Recommendation to include hydroxyethyl (meth)acrylate in the British Baseline Patch Test Series

S. Rolls; M. M. Chowdhury; S. Cooper; P. Cousen; A. M. Flynn; S. A. Ghaffar; C. M. Green; A. Haworth; C. Holden; G. A. Johnston; K. Naidoo; D. I. Orton; C. Reckling; R. A. Sabroe; M. Scorer; N. M. Stone; D. Thompson; S. Wakelin; M. Wilkinson; D. A. Buckley

doi:10.1111/bjd.17708

Recommendation to include hydroxyethyl (meth)acrylate in the British Baseline Patch Test Series

S. Rolls (Lead / Corresponding author), M. M. Chowdhury, S. Cooper, P. Cousen, A. M. Flynn, S. A. Ghaffar, C. M. Green, A. Haworth, C. Holden, G. A. Johnston, K. Naidoo, D. I. Orton, C. Reckling, R. A. Sabroe, M. Scorer, N. M. Stone, D. Thompson, S. Wakelin, M. Wilkinson, D. A. Buckley

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Abstract

Background: (Meth)acrylates are potent sensitizers and a common cause of allergic contact dermatitis (ACD). The frequency of (meth)acrylate ACD has increased with soaring demand for acrylic nails. A preliminary audit has suggested a significant rate of positive patch tests to (meth)acrylates using aimed testing in patients providing a clear history of exposure. To date, (meth)acrylates have not been routinely tested in the baseline patch test series in the U.K. and Europe.

Objectives: To determine whether inclusion of 2-hydroxyethyl methacrylate (2-HEMA) 2% in petrolatum (pet.) in the baseline series detects cases of treatable (meth)acrylate ACD.

Methods: During 2016–2017, 15 U.K. dermatology centres included 2-HEMA in the extended baseline patch test series. Patients with a history of (meth)acrylate exposure, or who tested positive to 2-HEMA, were selectively tested with a short series of eight (meth)acrylate allergens.

Results: In total 5920 patients were consecutively patch tested with the baseline series, of whom 669 were also tested with the (meth)acrylate series. Overall, 102 of 5920 (1·7%) tested positive to 2-HEMA and 140 (2·4%) to at least one (meth)acrylate. Had 2-HEMA been excluded from the baseline series, (meth)acrylate allergy would have been missed in 36 of 5920 (0·6% of all patients). The top (meth)acrylates eliciting a positive reaction were 2-HEMA (n = 102, 1·7%), 2-hydroxypropyl methacrylate (n = 61, 1·0%) and 2-hydroxyethyl acrylate (n = 57, 1·0%).

Conclusions: We recommend that 2-HEMA 2% pet. be added to the British baseline patch test series. We also suggest a standardized short (meth)acrylate series, which is likely to detect most cases of (meth)acrylate allergy.

Original language	English
Pages (from-to)	811-817
Number of pages	7
Journal	British Journal of Dermatology
Volume	181
Issue number	4
Early online date	31 Jan 2019
DOIs	https://doi.org/10.1111/bjd.17708
Publication status	Published - 1 Oct 2019

ASJC Scopus subject areas

Dermatology

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10.1111/bjd.17708

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Rolls, S., Chowdhury, M. M., Cooper, S., Cousen, P., Flynn, A. M., Ghaffar, S. A., Green, C. M., Haworth, A., Holden, C., Johnston, G. A., Naidoo, K., Orton, D. I., Reckling, C., Sabroe, R. A., Scorer, M., Stone, N. M., Thompson, D., Wakelin, S., Wilkinson, M., & Buckley, D. A. (2019). Recommendation to include hydroxyethyl (meth)acrylate in the British Baseline Patch Test Series. British Journal of Dermatology, 181(4), 811-817. https://doi.org/10.1111/bjd.17708

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title = "Recommendation to include hydroxyethyl (meth)acrylate in the British Baseline Patch Test Series",

abstract = "Background: (Meth)acrylates are potent sensitizers and a common cause of allergic contact dermatitis (ACD). The frequency of (meth)acrylate ACD has increased with soaring demand for acrylic nails. A preliminary audit has suggested a significant rate of positive patch tests to (meth)acrylates using aimed testing in patients providing a clear history of exposure. To date, (meth)acrylates have not been routinely tested in the baseline patch test series in the U.K. and Europe.Objectives: To determine whether inclusion of 2-hydroxyethyl methacrylate (2-HEMA) 2% in petrolatum (pet.) in the baseline series detects cases of treatable (meth)acrylate ACD.Methods: During 2016–2017, 15 U.K. dermatology centres included 2-HEMA in the extended baseline patch test series. Patients with a history of (meth)acrylate exposure, or who tested positive to 2-HEMA, were selectively tested with a short series of eight (meth)acrylate allergens.Results: In total 5920 patients were consecutively patch tested with the baseline series, of whom 669 were also tested with the (meth)acrylate series. Overall, 102 of 5920 (1·7%) tested positive to 2-HEMA and 140 (2·4%) to at least one (meth)acrylate. Had 2-HEMA been excluded from the baseline series, (meth)acrylate allergy would have been missed in 36 of 5920 (0·6% of all patients). The top (meth)acrylates eliciting a positive reaction were 2-HEMA (n = 102, 1·7%), 2-hydroxypropyl methacrylate (n = 61, 1·0%) and 2-hydroxyethyl acrylate (n = 57, 1·0%).Conclusions: We recommend that 2-HEMA 2% pet. be added to the British baseline patch test series. We also suggest a standardized short (meth)acrylate series, which is likely to detect most cases of (meth)acrylate allergy.",

author = "S. Rolls and Chowdhury, {M. M.} and S. Cooper and P. Cousen and Flynn, {A. M.} and Ghaffar, {S. A.} and Green, {C. M.} and A. Haworth and C. Holden and Johnston, {G. A.} and K. Naidoo and Orton, {D. I.} and C. Reckling and Sabroe, {R. A.} and M. Scorer and Stone, {N. M.} and D. Thompson and S. Wakelin and M. Wilkinson and Buckley, {D. A.}",

note = "{\textcopyright} 2019 British Association of Dermatologists.",

year = "2019",

month = oct,

day = "1",

doi = "10.1111/bjd.17708",

language = "English",

volume = "181",

pages = "811--817",

journal = "British Journal of Dermatology",

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Rolls, S, Chowdhury, MM, Cooper, S, Cousen, P, Flynn, AM, Ghaffar, SA, Green, CM, Haworth, A, Holden, C, Johnston, GA, Naidoo, K, Orton, DI, Reckling, C, Sabroe, RA, Scorer, M, Stone, NM, Thompson, D, Wakelin, S, Wilkinson, M & Buckley, DA 2019, 'Recommendation to include hydroxyethyl (meth)acrylate in the British Baseline Patch Test Series', British Journal of Dermatology, vol. 181, no. 4, pp. 811-817. https://doi.org/10.1111/bjd.17708

TY - JOUR

T1 - Recommendation to include hydroxyethyl (meth)acrylate in the British Baseline Patch Test Series

AU - Rolls, S.

AU - Chowdhury, M. M.

AU - Cooper, S.

AU - Cousen, P.

AU - Flynn, A. M.

AU - Ghaffar, S. A.

AU - Green, C. M.

AU - Haworth, A.

AU - Holden, C.

AU - Johnston, G. A.

AU - Naidoo, K.

AU - Orton, D. I.

AU - Reckling, C.

AU - Sabroe, R. A.

AU - Scorer, M.

AU - Stone, N. M.

AU - Thompson, D.

AU - Wakelin, S.

AU - Wilkinson, M.

AU - Buckley, D. A.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background: (Meth)acrylates are potent sensitizers and a common cause of allergic contact dermatitis (ACD). The frequency of (meth)acrylate ACD has increased with soaring demand for acrylic nails. A preliminary audit has suggested a significant rate of positive patch tests to (meth)acrylates using aimed testing in patients providing a clear history of exposure. To date, (meth)acrylates have not been routinely tested in the baseline patch test series in the U.K. and Europe.Objectives: To determine whether inclusion of 2-hydroxyethyl methacrylate (2-HEMA) 2% in petrolatum (pet.) in the baseline series detects cases of treatable (meth)acrylate ACD.Methods: During 2016–2017, 15 U.K. dermatology centres included 2-HEMA in the extended baseline patch test series. Patients with a history of (meth)acrylate exposure, or who tested positive to 2-HEMA, were selectively tested with a short series of eight (meth)acrylate allergens.Results: In total 5920 patients were consecutively patch tested with the baseline series, of whom 669 were also tested with the (meth)acrylate series. Overall, 102 of 5920 (1·7%) tested positive to 2-HEMA and 140 (2·4%) to at least one (meth)acrylate. Had 2-HEMA been excluded from the baseline series, (meth)acrylate allergy would have been missed in 36 of 5920 (0·6% of all patients). The top (meth)acrylates eliciting a positive reaction were 2-HEMA (n = 102, 1·7%), 2-hydroxypropyl methacrylate (n = 61, 1·0%) and 2-hydroxyethyl acrylate (n = 57, 1·0%).Conclusions: We recommend that 2-HEMA 2% pet. be added to the British baseline patch test series. We also suggest a standardized short (meth)acrylate series, which is likely to detect most cases of (meth)acrylate allergy.

AB - Background: (Meth)acrylates are potent sensitizers and a common cause of allergic contact dermatitis (ACD). The frequency of (meth)acrylate ACD has increased with soaring demand for acrylic nails. A preliminary audit has suggested a significant rate of positive patch tests to (meth)acrylates using aimed testing in patients providing a clear history of exposure. To date, (meth)acrylates have not been routinely tested in the baseline patch test series in the U.K. and Europe.Objectives: To determine whether inclusion of 2-hydroxyethyl methacrylate (2-HEMA) 2% in petrolatum (pet.) in the baseline series detects cases of treatable (meth)acrylate ACD.Methods: During 2016–2017, 15 U.K. dermatology centres included 2-HEMA in the extended baseline patch test series. Patients with a history of (meth)acrylate exposure, or who tested positive to 2-HEMA, were selectively tested with a short series of eight (meth)acrylate allergens.Results: In total 5920 patients were consecutively patch tested with the baseline series, of whom 669 were also tested with the (meth)acrylate series. Overall, 102 of 5920 (1·7%) tested positive to 2-HEMA and 140 (2·4%) to at least one (meth)acrylate. Had 2-HEMA been excluded from the baseline series, (meth)acrylate allergy would have been missed in 36 of 5920 (0·6% of all patients). The top (meth)acrylates eliciting a positive reaction were 2-HEMA (n = 102, 1·7%), 2-hydroxypropyl methacrylate (n = 61, 1·0%) and 2-hydroxyethyl acrylate (n = 57, 1·0%).Conclusions: We recommend that 2-HEMA 2% pet. be added to the British baseline patch test series. We also suggest a standardized short (meth)acrylate series, which is likely to detect most cases of (meth)acrylate allergy.

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U2 - 10.1111/bjd.17708

DO - 10.1111/bjd.17708

M3 - Article

C2 - 30703264

SN - 0007-0963

VL - 181

SP - 811

EP - 817

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 4

ER -

Recommendation to include hydroxyethyl (meth)acrylate in the British Baseline Patch Test Series

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