‘Allergen of the Yr’ Introduced at ACDS Assembly
Lanolin, identified primarily for its emollient properties, has been named by the American Contact Dermatitis Society because the Contact Allergen of the Yr for 2023.
Lanolin is a posh and ranging combination of excessive molecular weight esters, aliphatic alcohols, sterols, fatty acids, and hydrocarbons, however the allergic parts are primarily the free lanolin alcohols, particularly alkanediols, mentioned Donald V. Belsito, MD, professor of dermatology, Columbia College, New York, who introduced the Allergen of the Yr on the society’s annual assembly.
Standards for choice can embody a identified allergen with a brand new twist or growing frequency or a newly reported allergen with mini-epidemics that will have been missed for years, Belsito mentioned.
“The prevalence and severity of allergy to ‘lanolin’ have been hotly debated” since a possible case was first reported within the Nineteen Twenties, wrote Belsito and Blair A. Jenkins, MD, PhD, a dermatology resident at New York–Presbyterian Hospital, Columbia Campus, in a evaluate printed in Dermatitis.
“ ’Lanolin’ is certainly a paradox allergen,” wrote Jenkins and Belsito. “Essentially the most acceptable patch check preparation(s) for detecting allergy stay disputed. Detection of lanolin-induced contact dermatitis in diseased pores and skin by patch testing on regular pores and skin might result in false damaging outcomes.”
And people who check constructive for a lanolin allergy on diseased pores and skin might be able to use lanolin merchandise on regular pores and skin, they wrote.
“From my perspective, this was a well timed yr to consider lanolin, as there’s important ongoing controversy about whether or not it’s allergenic,” Jenkins mentioned in an interview. “Quite a few firms market lanolin-containing topicals as secure and efficient emollients,” she mentioned.
Medical grade and extremely purified anhydrous lanolin, which comprise lower than 2.5% and fewer than 1.5% of free alcohols, respectively, can nonetheless elicit or induce a contact allergy, Belsito mentioned in his presentation. Hydrogenated lanolin has proven extra allergenicity than lanolin alcohol, whereas lanolin wax, lanolin acid, and lanolin esters possess decrease allergenicity than lanolin alcohol, he mentioned.
Notably, trendy wool textiles don’t comprise lanolin, and lanolin-allergic sufferers needn’t keep away from wool, Belsito added.
Amerchol L-101, a standard commerce title on merchandise containing lanolin, incorporates 10% wool wax alcohols obtained from the hydrolysis of wool fats dissolved in mineral oil at a 1:1 ratio, mentioned Belsito. He advisable testing lanolin alcohols (in 30% petrolatum) and Amerchol L-101 (in 50% petrolatum) concurrently with or with out different lanolin derivatives and/or the affected person’s merchandise in instances of attainable allergy, he mentioned.
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Present proof means that the prevalence of contact allergy within the western European inhabitants is 0.4%, wrote Jenkins and Belsito.
Though the frequency of lanolin allergy is comparatively low, sure circumstances convey larger danger, comparable to stasis dermatitis, leg ulcers, perianal/genital dermatitis, and atopic dermatitis, they wrote. Older adults and youngsters are at elevated danger as a result of they’re extra prone to have these circumstances. Demographic knowledge additionally counsel that lanolin allergy is extra frequent in non-Hispanic Whites than in non-Hispanic Blacks, they wrote.
Wanting forward, “I feel additional exploration of allergy throughout completely different pores and skin sorts and ethnicities is warranted,” Jenkins mentioned. “Additional investigation of preferrred [lanolin] allergens for patch testing can also be wanted.”
Jenkins and Belsito mentioned that they had no related monetary conflicts to reveal.
This story initially appeared on MDedge.com, a part of the Medscape Skilled Community.