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J Geier

Publications and source records attributed to J Geier.

At least 37 records · Page 2Linked to original sources
PubMed2002

Epidemiology of contact allergy: an estimation of morbidity employing the clinical epidemiology and drug-utilization research (CE-DUR) approach.

Clinical epidemiology (CE) is considered unable to estimate morbidity concerning either contact sensitization (CS) or allergic contact dermatitis (ACD) at the population level. Drug-utilization research (DUR) methods estimate the morbidity of suitable diseases based on prescription data for disease-specific drugs. Our objective was to estimate population figures for incidence and prevalence of ACD and CS based on sales data for patch test material in Germany and on patient data from the Information Network of Departments of Dermatology (IVDK). Approximately 600000 standard series are sold per year in Germany, according to the 2 main manufacturers. This raw sales figure was corrected for certain effects (discarded preparations, proportion of formerly patch-tested patients, proportion of patients with ACD seeking medical advice) to obtain an estimate of the denominator of patients eligible for patch testing annually, and combined with patch test results from the Information Network of Departments of Dermatology (IVDK). In 17.8% (of 9266 IVDK patients) ACD was established. Extrapolated to the general population, an incidence of ACD of between 1.7 and 7 per 1000 per year was estimated, depending on whether conservative or more liberal assumptions concerning the above effects were made. Of 78067 IVDK patients tested between 1992 and 2000, 46.8% had at least 1 positive reaction (+ to + + +), and 22.7% had at least 1 stronger positive reaction (+ + or + + +). The 9-year prevalence of CS was estimated to lie between 4.0% and 16.6% for the first outcome, and between 2.0% and 8.1% for the second. Concerning single allergens, 1.9-4.5 million individuals are probably sensitized to nickel, and 1.4-3.4 million to fragrance mix among the German population of 82 million inhabitants. The morbidity data found in this study are in good accordance with data from population-based epidemiological studies. In comparison to these, the CE-DUR approach seems to be an economically feasible method to estimate continuously the population impact of ACD and CS.

Allergens↗
PubMed2001

Another look at seasonal variation in patch test results. A multifactorial analysis of surveillance data of the IVDK. Information Network of Departments of Dermatology.

There is conflicting evidence concerning seasonal variability of patch test results and no evidence concerning the influence of season on weak-positive, possibly false-positive, irritant reactions, which was analysed in the present study. Data collected in the German Information Network of Departments of Dermatology (IVDK) 1992 to 1997 were combined with external environmental data on temperature and absolute humidity in Germany, and bivariate as well as logistic regression analyses performed concerning the association between reactivity to selected allergens and air temperature and absolute humidity on the respective days of patch testing. Between 39,239 and 41,629 patients had been tested with the 4 allergens considered here. Only formaldehyde exhibited a distinct increase in questionable or irritant as well as weak-positive reactions associated with dry, cold weather. Methylchloroisothiazolinone/methylisothiazolinone and lanolin alcohol showed only a weak, and epoxy resin no, association with climatic conditions. The results indicate that weak-positive reactions, at least to formaldehyde as a prototype of an allergen which is at the same time a marginal irritant, may sometimes be irritant rather than allergic. Patients showing these should be re-tested to improve the poor reproducibilty observed with this allergen.

Climate↗
PubMed2001

Contact allergy to Disperse Blue 106 and Disperse Blue 124 in German and Austrian patients, 1995 to 1999.

Between 1995 and 1999, 1986 patients were tested in the 31 participating centres of the Information Network of Departments of Dermatology (IVDK), all of them members of the German Contact Dermatitis Research Group, with a textile dyes series containing Disperse Blue (DB) 106 and 124, and since 1997 also with a mix of both. 86 patients (4.3%) reacted positively to DB 106 and/or DB 124; with good concordance between the 2 allergens (Cohen's weighted kappa 0.72), and the single allergens and the mix (kappa=0.75 in both cases), which had been tested in parallel in 969 and 975 patients, respectively. In contrast, concordance between DB 106/124 and p-phenylenediamine and p-aminoazobenzene, respectively, was poor. Some 70% of positive reactions to DB 106/124 had current clinical relevance. Furthermore, a significant increase in the proportion of DB 106/124-positive patients among those tested was found from 1995 to 1999. Hence, DB 106/124 are important allergens deserving close monitoring. The use of a mix of DB 106 and DB 124 seems justified in view of the close chemical similarity of both compounds. If possible, the presence of the allergen(s) in individual textiles considered causative should be checked by thin layer or column chromatography.

Austria↗
PubMed2001

Associated positive patch test reactions to standard contact allergens.

BACKGROUND: Patch testing with a standard allergen series often yields positive reactions to more than 1 allergen in a patient. OBJECTIVE: To identify all significantly associated pairs of positive reactions and to assess their relation to the strength of the reactions and to the irritative potential of the allergens. METHODS: Based on the filed data of 57,822 patients, associations between positive reactions to 2 different allergens were quantified with odds ratios. Statistical methods included Fisher's exact test, the Bonferroni adjustment to account for the effect of multiple testing, and the Spearman rank correlation. RESULTS: Out of the 32,779 patients with complete readings of 24 standard allergens, 7,501 had shown more than 1 positive reaction. Statistically significant associations were detected for 166 out of the 276 possible different combinations of 2 distinct positive reactions, including combinations that had not been identified before. Patients with a strong reaction or a positive reaction to an allergen with a high irritative potential tended to have additional positive reactions to further allergens more often than others, but the number of significant associations was not dependent on these parameters. CONCLUSION: There are more significant associations that have to be taken into account for patch testing than has been known so far. Although irritation can favor a higher number of positive reactions, significant associations of positive reactions to distinct allergens are probably caused by other mechanisms that require further analyses.

Adult↗
PubMed2001

Association between occupation and contact allergy to the fragrance mix: a multifactorial analysis of national surveillance data.

OBJECTIVES: To assess the role of potential (occupational) risk factors for fragrance contact allergy (FCA). Most studies assessing the range of contact sensitisation in various clinical populations found the fragrance mix, a good screening tool for the detection of FCA in general, to be one of the leading allergens. The role of occupational exposure to fragrances is, however, yet unclear. METHODS: Firstly, crude analyses of the prevalence of FCA in various occupational fields including all 57,779 patients patch tested in the participating centres of the Information Network of Departments of Dermatology (IVDK) between January 1992 and December 1998. Secondly, a multifactorial Poisson regression analysis of these patients, including several potential risk factors. RESULTS: (a) The proportion of patients with FCA varied greatly between different occupational groups from 2.5% to 17.4%, (b) the highest occupational risk of FCA was associated with work as a masseur or physiotherapist, metal furnace operator, potter or glass maker etc, or geriatric nurse, (c) non-occupational factors that influenced risk of FCA included atopy, female sex, several sites, in particular the axillae, and increasing age. CONCLUSIONS: Occupations with a high risk of FCA were identified as targets of preventive action--that is, the substitution of scented products with fragrance free materials with which to work (skin disinfectants, cleaning solutions, personal care products) wherever possible.

Adult↗
PubMed2000

[Contact allergies in patients with eczema of the external ear canal. Results of the Information Network of Dermatological Clinics and the German Contact Allergy Group].

BACKGROUND AND OBJECTIVE: The Information Network of Departments of Dermatology (IVDK) centrally collects patch tests results in cooperation with the German Contact Dermatitis Research Group (DKG). Data of patients, who underwent patch testing to evaluate otitis externa were analyzed. PATIENTS/METHODS: Data of 145 patients that had been recorded between 1992 and 1997 were evaluated. The evaluation included data yielded by standardized patch testing as well as by patch testing of products that the patients had used. RESULTS: Allergic contact dermatitis was diagnosed in one third of patients suffering from otitis externa. Topical drugs were shown to be the most important allergens. In comparison to the entire IVDK collective, the population-adjusted frequency of sensitization (PAFS) of neomycin sulfate was higher in the study population whereas that of nickel sulfate was lower. That shows that in a very specific topographic area, different allergens may be of clinical significance. CONCLUSIONS: Whereas nickel sulfate represents an important allergen in the contact dermatitis of the external ear, topical therapeutical agents, especially neomycin sulfate and, as evaluation of the patch tests of the patient's own products revealed, probably polymyxin B are the dominating allergens in otitis externa.

Adult↗
PubMed2000

Increase in sensitization to oil of turpentine: recent data from a multicenter study on 45,005 patients from the German-Austrian Information Network of Departments of Dermatology (IVDK).

Contact allergy to oil of turpentine was reported to have become rare. However, the evaluation of standardized data of 45,005 patients tested 1992-1997 in 30 Dermatological Centers associated with the German-Austrian Information Network of Departments of Dermatology (IVDK) showed an increase in positive patch test reactions to turpentine from 0.5% during the years 1992-1995, up to 1.7% in 1996 and 3.1% in 1997. In particular, 17,347 patients tested in 1996-1997 were evaluated in detail by comparing 431 individuals with positive patch test reactions with the rest of the group found negative to turpentine. Using the so-called MOAHLFA index, the following characteristics were shown. Turpentine allergy (a) was found to be significantly less frequent in men and in patients with occupational dermatitis, (b) showed no difference in its association with atopic dermatitis, (c) patients with turpentine allergy had significantly less symptoms of the hands, more symptoms of the legs or in the face and (d) were significantly more often aged over 60 years. Also, patients sensitized to turpentine had increased rates of additional sensitizations. The definite reason for the increase in turpentine sensitization in the population tested here is not clear. Therefore, a detailed exposure analysis is necessary; the new increase in turpentine allergies may be due to popular topical remedies or household chemicals.

Adult↗
PubMed2000

Patch testing with methyldibromoglutaronitrile.

BACKGROUND: The combination of methyldibromoglutaronitrile (MDBGN) and phenoxyethanol (PE) is widely used as a preservative in body care products. Sensitization rates to MDBGN have increased parallel to its increasing use in cosmetics, skin care products, and moist toilet paper since the early 1990s, whereas PE is obviously not a sensitizer. The optimum patch preparation for diagnosing a contact allergy to MDBGN is still a matter of debate. OBJECTIVE: This study was performed to assess an adequate patch test concentration for MDBGN/PE and MDBGN. METHODS: Based on previous results from other countries, the German Contact Dermatitis Research Group (DKG) performed parallel patch tests with MDBGN/PE 0.5% in petrolatum (pet.) and 1% pet. in 4,615 patients and with MDBGN 0.1% pet. and 0.3% pet. in 988 patients. The results of these tests, performed in routine patch testing, were collected and analyzed be the Information Network of Departments of Dermatology (IVDK). RESULTS: Comparing MDBGN/PE 0.5% pet. with 1.0% pet., the percentage of patients showing a positive test reaction increased from 2.3% to 3. 5% (P <.001), mainly because of an increase in weak positive reactions. The reaction index remained stable at 0.54. Comparing MDBGN 0.1% pet. with 0.3% pet., the percentage of patients with positive reactions increased from 1.4% to 3.3% (P <.001), and the reaction index decreased from 0.33 to -0.10. With the lower test concentration, 79% of the positive reactions were only +, with the greater concentration, this was true of 64%. CONCLUSION: Testing MDBGN/PE 1.0% pet. shows additional cases of contact allergy to MDBGN that would have remained undetected with MDBGN 0.5% pet. The greater test concentration seems to have no disadvantages in quality. The DKG decided to keep MDBGN/PE 1.0% pet. in the standard series. MDBGN 0.3% pet. leads to far more doubtful or irritant test reactions than MDBGN 0.1% and may produce false-positive patch test results. Therefore, the DKG recommends testing MDBGN 0.3% pet only in special cases.

Cosmetics↗
PubMed2000

Downward trend of sensitization to glyceryl monothioglycolate in German hairdressers. IVDK study group. Information Network of Departments of Dermatology.

BACKGROUND: Due to a high incidence of cases of (occupational) sensitization to glyceryl monothioglycolate (GMT), products containing this compound were withdrawn from the German market some 8 years ago. METHODS: We analyzed the data of the Information Network of Departments of Dermatology in Germany which included 1, 336 hairdressers who had been tested with GMT (1% in petrolatum) between 1992 and 1998. RESULTS: The proportion of hairdressers reacting positively to GMT fell from initially 45% in 1992 to less than 20% in 1997 and 1998. CONCLUSION: This most likely reflects the above-mentioned preventive action.

Allergens↗
PubMed2000

Allergic contact dermatitis in patients with anogenital complaints.

OBJECTIVE: Allergic contact dermatitis is a common anogenital disease. STUDY DESIGN: The results of patch testing performed on 1,008 patients evaluated for allergic anogenital contact dermatitis from 21 dermatologic departments in the Information Network of Departments of Dermatology (IVDK) from 1992 to 1997 were analyzed. RESULTS: A final diagnosis of allergic contact dermatitis was made in 351 patients (34.8%). Irritant contact dermatitis was diagnosed in 230 patients (22.8%) and other, nonspecified forms of perianal eczema in 228 patients (22.6%). The remaining cases were due to other distinct dermatologic diseases. Analyzing patch test data from this large group of patients showed that the allergen spectrum resembled that of all patients (54,000) tested from 1992 to 1997. However, dibucaine HCl ranked fourth among contact allergens in the study population. Positive reactions to (chloro-)-methyl-isothiazolinone and to benzocaine were observed more frequently among patients with anogenital complaints as compared to the total IVDK population (3.7% vs. 2.5% and 2.7% vs. 1.5%, respectively). In general, active agents of topical medications and popular remedies, preservatives and ointment bases appeared to cause allergic reactions most frequently. CONCLUSION: Patients with chronic anogenital diseases seem to have a high risk of becoming sensitized. For patch testing we recommend the standard series, dibucaine HCl, propolis, bufexamac and other ingredients from topical preparations according to the patient's history.

Adult↗