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Repeated open application test with methyldibromo glutaronitrile, a multicentre study within the EECDRG
B Gruvberger1, K E Andersen, F M Brandão
1Department of Occupational and Environmental Dermatology, Malmö University Hospital, S-205 02 Malmö, Sweden. birgitta.gruvberger@derm.mas.lu.se
Contact Dermatitis
|February 11, 2005
Summary
Lower concentrations of methyldibromo glutaronitrile (MDBGN) in patch testing may miss allergic contact dermatitis cases. Testing with 0.3% and 0.1% MDBGN is insufficient for diagnosing relevant contact allergies.
Area of Science:
- Dermatology
- Allergology
- Toxicology
Background:
- Methyldibromo glutaronitrile (MDBGN) is a known contact allergen.
- Allergic contact dermatitis from MDBGN is frequently reported.
- Optimal diagnostic patch test preparations for MDBGN are needed.
Purpose of the Study:
- To determine the optimal patch test preparation for methyldibromo glutaronitrile (MDBGN).
- To evaluate the diagnostic accuracy of different MDBGN concentrations in patch testing.
Main Methods:
- 51 patients with suspected MDBGN allergy underwent patch testing with MDBGN at 1.0%, 0.5%, 0.3%, and 0.1% in petrolatum.
- A repeated open application test (ROAT) using moisturizers with and without 0.03% MDBGN was performed on the upper arms for 2 weeks.
- Patch test reactivity (PTRL) was correlated with ROAT outcomes.
Main Results:
- 18 out of 51 patients (35.3%) showed a positive ROAT, exclusively to the MDBGN-containing moisturizer.
- A significant association was found between patch test reactivity and ROAT results (P < 0.001).
- Lower MDBGN concentrations (0.3% and 0.1%) in patch tests were found to miss clinically relevant reactions.
Conclusions:
- Patch testing with methyldibromo glutaronitrile (MDBGN) at 0.3% and 0.1% concentrations is inadequate for diagnosing relevant allergic contact dermatitis.
- Higher concentrations or alternative testing methods may be necessary for accurate MDBGN allergy diagnosis.