1. The Contact Allergen Replacement Database James A. Yiannias MD Associate Professor of Dermatology Mayo Clinic Scottsdale

2. Purpose To facilitate antigen avoidance Database generates list of skin care products free of patient’s known allergens > 1,500 U.S. skin care products

3. Utility of Database fragrance mix Consider a patient who is patch test sensitive to fragrance mix Patient has been educated how to avoid fragrance, yet... Eczema persists since patient didn’t realize –Cinnamic alc. & Balsam of Peru –Cinnamic alc. & Balsam of Peru = Fragrance –Unscented & fragrance free products don’t assure elimination of fragrance cross-reactors

4. How CARD Helps… CARD recognizes cross-reactions & synonyms and –generates a comprehensive list of skin care products free of all fragrance like antigens!

5. Another eg: Utility of CARD Patient is imid urea & quat-15 sensitive Allergen avoidance reviewed Patient’s eczema persists-- Pt didn’t realize that DMDM-Hydantoin should be avoided Database recognizes cross-reactions & deletes all products containing formaldehyde releasers

6. Products in Database Soaps, Shampoos, Conditioners Moisturizers Sunscreens Make-ups All prescription topicals in PDR All OTC topicals in OTC PDR

7. How Products Were Chosen Hypoallergenic skin care product lines (eg. Aveeno, Almay, many others) Large companies with widely available products

8. Database Maintenance All product formulations are updated continuously Products with formulas > 1 year are deleted

9. Database Clinical Usage In use clinically at Mayo Clinic for 6 years and by American Contact Dermatitis Society Members for more than 3 years Broad patient and physician acceptance / endorsement

10. How to use CARD …next 7 slides

11. www.contactderm.org

18. CARD