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

Summary

Background

(Meth)acrylates are potent sensitisers 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. (Meth)acrylates have to date 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

5,920 patients were consecutively patch tested with the baseline series, of whom 669 were also tested to the (meth)acrylate series. 102 of 5,920 (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 5,920 (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%) and 2‐hydroxyethyl acrylate (n=57; 1%).

Conclusions

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

This article is protected by copyright. All rights reserved.

http://bit.ly/2MHj9ER