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Patch testing is the only clinically applicable diagnostic method for Type IV allergy. The availability of Type IV patch test (PT) allergens in Europe, however, is currently scarce. This severely compromises adequate diagnostics of contact allergy, leading to serious consequences for the affected patients. Against this background, the European Society of Contact Dermatitis (ESCD) has created a task force (TF) (i) to explore the current availability of PT substances in different member states, (ii) to highlight some of the unique characteristics of Type IV vs. other allergens and (iii) to suggest ways forward to promote and ensure availability of high‐quality patch testing substances for the diagnosis of Type IV allergies throughout Europe. The suggestions of the TF on how to improve the availability of PT allergens are supported by the ESCD, the European Academy of Allergy and Clinical Immunology, and the European Academy of Dermatology and Venereology and intend to provide potential means to resolve the present medical crisis. [ABSTRACT FROM AUTHOR]

Background: Eyelid dermatitis is a frequent reason of dermatological consultation. Its aetiology is not univocal, being contact dermatitis, both allergic and irritant, the most frequent. The primary sources of allergen exposure include cosmetics, metals, and topical medications, from direct, indirect, or airborne contact. Objectives: To define the frequency of positive patch test reactions to SIDAPA baseline series allergens, to document positive allergens, and to precise the final diagnosis in patients with eyelid involvement. Methods: A total of 8557 consecutive patients from 12 Italian Dermatology Clinics underwent patch testing with SIDAPA baseline series in 2018 and 2019. Patients were divided into two groups: (i) with eyelid involvement with or without other involved sites (E‐Group) and (ii) without eyelid involvement (NE‐Group). The final diagnosis and the frequency of positive relevant patch test reactions were evaluated. Results: E‐Group consisted of 688 patients (females 78.6%, mean age 45.3 years), 8.0% of 8557 consecutively patch‐tested patients. The final diagnosis in E‐Group was ADC in 42.4%, ICD in 34.2%, and AD in 30.5%. The highest reaction rates were elicited by nickel sulphate and methylchloroisothiazolinone/methylisothiazolinone in both E‐Group and NE‐Group, even if these allergens were significantly more frequently positive in NE‐Group patients than in E‐Group ones. Positive patch test reactions to fragrance Mix II, dimethylaminopropylamine, and sorbitan sesquiolate were significantly more frequent in E‐Group patients than in NE‐Group ones. Conclusions: Eyelid dermatitis is a frequent dermatological complaint. Allergic contact dermatitis is the most frequent diagnosis commonly caused by nickel sulphate, isothiazolinones, and fragrances. The surfactants dimethylaminopropylamine and sorbitan sesquioleate are emerging causes of eyelid allergic contact dermatitis. [ABSTRACT FROM AUTHOR]

The European baseline series was last updated in 2019. This article discusses the reasoning behind a further iteration of the series for 2023. [ABSTRACT FROM AUTHOR]

In common with many other members of this family, they contain sesquiterpene lactones (SLs) as allergens.[2] CASE REPORT A 35-year-old male greengrocer was referred from the Emergency Ward for severe "angioedema-like" periorbital eczema (Figure 1). Keywords: airborne ACD; artichoke; case report; Compositae; Cynara cardunculus; occupational; sesquiterpene lactones EN airborne ACD artichoke case report Compositae Cynara cardunculus occupational sesquiterpene lactones 120 122 3 07/11/23 20230801 NES 230801 Artichokes ( I Cynara cardunculus i L.) are known to cause allergic contact dermatitis (ACD) on exposed skin by direct contact but also by airborne spread.[[1], [3]] Formerly known as I Cynara scolymus i L., or I Cynara cardunculus i subsp. I scolymus i (L.) Hegi, or I Cynara cardunculus i var. I scolymus i (L.) Benth., or by other names all now regarded as synonyms, these vegetables belong the Compositae (or Asteraceae) family. The main SLs allergens in artichokes are reported to be cynaropicrin, grosheimin and its derivative 8-deoxy-11,13-dihydroxygrosheimin[2] but the specific SLs responsible for ACD to artichoke and their possible co- or cross-reactivity with other well-known SLs allergens remain unknown. [Extracted from the article]

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]

12 Napolitano M, Fabbrocini G, Patruno C. Allergic contact dermatitis to Compositae: a possible cause of dupilumab-associated facial and neck dermatitis in atopic dermatitis patients? Artichoke, airborne allergic contact dermatitis, case report, chronic actinic dermatitis, dupilumab, Parthenium hysterophorus, sesquiterpene lactone mix Keywords: airborne allergic contact dermatitis; artichoke; case report; chronic actinic dermatitis; dupilumab; Parthenium hysterophorus; sesquiterpene lactone mix EN airborne allergic contact dermatitis artichoke case report chronic actinic dermatitis dupilumab Parthenium hysterophorus sesquiterpene lactone mix 156 158 3 01/13/23 20230201 NES 230201 Parthenium hysterophorus is a recognized cause of airborne allergic contact dermatitis (ACD) in the Indian subcontinent. [Extracted from the article]

Background: Because Myroxylon pereirae (MP), or balsam of Peru, is nowadays almost not used "as such," and fragrance mix 1 (FM1) apparently is more sensitive in detecting fragrance allergy, the usefulness of testing MP in baseline series was recently questioned. Objectives: Identification of the number of clinically relevant patch test reactions to MP not detected by FM1. Methods: Retrospective analysis of 12 030 patients patch tested with MP and FM1 for contact dermatitis between January 2018 and December 2019 in 13 Italian dermatology clinics. Results: Four hundred thirty‐nine patients (3.6%) had a positive patch test reaction to MP; 437 (3.6%) had a positive patch test reaction to FM1. Positive reactions to both MP and FM1 were observed in 119 subjects (1.0%), 310 (2.6%) reacted to MP only, 304 (2.5%) to FM1 only, 5 to MP and sorbitan sesquioleate (SSO), 9 to FM1 and SSO, and 5 to MP, FM1, and SSO. Single sensitizations were clinically relevant in 75.2% of cases for MP (62.9% current, 12.3% past) and 76.3% for FM1 (70.1% current, 6.2% past). Conclusions: Based on our results, MP appears to be still worth testing along with FM1 in baseline series, because it allows detection of a remarkable number of fragrance allergies, often relevant, which would be otherwise missed. [ABSTRACT FROM AUTHOR]