Royal United Hospital Bath, Bath, U.K.
University Hospital of Wales, Cardiff, U.K.
Br J Dermatol. 2019 Oct;181(4):811-817. doi: 10.1111/bjd.17708. Epub 2019 Apr 21.
(Meth)acrylates are potent sensitizers and a common cause of allergic contact dermatitis (ACD). The frequency of (meth)acrylate ACD has increased with soaring demand for acrylic nails. A preliminary audit has suggested a significant rate of positive patch tests to (meth)acrylates using aimed testing in patients providing a clear history of exposure. To date, (meth)acrylates have not been routinely tested in the baseline patch test series in the U.K. and Europe.
To determine whether inclusion of 2-hydroxyethyl methacrylate (2-HEMA) 2% in petrolatum (pet.) in the baseline series detects cases of treatable (meth)acrylate ACD.
During 2016-2017, 15 U.K. dermatology centres included 2-HEMA in the extended baseline patch test series. Patients with a history of (meth)acrylate exposure, or who tested positive to 2-HEMA, were selectively tested with a short series of eight (meth)acrylate allergens.
In total 5920 patients were consecutively patch tested with the baseline series, of whom 669 were also tested with the (meth)acrylate series. Overall, 102 of 5920 (1·7%) tested positive to 2-HEMA and 140 (2·4%) to at least one (meth)acrylate. Had 2-HEMA been excluded from the baseline series, (meth)acrylate allergy would have been missed in 36 of 5920 (0·6% of all patients). The top (meth)acrylates eliciting a positive reaction were 2-HEMA (n = 102, 1·7%), 2-hydroxypropyl methacrylate (n = 61, 1·0%) and 2-hydroxyethyl acrylate (n = 57, 1·0%).
We recommend that 2-HEMA 2% pet. be added to the British baseline patch test series. We also suggest a standardized short (meth)acrylate series, which is likely to detect most cases of (meth)acrylate allergy.
（甲基）丙烯酸酯是一种强有力的敏化剂，也是过敏性接触性皮炎（ACD）的常见原因。随着对美甲用丙烯酸酯需求的飙升，（甲基）丙烯酸酯 ACD 的发病率也有所增加。初步审计表明，在明确接触史的患者中，使用针对性测试进行（甲基）丙烯酸酯斑贴试验的阳性率很高。迄今为止，（甲基）丙烯酸酯尚未在英国和欧洲的基础斑贴试验系列中常规检测。
确定在基础系列中加入 2-羟乙基甲基丙烯酸酯（2-HEMA）2%凡士林（pet.）是否能检测到可治疗的（甲基）丙烯酸酯 ACD。
在 2016-2017 年期间，15 个英国皮肤科中心将 2-HEMA 纳入了扩展基础斑贴试验系列。有（甲基）丙烯酸酯暴露史或对 2-HEMA 测试阳性的患者，选择性地用 8 种（甲基）丙烯酸酯过敏原进行短系列测试。
共有 5920 例患者连续进行了基础系列斑贴试验，其中 669 例患者还进行了（甲基）丙烯酸酯系列斑贴试验。总的来说，5920 例患者中有 102 例（1.7%）对 2-HEMA 呈阳性，140 例（2.4%）对至少一种（甲基）丙烯酸酯呈阳性。如果将 2-HEMA 从基础系列中排除，5920 例患者中有 36 例（所有患者的 0.6%）将被漏诊。引发阳性反应的主要（甲基）丙烯酸酯为 2-HEMA（n=102，1.7%）、2-羟丙基甲基丙烯酸酯（n=61，1.0%）和 2-羟乙基丙烯酰胺（n=57，1.0%）。
我们建议在英国基础斑贴试验系列中加入 2-HEMA 2% pet.。我们还建议使用标准化的短（甲基）丙烯酸酯系列，这可能会检测到大多数（甲基）丙烯酸酯过敏病例。
