title: Recommendation to include methylisothiazolinone in the European baseline patch test series--on behalf of the European Society of Contact Dermatitis and the European Environmental and Contact Dermatitis Research Group.
abstract: BACKGROUND
  Methylisothiazolinone (MI) is used as a preservative in occupational and household products, and cosmetics. It is a part of the preparation of methylchloroisothiazolinone (MCI)/MI, which is patch tested in water in the European baseline series. However, this preparation fails to detect a significant percentage of allergic contact reactions to MI.
  
  
  OBJECTIVE
  To investigate whether a separate test preparation with MI should be included in the European baseline series.
  
  
  METHODS
  Literature survey.
  
  
  RESULTS
  In consecutively tested dermatitis patients, the contact allergy rate for MI varies between 0.6% and 6%, with a marked increase in recent years. The contact allergy rate for MI alone, not detected with MCI/MI, varies between 0% and 1.6%. Most cases are relevant, as shown by repeated open application test studies, and are mainly related to exposure from cosmetic products.
  
  
  CONCLUSIONS
  Owing to the increase in contact allergy to MI not detected with MCI/MI, it is recommended that MI in water at 2000 ppm be included in the European baseline series. With the Finn Chamber(®) (diameter, 8 mm) technique, a volume of 15 µl should be applied, giving a dose of 60 µg/cm(2).
authors.affiliation: Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Bruze
authors.forename: Malin
authors.initials: M
authors.lastname: Engfeldt
authors.forename: Margarida
authors.initials: M
authors.lastname: Gonçalo
authors.forename: An
authors.initials: A
authors.lastname: Goossens
mesh_terms: D003429:Cross Reactions; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis*; D006801:Humans; D010328:Patch Tests / Q000379:methods*; D011310:Preservatives, Pharmaceutical / Q000008:administration & dosage; D018570:Risk Assessment; D013844:Thiazoles / Q000008:administration & dosage / Q000276:immunology
chemical_list: D011310:Preservatives, Pharmaceutical; D013844:Thiazoles; C011506:2-methyl-4-isothiazolin-3-one; C011421:5-chloro-2-methyl-4-isothiazolin-3-one
keywords: European baseline series; MCI/MI; allergic contact dermatitis; contact allergy; dose in µg/cm2; methylisothiazolinone; micropipette; patch test sensitization; preservative