Dear members,

This month’s summaries includes insights into contact allergy to propolis, other ingredients in sunscreen products, allergens for consideration in diabetic medical devices and an interesting case of contact allergy to benzalkonium chloride:

Propolis and Beeswax in Cosmetics: A Market Survey and Literature Review on Their Relationship and Role in Allergic Contact Dermatitis.

de Groot AC, Ipenburg NA, Rustemeyer R. Contact Dermatitis. 2026 May;94(5):494-503. doi: 10.1111/cod.70108. Epub 2026 Feb 9.

In this study, a market survey of cosmetic products found no propolis in the ingredients list of any of the products surveyed. Beeswax (Cera alba) was present in some, particularly in lip products. However, literature review found that contact allergy to purified beeswax is rare, and evidence for clinically significant cross-reactivity with propolis is inconsistent. Whilst trace propolis components may persist in beeswax, there is no convincing evidence that these occur at levels sufficient to elicit dermatitis in sensitised individuals. Reported reactions are predominantly cheilitis from lip balms. Overall, the authors concluded that routine avoidance of beeswax containing cosmetics in propolis-patch test positive patients is not indicated.

Allergen Content of Inactive Ingredients in Best-Selling Sunscreens: A Comparison of Key Product Features.

Levin E, Chung C, Hermes K, Lim H, Matthews N. Contact Dermatitis. 2026: 1–7.

In this cross-sectional analysis of 176 best-selling sunscreens identified on 3 largest American online retailers, presence of inactive ingredient allergens was common, with a mean of 2.5 North American 80 Comprehensive Series (NAC-80) allergens per product. The most frequent allergens were vitamin E (tocopherol derivatives), acrylate polymers, fragrance and parabens. Allergen load varied significantly by formulation: organic, spray and sport sunscreens contained more allergens, whereas inorganic, stick, tinted and facial formulations contained fewer. These findings highlight that inactive ingredients represent a substantial and often under-recognised source of contact allergens. Findings of this study are, however, based on the US retail market. Clinicians should consider full ingredient profiles when recommending sunscreens, particularly in patients with ACD or sensitive skin, and may preferentially suggest lower-allergen formulations such as inorganic or stick products.

Patch Testing in Individuals With Diabetes Using Medical Devices. Part 2—Contact Allergy to Medical Device Allergens and New Patch Test Recommendations.

Ulriksdotter J, Mowitz M, Sukakul T, Bruze M, Hamnerius N, and Svedman C. Contact Dermatitis (2026): 1–13.

This cross-sectional study of 204 adults in Sweden with type 1 diabetes using medical devices found 16.2% to have contact allergy to device-related allergens, rising to 28.1% among those with device-associated skin reactions compared with 1.1% in asymptomatic users. The most prevalent allergens were isobornyl acrylate (IBOA) (10.3%), N,N-dimethylacrylamide (DMAA) (4.9%), 2-hydroxyethyl acrylate (2-HEA) (3.4%) and dicyclohexylmethane-4,4’-diisocyanate (DMDI) (2.9%). Notably, findings of ACD to 2-HEA and DMDI underscores the need for repeated chemical analyses and continuous updates of the medical devices series. One third of positive IBOA reactions were found only on day 7, emphasising the importance of late readings on day 7 in suspected cases. The authors recommend an updated diabetes medical devices patch test series in this publication.

Systemic Contact Dermatitis Triggered by Benzalkonium Chloride in Laundry Detergent: A Case Initially Misdiagnosed as Eczema.

Yu M, Meng F, Tian S. Clin Cosmet Investig Dermatol. 2026 Jan 22;19:577154.

This case report highlights allergic contact dermatitis due to benzalkonium chloride (BAK) in a laundry disinfectant, initially misdiagnosed as eczema. The patient presented with a 2-month history of widespread well-defined erythematous plaques with fine scaling. Standard therapies provided only transient improvement. Careful exposure history identified use of a new laundry disinfectant containing BAK approximately eight weeks before symptom onset. Complete resolution followed allergen avoidance. This case underscores the importance of considering contact allergy in refractory rashes and the need for detailed enquiry into household and textile-related exposures, including laundry products.

Dear members,

Thanks to the hard work of the patient information leaflet (PIL) Update Group, there are new information leaflets on how to perform Repeat Open Application Test (ROAT) as well as for benzoic acid. These can be found on the Patient Information Leaflets section of the BSCA website.

The PDF version of the ROAT leaflet includes an additional infographic on how to perform testing and can be provided to patients who may prefer this.

The National Allergy Strategy was launched at a parliamentary reception in Westminster on 20 April 2026, hosted by Allergy UK at the start of Allergy Awareness Week.  Led by Professor Adam Fox OBE and developed in collaboration with BSACI, Allergy UK, Anaphylaxis UK and The Natasha Allergy Research Foundation, the Strategy aims to improve allergy care and reduce health inequalities across the UK. Dr Graham Johnston and Dr Aparna Sinha represented the BAD and BSCA at this truly inspiring event.  The full strategy is available at: https://www.nasguk.org/

Annual General Meeting of the BSCA 30^th June in Manchester

Notice is given of the Annual General Meeting of the BSCA on the morning of Tuesday 30^th June at Manchester Central

 Agenda

-President’s update

-Officer’s updates

-Committee change

The officers and members of the Committee will be re-elected at the Annual General Meeting

Proposals for alteration of the Constitution at the BSCA AGM June 2026

Alterations of the constitution can only occur at an Annual General Meeting. Notice of the proposals below by Dr Catherine Holden and duly seconded by Dr Philippa Cousen are now being circulated with notice two months before the meeting. For adoption, a two-thirds majority of those voting will be necessary.

We propose a new membership category of ‘associate’ membership’ to align with the BAD.

Current category:

8.Membership will be available to anyone interested in Contact Dermatitis upon application to and approved by, the Committee.

Is changed to:

8.Membership will be available to anyone interested in Contact Dermatitis upon application to and approved by the Committee:

• Ordinary membership with voting rights will be available to practising dermatologists, (including research) in UK and Ireland on the Specialist register for Dermatology of the GMC or the Irish Medical Council, UK and Ireland dermatology trainees on training schemes (with NTN) and SAS dermatology doctors fully committed to secondary care dermatology for 4 years (or more).
• Associate membership without voting rights will be available to doctors on the GMC or the Irish Medical Council, overseas consultant or trainee dermatologists in practice outside the United Kingdom and Ireland, nurses who are members of the British Dermatological Nursing Group (BDNG) or Irish Dermatology Nurses Association (IDNA), and scientists and relevant other non-medics who have a significant practice involving dermatological patients or cutaneous allergy.

Current Committee:

President: Natalie Stone
Secretary: Philippa Cousen
Meetings Secretary: Donna Thompson
Membership Secretary: Catherine Holden
Treasurer: Sarah Wakelin

Regional representation:

London and South East: David Orton, Sarah Wakelin

East Midlands and East: Graham Johnston

North East, Yorkshire and Humber: Philippa Cousen, Mark Wilkinson

North West: Jason Williams

West Midlands: Cat Wootton, Donna Thompson

South West and South Central: Aparna Sinha, Deirdre Buckley

Wales: Natalie Stone, Mabs Chowdhury

Ireland: Johnny Bourke

Scotland: Chandra Bertram, Sharizan Abdul Ghaffar

UK representative on the European Society of Contact Dermatitis (ESCD) committee: Deirdre Buckley

New Consultant Representative: Siobhan MacCarthy

Specialty and Associate Specialist Representative: Catherine Holden

Research and Audit Representative: Livia Soriano

Digital Representative: Ying Teo

Trainee Representatives: Kate Dear, Lydia Scrivens, Yasmine Khan

Dear members,

Summarised below are four recent publications which we hope will be of interest including assessment of testing with the 2021/2022 European baseline series and trends in sensitisation to hair care products:

Patch Test Results With the European Baseline Series, 2021/2022—Joint European Results of the ESSCAA and the EBSB Working Groups of the ESCD, and the GEIDACC. W.Uter, S. M.Wilkinson, O.Aerts, et al. Contact Dermatitis (2026): 1–16, doi.org/10.1111/cod.70134.

European surveillance data from 18, 832 patients patch testing with the European Baseline Series (2021- 2022) show largely stable sensitisation patterns, supporting its continued clinical validity. Nickel remains the most common allergen (18.9%), while fragrances continue to contribute a significant burden (13.8% positivity to at least one marker). Preservative allergy persists with MCI/MI and MI positivity (5-5.5%) approaching pre-epidemic levels, and improved detection of formaldehyde at higher concentrations. Of the allergens added to the series in 2019, propolis (5.5%) and 2-hydroxyethyl methacrylate (HEMA, 3.6%) were the most frequently detected. Methyldibromo glutaronitrile (MDBGN) sensitisation remains unexpectedly high despite regulatory bans, whereas parabens and quarternium-15 now show much lower levels, supporting their removal from the 2023 series. Overall, findings reinforce current baseline testing while highlighting allergen trends.

Contact Allergy to Ingredients of Hair Cosmetics Associated with Occupational and Non-Occupational Exposure-Trends from 1995 to 2020 in Central Europe, with or without Regulation.

Uter W, Schwensen JFB, Blömeke B, Gefeller O, John SM, Bieck C, Schubert S. Contact Dermatitis. 2026 Apr;94(4):347-363. doi: 10.1111/cod.70079. Epub 2025 Dec 30. PMID: 41472370; PMCID: PMC12956424.

Long-term IVDK surveillance data (1995–2020) demonstrate that contact allergy to hair cosmetic ingredients remains clinically important, with distinct patterns between occupational (hairdressers) and consumer exposure. Hair dye components, particularly PPD and related intermediates, remain relevant sensitisers with a notable and increasing burden in consumers, whereas trends in hairdressers are generally stable. Increasing sensitisation to toluene‐2,5‐diamine (PTD) in consumers was observed. Several allergens show persistent or rising sensitisation (e.g. hydroquinone), while others illustrate regulatory success, most clearly glyceryl thioglycolate, where sensitisation has clearly fallen in younger cohorts following withdrawal. Bleaching agents (e.g. ammonium persulfate) remain more relevant occupational allergens, whereas preservatives show mixed trends influenced by wider exposure patterns (including the MI epidemic). Overall, the data highlight increasing consumer-driven sensitisation, strong age effects, and variable impact of regulation, underscoring the need for continued surveillance and improved risk management of hair cosmetic ingredients.

Successful treatment of poison ivy dermatitis with upadacitinib.

Tai H, Tang A, Levine J, Talia J, Ungar B. JAAD Case Rep. 2026 Feb 9;70:69-71. doi: 10.1016/j.jdcr.2026.01.053. PMID: 41798158; PMCID: PMC12966863.

This case report describes the successful use of the JAK1 inhibitor upadacitinib in a 54-year-old patient with severe poison ivy (Toxicodendron) allergic contact dermatitis and a background of pityriasis rubra pilaris, on guselkumab. There was rapid resolution of itch and pain within 24 hours of administration of upadacitinib (30mg for 2 weeks followed by 15mg for 2 weeks) and near-complete resolution by 4 weeks. JAK inhibitors block cytokine signalling through the JAK–STAT pathway, reducing activation of multiple T-cell–driven inflammatory axes (Th1, Th2, Th17) central to allergic contact dermatitis. Although limited to a single case, this report suggests a potential role for JAK inhibitors as a therapeutic option in severe cases of allergic contact dermatitis and warrants further study.

Letter: A Case of Propylene Glycol Allergic Contact Dermatitis Associated With Soolantra. Roche D, Nolan B, Twomey N, Golchin R, Bourke J. Dermatitis. 2026 Mar 23:17103568261429237. doi: 10.1177/17103568261429237. Epub ahead of print. PMID: 41869959.

This case describes allergic contact dermatitis secondary to propylene glycol (PG) in a patient with a chronic facial eruption initially managed as rosacea and treated with ivermectin 1% cream (Soolantra). The dermatitis worsened with ongoing use, and patch testing demonstrated a strong positive reaction to PG and PG-containing products (including Soolantra and two cosmetic products). PG, although considered a weak sensitiser, is ubiquitous in topical products and may be under-recognised as a clinically relevant allergen. This report highlights the importance of reviewing excipient ingredients and considering patch testing in patients with persistent or treatment-refractory dermatitis, particularly when symptoms localise to sites of topical application.

Dear members,

Please find below brief summaries of recent publications of interesting, including a systematic review on the effect of JAK inhibitors on patch testing, and a case of an unusual source of chromium ACD.

Janus Kinase Inhibitors’ Effect on Patch Testing: A Systematic Review

Gratz BW, Chung S, Hussain AN. Dermatitis. 2026 Feb 17:17103568261415887. doi: 10.1177/17103568261415887.

This systematic review examines Janus kinase (JAK) inhibitors influence on patch test results. Eight studies (35 patients: 21 upadacitinib, 10 abrocitinib, 2 baricitinib, 2 tofacitinib) were included. Heterogeneity of study design limited quantitative meta-analysis. Majority (32 patients) were tested on full-dose treatment; 3 underwent patch testing after washout period (2 for 2 weeks, 1 unspecified duration). Of 32 patients with paired patch testing (results before and during JAK inhibitor treatment), 71.9% converted to entirely negative results on repeat testing. Some strong (2+ or 3+) reactions persisted, whereas other reactions were attenuated from strong (2+ or 3+) to weak positive or doubtful reactions. However, new weak positive reactions were also observed despite testing on JAK inhibitors. The authors conclude that clinicians should interpret patch test results cautiously in patients taking JAK inhibitors and to consider washout period of 2 weeks prior to patch testing.

Higher Prevalence of Contact Sensitization to Dodecyl Gallate in Patients With Atopic Dermatitis: A Cross-Sectional Study

Zaryczańska A, Sokołowska-Wojdyło M, Wilkowska A, Grubska-Suchanek E, Nowicki RJ, Trzeciak M. Dermatitis. 2026 Mar 1:17103568261427111. doi: 10.1177/17103568261427111.

Gallates are antioxidant preservatives widely used in cosmetics and foods, with dodecyl gallate considered the most allergenic derivative. Colleagues in Poland conducted a cross-sectional study (2023-2024) evaluating the prevalence of contact sensitisation to dodecyl gallate in patients with atopic dermatitis (AD) compared with non-atopic controls. Sensitisation was significantly more frequent in AD [20.0% (n=16/80) vs 7.5% (n=6/80), OR 3.08, p = 0.037]. This was particularly in children (13.6% vs 0%, p = 0.026) but not in adults nor was there correlation with severity of AD. Fifteen patients improved with avoidance of dodecyl gallate (13 AD, 2 without AD). The authors conclude that dodecyl gallate is an under-recognised allergen and recommend considering this allergen, especially in patients with persistent eczema.

Uncommon Source of Chromium Sensitization: Allergic Contact Dermatitis From Potassium Dichromate in Milk Adulteration Testing

Sharma A, Mittal AK, Balai M. Contact Dermatitis. 2026 Mar 2. doi: 10.1111/cod.70127.

This paper reports a 26-year-old female presenting with eczematous areas on both arms caused by exposure to potassium dichromate in the laboratory conducting milk adulteration testing, highlighting an unusual source of chromium sensitisation. Patch testing elicited strong positive (++) reaction to potassium dichromate 0.5% pet. The authors report that potassium dichromate is used in certain laboratory-based milk adulteration testing as oxidising reagent and indicator, albeit reducing in use. Other non-construction sources of chromium include laboratory reagents, photography chemicals, and industrial oxidising agents. This study emphasizes the need for awareness of unexpected exposure sources of chromium.

Abstract submissions for both oral and poster presentations are now being accepted for the 26^th World Congress of Dermatology 2027.

Topics include Contact Dermatitis and Adverse Cutaneous Drug Reaction. Abstracts can be submitted up till closing date on 14 September 2026 via the WCD2027 Abstract Platform.

Dear members,

We hope these recent publications will be of interest:

Isothiazolinones in Disposable Rubber Gloves-Results of Chemical Analysis
Suuronen K, Ylinen K, Suomela S, Pesonen M. Contact Dermatitis. 2026 Jan 15. doi: 10.1111/cod.70087. Epub ahead of print. PMID: 41540775.

Suuronen et al report findings of chemical analysis to identify isothiazolinones in a total of 52 disposable rubber gloves from patients with hand eczema in an occupational dermatology clinic. Benzisothiazolinone (BIT) was detected in 30/52 gloves (60%), predominantly nitrile, in concentrations of 0.3-73.7ppm (median 4.2ppm, average 12.7ppm). Methylisothiazolinone (MI) was found in 6 (13%) gloves, at low concentrations of 0.8-16.6ppm (median 8.4ppm, average 8.1ppm). None of the gloves contained detectable octyl-, or methylchloro- or dichloroctylisothiazolinone. Patch testing with patients’ own gloves (as is and/or ultrasonic extracts) were frequently negative or equivocal despite measurable BIT/MI. The authors conclude that disposable rubber gloves, including “accelerator-free” nitrile types, may be a clinically relevant hidden isothiazolinone exposure, although did identify other sources of isothiazolinone contact in many of the patients in this cohort.

Changes in Contact Dermatitis Allergen Profile in Chronic Actinic Dermatitis: Results From a Single Centre
Teo YX, Cunningham L, Fassihi H, Sarkany R, White IR, Fityan A. Contact Dermatitis. 2025 Dec 21. doi: 10.1111/cod.70073. Epub ahead of print. PMID: 41423722.

In this single-centre retrospective study, patch test results of 309 chronic actinic dermatitis (CAD) tested between 2011-2021 were examined. 186 (60.2%) had at least one positive reaction, with only 8 (2.6%) testing positive on photo-patch test. Patch test positivity was more likely in patients >40 years and in those with Fitzpatrick phototype V-VI. Sesquiterpene lactones (6.8%) and formaldehyde (4.8%) were amongst the top 10 most frequently positive allergens in CAD but not in non-CAD patients. Compared with earlier cohorts from the same centre (1987-1992 and 2000-2005), both overall patch test positivity and photo-patch positivity have progressively fallen, alongside declining reactions to historically CAD-associated allergens such as sesquiterpene lactone mix. This suggests evolving environmental and lifestyle exposures, whilst supporting the continued role of patch and photo-patch testing in CAD assessment.

Two Cases of Allergic Contact Dermatitis Caused by Coco Betaine in Clobetasol Propionate Shampoo.
Iijima S, Murayama K, Takayama N, Sugiyama M, Matsunaga K. Case Rep Dermatol Med. 2026 Jan 2;2026:9953943. doi: 10.1155/crdm/9953943.

This case report describes two Japanese men (aged 49 and 52) with severe atopic dermatitis on long-term ciclosporin who developed recalcitrant scalp dermatitis following the use of clobetasol propionate (CP) shampoo. Patch testing showed positive reactions to coco betaine 1% aq in both cases. The first patient also had positive reactions to the related amidopropyl betaines (cocamidopropyl betaine and lauramidopropyl betaine) whereas the second patient had doubtful reactions. Dimethylaminopropylamine (DMAPA) and lauramidopropyl dimethylamine (LAPDMA) were negative in the first patient and not tested in the second. Both patients were negative to clobetasol propionate. Symptoms improved markedly after discontinuing the shampoo. The authors highlight potential cross-reactivity or concomitant sensitisation among betaine surfactants, the possibility of suppressed or delayed patch test responses in steroid-containing products, and the need to consider excipients and select alternative “non-allergenic” shampoos carefully in persistent scalp dermatitis.

Allergic Contact Dermatitis to Trimethylpentanediol/Adipic Acid/Glycerin Crosspolymer in a Lip Balm
Lockmann A, Schill T, Schubert S, Buhl T. Contact Dermatitis. 2026 Jan;94(1):95-97. doi: 10.1111/cod.70040. Epub 2025 Oct 26. PMID: 41139661.

This case report describes the first reported case of allergic contact dermatitis to trimethylpentanediol/adipic acid/glycerin crosspolymer (TMPD-AA-GC), a film-forming agent and skin conditioning cosmetic ingredient considered to have a low sensitisation potential. A 34-year-old woman with a three-year history of recurrent lip and perioral dermatitis frequently used O’Keeffe’s Lip Repair lip balm as a lip care product. Patch testing including to single ingredients in the lip balm showed a positive reaction to the lip balm itself (- at day 2, + at day 3, + at day 7) and positive reaction to TMPD-AA-GC 5% pet at (+ at day 2, ++ at day 3 and + at day 7). The exact sensitiser within this three-component copolymer is unknown. This case underscores the value of patch testing with patient-specific products and individual ingredients to detect rare contact allergens and highlights TMPD-AA-GC as a potential sensitiser in cosmetics.

For ease of locating the patient information leaflets on the BSCA website, this poster and leaflet for patients contains a QR code which links to the Patient Information Leaflets page. This can be shared with patients for access to the leaflets electronically without having the print paper copies of the leaflet.