title: The epidemic of methylisothiazolinone: a European prospective study.
abstract: BACKGROUND
  The use of methylisothiazolinone (MI) in cosmetic products has caused an unprecedented epidemic of MI contact allergy. Current data concerning exposures at a European level are required.
  
  
  OBJECTIVE
  To describe demographics and MI exposures for European patients with MI contact allergy.
  
  
  METHODS
  Eleven European dermatology departments from eight European countries prospectively collected data between 1 May and 31 October 2015 among consecutive patients who had positive patch test reactions to MI (2000 ppm aq.).
  
  
  RESULTS
  A total of 6.0% (205/3434; range 2.6-13.0%) of patients had positive patch test reactions to MI. Dermatitis most frequently affected the hands (43.4%), face (32.7%), arms (14.6%), and eyelids (11.7%); 12.7% had widespread dermatitis. For 72.7% (149/205), MI contact allergy was currently relevant mainly because of exposure to cosmetic products (83.2%; 124/149). Of these 124 patients, 19.5% were exposed to leave-on and rinse-off cosmetic products, 24.8% only to leave-on cosmetic products and 38.9% only to rinse-off cosmetic products containing MI or methylchloroisothiazolinone/MI. The majority of these (79%) noted onset of their dermatitis between 2013 and 2015. Fifteen patients (7.3%) had previously experienced allergic reactions when they were in newly painted rooms.
  
  
  CONCLUSIONS
  Clinically relevant MI contact allergy remains prevalent across European countries, mainly because of exposure to rinse-off and leave-on cosmetic products.
authors.affiliation: Department of Dermato-Allergology, National Allergy Research Centre, Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark.
authors.forename: Jakob F
authors.initials: JF
authors.lastname: Schwensen
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, 91054, Erlangen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Uter
authors.affiliation: Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, 205 02, Malmö, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Bruze
authors.affiliation: Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, 205 02, Malmö, Sweden.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Svedman
authors.affiliation: Contact Allergy Unit, Department of Dermatology, University Hospital KU Leuven, 3000, Leuven, Belgium.
authors.forename: An
authors.initials: A
authors.lastname: Goossens
authors.affiliation: Department of dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, LS7 4SA, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Wilkinson
authors.affiliation: Department of Dermatology, Hospital del Mar, Universitat Autònoma de Barcelona, 08003, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Giménez Arnau
authors.affiliation: Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, 3000-075, Coimbra, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Gonçalo
authors.affiliation: Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, 5000, Odense, Denmark.|Centre for Innovative Medical Technology, Institute of Clinical Research, Odense University Hospital, University of Southern Denmark, 5000, Odense, Denmark.
authors.forename: Klaus E
authors.initials: KE
authors.lastname: Andersen
authors.affiliation: Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, 5000, Odense, Denmark.
authors.forename: Evy
authors.initials: E
authors.lastname: Paulsen
authors.affiliation: Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, 2400, Copenhagen, Denmark.
authors.forename: Tove
authors.initials: T
authors.lastname: Agner
authors.affiliation: Unit of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, 70124, Bari, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Foti
authors.affiliation: Occupational Medicine, Finnish Institute of Occupational Health, 00250, Helsinki, Finland.
authors.forename: Kristiina
authors.initials: K
authors.lastname: Aalto-Korte
authors.affiliation: St John's Institute of Dermatology, St Thomas' Hospital, London, SE1 7EH, UK.
authors.forename: John
authors.initials: J
authors.lastname: McFadden
authors.affiliation: St John's Institute of Dermatology, St Thomas' Hospital, London, SE1 7EH, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: White
authors.affiliation: Department of Dermato-Allergology, National Allergy Research Centre, Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark.
authors.forename: Jeanne D
authors.initials: JD
authors.lastname: Johansen
mesh_terms: D017449:Dermatitis, Allergic Contact / Q000453:epidemiology*; D009783:Dermatitis, Occupational / Q000453:epidemiology*; D005060:Europe; D005148:Facial Dermatoses / Q000139:chemically induced; D006229:Hand Dermatoses / Q000139:chemically induced; D006801:Humans; D007868:Leg Dermatoses / Q000139:chemically induced; D011310:Preservatives, Pharmaceutical / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies; D013844:Thiazoles / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D011310:Preservatives, Pharmaceutical; D013844:Thiazoles; C011506:2-methyl-4-isothiazolin-3-one
keywords: CAS no. 2682-20-4; allergic contact dermatitis; cosmetics; exposure; methylchloroisothiazolinone; methylisothiazolinone