title: Contact allergy to ingredients of topical medications: results of the European Surveillance System on Contact Allergies (ESSCA), 2009-2012.
abstract: The aim of this study was to give an overview of the prevalence of contact allergy to active ingredients and excipients of topical medications across Europe.
  
  
  
  Retrospective analysis of data collected by the European Surveillance System on Contact Allergies (www.essca-dc.org) with substances applied to consecutively patch tested patients, 2009-2012, in 54 departments in 12 European countries.
  
  
  
  In view of the varying composition of the baseline series used in the previously mentioned departments and countries, between 58 833 (lanolin alcohols) and 16 498 patients (sodium metabisulfite) were patch tested with the topical agents covered in this study. Among these, positive (allergic) reactions were most commonly observed to sodium metabisulfite (3.12% positive), followed by propolis (2.48%), Compositae mix (1.73%), lanolin alcohols (1.65%) and caine mix III (benzocaine, cinchocaine and tetracaine; 1.27%).
  
  
  
  Several of the substances warrant routine screening for contact allergy, i.e. patch testing in a baseline series. However, in view of a vast number of other topical agents, additional patch testing with the suspect topical drug preparations (including natural remedies and cosmetics) is warranted. In the event of a positive test to the (pharmaceutical) product, single ingredients should be tested individually to precisely identify the hapten(s). Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany. wolfgang.uter@fau.de.
authors.forename: Wolfgang
authors.identifier: 0000-0002-4498-3710
authors.initials: W
authors.lastname: Uter
authors.affiliation: Department of Experimental Dermatology and Cosmetology, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Radoslaw
authors.initials: R
authors.lastname: Spiewak
authors.affiliation: Department of Dermatology, Churchill Hospital, Oxford, UK.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Cooper
authors.affiliation: Department of Dermatology, Chapel Allerton Hospital, Leeds, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Wilkinson
authors.affiliation: Department of Dermatology, Hospital Universitario la Princesa, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Sánchez Pérez
authors.affiliation: Information Network of Departments of Dermatology (IVDK), University Medicine Göttingen, Göttingen, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Schnuch
authors.affiliation: Department of Dermatology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Schuttelaar
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology* / Q000209:etiology; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005079:Excipients / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000485:Allergens; D005079:Excipients; D004364:Pharmaceutical Preparations
keywords: adverse event; clinical epidemiology; contact allergy; patch testing; pharmacoepidemiology; topical drugs