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Recommendation to include hydroxyethyl (meth)acrylate in the British baseline patch test series.

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  • 1Royal United Hospital Bath, Bath, U.K.

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Adding 2-hydroxyethyl methacrylate (2-HEMA) to baseline patch testing significantly detects allergic contact dermatitis (ACD) caused by (meth)acrylates, particularly from acrylic nail use. This inclusion is crucial for diagnosing and treating this common skin condition.

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Area of Science:

  • Dermatology
  • Allergology
  • Toxicology

Background:

  • (Meth)acrylates are common causes of allergic contact dermatitis (ACD), with increasing incidence linked to acrylic nail demand.
  • Current UK and European baseline patch testing protocols do not routinely include (meth)acrylates.
  • Preliminary data suggest a high rate of positive patch tests for (meth)acrylates in patients with relevant exposure history.

Purpose of the Study:

  • To evaluate the efficacy of including 2-hydroxyethyl methacrylate (2-HEMA) 2% in petrolatum in the baseline patch test series for detecting treatable (meth)acrylate ACD.
  • To assess the diagnostic yield of 2-HEMA as a marker for broader (meth)acrylate allergy.

Main Methods:

  • A multi-centre study in 15 UK dermatology centres from 2016-2017.
  • Inclusion of 2-HEMA in the extended baseline patch test series for 5920 patients.
  • Selective patch testing with eight (meth)acrylate allergens for patients with suspected exposure or positive 2-HEMA results (669 patients).

Main Results:

  • 1.7% (102/5920) of patients tested positive to 2-HEMA.
  • 2.4% (140/5920) tested positive to at least one (meth)acrylate.
  • Excluding 2-HEMA would have missed 0.6% (36/5920) of all patients with (meth)acrylate allergy. Top allergens: 2-HEMA (1.7%), 2-hydroxypropyl methacrylate (1.0%), 2-hydroxyethyl acrylate (1.0%).

Conclusions:

  • Routine inclusion of 2-HEMA 2% petrolatum in the UK baseline patch test series is recommended.
  • A standardized short (meth)acrylate series is suggested to improve detection of (meth)acrylate allergy.
  • This strategy will enhance the diagnosis and management of (meth)acrylate-induced ACD.