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Background: Differences in patterns of allergic contact dermatitis (ACD) among underrepresented minority populations are not well studied., Objective: The aim of the study was to investigate patterns of ACD in African American and White patch-tested patients in a distinct metropolitan area over a 10-year period., Methods: We conducted a retrospective review of 297 ACD patients patch tested from 2009 to 2019. Differences in allergen frequency, relevance, and sources of exposure were evaluated. Fisher exact test analyses were performed to examine these differences., Results: Among 297 patients, 215 were White and 47 were African American. The most common sensitizers differed between the 2 groups. African American patients also reacted with statistically significant greater frequency to disperse dye blue (P = 0.019) and textile dye mix (P = 0.001). The most common source of positive patch tests for all patients was personal care products (72%). Occupational allergy was greater in African American male patients, and personal care product exposure was greater in White male patients (P = 0.009)., Conclusions: Our study highlights the differing patterns of sensitization seen in African American and White patients. This is likely due to differences in personal care product use or occupational allergy. Additional studies with larger sample sizes are needed to expand upon these differences., Competing Interests: The authors have no funding or conflicts of interest to declare., (Copyright © 2021 American Contact Dermatitis Society. All Rights Reserved.)

Background: Chemicals in textile manufacturing and laundering products are important sources of allergens triggering allergic contact dermatitis. Allergens corresponding to the textile production process have been well recognized. However, there is limited information regarding potential allergens in laundering products., Objective: The aim is to investigate the presence and prevalence of potential allergens in commonly used laundering products., Methods: An Internet-based search was performed to identify the current best-selling laundering products in the United States. Subsequent inquiry of common allergens for each product was collected through a review of ingredients listed by manufacturers., Results: Sixty-five laundering products were examined: 30 laundry detergents, 10 fabric softeners, 8 dryer sheets, and 17 stain removers. Ten common allergens were identified: benzisothiazolinone, benzyl benzoate, cocamidopropyl betaine, decyl glucoside, "fragrances," lauryl glucoside, methylisothiazolinone, methylchloroisothiazolinone, phenoxyethanol, and propylene glycol. Fragrances and essential oils are the top allergens in laundry detergents (66.7%), fabric softeners (90%), dryer sheets (75%), and stain removers (58.8%). Laundry detergents labeled as "baby safe" and "free and gentle" contained common allergens, with methylisothiazolinone being the most prevalent, in 80% and 57.1%, respectively., Conclusions: Textile dermatitis can negatively impact quality of life and function. Aside from textile dyes and finishing resins, laundering products should also be considered.

Limonene is a fragrance widely used in cosmetics and household products. Until recently, contact allergy to limonene was considered rare because positive patch tests to it were infrequently observed. In recent years, however, it has been demonstrated that exposure of limonene to oxygen (air) results in the formation of a number of oxidation products, of which the hydroperoxides have a far stronger sensitizing potency than the pure compound. By routine testing of patients suspected of contact dermatitis with hydroperoxides of limonene, high frequencies of positive reactions were found, indicating that these chemicals are important fragrance allergens. It should be realized, however, that a number of "positive" reactions may well be false-positive, irritant responses.

Background: Formaldehyde is a common preservative and strong sensitizer., Objective: The aim of the study was to evaluate the release of formaldehyde from baby/toddler wet wipes using the chromotropic acid method (CAM)., Methods: An online search of best-selling baby wipes was conducted. None declared formaldehyde or formaldehyde-releasing preservatives. Standard CAM procedures were used: a 1 × 1-in square of fresh wipe was placed in a bottle with an open vial of 4 mg/1 mL of chromotropic acid and sulfuric acid solution, sealed, and stored for 48 hours. Formalin and water served as controls. A blinded investigator graded color change (negative, indeterminate, mild, moderate, or strong). For quality control, 20% of all samples as well as all positives were retested., Results: Fifty-one popular and highly reviewed baby and toddler wet wipe products were tested using CAM. Twelve wipes (24%) released formaldehyde (8 mild, 4 moderate/strong). Chromotropic acid method testing of 9 wipes (18%) was indeterminate and 30 (59%) were negative., Conclusions: Almost one quarter of baby/toddler wet wipes released formaldehyde when evaluated with CAM. Patients and clinicians should be aware of this potentially undeclared source of this common allergen.

Background: Wet wipes are a significant allergen source for anogenital allergic contact dermatitis., Objective: The aim of the study was to calculate the frequency of potentially allergenic ingredients in personal hygiene wet wipes., Methods: Ingredient lists from brand name and generic personal hygiene wet wipes from 4 large retailers were compiled., Results: In the 54 personal hygiene wet wipes evaluated, a total of 132 ingredients were identified (average of 11.9 ingredients per wipe). The most common ingredients were Aloe barbadensis (77.8%), citric acid (77.8%), fragrance (72.2%), sorbic acid derivatives (63.0%), tocopherol derivatives (63.0%), glycerin (59.3%), phenoxyethanol (55.6%), disodium cocoamphodiacetate (53.7%), disodium ethylenediaminetetraacetic acid (EDTA) (42.6%), propylene glycol (42.6%), iodopropynyl butylcarbamate (40.7%), chamomile extracts (38.9%), sodium benzoate (35.2%), bronopol (22.2%), sodium citrate (22.2%), lanolin derivatives (20.4%), parabens (20.4%), polyethylene glycol derivatives (18.5%), disodium phosphate (16.7%), dimethylol dimethyl hydantoin (DMDM) (14.8%), and cocamidopropyl propylene glycol (PG)-dimonium chloride phosphate (11.1%). Of note, methylisothiazolinone (5.6%) was uncommon; methylchloroisothiazolinone was not identified in the personal hygiene wet wipes examined., Conclusions: There are many potential allergens in personal hygiene wet wipes, especially fragrance and preservatives.

Background: The usage prevalence of ingredients in topical products is important to dermatologists and industry., Objective: To determine the prevalence of methylisothiazolinone (MI) in various types of consumer products, Methods: The Contact Allergy Management Program (CAMP) database was mapped and sorted in spreadsheet format to determine the prevalence of MI in various types of consumer products., Results: Methylisothiazolinone was found in 13.2% of 4660 total products in CAMP. High usage of MI was seen in dishwashing products (64%), shampoos (53%), bathroom/kitchen/all-purpose cleaners (47%), hair conditioners (45%), hair dyes (43%), laundry additives/fresheners/softeners (30%), soaps/cleansers (29%), and surface cleaners/disinfectants (27%). Of the products containing MI, MI alone (without methylchloroisothiazolinone) was most common in makeup products (100%), cleaning/dish/laundry products (>99%), moisturizers (82%), shaving products (78%), sunscreens (71%), and antiaging products (67%)., Conclusions: The American Contact Dermatitis Society's CAMP is a valuable tool to collect epidemiologic data on the incidence of specific ingredient usage in various types of topical products.

Background: The isothiazolinones methylchloroisothiazolinone and methylisothiazolinone (MCI/MI) are the active ingredients in a frequently used preservative in cosmetic, household, and industrial products., Objectives: This study reviewed our department's cases of allergic contact dermatitis caused by MCI/MI, outlining their clinical presentation and possible sources of sensitization. The effect of changing the concentration of MCI/MI from 0.01% to 0.02% in the British Society for Cutaneous Allergy baseline series was also measured., Methods: A total of 964 patients were patch tested to the British Society for Cutaneous Allergy baseline series in our department over 4 years. Patients were tested either to 0.01% MCI/MI (697) or 0.02% MCI/MI (267)., Results: Twenty-one patients (2.2%) had positive reactions to MCI/MI. Of patients tested to 0.02% MCI/MI, 3.8% had a positive reaction compared with 1.6% of those tested to MCI/MI 0.01%. Ten patients (48%) had perianal dermatitis; of these, 50% had used moist toilet wipes., Conclusions: We highlight MCI/MI as important contact allergens found in moist toilet wipes and should be considered particularly in patients with facial, hand, and perianal allergic contact dermatitis. Patch testing to 0.01% MCI/MI may underestimate its allergenic potential, missing more than half of allergic cases compared with testing to 0.02%. To identify isothiazolinone allergy, we recommend that 0.02% MCI/MI should be used in baseline series.

Exposure to hydrofluoric acid can cause severe skin damage via both corrosive and chemical means. Dermatologists should be aware of the various clinical presentations and knowledgeable of how to manage such patients. A case of a man with exposure of the hands after use of a consumer product containing hydrofluoric acid is presented. The presentation may vary depending on the concentration and duration of exposure. Patients experiencing exposure are at risk of serious complications, including death, resulting from electrolyte abnormalities. Information regarding the source of exposure will allow the physician to better predict the patient's course. The use of immediate flushing with water and the use of topical calcium gluconate can prevent extensive damage to the area of exposure and potentially fatal complications that may occur. More extensive burns may necessitate more invasive therapies. The treatment and the management and monitoring of such cases will allow for more optimal outcomes.

Sodium hydroxymethylglycinate (SHMG) is a preservative used in many commercially available products, including shampoos, conditioners, soaps, moisturizers, body sprays, baby wipes, room sprays, cleaning agents, and pesticides. It is in a class of chemicals known as formaldehyde-releasing preservatives. Notably, members of this class have been associated with allergic contact dermatitis, possibly due to the agents themselves, the formaldehyde they release, or both. Studies on SHMG in animals have demonstrated potential for sensitization and dermatitis, and formaldehyde-allergic patients have been reported to improve when products containing SHMG are avoided. Patients and providers need to be aware of this preservative.