Recent increase in allergic reactions to methylchloroisothiazolinone/methylisothiazolinone: is methylisothiazolinone the culprit?

BACKGROUND: The frequency of sensitization to methylchloroisothiazolinone (MCI)/ methylisothiazolinone (MI) observed in the Information Network of Departments of Dermatology (IVDK) was constantly around 2.1% from 1998 to 2009. After that, it increased to 3.9% in 2011, paralleled by an increase in the frequency of allergic reactions to MI in the preservative series from 1.9% in 2009 to 4.4% in 2011. MI without MCI has increasingly been used as a preservative in cosmetics and skin care products in recent years. OBJECTIVES: To epidemiologically investigate the possible reasons for this development and to analyse concomitant reactions to MCI/MI and MI. METHODS: A retrospective analysis of IVDK data from 2009 to 2011 was performed. RESULTS: Stratified data analysis revealed pronounced increases in reactivity to MCI/MI and MI in females, face dermatitis patients, and patients tested because of suspected cosmetic intolerance. The proportion of MI-positive patients among those reacting to MCI/MI increased from 43% to 59% between 2009 and 2011. CONCLUSION: More widespread consumer exposure has most likely led to the increase in primary sensitization to MI and subsequently to a rise in MCI/MI reactions resulting from immunological cross-reactions. A reduction in the maximum use concentration of MI seems advisable. MI should be patch tested in the baseline series.