TY - JOUR
T1 - Positive patch-test reactions to iodopropynyl butylcarbamate
T2 - retrospective analysis of North American contact dermatitis group data, from 1998 to 2008
AU - Warshaw, Erin M.
AU - Ratnayake, Dilangani Boralessa
AU - Maibach, Howard I.
AU - Sasseville, Denis
AU - Belsito, Donald V.
AU - Zug, Kathryn A.
AU - Fowler, Joseph F.
AU - Taylor, James S.
AU - Mathias, C. G Toby
AU - Fransway, Anthony F.
AU - DeLeo, Vincent A.
AU - Marks, James G.
AU - Storrs, Frances J.
AU - Pratt, Melanie D.
AU - Rietschel, Robert L.
PY - 2010/11
Y1 - 2010/11
N2 - Background: Iodopropynyl butylcarbamate (IPBC), a commonly used preservative, is found in industrial and personal care products. Objective: To evaluate prevalence, clinical relevance, occupational relationship, and sources of positive reactions to IPBC in patients in North America. Methods: The North American Contact Dermatitis Group (NACDG) tested IPBC 0.1% and/or 0.5% in petrolatum (pet) between 1998 and 2008. Two patient groups of interest were defined, based on patch-test reactions to IPBC: weak (+) reactors and strong (++ or +++) reactors. Patient characteristics, site(s) of dermatitis, sources of positive reactions, clinical relevance, and occupational relevance to IPBC were tabulated. Results: Of the 25,321 patients tested, there were 226 (0.9%) weak reactors and 67 (0.3%) strong reactors. For IPBC-positive patients, the most frequent sites of dermatitis were scattered generalized distribution, hands, and arms. The majority (> 50%) of currently relevant reactions were to personal care products, and most reactions (> 90%) were not related to occupation. Only four of the strong reactors had definite clinical relevance (positive use-test reaction or positive patch-test reaction to a product containing IPBC). The frequency of positive reactions increased (0.2% vs 1.5%) when the higher concentration of IPBC was utilized, but most (> 64%) were weak reactions, of which some were likely irritant. Conclusions: Allergy to IPBC is relatively uncommon. When clinically relevant, personal care products were the most likely allergen source. Because IPBC is a marginal irritant, caution should be utilized when testing with higher concentrations of IPBC (≥ 0.5% pet) and when interpreting weak (+) reactions. Verification of clinical relevance by use test or repeat patch testing or both is also important.
AB - Background: Iodopropynyl butylcarbamate (IPBC), a commonly used preservative, is found in industrial and personal care products. Objective: To evaluate prevalence, clinical relevance, occupational relationship, and sources of positive reactions to IPBC in patients in North America. Methods: The North American Contact Dermatitis Group (NACDG) tested IPBC 0.1% and/or 0.5% in petrolatum (pet) between 1998 and 2008. Two patient groups of interest were defined, based on patch-test reactions to IPBC: weak (+) reactors and strong (++ or +++) reactors. Patient characteristics, site(s) of dermatitis, sources of positive reactions, clinical relevance, and occupational relevance to IPBC were tabulated. Results: Of the 25,321 patients tested, there were 226 (0.9%) weak reactors and 67 (0.3%) strong reactors. For IPBC-positive patients, the most frequent sites of dermatitis were scattered generalized distribution, hands, and arms. The majority (> 50%) of currently relevant reactions were to personal care products, and most reactions (> 90%) were not related to occupation. Only four of the strong reactors had definite clinical relevance (positive use-test reaction or positive patch-test reaction to a product containing IPBC). The frequency of positive reactions increased (0.2% vs 1.5%) when the higher concentration of IPBC was utilized, but most (> 64%) were weak reactions, of which some were likely irritant. Conclusions: Allergy to IPBC is relatively uncommon. When clinically relevant, personal care products were the most likely allergen source. Because IPBC is a marginal irritant, caution should be utilized when testing with higher concentrations of IPBC (≥ 0.5% pet) and when interpreting weak (+) reactions. Verification of clinical relevance by use test or repeat patch testing or both is also important.
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U2 - 10.2310/6620.2010.10053
DO - 10.2310/6620.2010.10053
M3 - Article
C2 - 21144341
AN - SCOPUS:78650382501
SN - 1710-3568
VL - 21
SP - 303
EP - 310
JO - Dermatitis
JF - Dermatitis
IS - 6
ER -