Allergic contact dermatitis (ACD) is a type IV delayed hypersensitivity reaction that can commonly arise from exposure to allergens in personal care and cosmetic products. Depilatory waxing, a common hair removal practice, involves the use of various products that may contain potential contact allergens. There is limited literature discussing ACD to hair removal products. We aim to discover the most common allergens prevalent in depilatory waxing products used in a popular wax center in the United States and those found in online marketplaces. Through communication with the salon staff, we reviewed the involved products and analyzed all ingredients for common allergens. We also conducted an online search to examine the ingredients and the most common allergens of the top 10 bestselling wax strips across four selected online marketplaces (CVS, Amazon, Walmart, and Walgreens). The final query of online products consisted of 12 distinct wax products and 10 postwax products. Among the products used in the salon, the most common allergens were vitamin E, colophony, botanicals, fragrance, beeswax/propolis, and color additives, in descending order. The most frequent allergens commonly encountered in online wax products included color additives, found in 67% (8/12) products, followed by botanicals and colophony, both present in 58% (7/12) products. In the postwax products, the most frequent allergen was vitamin E present in 100% (10/10) of the products, followed by fragrance (8/10). Although these allergens do not frequently cause ACD, it remains crucial to identify and note them in hair removal products to address any potential cases. Raising awareness of these allergens in all steps of hair removal can help ensure the safety and comfort of patients undergoing waxing treatments.

Chronic hand eczema (CHE) is a distressing and pervasive dermatologic condition, and effective treatment can be challenging. The novel IL-4/13 inhibitor dupilumab has shown clinical efficacy for atopic dermatitis (AD) and is being studied for CHE. PubMed database was searched for terms dupilumab and chronic hand eczema/dermatitis, including CHE subtypes (dyshidrotic, hyperkeratotic, allergic, contact, atopic, occupational, vesicular). Twenty-two study publications met inclusion and exclusion criteria for evaluation. Two multicenter prospective studies, one randomized controlled trial, two prospective observational studies, one retrospective study, nine case series, and seven case reports were included in the analysis with 374 total patients. Any partial response or complete resolution of CHE occurred in 80.3% of patients treated with dupilumab within 4-16 weeks of treatment. The patient response tended to increase throughout the duration of these studies for a significant percentage of patients, and for many it lasted beyond the study duration. Significant improvement in hand eczema severity scores and quality-of-life scores were noted. Efficacy was reported in over half of the cases of hyperkeratotic hand eczema; however, efficacy was decreased compared with relatively high consistent efficacy in other CHE subtypes such as dyshidrotic, vesicular, atopic, and contact CHE. Patients with current or previous AD had increased improvement scores compared to those without. The most common adverse effects were conjunctivitis (9.9%), herpes viral infection (1.4%), and facial erythema/dermatitis (1.3%). Dupilumab shows therapeutic efficacy in treating CHE. Further randomized controlled studies of dupilumab use in CHE subtypes are needed.

Personal care product usage is becoming increasingly prevalent among men due to evolving attitudes surrounding appearance, aging, and masculinity. Given the specific characteristics of male skin compared with female skin and varying product use between males and females, the occurrence of allergic contact dermatitis (ACD) due to men's personal care products needs to be better characterized. The purpose of this review was to identify specific product types and ingredients causing ACD in males. PubMed search was conducted from conception to present day using keywords pertaining to male personal care product use. Case reports, case series, and case-control studies reporting a diagnosis of ACD due to a personal care product ingredient were analyzed. Products resulting in ACD included aftershave, cologne, deodorant, hair dye, hair gel, hair loss preparation, hand cleanser, lip balm, moisturizer, shampoo, and sunscreen. Although >90 allergens resulting in ACD were identified, the 5 most common allergens included para-phenylenediamine, minoxidil, musk ambrette, methylisothiazolinone, and cocamidopropyl betaine. Following this review, clinicians should be better able to recognize men's personal care products that commonly result in ACD, as well as specific allergens present across multiple product types. Doing so will lead to improved diagnosis and treatment of ACD due to personal care product usage in men and, in doing so, guide both clinical practice and future investigation in this area.

There is no doubt that global warming, with its extreme heat events, is having an increasing impact on human health. Heat is not independent of ambient temperature but acts synergistically with relative humidity (RH) to increase the risk of several diseases, such as cardiovascular and pulmonary diseases. Although the skin is the organ in direct contact with the environment, it is currently unknown whether skin health is similarly affected. While mechanistic studies have demonstrated the mechanism of thermal aging, this is the first epidemiological study to investigate the effect of long-term exposure to heat index (HI) as a combined function of elevated ambient temperature and RH on skin aging phenotypes in Indian women. The skin aging phenotypes of 1510 Indian women were assessed using the Score of Intrinsic and Extrinsic Skin Aging (SCINEXA™) scoring tool. We used data on ambient temperature and RH, combined into an HI with solar ultraviolet radiation (UVR), and air pollution (particulate matter <2.5 µm [PM; nitrogen dioxide [NO]) from secondary data sources with a 5-year mean residential exposure window. An adjusted ordinal multivariate logistic regression model was used to assess the effects of HI on skin aging phenotypes. HI increased pigmentation such as hyperpigmented macula on the forehead (odds ratios [OR]: 1.31, 95% confidence interval [CI]: 1.12, 1.54) and coarse wrinkles such as crow's feet (OR: 1.17, 95% CI: 1.05, 1.30) and under-eye wrinkles (OR: 1.3, 95% CI: 1.15, 1.47). These associations were robust to the confounding effects of solar UVR and age. Prolonged exposure to extreme heat, as indicated by high HI, contributes to skin aging phenotypes. Thus, ambient temperature and RH are important factors in assessing the skin aging exposome.

Contact dermatitis (CD) affects ∼15% of the general population over a lifetime. However, there is a lack of epidemiological studies on treatment patterns for CD. We aim to analyze the patient characteristics and prescribing patterns among dermatologists and general practitioners (GPs) (internal medicine [IM] and family medicine [FM]) for CD in the United States. We conducted a population-based study using the National Ambulatory Medical Care Survey. We identified 178,017,680 weighted patient visits for CD from 2001 to 2016. Dermatologists saw more white and non-Hispanic patients than GPs. GPs were less likely to prescribe ultrahigh potency topical corticosteroids (FM OR 0.27; < 0.001, IM OR 0.41; < 0.001) and more likely to prescribe oral antihistamines (FM OR 3.71; < 0.001, IM OR 3.56; < 0.001), oral corticosteroids (FM OR 5.35; < 0.001, IM OR 6.87; < 0.001), and injectable corticosteroids (FM OR 3.42; = 0.006, IM OR 5.68; < 0.001) than dermatologists. Across CD visits, GPs were less likely than dermatologists to prescribe ultrahigh potency topical corticosteroids and more likely than dermatologists to prescribe oral antihistamines and systemic corticosteroid therapy.

Polysensitization, defined as contact sensitization to three or more allergens, is an allergic phenotype with a common genetic background. Our study aims to characterize the clinical features of patients with polysensitization. We analyzed patch test results of 5,082 patients from a designated contact dermatitis clinic in Tel Aviv between 2012 and 2022 and compared the polysensitized group with nonsensitized and oligosensitized patients, hence patients reacting to 1 or 2 allergens. About 8.5% of patients were polysensitized. In the nonsensitized group, there were significantly fewer female patients and more children ( < 0.05) than in the polysensitized group. Asthma prevalence was linearly associated with the number of positive reactions in patch test. Polysensitized patients were more commonly suffering from hand eczema and an occupational etiology ( < 0.05). Textile dye mix, lyral, fragrance mix II, formaldehyde, colophonium, and p-phenylendiamine were more common sensitizers among the polysensitized group, whereas nickel sulfate, 2-hydroxyethyl methacrylate, fragrance mix 1, p-tert-butylphenol formaldehyde resin, and sodium metabisulfite were more common among the oligosensitized group. The association between polysensitization, asthma prevalence, and sensitization to volatile allergens raises an intriguing clinical phenotype. Further mechanistic studies are needed in this regard.

Tralokinumab, a monoclonal anti-IL-13 antibody, is approved for treating atopic dermatitis (AD). Real-world data on its effectiveness and safety are limited. To evaluate the real-world effectiveness and safety of tralokinumab and the transition of laboratory indexes during 24-week treatment for AD patients. This retrospective study included 104 patients with moderate-to-severe AD treated with tralokinumab 300 mg every 2 weeks after primary 600 mg. Clinical and laboratory indexes were assessed until week 24. At week 24, achievement rates of Eczema Area and Severity Index 75 (EASI 75), EASI 90, and investigator's global assessment 0 out of 1 in systemic therapy-naïve patients, 83.3%, 72.2%, and 44.4%, respectively, were higher than those in systemic therapy-experienced patients, 46.7%, 20.0%, and 6.7%, respectively. Serum levels of immunoglobulin E (IgE), thymus and activation-regulated chemokine (TARC), and lactate dehydrogenase (LDH) significantly decreased at week 24, whereas neutrophil-to-lymphocyte ratio (NLR) and systemic inflammation response index (SIRI) significantly decreased at week 12 from baseline. Twenty-nine patients (27.9%) experienced mild treatment-emergent adverse events. Tralokinumab treatment showed prosperous therapeutic effects and good tolerability in real-world practice for AD, with higher effectiveness in patients without prior systemic therapy compared with those with prior systemic therapy. Tralokinumab treatment significantly decreased clinical and laboratory indexes, EASI, Peak Pruritus-Numerical Rating Scale, IgE, TARC, LDH, NLR, and SIRI.

Atopic dermatitis (AD) is a highly burdensome inflammatory skin condition affecting nearly one-quarter of the pediatric population and often continuing into adulthood. Despite recent advancements in systemic therapies providing temporary symptom relief over the past decade, AD frequently remains difficult to control, necessitating increased dosages or alternative treatments due to recurrent disease. This review synthesizes current literature to identify unmet needs of treating AD beyond medication-related limitations and evaluates existing therapies for their efficacy in modifying underlying disease mechanisms. Key findings include variability in AD pathophysiology and phenotypes across different age groups and ethnicities, indicating a need for research into endotype-specific treatments. The literature also comprises evidence suggesting that select current drugs, such as targeted biologics and Janus Kinase (JAK) inhibitors, may offer long-term disease-modifying benefits. Future management strategies should explore novel approaches, including manipulation of the microbiome, immune response, and neural function, as these may lead to additional improvements in AD treatment and long-term symptom relief.