CD01 Contact allergy to alkyl glucosides: a multicentre audit in the UK and Ireland

Abstract Alkyl glucosides (AGs) are surfactants widely used in cosmetic and household products (Soriano LF, Bertram CG, Chowdhury MMU et al. Prevalence of allergic contact dermatitis to decyl and lauryl glucoside in the UK and Ireland. Br J Dermatol 2021; 184: 571–3). This audit investigated the frequency of allergic contact dermatitis (ACD) to AGs in the UK and Ireland. Between December 2023 and December 2024, consecutive patients with suspected ACD were patch tested to decyl glucoside (DG), lauryl glucoside (LG) and cetearyl glucoside (CeG) in both petrolatum (pet.) and aqueous (aq.) preparations, and to coco glucoside (CoG) and glyceryl glucoside (GG) in aqueous solution in an extended baseline and/or cosmetic series. Eleven centres tested AGs in 2704 patients in an extended baseline series. Of these, 57 patients (2.1%) had a positive reaction to at least one AG. The mean age was 45 years, 73.7% of patients were female and 66.7% had a background of atopy. The most commonly affected sites were the face (72.1%), hands (43.9%), neck (21.1%), legs (17.5%) and torso (17.5%). Multiple sites were affected in 68.4%. Implicated products included shampoo, makeup, hand wash, hair dye, wipes and sunscreen. DG 5% pet. elicited a positive reaction in 36 patients (1.3%), with 50% concomitant positivity to DG 5% aq.; current relevance was identified in 50%. There were five irritant reactions. DG 5% aq. had a positive reaction in 19 patients (0.7%), with 57.9% concomitant positivity to DG 5% pet., current relevance in 57.9% and eight irritant reactions. LG 3% aq. had a positive reaction in 24 patients (0.9%), 46% concomitant positivity to LG 3% pet., current relevance in 46% and eight irritant reactions. LG 3% pet. had a positive reaction in 22 patients (0.8%), 50% concomitant positivity to LG 3% aq., current relevance in 55% and 15 irritant reactions. CeG 5% aq. had a positive reaction in 12 patients (0.4%), with 8.3% concomitant positivity to CeG 5% pet., current relevance in 50% and three irritant reactions. CeG 5% pet. had a positive reaction in four patients (0.1%), with 25% concomitant positivity to CeG 5% aq., current relevance identified in 25% and four irritant reactions. CoG 5% aq. had a positive reaction in 19 patients (0.7%), with current relevance in 73.7% and eight irritant reactions. GG 2% aq. had no positive reactions and five irritant reactions. In addition, six centres tested 1099 patients to AGs in an extended cosmetic series, identifying a further 14 (1.3%) patients with a positive reaction to at least one AG. AG sensitization is common, with frequent irritant reactions. Clinical relevance is unknown in many cases. Concomitant positivity between petrolatum and aqueous formulations is variable. Testing glucosides in both vehicles may prevent missed diagnoses, highlighting the need for further investigation into an optimal patch testing strategy.