Allergy to cocamidopropyl betaine may be due to amidoamine: a patch test and product use test study

@article{Fowler1997AllergyTC,
  title={Allergy to cocamidopropyl betaine may be due to amidoamine: a patch test and product use test study},
  author={Joseph F. Fowler and Lynn M. Fowler and Judith E Hunter},
  journal={Contact Dermatitis},
  year={1997},
  volume={37}
}
Cocamidopropyl betaine (CAPB) is an amphoteric surfactant commonly used in personal care products and surface cleaners. Patch testing with commercially‐available CAPB has yielded occasional reactions indicative of allergic contact dermatitis. To determine if subjects with previous positive patch tests would react in provocative use tests of products containing CAPB, and to study various contaminants in commercial CAPB supplies for allergenicity in these subjects. 10 subjects previously positive… 
Provocative use tests in CAPB‐allergic subjects with CAPB‐containing product
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The study confirmed thatCAPB‐sensitive individuals can use a CAPB‐based rinse‐off product without the risk of experiencing an allergic reaction to CAPB, as well as uncontrolled use testing with the shower gel.
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Results suggest that DMAPA is unlikely to be an important contact allergen in CAPB of appropriate quality and confirm thatCAPB of suitable purity, where levels of both cocamidopropylamine andDMAPA are minimized, is likely to trigger reactions in those ostensibly allergic to the material.
Cutaneous Delayed-Type Hypersensitivity to Surfactants
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This study reports the frequency of positive patch test results to surfactants tested on the North American Contact Dermatitis Group screening series including cocamidopropyl betaine (CAPB), amidoamine (AA), dimethylaminopropylamine (DMAPA), OPD, and cocamide diethanolamide (CDEA), and correlations of positive reactions between CAPB and the other surfactant.
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The authors’ overall assessment design was an involved procedure by elimination, which lasted over 6 weeks, required many successive challenges in the patients, and featured a progressive drop in the population such as to result in a statistically irrelevant final sample.
The role of 3‐dimethylaminopropylamine and amidoamine in contact allergy to cocamidopropylbetaine
TLDR
It is hypothesized that DMAPA is in fact the true sensitizing substance, while amidoamine, which may in any case releaseDMAPA in vivo as a result of enzymatic hydrolysis, may favour the transepidermal penetration of the sensitizing agent.
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    Contact dermatitis
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3-dimethylaminopropylamine (DMAPA, N,N-dimethylpropyl-1,3-diamine, CAS 109-55-7) is a raw material in the synthesis of cocamidopropylbetaine (CAPB), a detergent widely used in shampoo. Angelini et
Cocamidopropyl betaine.
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A 42‐year‐old woman with intractable eyelid dermatitis is presented with sensitization to 3‐(dimethylamino)propylamine (DMAPA), an important etiology of allergic contact dermatitis of the eyelids and face but is easily missed even with expanded‐series patch testing.
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Isostearamidopropyl morpholine lactate may be an important emerging allergen with sensitivity rates comparable with those of oleamido-dimethylamine and dimethylaminopropylamine, and co-reactivity among surfactants was frequent except for cocamide DEA.
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The second symposium on the definition and Management of anaphylaxis and the risk for Cardiopulmonary Adverse Events and Epidemiology of life-threatening and lethal anaphYLaxis: a review was held in Washington, DC.
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