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Background: The textile dye mix (TDM) 6.6% pet. contains Disperse Blue (DB) 35, Disperse Yellow 3, Disperse Orange (DO) 1 and 3, Disperse Red 1 and 17, and DB 106 and 124. The most frequent allergen in TDM-positive patients is DO 3. Around 85% of p-phenylenediamine (PPD)-allergic dermatitis patients have shown positive patch test reactions to DO 3. There has been a discussion to exclude DO 3 from TDM 6.6% because of frequent, strong reactions to TDM 6.6% and PPD., Objectives: To study if DO 3 can be omitted from a TDM., Methods: Patch tests were performed on 2250 dermatitis patients with TDM 6.6%, TDM 5.6% pet., TDM 7.0% pet., and PPD 1.0% pet.; 122 patients were also patch tested with DO 3 1.0% pet., Results: Among the 2250 patients patch tested, contact allergy prevalence to TDM 6.6% was 2.4%, to TDM 5.6% 1.8%, and to TDM 7.0% 2.0%. Of the 54 TDM 6.6%-positive patients, 55.6% reacted to PPD; as much as 42.2% of PPD-allergic women and 50% of PPD-allergic men reacted to TDM 6.6%. Of the 17 DO 3-positive patients, 94.1% showed a positive reaction to PPD., Conclusion: Results indicate that DO 3 can probably be omitted from TDM, but patch testing with TDM 6.6%, TDM 7.0%, DO 3 1.0%, and PPD 1.0% simultaneously is needed to finally decide whether it is possible or not., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Formaldehyde is a widely used organic compound, used in several applications (hard thermoset resins, adhesives, disinfectants, tissue fixatives, etc), in its free form or released by formaldehyde releaser products. Its use is under control due to its toxic, carcinogenic, and allergenic properties., Objective: The aim of this study was to investigate the frequency of formaldehyde sensitization, time trend, and correlation to occupations., Methods: This study is a cross-sectional study on a population of 23,774 patients tested from 1996 to 2012 in Northeastern Italy., Results: Frequency of sensitization was 3.3%, without any significant time trend. Hands (39.8% overall) and face (25.6% females, 15.5% males) were mainly involved. We found a trend toward decrease by age in females (3.11% in first quintile [14-26 years], 2.29% in fifth quintile [59-97 years], P < 0.01). On a logistic regression analysis (control group: white-collar workers), we found associations in health care (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.04-1.81), wood (OR, 2.14; 95% CI, 1.30-3.51), and textile (OR, 1.79; 95% CI, 1.14-2.79) sectors and professional drivers (OR, 1.94; 95% CI, 1.05-3.60). We found a high rate of cosensitization to formaldehyde in patients with positive patch test reactions to quaternium-15 (OR, 18.7; 95% CI, 12.6-27.7)., Conclusions: Sensitization to formaldehyde is relevant in our population, especially in the health care sector, wood and textile industries, and professional drivers. No significant time trend was found.

Background: The prevalence of occupational and non-occupational textile dermatitis seems to be increasing, probably because of changed textile manufacturing techniques., Objective: Evaluation of the clinical features and epidemiology of textile contact dermatitis (TCD) in Italy., Methods: Demographic data, clinical history aspects, atopy and positive patch test reactions to occupational and non-occupational allergens were investigated in 277 textile dermatitis patients., Results: Contact dermatitis was the most frequent clinical presentation (95.3%). TCD was more common in females, in the fourth to fifth decades of life, and in atopic dermatitis patients. The lesions were prevalently eczematous (74.2%), and mostly located on the trunk and lower limbs in non-occupational cases, and on the hands in textile workers. Allergic TCD (58.3%) was more frequent than irritant TCD. The dyes (Disperse Blue 124, Disperse Blue 106, and Disperse Yellow 3) were most frequently responsible (79.8%), especially in non-occupational TCD. Formaldehyde and resins were more important in occupational TCD. Concomitant reactions among textile dyes and/or finishing resins were observed in 50.0% of patients., Conclusions: Some strategies (sensitization potential of new textile chemicals, more stable dyes, reduced levels of formaldehyde in clothing, and collaboration with textile industry and trade associations) should be adopted to decrease the TCD incidence and update the textile patch testing series., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Recognition of allergic contact dermatitis attributed to textile dyes and resins is steadily increasing., Objective: This study aims to review the results of patch testing with a textile series at our institution and to compare with previously published reports., Methods: We performed a retrospective review of results in patients who underwent patch testing using a series of textile dyes and resins from January 1, 2000, through September 30, 2011., Results: A total of 671 patients (mean age, 56.5 years; female, 65.9%) were patch tested with the textile series (42 dyes and resins). These patients were also generally tested with the standard patch test series (n = 620). Of the patients, 219 (32.6%) demonstrated allergic reaction to 1 or more textile dyes and resins, and 71 (10.6%) manifested irritant reactions. The most frequent allergens were disperse blue 106 1% (8.3%), disperse blue 124 1% (8.0%), and melamine formaldehyde 7% (8.0%). Of patients tested with the standard series, 36 (5.8%) showed a positive reaction to the traditional textile screening allergen p-phenylenediamine 1%., Conclusions: Supplementing the standard series with the textile series increased detection of textile allergies. In patients suspected of textile allergy, addition of the textile series is necessary for appropriate diagnosis.

Formaldehyde-based resins have been used to create permanent-press finishes on fabrics since the 1920s. These resins have been shown to be potent sensitizers in some patients, leading to allergic contact dermatitis. This review summarizes the history of formaldehyde textile resin use, the diagnosis and management of allergic contact dermatitis from these resins, and current regulation of formaldehyde resins in textiles.

Background: Disperse dyes (DDs) are the most common sensitizers among textile dyes, but there is little knowledge of the clinical relevance of positive patch test reactions., Objective: To investigate if patient-reported textile-related skin problems can be explained by contact allergy to eight different DDs and/or to chemically related substances, by occupation or by atopic constitution, and if the skin problems are influenced by age or sex., Methods: A questionnaire on textile-related skin problems was answered by 858 of 982 consecutively patch tested patients in Malmö, Sweden and in Leuven, Belgium. The baseline series used for patch testing was supplemented with a textile dye mix (TDM) consisting of the eight DDs and with the separate dyes. The association between textile-related skin problems and contact allergy to the DDs and other risk factors was investigated using multiple logistic regression analysis., Results: Eighteen per cent of the patients suspected textiles as a cause of their skin problems. Atopic constitution and female sex were risk factors for skin reactions. Synthetic materials were the most common textiles to give skin problems. A significant association was found between self-reported textile-related skin problems and contact allergy to para-phenylenediamine (PPD) [adjusted odds ratio (OR) 2.1; 95% confidence interval (CI) 1.0-4.3]. A similar, but more imprecise, adjusted OR was found for TDM (OR 1.9; 95% CI 0.57-5.6). Contact allergy to black rubber mix was too rare to be evaluated., Conclusions: Contact allergy to PPD was a more prevalent indicator for skin reactions to textiles than the TDM used in this study.

Chlorothalonil (tetrachloro-1,3-benzenedicarbonitrile, CAS 1897-45-6) is a pesticide that has been on the market for many years. It is used as a fungicide in agriculture, horticulture, and floriculture; as a wood preservative; and in paint. We report an epidemic of airborne irritant contact dermatitis, conjunctivitis, and upper airway complaints among seamstresses in a Portuguese trailer tent factory, which we attribute to chlorothalonil. All exposed workers had work-related skin symptoms. After patch testing, we showed that none of these were of allergic origin. Instead of allergic reactions, we noticed a delayed type of irritation after 72 hr to chlorothalonil and to the textile extracts containing high concentrations of chlorothalonil. Although allergic and irritant contact dermatitis from chlorothalonil has been described before, this is, as far as we know, the first time that a delayed type of dermatitis, conjunctivitis, and upper airway irritation after exposure to chlorothalonil in tent-cloth is described.

Despite a trend for reduction in the concentration of free formaldehyde in textiles, formaldehyde textile resin (FTR) allergic contact dermatitis (ACD) remains an important clinical issue and is likely underdiagnosed. Patients with FTR ACD may react to formaldehyde released from the resin or to the resin itself. Screening with formaldehyde and ethyleneurea/melamine formaldehyde resin will uncover most cases. Patch testing with the suspected offending fabric most often leads to false-negative results. We present a case of a 49-year-old pediatrician who developed a severe widespread dermatitis caused by contact with FTRs from her hospital "greens" ("scrubs") and mask.

2-N-octyl-4-isothiazolin-3-one (OIT) is an antimicrobial agent that is mainly used in industrial settings. The objective of the study was to find the significance of OIT contact allergy at our clinic of occupational dermatology. We looked through our patient material from 1991 for allergic reactions to OIT and analysed the clinical records. We found 8 patients with ordinary allergic reactions to OIT and 1 late reaction. 2 workers in the manufacture of paints had occupational allergic contact dermatitis from OIT in biocides. 2 patients were machinists and 3 were female farmers: in these cases, however, we could not find any exposure. A sewing machine operator had patch test reactions to 2 of her mattress textiles, and chemical analysis of them showed 40-50 parts per million OIT. In conclusion, OIT is a rare sensitizer, and its contact allergies occur mainly in paint manufacturing. It is infrequently used in metal-working fluids and possibly sensitizes machinists. Although it is also used in some biocides recommended for use in the textile industry, there are no previous reports of contact allergy in this field. Our sewing machine operator with OIT contact allergy had probably been sensitized from mattress textiles.

Cases of textile-related dermatitis reported in the medical literature after the mid-1980s are reviewed. Part I focuses on cases in which textile resins, fiber additives, or fibers were the causal agent. Studies which provide insight into understanding fabric-induced prickle and itch are included.