Abstract Introduction: Other than nickel, fragrance and rubber, preservatives are well known sensitizers. Objectives: To study the pattern of preservative allergy among patients patch tested at Patch Test Unit Selayang Hospital. Materials & Methods: We conducted a retrospective analysis of the data of all the patients patch tested with preservative sensitizers present in the European Baseline Series and other commercial series in Selayang Hospital from January 2011 to December 2011. Results: 243 patients were patch tested. 28.4% of the patients had a positive reaction to one or more of the preservative sensitizers. Paraben mix was the most frequently positive allergen (11.8%). 17.8% of the Indians had paraben allergy, as compared to 11.3% of Malays and 11.2% of Chinese. Females were more significantly associated with a positive reaction to one or more of the preservative sensitizers (p=0.010). A younger age group (<35) was more significantly associated with formaldehyde allergy. “Face and upper limbs combined” presentation was significantly associated with a positive reaction to formaldehyde and methylchloroisothiazolinone/ methylisothiazolinone (p=0.042 and p<0.001 respectively). Conclusion: Our data differ from most other countries in that paraben mix was the most frequently positive preservative sensitizer and that younger age group was significantly associated with sensitization to formaldehyde.

Introduction: DRESS is an uncommon severe cutaneous adverse drug reaction, which is under recognized. In this review, we aim to study the clinical characteristics of patients with DRESS that presented to our hospital. Methods: We conducted a retrospective analysis on the data of all the patients with DRESS from January 2006 to December 2012 in Selayang Hospital. Results: Twenty-one patients were included with median age of 33 and male to female ratio of 1:1. Allopurinol was the most frequent causative drug followed by anti-tuberculous drugs. The mean latency period was 28.6 days. All patients had macula-papular rash of which 6 progressed to erythroderma. Liver was the most frequent extra cutaneous organ involvement with median peak alanine transaminase of 746 iu/l, (range 45-3677) and median peak aspartate transaminase of 632 iu/l (range 30-3136). Six patients (28.5%) had acute liver failure. The mainstay of treatment was systemic corticosteroid. Mortality rate was 23.8%. Conclusion: DRESS is a severe cutaneous adverse drug reaction with a myriad of clinical presentation and is associated with mortality. Our series has higher mortality compared to most other reported studies, most probably due to referral bias. Early recognition is crucial.

The main objective of this review article is to provide an update of the literature concerning delayedtypereactions or contact allergic dermatitis caused by cosmetic and anti-ageing ingredients. We scanfor tips on how to recognize these reactions from the history and clinical signs. The common allergensreported include fragrances and preservatives. Be aware of the new allergens. There is a need to patchtest with some of the heavy metals because of their presence in cosmetics but besides nickel, cobaltand occasional mercury, heavy metals do not frequently cause allergic contact dermatitis. They aredangerous because of their systemic toxicity on other internal organs. It is important to recognizethe source of the contact allergens that have been documented in various continents. Reports fromAsian countries (India, China, Korea, Singapore, Malaysia and Japan) have been included to increasethe awareness of cosmetic induced contact allergic dermatitis in this region. This knowledge uponreflections may assist us in our own daily practice.

Introduction:Patch test is the gold standard diagnostic test for contact allergy. Periodic analysis of the trend ofcontact allergy provides a valuable guide to clinicians. We aim to study the pattern of contact allergyin adults at Hospital Selayang.Methods:This is a retrospective review of patch test data in adults suspected with allergic contact dermatitisbetween January 2011 and December 2013 at Hospital Selayang.Results:There were 705 subjects with 247 males (35%) and 458 females (65%). At least 1 positive reactionwas detected in 546 (77.4%) subjects patch tested with European Baseline Series (EBS) and additionalseries. The top 5 common allergens in the EBS were nickel sulfate (28.7%), cobalt chloride (13.6%),paraben mix (11.6%), balsam of peru (10.6%), and potassium dichromate (10.5%). Among thosepatch tested with rubber additives series, the top 3 allergens were N,N-Diphenylguanidine (DPG),N-Cyclohexyl-N-phenyl-4-phenylenediamine (CPPD), and N-Cyclohexylthiophthalimide. Of thetop 5 common allergens in the group tested with fragrance series, all except Ylang ylang oil werecomponents of fragrance mix I. Among the subjects tested with fragrance series, the top 5 commonallergens were individual components of fragrance mix I and Ylang ylang oil.Conclusion:A multicentre study would reflect better the pattern of allergen exposure of the nation. Furtherevaluation of the prevalence of contact allergy to DPG, CPPD, N-Cyclohexylthiophthalimide andYlang ylang oil would guide the need to incorporate these allergens in routine testing along with EBS.

Allergic contact dermatitis affects 15 to 20% of the population. The pattern of contact allergy varies across nations. Therefore, many countries utilize their unique individual baseline series for patch testing. In this study, we aimed to assess the outcome of rubber and fragrance allergy detection with the addition of 1,3-Diphenylguanidine. N-Cyclohexyl-N-Phenyl-4-Phenylenediamine, N-Cyclohexylthiophthalimide and Ylang ylang oil.