Olivier Aerts

Universitair Ziekenhuis Antwerpen | UZA · Department of Dermatology

Introduction Tert‐butylphenol (TBP) derivatives, antioxidants in adhesives and diabetes devices, may provoke allergic contact dermatitis (ACD). Objectives The objective of this study is to report sensitization to TBP derivatives in medical devices and to highlight that tert‐butylhydroquinone (BHQ) and tert‐butylcatechol (TBC) are potential screene...

Background The use of methylisothiazolinone (MI) as a preservative in cosmetic products caused an alarming increase in MI contact allergy across Europe in the 2010s. This was followed by regulations of use with a total ban on leave‐on (implemented in 2017) and reduced use concentrations in rinse‐off cosmetics (2018). Objective To follow‐up on the...

Patch testing is the only clinically applicable diagnostic method for Type IV allergy. The availability of Type IV patch test (PT) allergens in Europe, however, is currently scarce. This severely compromises adequate diagnostics of contact allergy, leading to serious consequences for the affected patients. Against this background, the European Soci...

The diagnosis of eczema (‘dermatitis’) is mostly clinical and depends on the clinical history and exploratory objective findings (primary lesions, patterns). Contact dermatitis remains as an important condition in the group of eczematous disorders, with important socioeconomic and occupational relevance. Although irritant and allergic contact derma...

Use of medical devices (MDs), that is, glucose sensors and insulin pumps, in patients with Type 1 diabetes mellitus (T1D) has proven an enormous advantage for disease control. Adverse skin reactions from these MDs may however hamper compliance. The objective of this study was to systematically review and analyse studies assessing the prevalence and...

The varicella-zoster virus (VZV) infects >95% of the population. VZV reactivation causes herpes zoster (HZ), known as shingles, primarily affecting the elderly and individuals who are immunocompromised. However, HZ can occur in otherwise healthy individuals. We analyzed the immune signature and risk profile in patients with HZ using a genome-wide a...

Background: A popular antiseptic spray in Switzerland (Merfen spray), containing chlorhexidine digluconate, benzoxonium chloride and lauramine oxide, is frequently used to treat skin wounds. However, it is also increasingly reported as a major cause of adverse skin reactions, including allergic contact dermatitis (ACD). Objectives: To investigat...

The varicella-zoster virus (VZV) infects over 95% of the population and establishes latency afterwards. Reactivation of VZV causes herpes zoster (HZ), commonly known as shingles, which presents as a painful rash in mostly the elderly and people with a weakened immune system. However, HZ might occur in otherwise healthy individuals too. In this stud...

The European baseline series was last updated in 2019. This article discusses the reasoning behind a further iteration of the series for 2023.

Background Transcriptome profiling of blood cells is an efficient tool to study the gene expression signatures of rheumatic diseases. This study aims to improve the early diagnosis of pediatric rheumatic diseases by investigating patients’ blood gene expression and applying machine learning on the transcriptome data to develop predictive models. M...

Background: Isocyanates are well-known occupational allergens, but can also be present in medical devices. Objectives: To highlight that contact sensitization to isocyanates might contribute to allergic contact dermatitis (ACD) from polyurethane (PU)-containing diabetes devices and wound dressings. Patients and methods: Nineteen patients with...

Background: Continual analyses of patch test results with the European baseline series (EBS) serve both contact allergy surveillance and auditing the value of included allergens. Objectives: To present results of current EBS patch testing, obtained in 53 departments in 13 European countries during 2019 and 2020. Methods: Anonymised or pseudony...

This review aims to provide a clinically useful update regarding the role of formaldehyde (FA) and its five main releasers (FRs) quaternium‐15, diazolidinyl urea, DMDM hydantoin, imidazolidinyl urea and 2‐bromo‐2‐nitropropane‐1,3‐diol (bronopol) in contact allergy and allergic contact dermatitis. These ubiquitous preservatives are still often, and...

Limonene and linalool are among the most common fragrance terpenes used in products of everyday life. They are pre‐haptens forming hydroperoxides (Lim‐OOHs, Lin‐OOHs) upon oxidation inducing frequent positive patch test reactions in patients with dermatitis. Still, they are not yet routinely tested in Europe. This review evaluates the patch testing...

Background: In 2019, a number of allergens (haptens), henceforth, 'the audit allergens,' were considered as potential additions to the European baseline series (EBS), namely, sodium metabisulfite, 2-bromo-2-nitropropane-1,3-diol, diazolidinyl urea, imidazolidinyl urea, Compositae mix II (2.5 or 5% pet), linalool hydroperoxides (lin-OOH), limonene...

Background Besides being a potential component of (some species of) colophonium, D-limonene is also used as a tackifier in the production of adhesives. Hydroperoxides of limonene are well-known skin sensitizers. Objectives To show that D-limonene may be present in colophonium-containing but also colophonium-free (“hypoallergenic”) adhesives, and t...

Background In the 2010s an epidemic of allergic contact dermatitis to methylisothiazolinone occurred in Europe. European authorities banned the use of methylisothiazolinone in leave-on cosmetics in 2017 and limited its use in rinse-off products in 2018. Objectives To investigate the sensitization rate to methylisothiazolinone in Belgium between Ja...

Background The reason why patients photosensitized to the drug ketoprofen (KP) may develop severe photo‐allergic skin reactions to octocrylene (OCT), an organic UV‐filter in sunscreens and cosmetics, remains largely unknown. OCT can be synthesized by using unsubstituted benzophenone (BP), a possible human carcinogen. Objectives To verify if, and t...

Background: The preservatives sorbic acid (SA) and potassium sorbate (PS) are considered rare skin sensitizers. PS-containing products always contain SA to a certain extent, and positivity to PS may reflect sensitization to SA. Their optimal patch test conditions are unknown. Objectives: To report on the outcome of testing with SA and PS in vari...

Background: Contact dermatitis to homemade slime has been frequently reported, with isothiazolinones as a likely sensitizer. Little is known on the presence of these preservatives in commercial, store-bought slime products. Objectives: The aims of the study were to review the literature on "slime dermatitis" and to assess for the presence of iso...

National baseline series, often based on continental baseline series, usually contain contact allergens to which patients from a particular region are exposed, and that frequently elicit positive and/or relevant patch test reactions. Differences between national baseline series can be explained, among others, by differences in exposure, prescribing...

Every water-containing product needs preservatives to prevent microbial contamination in order to ensure product stability and consumer safety. These preservative agents can be natural or, more often, synthetic in nature. Beside displaying direct antimicrobial effects, some of them also function as antioxidants and/or have additional properties (“p...

Introduction Nous rapportons un premier cas d’allergie de contact à un brassard tensionnel jetable lié à un nouvel allergène acrylate. Observations Un jeune homme de 16 ans était adressé en 2019 pour eczéma en regard d’un brassard tensionnel jetable. Ce patient diabétique de type 1 avait été hospitalisé 3 fois en réanimation médicale pour acidocét...

Background: Concomitant positive patch test reactions in patients sensitized to isobornyl acrylate (IBOA) have only rarely been documented. Objectives: To report concomitantsensitizationsinpatients with allergic contact dermatitis (ACD) from the glucose sensor FreeStyleLibre (FL)and sensitized to IBOA. Patients and methods: In 2019,26patients...

Background Notwithstanding that concomitant exposure to different isothiazolinone derivatives may result in concomitant sensitization, clinical and animal studies have suggested cross‐reactivity between these derivatives, notably between methylisothiazolinone (MI) and octylisothiazolinone (OIT). Objective To investigate if patients sensitized to M...

An otherwise healthy 13‐year‐old girl developed a bullous skin reaction on the upper arm 2 hours following the intramuscular administration of Cervarix® (GSK, Rixensart, Belgium), a bivalent vaccine targeting Human Papilloma Virus (HPV) types 16 and 18. She had received a first and uncomplicated dose of the vaccine eight months earlier. Clinical ex...

Objective: Cutaneous adverse events (CAE) from FreeStyle Libre include allergic contact dermatitis (ACD) caused by the allergen isobornyl acrylate (IBOA). We aim to report CAE from this glucose sensor, ACD to IBOA in particular, and the outcome of using barrier films as a prevention. Research design and methods: A monocentric, retrospective revi...

Multidisciplinary collaboration between several European dermatology departments has identified isobornyl acrylate (IBOA; CAS 5888-33-5), once deemed a low-risk sensitizer, as a major culprit contact allergen in glucose sensors and insulin pumps, medical devices used by diabetes patients worldwide. Although the patch test modalities of IBOA have be...

Eccrine porocarcinoma is a rare and potentially fatal malignant adnexal tumor that can arise de novo or develop from its benign precursor, poroma. Diagnosis is difficult due to its rarity and resemblance to many other (benign) skin tumors. We present the case of a 71-year-old woman presenting with a long-standing case of eccrine porocarcinoma on th...

Sulfites are widely used as antioxidants and preservatives (1‐3), but are also frequent contact sensitizers. Indeed, more than 1% of subjects routinely patch‐tested to sodium metabisulfite (SMB) 1% diluted in petrolatum (pet.), the best marker to detect contact allergy to sulfites (1), are sensitized to them (1, 4). SMB 1% pet., has recently been p...

Shin dermatitis can be an irritant contact dermatitis due to friction of shin pads during sports activities1. However, allergic contact dermatitis remains an important differential diagnosis. Rubber additives, textile dyes and preservatives have been highlighted as potential culprit allergens1. Recently, acetophenone azine (AA)2,3,4,5, a biocide pr...

Although some moisturizing creams are specifically formulated for use by atopic dermatitis patients, they may still contain ingredients that provoke contact allergy. This article is protected by copyright. All rights reserved.

Background: Most diabetic patients sensitized to FreeStyle Libre react to isobornyl acrylate, with a considerable number of them also showing unexpected positive patch test reactions to sesquiterpene lactone mix (SLM) tested in the baseline series. Objectives: To compile patch test results of subjects affected, and provide potential explanations...

Allergic contact dermatitis caused by fragrances and formaldehyde is common (1,2), but pustular dermatitis as a manifestation of contact allergy is rare (3). We report a case of therapy‐resistant rosacea for which (occupational) contact allergy to fragrances, and to a lesser extent formaldehyde, was identified as an aggravating factor. This article...

Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI are well‐known sensitizers that can be present in cosmetics, paints and household detergents. A 60‐year‐old, non‐atopic woman presented with eyelid dermatitis extending towards the cheeks (Figure 1). Patch tests were performed with the Belgian baseline and additional series, all appl...

Background Patients suffering from drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome caused by first‐line antituberculous drugs often need to be re‐treated rapidly. Patch tests prior to the re‐introduction of antituberculosis drugs are rarely performed. Objectives We aim to highlight those drugs most often involved in DRESS fr...

Reticular telangiectatic erythema (RTE) is a poorly defined clinical condition occurring days, months to even years after the implantation of medical devices such as orthopedic prostheses, neurostimulators and pacemakers. In its pathogenesis a role for Staphylococcus epidermidis has been suggested, but such cases have only rarely been reported. We...

Background Iodopropynyl butylcarbamate (IPBC) is a broad‐spectrum preservative for use in several product types, including cosmetics in which its concentrations have been limited by EU legislation because of concerns related to its iodine content and release, and risk of subsequent overdose. Objectives To report about concomitant patch‐test reacti...

Amino acid alkyl amides (AAAA) are polyfunctional cosmetic ingredients, some also with preservative properties. Here we report a case of allergic contact dermatitis caused by a body lotion containing an AAAA, namely, capryloyl glycine (CG) (syn: caprylyl glycine, N‐octanoylglycine; CAS no. 14246‐53‐8)(Figure 1). This article is protected by copyrig...

Background Ecthyma gangrenosum (EG) is characterized by the occurrence of erythematous, violaceous or hemorrhagic macules and/or vesicles, often evolving into necrotic ulcers, with a central gray‐black eschar. It is a rare skin condition, usually occurring in immunocompromised patients suffering from bacterial sepsis caused by Pseudomonas aeruginos...

Allergic contact dermatitis (ACD) from isothiazolinones has frequently been described in the literature. Following an epidemic of sensitization to methylchloroisothiazolinone/ methylisothiazolinone (MCI/MI) in the 1980′s, and more recently to MI, the Scientific Committee on Consumer Safety of the European Commission banned their use in leave‐on pro...

We read with interest the publication by Brunet‐Possenti F et al. who report on the presence of titanium dioxide nanoparticles (TiO2 NP) along the hair shafts of a patient suffering from frontal fibrosing alopecia (FFA)¹. Given the widespread use of TiO2 NP in leave‐on cosmetics, and particularly in sunscreens, and the recent publications reporting...

Background The frequency of allergic contact dermatitis caused by (meth)acrylates is increasing worldwide, and isobornyl acrylate (IBOA) has been identified as a culprit sensitizer in FreeStyle Libre, a medical device used by diabetic patients. Objectives To report on 4 patients sensitized to IBOA contained in OmniPod, a new, tubeless insulin pump...

In the past decade, new diabetes technologies, including continuous glucose monitoring (CGM) systems, support patients with diabetes in their daily struggle with achieving a good glucose control. However, shortly after the first CGM systems appeared on the market, also the first concerns about adverse skin reactions were raised. Most patients claim...

Contact allergy usually presents as a classic, vesicular allergic contact dermatitis. However, many different subtypes of contact-allergic eczema exist, notably: bullous, chronic lichenified, follicular, seborrheic, nummular, etc. Furthermore, a contact allergy may also manifest itself, both clinically and histologically, in a non-eczematous way, w...

Background: Photoaggravated allergic contact dermatitis caused by methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) and MI has been reported. Objectives: To describe the clinical characteristics and results of (photo)patch tests and photo-tests of 10 patients in Belgium and France suffering from photoaggravated contact dermatitis caus...