Allergic contact dermatitis caused by acrylates and methacrylates - a 7-year study

Backgound. Allergic contact dermatitis (ACD) caused by (meth) acrylates is traditionally an occupational disease among dentists, printers, and fibreglass workers. With the use of artificial nails, cases have been reported both in nail technicians and in users. Objectives. The aims of this study were to characterize ACD caused by (meth) acrylates, identify the responsible allergens, and assess the sensitivity of the patch test with 2-hydroxyethyl methacrylate (HEMA) for diagnosis. Methods. An observational and retrospective study (January 2006-April 2013) was performed, evaluating and correlating epidemiological and clinical parameters and positive patch test results with (meth) acrylates. Results. Among 2263 patch tested patients, 122 underwent aimed testing with an extended (meth) acrylate series, and 37 showed positive and relevant reactions. Twenty-five cases (67.6%) were occupational. Hand eczema with pulpitis was observed in 32 patients. Twenty-eight cases were related to artificial nails, 3 were related to dental materials, and 2 were industrial workers. Oral lesions associated with dental prostheses were observed in 4 patients. Thirty-one patients reacted to more than one (meth) acrylate. In our sample, beauty technicians working with artificial nails were the most affected group (80% of occupational cases). Conclusion. HEMA detected 80.6% of our cases, and may be considered a good screening allergen. However, to perform an accurate diagnosis, it is safer to use a broader series of allergens.