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Positive relationship – intensity of response to p ‐phenylenediamine on patch testing and cross‐reactions with related allergens
Author(s) -
Thomas Bjorn R.,
White Ian R.,
McFadden John P.,
Banerjee Piu
Publication year - 2014
Publication title -
contact dermatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.524
H-Index - 96
eISSN - 1600-0536
pISSN - 0105-1873
DOI - 10.1111/cod.12255
Subject(s) - patch test , medicine , p phenylenediamine , dermatology , cross reactions , allergic contact dermatitis , allergen , patch testing , contact dermatitis , sensitization , allergy , immunology , chemistry , antibody , organic chemistry
Summary Background Hair dye exposure is the most common cause of sensitization to p ‐phenylenediamine ( PPD ). Cross‐reactions with structurally related allergens occur. Objectives It is suggested that a stronger patch test reaction (3+ rather than 1+) to PPD (usually tested as 1% petrolatum) is associated with an increased propensity for cross‐reactions. In this article we will demonstrate this association. Methods Of 230 patients with allergic reactions to PPD on patch testing identified during 2007–2012 from clinical records, notes for 221 were available for review. Data were collected regarding age, sex, and grade of reaction [International Contact Dermatitis Research Group ( ICDRG ) criteria] to PPD . Cross‐reactions with the following allergens, found in our baseline series, were recorded: D isperse Y ellow 3, N ‐isopropyl‐ N ′ ‐phenyl‐ p ‐phenylenediamine ( IPPD ), and caine mix. Having excluded 23 doubtful reactions, the reactions from 198 patients were further considered. Results Of the patients, 75.3% (n = 149) were female, and the mean age was 48.6 years (12–82 years). Of the patients allergic to PPD , 16.6% (n = 33) showed cross‐reactions with one or more related allergens. Cross‐reactions were seen in 16% with a grade of 1+, 14.5% with a grade of 2+, 28.6% with a grade of 3+ when PPD was tested 1% pet., and 50.0% when PPD was tested at 0.1–0.001%, arbitrarily considered to be 4+ ( p = 0.02; Cramér's V = 0.23). Conclusion An increasing likelihood of reactions to D isperse Y ellow 3, IPPD or caine mix was seen with increasing strength of patch test reaction to PPD . The clinical relevance of these cross‐reactions is unclear.