Contact dermatitis associated with preservatives: Retrospective analysis of North American Contact Dermatitis Group data, 1994 through 2016

Amber Reck Atwater; Amy J. Petty; Beiyu Liu; Cynthia L. Green; Jonathan I. Silverberg; Joel G. DeKoven; Donald V. Belsito; Margo J. Reeder; Denis Sasseville; James S. Taylor; Howard I. Maibach; Matthew J. Zirwas; James G. Marks; Kathryn A. Zug; Joseph F. Fowler; Melanie D. Pratt; Vincent A. DeLeo; Erin M. Warshaw

doi:10.1016/j.jaad.2020.07.059

Contact dermatitis associated with preservatives: Retrospective analysis of North American Contact Dermatitis Group data, 1994 through 2016

Amber Reck Atwater, Amy J. Petty, Beiyu Liu, Cynthia L. Green, Jonathan I. Silverberg, Joel G. DeKoven, Donald V. Belsito, Margo J. Reeder, Denis Sasseville, James S. Taylor, Howard I. Maibach, Matthew J. Zirwas, James G. Marks, Kathryn A. Zug, Joseph F. Fowler, Melanie D. Pratt, Vincent A. DeLeo, Erin M. Warshaw

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Preservatives are often necessary components of commercial products. Large-scale North American studies on preservative allergy are limited. Objective: To evaluate demographics, positive patch test reactions (PPTRs), clinical relevance, and trends for preservatives tested by the North American Contact Dermatitis Group. Methods: We conducted a retrospective cross-sectional analysis of North American Contact Dermatitis Group patch testing results of preservatives from 1994 through 2016. Results: A total of 50,799 patients were tested; 11,338 (22.3%) had a PPTR to at least 1 preservative. The most frequent reactions were to methylisothiazolinone 0.2% aqueous (aq) (12.2%), formaldehyde 2% aq (7.8%), formaldehyde 1% aq (7.8%), quaternium-15 2% petrolatum (pet) (7.7%), and methyldibromo glutaronitrile/phenoxyethanol 2% pet (5.1%). Paraben mix 12% pet (1%), iodopropynyl butylcarbamate 0.1% pet (0.4%), benzyl alcohol 1% pet (0.3%), and phenoxyethanol 1% pet (0.2%) had the lowest PPTRs. Linear regression analysis of preservatives tested showed that only methylchloroisothiazolinone/methylisothiazolinone 0.01% aq (parameter estimate, 0.42; 95% CI, 0.17-0.66; P <.005) had a significant increase in PPTRs over time. Limitations: Collected variables are dependent on clinical judgment. Results may be prone to referral selection bias. Conclusions: This large North American study provides insight on preservative PPTRs and trends from 1994 through 2016.

Original language	English (US)
Pages (from-to)	965-976
Number of pages	12
Journal	Journal of the American Academy of Dermatology
Volume	84
Issue number	4
DOIs	https://doi.org/10.1016/j.jaad.2020.07.059
State	Published - Apr 2021

All Science Journal Classification (ASJC) codes

Dermatology

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10.1016/j.jaad.2020.07.059

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Atwater, A. R., Petty, A. J., Liu, B., Green, C. L., Silverberg, J. I., DeKoven, J. G., Belsito, D. V., Reeder, M. J., Sasseville, D., Taylor, J. S., Maibach, H. I., Zirwas, M. J., Marks, J. G., Zug, K. A., Fowler, J. F., Pratt, M. D., DeLeo, V. A., & Warshaw, E. M. (2021). Contact dermatitis associated with preservatives: Retrospective analysis of North American Contact Dermatitis Group data, 1994 through 2016. Journal of the American Academy of Dermatology, 84(4), 965-976. https://doi.org/10.1016/j.jaad.2020.07.059

@article{e926276cc5a142489bb35c1e9314c246,

title = "Contact dermatitis associated with preservatives: Retrospective analysis of North American Contact Dermatitis Group data, 1994 through 2016",

abstract = "Background: Preservatives are often necessary components of commercial products. Large-scale North American studies on preservative allergy are limited. Objective: To evaluate demographics, positive patch test reactions (PPTRs), clinical relevance, and trends for preservatives tested by the North American Contact Dermatitis Group. Methods: We conducted a retrospective cross-sectional analysis of North American Contact Dermatitis Group patch testing results of preservatives from 1994 through 2016. Results: A total of 50,799 patients were tested; 11,338 (22.3%) had a PPTR to at least 1 preservative. The most frequent reactions were to methylisothiazolinone 0.2% aqueous (aq) (12.2%), formaldehyde 2% aq (7.8%), formaldehyde 1% aq (7.8%), quaternium-15 2% petrolatum (pet) (7.7%), and methyldibromo glutaronitrile/phenoxyethanol 2% pet (5.1%). Paraben mix 12% pet (1%), iodopropynyl butylcarbamate 0.1% pet (0.4%), benzyl alcohol 1% pet (0.3%), and phenoxyethanol 1% pet (0.2%) had the lowest PPTRs. Linear regression analysis of preservatives tested showed that only methylchloroisothiazolinone/methylisothiazolinone 0.01% aq (parameter estimate, 0.42; 95% CI, 0.17-0.66; P <.005) had a significant increase in PPTRs over time. Limitations: Collected variables are dependent on clinical judgment. Results may be prone to referral selection bias. Conclusions: This large North American study provides insight on preservative PPTRs and trends from 1994 through 2016.",

author = "Atwater, {Amber Reck} and Petty, {Amy J.} and Beiyu Liu and Green, {Cynthia L.} and Silverberg, {Jonathan I.} and DeKoven, {Joel G.} and Belsito, {Donald V.} and Reeder, {Margo J.} and Denis Sasseville and Taylor, {James S.} and Maibach, {Howard I.} and Zirwas, {Matthew J.} and Marks, {James G.} and Zug, {Kathryn A.} and Fowler, {Joseph F.} and Pratt, {Melanie D.} and DeLeo, {Vincent A.} and Warshaw, {Erin M.}",

note = "Publisher Copyright: {\textcopyright} 2020 American Academy of Dermatology, Inc.",

year = "2021",

month = apr,

doi = "10.1016/j.jaad.2020.07.059",

language = "English (US)",

volume = "84",

pages = "965--976",

journal = "Journal of the American Academy of Dermatology",

issn = "0190-9622",

publisher = "Elsevier Inc.",

number = "4",

}

Atwater, AR, Petty, AJ, Liu, B, Green, CL, Silverberg, JI, DeKoven, JG, Belsito, DV, Reeder, MJ, Sasseville, D, Taylor, JS, Maibach, HI, Zirwas, MJ, Marks, JG, Zug, KA, Fowler, JF, Pratt, MD, DeLeo, VA & Warshaw, EM 2021, 'Contact dermatitis associated with preservatives: Retrospective analysis of North American Contact Dermatitis Group data, 1994 through 2016', Journal of the American Academy of Dermatology, vol. 84, no. 4, pp. 965-976. https://doi.org/10.1016/j.jaad.2020.07.059

TY - JOUR

T1 - Contact dermatitis associated with preservatives

T2 - Retrospective analysis of North American Contact Dermatitis Group data, 1994 through 2016

AU - Atwater, Amber Reck

AU - Petty, Amy J.

AU - Liu, Beiyu

AU - Green, Cynthia L.

AU - Silverberg, Jonathan I.

AU - DeKoven, Joel G.

AU - Belsito, Donald V.

AU - Reeder, Margo J.

AU - Sasseville, Denis

AU - Taylor, James S.

AU - Maibach, Howard I.

AU - Zirwas, Matthew J.

AU - Marks, James G.

AU - Zug, Kathryn A.

AU - Fowler, Joseph F.

AU - Pratt, Melanie D.

AU - DeLeo, Vincent A.

AU - Warshaw, Erin M.

PY - 2021/4

Y1 - 2021/4

N2 - Background: Preservatives are often necessary components of commercial products. Large-scale North American studies on preservative allergy are limited. Objective: To evaluate demographics, positive patch test reactions (PPTRs), clinical relevance, and trends for preservatives tested by the North American Contact Dermatitis Group. Methods: We conducted a retrospective cross-sectional analysis of North American Contact Dermatitis Group patch testing results of preservatives from 1994 through 2016. Results: A total of 50,799 patients were tested; 11,338 (22.3%) had a PPTR to at least 1 preservative. The most frequent reactions were to methylisothiazolinone 0.2% aqueous (aq) (12.2%), formaldehyde 2% aq (7.8%), formaldehyde 1% aq (7.8%), quaternium-15 2% petrolatum (pet) (7.7%), and methyldibromo glutaronitrile/phenoxyethanol 2% pet (5.1%). Paraben mix 12% pet (1%), iodopropynyl butylcarbamate 0.1% pet (0.4%), benzyl alcohol 1% pet (0.3%), and phenoxyethanol 1% pet (0.2%) had the lowest PPTRs. Linear regression analysis of preservatives tested showed that only methylchloroisothiazolinone/methylisothiazolinone 0.01% aq (parameter estimate, 0.42; 95% CI, 0.17-0.66; P <.005) had a significant increase in PPTRs over time. Limitations: Collected variables are dependent on clinical judgment. Results may be prone to referral selection bias. Conclusions: This large North American study provides insight on preservative PPTRs and trends from 1994 through 2016.

AB - Background: Preservatives are often necessary components of commercial products. Large-scale North American studies on preservative allergy are limited. Objective: To evaluate demographics, positive patch test reactions (PPTRs), clinical relevance, and trends for preservatives tested by the North American Contact Dermatitis Group. Methods: We conducted a retrospective cross-sectional analysis of North American Contact Dermatitis Group patch testing results of preservatives from 1994 through 2016. Results: A total of 50,799 patients were tested; 11,338 (22.3%) had a PPTR to at least 1 preservative. The most frequent reactions were to methylisothiazolinone 0.2% aqueous (aq) (12.2%), formaldehyde 2% aq (7.8%), formaldehyde 1% aq (7.8%), quaternium-15 2% petrolatum (pet) (7.7%), and methyldibromo glutaronitrile/phenoxyethanol 2% pet (5.1%). Paraben mix 12% pet (1%), iodopropynyl butylcarbamate 0.1% pet (0.4%), benzyl alcohol 1% pet (0.3%), and phenoxyethanol 1% pet (0.2%) had the lowest PPTRs. Linear regression analysis of preservatives tested showed that only methylchloroisothiazolinone/methylisothiazolinone 0.01% aq (parameter estimate, 0.42; 95% CI, 0.17-0.66; P <.005) had a significant increase in PPTRs over time. Limitations: Collected variables are dependent on clinical judgment. Results may be prone to referral selection bias. Conclusions: This large North American study provides insight on preservative PPTRs and trends from 1994 through 2016.

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UR - http://www.scopus.com/inward/citedby.url?scp=85100637889&partnerID=8YFLogxK

U2 - 10.1016/j.jaad.2020.07.059

DO - 10.1016/j.jaad.2020.07.059

M3 - Article

C2 - 33579596

AN - SCOPUS:85100637889

SN - 0190-9622

VL - 84

SP - 965

EP - 976

JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

IS - 4

ER -

Contact dermatitis associated with preservatives: Retrospective analysis of North American Contact Dermatitis Group data, 1994 through 2016

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