Browsing by Author "Bruze, M"
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- Design and feasibility of an international study assessing the prevalence of contact allergy to fragrances in the general population: the European Dermato-Epidemiology Network Fragrance StudyPublication . Rossi, M; Coenraads, PJ; Diepgen, T; Svensson, A; Elsner, P; Gonçalo, Margarida; Bruze, M; Naldi, LBACKGROUND/AIMS: Data on contact allergy to fragrances in the general population are limited. Data from allergological services suggest that the frequency of contact allergy to fragrances is increasing. The European Dermato-Epidemiology Network (EDEN) Fragrance Study aims to obtain reliable data on the prevalence of contact allergy to fragrances and other sensitizers of the European baseline series, in the general population of different geographical areas of Europe. We report the methodology and the reliability of instruments adopted and discuss the feasibility based on a pilot phase. METHODS: Descriptive epidemiology survey. A random sample from the general population is selected and interviewed, and is offered patch testing in a randomized way. We specifically enquire about any skin rash reported during the previous year, and any history of reactions to products that may contain the sensitizer and/or a history of avoidance of the same products. Patch test data are linked to the questionnaire information to define clinical relevance. RESULTS: The questionnaire showed high test-retest reliability in 94 individuals. Patch test reading also showed a high level of interrater reliability. During the pilot phase, a total of 589 participants were recruited. CONCLUSIONS: The EDEN Fragrance Study is feasible and able to provide useful data on fragrance allergy.
- Development of a clinical score system for the diagnosis of photoallergic contact dermatitis using a consensus process: item selection and reliabilityPublication . Cazzaniga, S; Lecchi, S; Bruze, M; Chosidow, O; Diepgen, T; Gonçalo, M; Hercogova, J; Pigatto, PD; Naldi, LBACKGROUND: Photoallergic contact dermatitis (PACD) is an uncommon condition, and there is a lack of validated criteria for its diagnosis. OBJECTIVE: To identify a set of relevant criteria to be considered when suspecting a diagnosis of PACD and to assess the reproducibility of these criteria. METHODS: This was a diagnostic item selection and reliability study performed between July 2012 and October 2012. A panel of seven recognized experts was invited to consecutive rounds of a Delphi survey and to a conclusive face-to-face meeting with the aim of obtaining an agreement on criteria for the diagnosis of PACD. The panel was also provided with a series of 16 reports of suspected PACDs to be classified according to a five-point likelihood scale. Identified criteria with the weights attributed by experts were used to develop a score system for the diagnosis of PACD. Consensus was measured by calculating the Intraclass Correlation Coefficient (ICC). The performance of the score system was evaluated in terms of overall classification accuracy. RESULTS: Seven criteria were identified by experts as relevant for the diagnosis of PACD. The criteria were related to the type of skin lesions, accompanying symptoms, skin area involved, general medical history, modality of exposure to the culprit substance, history of exposure to the sun or other light sources and photopatch test results. Experts reached a moderate agreement on PACD cases classification, with ICC = 0.69 (95% Confidence Interval, CI, 0.50-0.86). The score system enabled discrimination of probable and definite PACD cases from possible and unlikely or excluded ones, with a nearly perfect agreement being observed between the score system classification and judgment by experts. CONCLUSION: A diagnostic score was proposed. The score should receive a comprehensive validation on a larger series of cases and with multiple evaluators.
- Follow-up of the monitored levels of preservative sensitivity in Europe. Overview of the years 2001–2008Publication . Svedman, C; Andersen, KE; Brandão, FM; Bruynzeel, DP; Diepgen, TL; Frosch, PJ; Rustemeyer, T; Gimnez-Arnau, A; Gonçalo, Margarida; Goossens, A; Johansen, JD; Lahti, A; Menné, T; Seidenari, S; Tosti, A; Wahlberg, JE; White, IR; Wilkinson, JD; Mowitz, M; Bruze, M
- Hand eczema severity and quality of life: a cross-sectional, multicentre study of hand eczema patients.Publication . Agner, T; Andersen, KE; Brandão, FM; Bruynzeel, DP; Bruze, M; Frosch, P; Gonçalo, Margarida; Goossens, A; Le Coz, C; Rustemeyer, T; White, IR; Diepgen, TBACKGROUND AND OBJECTIVES: Hand eczema is a chronic disease with negative impact on quality of life (QoL). In this study, QoL in hand eczema patients is assessed and related to age, sex, severity, and diagnostic subgroups. METHODS: A total of 416 patients with hand eczema from 10 European patch test clinics participated in the study. Data on QoL were obtained from a self-administered questionnaire using the Dermatology Life Quality Index (DLQI). Severity was assessed by a scoring system (Hand Eczema Severity Index, HECSI) as well as frequency of eruptions and sick leave due to hand eczema. RESULTS: No significant difference was found between males and females with respect to QoL [DLQI median values and 25/75 percentiles for males and females being 7.0 (3-14) and 8.0 (3-13), respectively], although males were more severely affected than females (P < 0.025). A significant positive correlation was found for hand eczema severity and age (P < 0.001), while no significant correlation was found for QoL and age. QoL was found increasingly reduced when sick leave was getting higher (P < 0.001). A statistically significant correlation between QoL (as measured by DLQI) and hand eczema severity as measured by HECSI was found (P < 0.001). No significant difference in QoL was found between diagnostic subgroups. CONCLUSIONS: QoL was found markedly negatively affected in hand eczema patients and was significantly correlated to disease severity. No significant difference in QoL was found between males and females, in spite of significantly more severe eczema in males, indicating that QoL in female patients is more easily affected.
- Mercaptobenzothiazole or the mercapto-mix: which should be in the standard series?Publication . Diepgen, T; Bruynzeel, DP; Andersen, KE; Brandão, FM; Bruze, M; Gonçalo, Margarida; Goossens, A; Lathi, A; Mahler, V; Menné, T; White, IR; Wilkinson, JD; European Environmental Contact Dermatitis Research Group (EECDRG)Mercaptobenzothiazole (MBT) compounds are well known contact allergens. To detect rubber allergic patients we use both MBT (2% in petrolatum) and a mercapto-mix with 4 constituents of 0.5% each in our standard series. In this article the EECDRG presents data of in total 32,475 consecutive tested patients attending the respective contact dermatitis clinics from 11 centres in Europe to determine if the mix and MBT detected the same allergic patients. We found 327 patients positive to the mix or MBT, or to both. 261 were positive to the mix and 254 to MBT. MBT was negative in 73 patients who were positive to the mix. If the mix had not been in the standard series, on average 22% of patients allergic to a mercapto-compound would have been missed, for MBT this would have been on average 20%. All clinics would have missed a significant number of positive reactions if both compounds had not been tested. We conclude, that both the mercapto mix and MBT are required in the standard series.
- p-Phenylenediamine sensitization is more prevalent in central and southern European patch test centres than in Scandinavian: results from a multicentre studyPublication . Thyssen, JP; Andersen, KE; Bruze, M; Diepgen, T; Giménez-Arnau, AM; Gonçalo, Margarida; Goossens, A; Le Coz, C; McFadden, J; Rustemeyer, T; White, IR; White, JM; Johansen, JDBACKGROUND: Positive patch test reactions to p-phenylenediamine (PPD) are common. PPD is used in oxidative hair dyes and is also present in dark henna temporary 'tattoos'. Cross-sensitization to other contact allergens may occur. Because subjects sensitized to PPD are at risk of clinically severe reactions upon hair dyeing, there is a need for 'current' prevalence data on PPD sensitization. OBJECTIVES: To compare PPD patch test results from dermatitis patients tested between 2003 and 2007 in 10 European patch test centres and to analyse the causes and determine relevance of positive PPD patch test reactions. MATERIALS: Patch testing was performed using PPD (1% free base in petrolatum from Trolab (Almirall Hermal GmbH, Reinbeck, Germany) or Chemotechnique (Malmö, Sweden), equivalent to 0.090 mg/cm(2) in the TRUE test from MEKOS Laboratories AS). Statistical analysis was performed using the chi-squared test. RESULTS: The weighted average prevalence was 4.6% among 21 515 patients. PPD sensitization occurred more often in centres located in Central and Southern Europe than in Scandinavian centres (odds ratio = 2.40; 95% confidence interval = 2.07-2.78). The overall proportion of positive patch test reactions to PPD that were registered as being of either current or 'past' relevance was high (weighted average 53.6% and 20.3%, respectively). Consumer hair dyeing was the most prominent cause of PPD sensitization (weighted average 41.8%). Furthermore, occupational hair dye exposure (10.6%) and cross-sensitization to textile dyes (12.6%) were frequently reported. CONCLUSIONS: PPD sensitization caused by exposure to hair dyes is frequent and remains a present problem for patients visiting contact dermatitis clinics, especially in patch test centres located in Central and Southern Europe.
- Patch testing with 2.0% (0.60 mg/cm2) formaldehyde instead of 1.0% (0.30 mg/cm2) detects significantly more contact allergyPublication . Pontén, A; Aalto-Korte, K; Agner, T; Andersen, KE; Gimenez-Arnau, AM; Gonçalo, Margarida; Goossens, A; Johansen, JD; Le Coz, CJ; Maibach, HI; Rustemeyer, T; White, IR; Bruze, MBACKGROUND: The currently used patch test concentration for formaldehyde is 1.0% (wt/vol) in water. However, clinical experience and previous studies suggest that 1.0% might be insufficient for detecting an optimized number of clinically relevant cases of contact allergy to formaldehyde. OBJECTIVES: To validate earlier patch test results for comparison of 1% (wt/vol) and 2% (wt/vol) formaldehyde in water, and to investigate co-reactivity with quaternium-15. MATERIALS AND METHODS: In 12 dermatology clinics, 3591 patients were routinely patch tested simultaneously with 2.0% (wt/vol) (0.60 mg/cm(2)) and 1.0% (wt/vol) (0.30 mg/cm(2)) formaldehyde. Micropipettes were used for delivering the exact dosage of the allergen. RESULTS: Significantly more patients reacted to 2.0% formaldehyde than to 1.0% (3.4% versus 1.8%, p < 0.001). Overall, there were no sex differences between those reacting positively to 2.0% and 1.0%. Of 25 quaternium-15-positive patients, 4 (0.1%) reacted positively without reacting to formaldehyde. CONCLUSION: On the basis of the results of this multicentre study, as well as of previous studies, it can be suggested that 2.0% (wt/vol) in water formaldehyde should be used in routine patch testing in the baseline series.