Clinical surveillance of contact allergy in central Europe: Results of the IVDK

Contact allergy surveillance in Germany, Switzerland and, at least partially, Austria, thanks to the contribution of the Graz department, is provided by the Information Network of Departments of Dermatology (IVDK, www.ivdk.org). The IVDK has published a number of analyses in the past 3 years which are presented in this narrative review: 1. evidence of persistence of a level of nickel exposure, despite regulatory efforts, which leveled-off the decline of nickel allergy prevalence observed until 2000, most likely due to excessive nickel exposure introduced by an overly generous "adjustment factor" in the method used for nickel liberation (EN 1811 :1998 recently amended), 2. a decline of chromium sensitization in the building trade since addition of ferrous sulfate, however, a marked increase of sensitization to epoxy resin, 3. among biocides (used as preservatives in cosmetics) an epidemic of contact allergy to methyldibromo glutaronitrile (contained in the meantime), a persisting problem with (chloro-)methylisothiazolinone and on a lower level formaldehyde, compared to less commonly observed sensitization to formaldehyde-liberating biocides or halogenated compounds, 4. risk assessment of biocides in cosmetics by means of relating morbidity (see "3.") to grossly estimated exposure (based on a large survey of INCI declaration), 5. dose-elicitation relationship in patients sensitized to HICC, using the ROAT, 6. the current spectrum of contact allergy to fragrances, addressing not only the screening agents used in the baseline series, but also, e.g., essential oils and less common fragrances, 7. the association with, and time trends in, certain occupational sectors regarding sensitization to thiurams.