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Aminoethylethanolamine: a new allergen in cosmetics?

Amphoacetates are organic compounds used in many industrial applications and in cosmetic formulations for the skin, hair and mucosa, as surfactants, mild foaming and cleansing agents in concentrations ranging from 0.1% to 50%. Despite the fact that they have been in use for many years, cases of contact allergy to them are extremely rare. We describe 4 patients who developed an eczematous reaction after use of detergents containing amphoacetates. Patch testing showed positive reactions to sodium lauroamphoacetate (Miranol HM Special, Rhodia, England) as is or diluted at decreasing concentration (10%, 5% and 1%) in water and to aminoethylethanolamine (AEE) at the concentration of 1% in various vehicles (ethanol, acetone, and sodium laurylethersulfate 1% aqueous solution) and at decreasing concentrations ranging from 1% to 0.005% in water. AEE is one of the reagents used in the synthesis of amphoacetates. This molecule, that is structurally an ethylenediamine derivative, has sensitizing power and is reported as a cause of occupational contact allergy in cable jointers. Combined eczematous reactions to AEE and sodium lauroamphoacetate can be consequent to the presence of the former substance as an impurity in amphoacetates-containing products, as demonstrated by ion chromatography-mass spectrometry analysis.

Adult↗

Allergic contact dermatitis from sodium dihydroxycetyl phosphate, a new cosmetic allergen?

Sodium dihydroxycetyl phosphate (trade name Dragophos S 2/918501) was identified as a contact allergen in a herbal moisturizing cream causing severe acute contact dermatitis on the hands and face of a 41-year-old woman. Sodium dihydroxycetyl phosphate is a complex mixture of phosphate esters of dihydroxycetyl alcohol, and subsequent analysis and testing revealed hexadecane-1,2-diol as 1 of the allergenic ingredients. Another possible allergen in the compound appears to be hexadecane-1,2-diol, 2-isopropyl ether.

Adult↗

The risk of active sensitization to PPD.

Para-phenylenediamine (PPD) and para-aminoazobenzene are strong sensitizers. By the patch test procedure, the patient may be sensitized to these agents. Combined testing of para-compounds may increase the risk of active sensitization. We studied the % of positive patch test reactions and their relevance. In order to assess the risk of active sensitization, we compared the % of relevant reactions of both early (2/3 days) and late (7 days) reactions. We also compared the percentage of positive patch test reactions to PPD and their relevance if simultaneously tested with para-aminoazobenzene. We studied the patch test reactions to PPD in the routine series in 2058 patients. In a group of 678 patients we tested PPD and para-aminoazobenzene simultaneously. 4.3% and 3.1% of the patients reacted to PPD, respectively, with and without simultaneous testing with para-aminoazobenzene. We estimated the reactions as relevant in 21.1% and 39.7%, respectively, with and without simultaneous testing with para-aminoazobenzene. We considered none of the late reactions as relevant. We found a high proportion of relevant patch test reactions to PPD, but sensitization to PPD by the patch test procedure is a risk. We state that routine series should not contain PPD. The high number of irrelevant late positive reactions strongly suggests active sensitization. Moreover, PPD is not a ubiquitous allergen and can be tested on a non-routine basis if industrial exposure to para-compounds is suspected or if a specific localization (e.g., head or feet) prompts the testing of PPD. Testing PPD combined with para-aminoazobenzene does lead to a slight increase in positive reactions to PPD (p<0.25) and to an increase in irrelevant reactions (p<0.10).

Adolescent↗

The seamy side of natural medicines: contact sensitization to arnica (Arnica montana L.) and marigold (Calendula officinalis L.).

Medical remedies of plant origin have gained increasing popularity in recent years. Both anaphylactic and eczematous allergic reactions are on the rise, accordingly. Arnica and marigold, both of the Compositae family, are in widespread use, but only limited data are available on their allergenic potential. We tested 443 consecutive patients, in addition to the European standard and other series, with Compositae mix, sesquiterpene lactone mix, arnica, marigold, and propolis. 5 subjects ( approximately 1.13%) reacted to arnica, 9 ( approximately 2.03%) to marigold. The Compositae mix was positive in 18 cases ( approximately 4.06%). Among them were 3 out of 5 individuals with a sensitization to arnica, and 4 out of 9 who reacted to marigold. Sensitization to arnica and marigold was often accompanied by reactions to nickel, Myroxylon Pereirae resin, fragrance mix, propolis, and colophonium. We conclude that Compositae allergy contributes significantly to the epidemiology of contact dermatitis and that sensitization to arnica and marigold cannot be assessed by testing with the Compositae or sesquiterpene mix alone. As extracts of these plants are frequently used in occupational and cosmetic products, patch testing with additional plant extracts or adjustment of the commercial Compositae mix to regional conditions is recommended.

Adult↗