Conflicts — shea-butter (round 8)

Conflict: [Sivapiromrat et al., J Med Assoc Thai, 2021] concludes a shea-butter + ceramide emollient “is effective in the treatment and prevention of relapse” of mild–moderate childhood AD, matching 1% hydrocortisone. [Hon et al., Hong Kong Med J, 2015] found its shea-extract cream did not reduce objective severity (SCORAD) or S. aureus; benefits were confined to patients who liked the product. Unresolved — add to open_questions. Note: Shea Butter

Conflict: [FARRP, 2018] says an exhaustive literature search found no allergic reactions ever reported to shea nut butter and that refined shea is safe for everyone. [Castelain, Aubin & Pelletier, Contact Dermatitis, 2024] report contact allergy to Butyrospermum parkii butter in a patient with cheilitis. Possibly different mechanisms (IgE food allergy vs delayed contact allergy). Unresolved — add to open_questions. Note: Shea Butter

Conflict: [Kligman, Contact Dermatitis, 1998, via Cutis 2023] called lanolin allergy “a myth” of overzealous patch testing. [Silverberg et al., NACDG, Dermatitis, 2022] found 86.5% of Amerchol L-101 reactions clinically relevant; ACDS named lanolin 2023 Allergen of the Year. Unresolved — add to open_questions. Note: Lanolin

Conflict: [Silverberg et al., NACDG, Dermatitis, 2022] report lanolin-allergic patients more likely of Black race. [Jenkins & Belsito, Dermatitis, 2023] state US non-Hispanic white patients are more likely lanolin-allergic than non-Hispanic Black patients (2022 paper has a 2023 erratum, content unchecked). Unresolved — add to open_questions. Note: Lanolin