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Wet Wipe Allergens: Retrospective Analysis From the North American Contact Dermatitis Group 2011-2014
Erin M Warshaw1, Kelly A Aschenbeck, Kathryn A Zug
1From the *Department of Dermatology, Minneapolis Veterans Affairs Medical Center; †HCMC Parkside Occupational and Contact Dermatitis Clinic; ‡Department of Dermatology, University of Minnesota Medical School; §University of Minnesota School of Medicine, Minneapolis; ∥Dartmouth-Hitchcock Medical Center, Lebanon, NH; ¶Department of Dermatology, Keck School of Medicine, Los Angeles, CA; #Ohio State University, Columbus; **University of Louisville, KY; ††Department of Dermatology, Cleveland Clinic, OH; ‡‡Division of Dermatology, Royal Victoria Hospital, McGill University, Montreal, Canada; §§Associates in Dermatology, Fort Myers, FL; ∥∥Department of Dermatology, Pennsylvania State University, State College; ¶¶Division of Dermatology, University of Ottawa, Canada; ##Department of Dermatology, University of California San Francisco; ***Department of Dermatology, University of Cincinnati, OH; and †††Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Canada.
Background:
Although there are several case reports of wet wipe-associated contact dermatitis, the prevalence of wipes as a source of allergic contact dermatitis in larger populations and the responsible allergens are largely unknown.
Objective:
The aim of the study was to determine the prevalence of wet wipes as a source of contact allergy and the most commonly associated allergens in a North American tertiary referral patch test population.
Methods:
Data collected from 2011 to 2014 by the North American Contact Dermatitis Group was used to conduct a retrospective cross-sectional analysis of patient demographics and patch test results associated with the triple-digit source code for "wet wipe."
Results:
Of the 9037 patients patch tested during the study period, 79 (0.9%) had a positive patch test reaction to an allergen identified with a wet wipe source. The most commonly associated allergens were preservatives, including the following: methylisothiazolinone (MI) (59.0%), methylchloroisothiazolinone (MCI)/MI (35.6%), bronopol (2-bromo-2-nitropropane-1,3-diol) (27.4%), and iodopropynyl butylcarbamate (12.3%). Fragrance (combined) represented 12.3%. Anal/genital dermatitis was 15 times more likely (P < 0.0001) in those with wet wipe allergy. More than 92% of patients with wipe-associated contact allergy had their contact allergens detected by the North American Contact Dermatitis Group screening series.
Conclusions:
Wet wipes are an important source of contact allergy. Preservatives are the main allergens, especially isothiazolinones.