Charlotte Gotthard Mortz

Odense University Hospital, Odense, South Denmark, Denmark

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Publications (43)122.96 Total impact

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    ABSTRACT: Several studies have evaluated the incidence and prevalence of hand eczema in unselected adults. However, no studies have followed unselected adolescents from primary school into adult life to evaluate the course and risk factors for hand eczema.
    British Journal of Dermatology 08/2014; 171(2). · 3.76 Impact Factor
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    ABSTRACT: Background Blue-collar workers have a high risk of occupational contact dermatitis, but epidemiological studies are scarce.Objectives To investigate allergic contact dermatitis in blue-collar workers with dermatitis registered by the Danish Contact Dermatitis Group.MethodsA retrospective analysis of patch test data from 1471 blue-collar workers and 1471 matched controls tested between 2003 and 2012 was performed. A logistic regression was used to test for associations.ResultsThe blue-collar workers often had occupational hand dermatitis (p < 0.001). Atopic dermatitis was less commonly observed among blue-collar workers (19.6%) than among controls (23.9%) (p = 0.005). Allergens with a statistically significant association with the occupational group of blue-collar workers were epoxy resins, methyldibromo glutaronitrile, 2-bromo-2-nitro-1,3-propanediol, potassium dichromate, and methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI). The following occupations were additionally identified as risk factors for contact sensitization to MCI/MI and MI, epoxy resins, and potassium dichromate, respectively: painting, construction work, and tile setting/terrazzo work.Conclusion Contact allergy is a major problem among blue-collar workers. The data indicate a healthy worker effect among blue-collar workers diagnosed with dermatitis, as blue-collar workers were diagnosed significantly less often with atopic dermatitis than were controls.
    Contact Dermatitis 07/2014; · 2.93 Impact Factor
  • Journal of Allergy and Clinical Immunology. 01/2014;
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    ABSTRACT: Occupational contact dermatitis among hairdressers is frequent, owing to daily exposure to irritants and allergens. To identify sensitization to the most common allergens associated with the occupation of hairdressing. Patch test results of 399 hairdressers and 1995 matched controls with contact dermatitis, registered by the Danish Contact Dermatitis Group between January 2002 and December 2011, were analysed. All patients were patch tested with the European baseline series, and hairdressers were additionally tested with the hairdressing series. Occupational contact dermatitis (p < 0.001) and hand eczema (p < 0.001) were observed significantly more often among hairdressers than among controls. Atopic dermatitis was less commonly observed among hairdressers (21.3%) than among controls (29.4%) (p < 0.01). Allergens from the European baseline series with a statistically significant association with the occupation of hairdressing were p-phenylenediamine, thiuram mix, and benzocaine. Frequent sensitizers from the hairdressing series were ammonium persulfate, toluene-2,5-diamine, 3-aminophenol, and 4-aminophenol. Cysteamine hydrochloride and chloroacetamide emerged as new sensitizers. These results indicate a healthy worker effect among hairdressers diagnosed with eczema. Ammonium persulfate and p-phenylenediamine remain frequent sensitizers in hairdressers with contact dermatitis. Cysteamine hydrochloride and chloroacetamide should be included in future surveillance studies.
    Contact Dermatitis 12/2013; · 2.93 Impact Factor
  • The Journal of allergy and clinical immunology 12/2013; · 12.05 Impact Factor
  • Allergy 12/2013; 68(12):1626-7. · 5.88 Impact Factor
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    ABSTRACT: Although contact allergy among children was previously considered to be rare, data from the past decade have shown that it is common among children and that the prevalence may be increasing. To describe the demographics of all children referred for patch testing in Denmark during 2003-2011, to examine the frequency and relevance of positive patch test reactions, and to assess the most common allergens. A retrospective analysis of the patch test data from the Danish National Database of Contact Allergy was performed. Of 2594 children and adolescents aged 1-17 years, 25.1% had one or more positive patch test reactions. The associated relevance was 66.4%. The most common sensitizers were metals, fragrances, and hair dyes. The frequency of positive patch test reactions and allergic contact dermatitis was significantly higher among girls. Allergic contact dermatitis in children is a significant clinical problem. Contact allergy should always be considered when children with recalcitrant eczema are encountered, and special attention should be paid to girls. Patch testing is important, and children may be tested with the same patch test concentrations as adults.
    Contact Dermatitis 09/2013; · 2.93 Impact Factor
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    ABSTRACT: Skin testing in duplicate, correlation between case history of immediate and nonimmediate reactions and challenge outcome and prolonged oral treatment with penicillin in the diagnostic evaluation of allergic reactions to β-lactam antibiotics, mimicking real-life situations, have only been addressed in few studies. A total of 342 patients suspected of having β-lactam allergy were investigated according to the European Network for Drug Allergy (ENDA) guidelines and patients found to be negative in the ENDA program were supplemented with a 7-day oral treatment with penicillin. Skin testing with penicillins was performed in duplicate. Patients with case histories of reactions to other β-lactams were also subsequently challenged with the culprit drug. Nineteen patients were IgE-sensitized to penicillin. Then, intracutaneous tests (ICTs) were performed, in which 35 patients tested positive for allergy, 21 with delayed and 14 with immediate reactions. Only three patients tested positive for the major (PPL) and/or minor (MDM) penicillin determinants, all being positive for penicillin G in ICT. The remaining 291 patients were challenged with penicillin: 10 tested positive in single-dose challenge and 23 tested positive in the 7-day challenge. A total of 17 of 78 patients with a negative penicillin challenge tested positive during challenges with other β-lactams. We found no correlation between case histories of immediate and nonimmediate reactions and reaction time during challenge. The data suggest that case history is often insufficient to discriminate between immediate reactors and nonimmediate reactors. A 7-day challenge with the culprit β-lactam may yield more positive reactions than the accepted one- or 2-day challenge. Interpretation of skin testing should be made with caution.
    Allergy 07/2013; · 5.88 Impact Factor
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    ABSTRACT: Background In 1995, we established a cohort of 1501 unselected eighth-grade schoolchildren to investigate the course of nickel allergy into adult life. Objectives To follow the course of nickel allergy and clinically relevant nickel dermatitis over 15 years from adolescence to adulthood, and the effect of ear piercing, atopic dermatitis and degree of nickel patch test reactivity. Methods One thousand two hundred and six young adults from the cohort were asked to complete a questionnaire and participate in a clinical examination including patch testing with TRUE Test® including a nickel dilution series. Results The questionnaire was answered by 899 (74.6%), and 442 (36.7%) had patch tests performed. The point prevalence of nickel allergy was 11.8% (clinical relevance 80.8%). The 15-year incidence rate was 6.7%. Most new sensitizations were clinically relevant with strong reactions, and many participants reacted to low concentrations. Only a few positive reactions were lost. Nickel allergy was more common among women with childhood atopic dermatitis, whereas no association with ear piercing was found. However, there was a significantly higher prevalence of nickel allergy among women ear pierced before implementation of the nickel regulation in Denmark. Conclusion This follow-up study in young adults 15 years after leaving primary school showed a high prevalence and a high incidence rate of nickel allergy, despite the nickel regulation. Most reactions from childhood could be reproduced and were clinically relevant. In women, childhood atopic dermatitis was associated with nickel allergy in adulthood, whereas only ear piercing before the Danish nickel regulation was associated with adult nickel allergy.
    Contact Dermatitis 06/2013; 68(6):348-56. · 2.93 Impact Factor
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    ABSTRACT: Allergic Contact Dermatitis (ACD) in children is increasing. Sensitization to contact allergens can start in early infancy. The epidermal barrier is crucial for the development of sensitization and elicitation of ACD. Factors that may influence the onset of sensitization in children are atopic dermatitis, skin barrier defects and intense or repetitive contact with allergens. Topical treatment of ACD is associated with cutaneous sensitization, although the prevalence is not high. ACD because of haptens in shoes or shin guards should be considered in cases of persistent foot eruptions or sharply defined dermatitis on the lower legs. Clinical polymorphism of contact dermatitis to clothing may cause difficulties in diagnosing textile dermatitis. Toys are another potentially source of hapten exposure in children, especially from toy-cosmetic products such as perfumes, lipstick and eye shadow. The most frequent contact allergens in children are metals, fragrances, preservatives, neomycin, rubber chemicals and more recently also colourings. It is very important to remember that ACD in young children is not rare, and should always be considered when children with recalcitrant eczema are encountered. Children should be patch-tested with a selection of allergens having the highest proportion of positive, relevant patch test reactions. The allergen exposure pattern differs between age groups and adolescents may also be exposed to occupational allergens. The purpose of this review is to alert the paediatrician and dermatologist of the frequency of ACD in young children and of the importance of performing patch tests in every case of chronic recurrent or therapy-resistant eczema in children.
    Pediatric Allergy and Immunology 02/2013; · 3.38 Impact Factor
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    ABSTRACT: Background A cohort of 1501 unselected 8th grade schoolchildren was established 15 years ago with the aim to follow the course of contact allergy and allergic contact dermatitis (ACD) from school age into adult life. To date no studies have evaluated incidence rates and persistence of contact allergy and ACD in an unselected population from adolescence to adulthood. Objectives To estimate the incidence rates and persistence of contact allergy and ACD from adolescence to adulthood, and the point prevalence in adulthood. Methods In total, 1206 young adults from the cohort were contacted and asked to complete a questionnaire and participate in a clinical examination including patch testing with TRUE Test®. The questionnaire was answered by 899 (74.6%), however, only 442 (36·7%) of those invited participated in patch testing. Results Over the 15-year period the incidence rates of contact allergy and ACD were 13·4% and 7·8%, respectively. The point prevalence of contact allergy was 20·1%, and present or past ACD was found in 12·9% of those followed. Nickel was the most common contact allergen (11·8%), followed by cobalt (2·3%), colophony (2·0%), thiomersal (1·4%) and p-phenylenediamine (1·1%). Most nickel reactions were persistent, and a significant number of new nickel sensitizations were found. Fragrance mix I reactions from adolescence could not be reproduced. Conclusions From adolescence to adulthood the incidence rates of contact allergy and ACD were high. Nickel was still the most common contact allergen, and new sensitizations occurred despite the European Union nickel regulation. Fragrance mix I was a poor marker for history of eczematous skin reaction to perfumed products.
    British Journal of Dermatology 02/2013; 168(2). · 3.76 Impact Factor
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    ABSTRACT: BACKGROUND: We have previously reported patch test reactivity to nickel sulphate in a cohort of unselected infants tested repeatedly at 3-18 months of age. A reproducible positive reaction at 12 and 18 months was selected as a sign of nickel sensitivity provided a patch test with an empty Finn chamber was negative. A reproducible positive reaction was seen in 8.6% of the infants. The objective of this study is to follow-up on infants with alleged nickel sensitivity. METHODS: A total of 562 infants were included in the cohort and patch tested with nickel sulphate (ICDRG guidelines). The 26 children with a positive patch test reaction to nickel sulphate at 12 and 18 months were offered repeated patch tests at 3 and 6 yr. RESULTS: Among the 21 children tested at both 12 months, 18 months and at 3 and 6 yr only 2 of 21 had reproducible nickel reactions (one clinically relevant), 13 of 21 were negative and 6 of 21 were negative at 3 or 6 yr. CONCLUSIONS: Only 9.5% of the children had reproducible nickel sulphate reactivity, while 62% became negative. The results are noteworthy and can be interpreted in different ways: Repeated nickel patch tests did not cause patch test sensitization. The test reactions in infancy are probably of irritant or non-specific nature. Hence, nickel patch tests should only be performed in small children if there is a clinical suspicion of nickel-induced allergic contact dermatitis.
    Pediatric Allergy and Immunology 02/2013; 24(1):84-87. · 3.38 Impact Factor
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    ABSTRACT: Pseudomonas aeruginosa is a rare cause of folliculitis. Pseudomonas folliculitis can develop after contact with contaminated water from swimming pools, hot tubs and spa baths. Systemic therapy may be indicated in patients with widespread lesions, systemic symptoms or in immunosuppressed patients. We describe a 23-year-old healthy woman who developed a pustular rash and general malaise after using a spa bath contaminated with Pseudomonas aeruginosa. Bacterial culture from a pustule confirmed Pseudomonas folliculitis and the patient was treated with ciprofloxacin with rapid good effect.
    Ugeskrift for laeger 06/2012; 174(26):1824-5.
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    Liv Schollhammer, Klaus Ejner Andersen, Charlotte Gotthard Mortz
    Contact Dermatitis 06/2012; 66(6):350-2. · 2.93 Impact Factor
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    ABSTRACT: Background. Painters are among the occupational groups that most commonly experience occupational contact dermatitis, but few investigations exist concerning this occupation. Objectives. To characterize painters with contact dermatitis and identify the most common allergens associated with the occupation. Materials and methods. All patch test results of 219 painters and 1095 matched controls registered by the Danish Contact Dermatitis Group between 2001 and 2010 were analysed. Results. Hand eczema (p < 0.0001) and occupational contact dermatitis (p < 0.0001) were observed significantly more often in the painters than in the group of controls. Sensitizations to the following allergens from the European baseline series were associated with the occupation and were statistically significant: methylchloroisothiazolinone/methylisothiazolinone, epoxy resin, formaldehyde, and quaternium-15. Three different isothiazolinones emerged as the most frequent sensitizers of the allergens tested in addition to the baseline series. Conclusions. The results indicate that painters have an increased risk of developing occupational hand eczema. Isothiazolinones and epoxy resin proved to be the two most frequent sensitizers in painters.
    Contact Dermatitis 05/2012; 67(5):293-297. · 2.93 Impact Factor
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    ABSTRACT: Epoxy resin monomers are strong skin sensitizers that are widely used in industrial sectors. In Denmark, the law stipulates that workers must undergo a course on safe handling of epoxy resins prior to occupational exposure, but the effectiveness of this initiative is largely unknown. To evaluate the prevalence of contact allergy to epoxy resin monomer (diglycidyl ether of bisphenol A; MW 340) among patients with suspected contact dermatitis and relate this to occupation and work-related consequences. The dataset comprised 20 808 consecutive dermatitis patients patch tested during 2005-2009. All patients with an epoxy resin-positive patch test were sent a questionnaire. A positive patch test reaction to epoxy resin was found in 275 patients (1.3%), with a higher proportion in men (1.9%) than in women (1.0%). The prevalence of sensitization to epoxy resin remained stable over the study period. Of the patients with an epoxy resin-positive patch test, 71% returned a questionnaire; 95 patients had worked with epoxy resin in the occupational setting, and, of these, one-third did not use protective gloves and only 50.5% (48) had participated in an educational programme. The 1% prevalence of epoxy resin contact allergy is equivalent to reports from other countries. The high occurrence of epoxy resin exposure at work, and the limited use of protective measures, indicate that reinforcement of the law is required.
    Contact Dermatitis 04/2012; 67(2):73-7. · 2.93 Impact Factor
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    Anne B-H Dall, Klaus E Andersen, Charlotte G Mortz
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    ABSTRACT: Diethylthiourea is widely used in the rubber industry, particularly in neoprene rubber, and may cause allergic contact dermatitis. However, as thiourea allergens are not part of the European baseline series, the diagnosis of allergic contact dermatitis caused by thiourea compounds depends on clinical suspicion and aimed testing. The aims of this study were to evaluate the occurrence of sensitization to diethylthiourea during a 19-year period by using data from the Allergen Bank database at the Department of Dermatology and Allergy Centre, Odense University Hospital, and to evaluate whether the yield of aimed patch tests with diethylthiourea differed between the dermatologists in practice and those working in the dermatology department. A total of 239 patients were patch tested with diethylthiourea 1% in petrolatum obtained from the Allergen Bank. The records for patients with positive reactions were evaluated retrospectively. One hundred and fifty-one patients were tested by 27 different dermatologists in private practice, and positive reactions were found in 16% (24/151) of the patients; 88 patients were tested at the dermatology department, and positive reactions were found in 15% (13/88). Thus, 15% (37/239) had positive patch test reactions to diethylthiourea, all with current clinical relevance and all strong. Clinical suspicion of neoprene rubber allergy and subsequent aimed patch testing with diethylthiourea give a high yield of clinically relevant allergic patch test reactions for both dermatologists in practice and dermatologists in the hospital department.
    Contact Dermatitis 03/2012; 67(2):89-93. · 2.93 Impact Factor
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    ABSTRACT: Many patients experience reactions during penicillin treatment. The diagnosis may be difficult and is mainly based on short-term tests. The European Network for Drug Allergy (ENDA) guidelines proposed for diagnosing penicillin allergy do not include long-term challenge. In this study a total of 405 patients were evaluated. The ENDA guidelines were extended, to include a 7-day oral treatment (p.o.7) with penicillin for all patients who were negative in the ENDA programme. Among the 405 patients; 85 had an immediate reaction to penicillin, and a further 13 reacted during p.o.7. Among the 307 patients with a negative outcome, 88 had a case history of reaction to other β-lactam antibiotics and were subsequently tested with the culprit drug. Thirteen patients had a positive outcome: 3 on single-dose challenge and 10 during p.o.7. The extended penicillin diagnostic work-up was positive in 111 patients, 30.0% showed immediate reactions and 5.7% reacted during p.o.7. Approximately 20% of all patients with positive outcome during penicillin challenge are detected by adding p.o.7 with penicillin to the original ENDA guidelines.
    Acta Dermato-Venereologica 12/2011; 92(3):307-12.
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    Caroline Carøe, Klaus E Andersen, Charlotte G Mortz
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    ABSTRACT: A recent Danish study showed that the prevalence of nickel allergy decreased among young female patients and increased among older female patients with dermatitis patch tested between 1985 and 2007 at Gentofte Hospital, Denmark. The prevalence of cobalt allergy remained unchanged. To examine fluctuations in the prevalence of nickel and cobalt allergy after implementation of the nickel regulation, by analysing patch test results from male and female patients with dermatitis tested between 1992 and 2009 at Odense University Hospital, Denmark. A retrospective analysis of patch test data was performed (female, n = 5821; male, n = 3317). Comparisons were made using the chi-square test for trend. Logistic regression analyses were used to test for associations. The prevalence of nickel allergy decreased significantly among the 2-30-year-old female patients, from 29.8% in 1992-1997 to 19.6% in 2004-2009 (p < 0.001), whereas it increased significantly, from 6.9% in 1992-1997 to 11.1% in 2004-2009 (p = 0.04), among the >60-year-old female patients. The overall prevalence of cobalt allergy increased significantly, from 3.7% in 1992-1997 to 5.1% in 2004-2009 (p = 0.03). The overall prevalence of nickel and cobalt allergy among male patients during the test period was 5.2% and 2.2%, respectively, and no significant change across the test years was detected. The prevalence of nickel allergy decreased among young female patients and increased among older female patients with dermatitis, probably because of a cohort effect. The overall prevalence of cobalt allergy increased from 1992 to 2009. No significant trend in the prevalence of nickel and cobalt allergy among male patients was found.
    Contact Dermatitis 03/2011; 64(3):126-31. · 2.93 Impact Factor

Publication Stats

748 Citations
122.96 Total Impact Points

Institutions

  • 1997–2014
    • Odense University Hospital
      Odense, South Denmark, Denmark
  • 2003–2013
    • University of Southern Denmark
      • Department of Chemical Engineering, Biotechnology and Environmental Technology
      Odense, South Denmark, Denmark