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Background: In 2019, a number of allergens (haptens), henceforth, "the audit allergens," were considered as potential additions to the European Baseline Series (EBS), namely, sodium metabisulfite, 2‐bromo‐2‐nitropropane‐1,3‐diol, diazolidinyl urea, imidazolidinyl urea, Compositae mix II (2.5% or 5% pet), linalool hydroperoxides (lin‐OOH), limonene hydroperoxides (lim‐OOH), benzisothiazolinone (BIT), octylisothiazolinone (OIT), decyl glucoside, and lauryl glucoside; Evernia furfuracea (tree moss), was additionally tested by some departments as well. Objectives: To collect further data on patch test reactivity and clinical relevance of the audit allergens in consecutive patients across Europe. Methods: Patch test data covering the audit allergens in 2019 and 2020 were collected by those departments of the European Surveillance System on Contact Allergies testing these, as well as further collaborators from the EBS working group of the European Society of Contact Dermatitis (ESCD), and the Spanish Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea. As patch test outcome, reactions between day (D) 3 and D5 were considered. Results: Altogether n = 12 403 patients were tested with any of the audit allergen. Positive reactions were most common to lin‐OOH 1% pet. (8.74% [95%CI: 8.14–9.37%]), followed by lin‐OOH 0.5% pet., and lim‐OOH 0.3% pet (5.41% [95% CI: 4.95–5.89%]). Beyond these terpene hydroperoxides, BIT 0.1% pet. was the second most common allergen with 4.72% (95% CI: 4.2–5.28%), followed by sodium metabisulfite 1% pet. (3.75% [95%CI: 3.32–4.23%]) and Compositae mix 5% pet. (2.31% [95% CI: 1.84–2.87%]). For some allergens, clinical relevance was frequently difficult to ascertain. Conclusions: Despite many positive patch test reactions, it remains controversial whether lin‐ and lim‐OOH should be tested routinely, while at least the two preservatives BIT and sodium metabisulfite appear suitable. The present results are a basis for further discussion and ultimately decision on their implementation into routine testing among the ESCD members. Highlights: Twelve preservatives, fragrances, and emulsifiers were evaluated as potential additions to the European Baseline Series (EBS)The highest prevalences of positive reactions were to linalool hydroperoxides 1% pet. or 0.5% pet. and limonene hydroperoxides 0.3% pet. Benzisothiazolinone 0.1% pet. was positive in 4.7%, followed by sodium metabisulfite 1% pet. (3.8%) and Compositae mix 5% pet. (2.3%).The results are a basis for further discussion and ultimately a decision on their implementation into routine testing among the European Society of Contact Dermatitis (ESCD) members. [ABSTRACT FROM AUTHOR]

Background: In about half of the patients reacting positive to fragrance mix I (FM I), breakdown testing remains negative. This raises the question of whether the reaction to FM I is false‐positive, or the breakdown test is false‐negative. Objectives: To identify characteristics and sensitization patterns of patients positive to FM I, but not to its fragrance constituents. Patients and Methods: Retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK) between 2005 and 2019. Three patient groups were defined according to their reaction pattern: Group I, FM I positive and ≥1 single fragrance positive in the breakdown test (n = 1912); Group II, FM I positive and breakdown test negative (n = 1318); Group III, FM I negative (n = 19 790). Results: Regarding the pattern of concomitant reactions to other fragrances, Group II had an intermediate position between Group I and Group III. In other respects (age and sex distribution, frequency of sensitization to non‐fragrance baseline series allergens), Group II rather resembled Group I. Conclusions: Not every positive reaction to FM I in patients with negative breakdown tests is false‐positive. There may be false‐negative reactions to the single fragrance components when patch tested at 1% pet. Raising patch concentrations of some single fragrances is recommended. [ABSTRACT FROM AUTHOR]

Background: Clinical surveillance of the prevalence of contact allergy in consecutively patch tested patients is a proven instrument to continually assess the importance of contact allergens (haptens) assembled in a baseline series. Objectives: To present current results from the European Surveillance System on Contact Allergies, including 13 countries represented by 1 to 11 departments. Methods: Anonymized or pseudonymized patch test and clinical data from various data capture systems used locally or nationally as transferred to the Erlangen data centre were pooled and descriptively analysed after quality control. Results: In the 4 years (2015‐2018), data from 51 914 patients patch tested with the European baseline series (EBS) of contact allergens were analysed. Contact allergy to nickel was most frequent (17.6% positive), followed by contact allergy to fragrance mix I (6.9%), methylisothiazolinone (MI; 6.2%), and Myroxylon pereirae resin (balsam of Peru; 5.8%). Conclusions: While the prevalence of MI contact allergy decreased substantially following regulatory intervention, the persistently high levels of allergy to metals, fragrances, other preservatives, and rubber chemicals point to problems needing further research and, potentially, preventive efforts. Results with national additions to the baseline series provide important information on substances possibly to be considered for inclusion in the EBS. [ABSTRACT FROM AUTHOR]

Background: Sensitization to methylisothiazolinone (MI) has seen an exceptional epidemic, mainly attributed to its use in cosmetics. Objectives: To trace the epidemic of MI allergy (2009–2018), and to analyze a possible change of patients' characteristics. Methods: Informationsverbund Dermatologischer Kliniken‐data of patients patch tested between 2009 and 2018 with MI (0.05% aq.) were analyzed concerning anamnestic items and sensitization frequencies. Results: Overall, 4.9% reacted positive to MI. Comparing sensitization to MI in three periods (2009, 2013/14, and 2017/18), there was an increase to 7% in 2013 and a decrease to 3.4% in 2018. The MOAHLFA Index (M=Men, O=Occupational Dermatitis, A=Atopic Dermatitis, L=Leg Dermatitis, F=Face Dermatitis, A= Age > 40) for the period 2013/14 is characterized by a lower proportion of occupational dermatitis and a higher proportion of face dermatitis. The period 2017/18 is characterized by increases of occupational dermatitis and hand dermatitis, and a decrease of face dermatitis. Painters, personal care workers, and hairdressers were particularly affected. Sensitization in hairdressers and personal care workers (mostly cosmeticians) decreased after the peak in 2013/14, whereas sensitization to MI in painters continued to increase. Conclusions: After an unprecedented epidemic of MI allergy, mainly caused by its use in cosmetics, the continuous use of MI in industrial applications, for example, paints, and subsequent sensitization remain a matter of concern. Highlights: After an epidemic of MI allergy mainly caused by its use in cosmetics, the continuous use of MI in industrial applications, for example, paints, and subsequent sensitization remain a matter of concern. [ABSTRACT FROM AUTHOR]

Background: In 2019, a number of allergens (haptens), henceforth, "the audit allergens," were considered as potential additions to the European Baseline Series (EBS), namely, sodium metabisulfite, 2‐bromo‐2‐nitropropane‐1,3‐diol, diazolidinyl urea, imidazolidinyl urea, Compositae mix II (2.5% or 5% pet), linalool hydroperoxides (lin‐OOH), limonene hydroperoxides (lim‐OOH), benzisothiazolinone (BIT), octylisothiazolinone (OIT), decyl glucoside, and lauryl glucoside; Evernia furfuracea (tree moss), was additionally tested by some departments as well. Objectives: To collect further data on patch test reactivity and clinical relevance of the audit allergens in consecutive patients across Europe. Methods: Patch test data covering the audit allergens in 2019 and 2020 were collected by those departments of the European Surveillance System on Contact Allergies testing these, as well as further collaborators from the EBS working group of the European Society of Contact Dermatitis (ESCD), and the Spanish Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea. As patch test outcome, reactions between day (D) 3 and D5 were considered. Results: Altogether n = 12 403 patients were tested with any of the audit allergen. Positive reactions were most common to lin‐OOH 1% pet. (8.74% [95%CI: 8.14–9.37%]), followed by lin‐OOH 0.5% pet., and lim‐OOH 0.3% pet (5.41% [95% CI: 4.95–5.89%]). Beyond these terpene hydroperoxides, BIT 0.1% pet. was the second most common allergen with 4.72% (95% CI: 4.2–5.28%), followed by sodium metabisulfite 1% pet. (3.75% [95%CI: 3.32–4.23%]) and Compositae mix 5% pet. (2.31% [95% CI: 1.84–2.87%]). For some allergens, clinical relevance was frequently difficult to ascertain. Conclusions: Despite many positive patch test reactions, it remains controversial whether lin‐ and lim‐OOH should be tested routinely, while at least the two preservatives BIT and sodium metabisulfite appear suitable. The present results are a basis for further discussion and ultimately decision on their implementation into routine testing among the ESCD members. Highlights: Twelve preservatives, fragrances, and emulsifiers were evaluated as potential additions to the European Baseline Series (EBS)The highest prevalences of positive reactions were to linalool hydroperoxides 1% pet. or 0.5% pet. and limonene hydroperoxides 0.3% pet. Benzisothiazolinone 0.1% pet. was positive in 4.7%, followed by sodium metabisulfite 1% pet. (3.8%) and Compositae mix 5% pet. (2.3%).The results are a basis for further discussion and ultimately a decision on their implementation into routine testing among the European Society of Contact Dermatitis (ESCD) members. [ABSTRACT FROM AUTHOR]