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Mechanisms and Regional Prevalence of Contact Allergens in Allergic Contact Dermatitis
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DOI：10.1155/dth/5582213.png)
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Abstract
En 中文
Allergic contact dermatitis (ACD) represents a prevalent inflammatory skin condition resulting from exposure to environmental chemicals. The landscape of ACD has evolved significantly beyond traditional occupational settings, with widespread integration of allergens into cosmetics, consumer goods, and medical devices, creating new sensitization patterns among the general population. This review summarizes the pathophysiology of ACD, reviews the most clinically important contact allergens with attention to regional variation in prevalence, and discusses the regulatory and educational implications of these trends. Key allergen categories include surfactants (alkyl glucosides), acrylates (isobornyl acrylate), metals (nickel, cobalt, chromium, and aluminum), fragrances (hydroperoxides), preservatives (benzisothiazolinone), and dyes (p-phenylenediamine [PPD] and toluene-2,5-diamine sulfate [PTDS]). Pediatric populations show particularly high sensitization rates to alkyl glucosides (19.5% for decyl glucoside). Medical device–related allergens, particularly acrylates in continuous glucose monitors, represent a growing concern. Prevalence differs substantially between regions: for example, nickel sulfate positivity is 24.9% in the North American Contact Dermatitis Group (NACDG) 2021-2022 data but considerably lower in Europe after the 1994 EU Nickel Directive, and neomycin contact allergy is 6.4% in North America versus 2.5% in Europe, reflecting differences in over-the-counter availability and regulation. Regulatory interventions have successfully reduced some allergen exposures but have led to substitution with potentially problematic alternatives. Effective allergen management requires proactive surveillance, comprehensive patch testing, enhanced clinician education, and coordinated regulatory responses. The appearance of new allergens following restrictions on established sensitizers underscores the need for systematic premarket evaluation and industrywide adoption of safer alternatives.
Keywords:
allergic contact dermatitis
Asia
contact allergens
Korea
medical devices
patch testing
regional prevalence
regulatory trends
sensitization
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