Allergic Contact Dermatitis of the Scalp: Analysis of Allergen Profiles

Authors

DOI:

https://doi.org/10.14738/bjhr.1301.19992

Keywords:

allergen, allergic scalp contact dermatitis, patch test

Abstract

Background: Allergic scalp contact dermatitis (ASCD) is a delayed type of hypersensitivity from contact with a specific allergen to which the patients has developed a specific sensitivity. The aim of the study was to evaluate the results of patch testing with standard series of contact allergen in patients suspected to have ASCD. Methods: 112 cases of scalp contact dermatitis were included in the study. Test substances were applied on the upper part of the patient's back, on clinically uninvolved and untreated skin. The patch test was removed and reaction were evaluated after 48 h and 72 h. The grading of negative (-) to positive (+ to ++++) patch test was done in accordance with the International Contact Dermatitis Research Group. Results: Among the 112 cases, 83 patients were female (74.1 %) and 29 were male (25.9 %). The age of participants spanned 17 to 72 years. The commonest age group affected was 41-50 years. The most common positive reactions were recorded to nickel sulphate 22 (26.2%), cobalt chloride 18 (21.4%), fragrance mix 16 (19%), balsam of Peru 14 (16.7%), carba mix 8 (9.5%) and paraphenylenediamine 5 (5.9%).  Females were more likely to show a positive response to two or more allergens. Scalp itching or burning were reported as the most common symptom. Conclusions: Scalp ACD predominantly affects middle-aged women. Our results suggest that nickel sulphate and cobalt are the predominant allergens responsible for the induction of ASCD. These findings are crucial in the treatment, long term management, and education of patients with ASCD.

References

Alinaghi F, Bennike NH, Egeberg A, Thyssen JP, Johansen JD. Prevalence of contact allergy in the general population: a systematic review and meta-analysis. Contact Dermatitis 2019; 80(2): 77-85 .

Czarnobilska E, Obtulowicz K, Dyga W, Spiewak R. A half of schoolchildren with "ISAAK eczema" are ill with allergic contact dermatitis. J Eur Acad dermatol venereol 2011; 25(9): 1104-7.

Marks JG, DeLeo VA. Allergic and irritant contact dermatitis. In: Marks JG Jr, Deleo VA, eds. Contact and occupational dermatology, 2nd ed. St. Louis: Mosby, 1997. pp. 3-14.

De Benedetto A, Kubo A, Beck LA. Skin barrier disruption: a requirement for allergen sensitisation? J Invest dermatol 2012; 132(3): 949-63.

Lazzarini R, Duarte I, Lindmayer Ferreira A. Patch tests. An Bras Dermatol 2013; 88(6): 879-88.

Carlsen Bc, Menne T, Johonsen JD. 20 years of standard patch testing in eczema population with focus on patients with multiple contact allergies. Contact Dermatitis 2007; 57(2): 76-83.

Pongpairoj K, Ale I, Andersen KE, Brize M, Diepgen TL, Elsner PU et al. Proposed ICDRG classification of the clinical presentation of contact allergy. Dermatitis 2016; 27(5): 248-58.

Warshaw EM, Kullberg S, DeKoven JG et al. Scalp involvement in patients referred for patch testing: retrospective cross-sectional analysis of North American Contact Dermatitis Group data 1996 to 2016. J Am Acad Dermatol 2021; 84: 977-88.

Lewallen R, Clark A, Feldman SR. Clinical handbook of contact dermatitis: diagnosis and management by body region. First edition. Boca Ration CRC Press; 2014.

Hwang JC, Beatty CJ, Khobzei K, Kazlouskaya V. Allergic contact dermatitis of the scalp: a review of an undiagnosed entity. Int J Women’s Dermatol 2024; 10(3): e167. Scholar Publishing

Starace M, Bruni F, Marcondes M, Alessandrini A, Piraccini BM. The identification of trichoscopic features of allergic scalp cantact dermatitis: a pilot study of a single center. Ind J Dermatol Venereol 2023; 158(4): 334-40.

Kuljanac I, Knezevic E, Cvitanovic H. Epicutaneous patch test result in children and adults with allergic contact dermatitis in Karlovac county: a retrospective survey. acta Dermatovenereol Croat 2011; 19(2): 91-7.

Aleid NM, Fertig R, Maddy A, Tosti A. Common allergens identified based on patch test results in patients with suspected contact dermatitis of the scalp.Skin Appendage Disord 2017; 3: 7-

Zug KA, Warshav EM, Fowler JF Jr, Maibach HI, Belsito DL, Pratt MD et al. Patch-test results of the North American Contact Dermatitis Group 2005-2006. Dermatitis 2009; 20(3): 149-60.

Counts AL, Miller MA, Khakhria ML, Strange S. Nickel allergy associated with a transpalatal arch appliance. J Orofac Orthop 2002; 63(6): 509-15.

Wojciechowska M, Czajkowski R, Kowaliszyn B, Zbikowska-Gotz M, Bartuzi Z. Analysis of skin patch results and metalloproteinase-2 levels in a patients with contact dermatitis. Postep Derm Alergol 2015; 32(3): 154-61.

Hillen U, Grabbe S, Uter W. Patch test results in patients with scalp dermatitis: analysis of data of the Information Network of Departments of Dermatology. Contact Dermatitis 2007; 56:87-93.

Thyssen J, Menne T, Johansen J. Nickel release from inexpensive jewelry and hair clasps purchased in an EU country-are consumers sufficiently protected from nickel exposure. Sci Total Env 2009; 407: 5315-8.

Uter W, Werfel T, White JR, Johansen JD. Contact allergy: a review of current problems from a clinical perspective. Int J Environ Res Health 2018; 15(6):E1108.

European Parliament and Council Directive 94/27EEC. Official Journal of the European Communities, 22-07-1994. no. L 188/1-2 (nickel)

Uter W, Ramsch C, Aberer W, Ayala F, Balato A, Beliauskiene A at al. The European baseline series in 10 European countries, 2005/2006-results of the European Surveillance System on Contact Allergies (ESSCA). Contact Dermatitis 2009; 61(1): 31-8.

Marks JG, Elsner P, DeLeo VA: Standard allergens, in Contact and occupational dermatology, ed 3. Philadelphia, Mosby, 2002, pp65-9.

Zukiewitz-Sobczak W, Adamczuk P, Wroblewska P, Zvolinski J, Chmielewska-Badora J, Krasowska E et al. Allergy to selected cosmetic ingredients. Postep Derm Alergol 2013; 30(5):307-10.

Johansen J, Menne T. The fragrance mix and its constituents: a 14-year material. Contact Dermatitis 1999; 32(1):18-23.

Warburton KL, Bauer A, Chowdhury MM, Cooper S, Krecisz B, Chomiczewska-Skora D et al. ESSCA results with the baseline series, 2009-2012: rubber allergens. Contact Dermatitis 2015; 73(5): 305-12.

Cebola-Verdugo M, Velasco-Amador JP, Navaro-Trivino FJ. Contact dermatitis due to hair care products: a comprehensive review. Cosmetics 2024; 11,78.

Rozas-Munoz E, Game D, Serra-Baldrich E. Allergic contact dermatitis by anatomical regions: diagnostic clues. Actas Dermatosifiliogr 2018; 109: 485-507.

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Published

2026-02-17

How to Cite

Kasumagic-Halilovic, E., Ovcina- Kurtovic, N., Suljagic, O., & Gujic, E. (2026). Allergic Contact Dermatitis of the Scalp: Analysis of Allergen Profiles. British Journal of Healthcare and Medical Research, 13(01), 352–358. https://doi.org/10.14738/bjhr.1301.19992