cycle; 11.9% of patch-tested individuals were allergic to 1 or both isothiazolinones. Individuals with MCI/MI and MI allergy were significantly more likely to have occupationally related skin disease (P < 0.0001) and hand dermatitis (P < 0.0001, P = 0.0474).

CONCLUSIONS:

The epidemic of isothiazolinone sensitivity documented in Europe is now in North America. Patch testing with only MCI/MI 0.01% aq will miss approximately half of isothiazolinone allergy cases, whereas testing with only MI 0.2% aq will miss approximately 10% of isothiazolinone allergy cases.

PMID:
28509715
DOI:
10.1097/DER.0000000000000288
[Indexed for MEDLINE]

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