title: Wet Wipe Allergens: Retrospective Analysis From the North American Contact Dermatitis Group 2011-2014.
abstract: 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.
authors.affiliation: From 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.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Warshaw
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Aschenbeck
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Zug
authors.forename: Donald V
authors.initials: DV
authors.lastname: Belsito
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Zirwas
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Fowler
authors.forename: James S
authors.initials: JS
authors.lastname: Taylor
authors.forename: Denis
authors.initials: D
authors.lastname: Sasseville
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Fransway
authors.forename: Vincent A
authors.initials: VA
authors.lastname: DeLeo
authors.forename: James G
authors.initials: JG
authors.lastname: Marks
authors.forename: Melanie D
authors.initials: MD
authors.lastname: Pratt
authors.forename: Howard I
authors.initials: HI
authors.lastname: Maibach
authors.forename: C G Toby
authors.initials: CG
authors.lastname: Mathias
authors.forename: Joel G
authors.initials: JG
authors.lastname: DeKoven
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000009:adverse effects*; D000890:Anti-Infective Agents / Q000009:adverse effects*; D003358:Cosmetics / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D006795:Household Products; D006801:Humans; D010328:Patch Tests; D012189:Retrospective Studies; D013844:Thiazoles / Q000009:adverse effects
chemical_list: D000485:Allergens; D000890:Anti-Infective Agents; D003358:Cosmetics; D013844:Thiazoles; C011506:2-methyl-4-isothiazolin-3-one; C011421:5-chloro-2-methyl-4-isothiazolin-3-one