用曲泰斯贴剂检测变应性接触性皮炎

目的 观察曲泰斯斑贴试剂在我国应用的可行性。方法 对100例皮肤病门诊患者用曲泰斯贴剂进行斑贴试验研究。其中确诊变应性接触性皮炎患者21例，非变应性接触性皮炎患者19例，可疑变应性接触性皮炎60例。结果 确诊变应性接触性皮炎组获与临床符合的阳性结果19例；非变应性接触性皮炎组阳性4例，均与临床无关。斑贴试验的灵敏度为90.5%，特异度78.9%，准确性85.0%，除轻度瘙痒外，未见不良反应。结论 曲泰斯贴剂在我国检测变应性接触性皮炎安全有效。     

生物共振法与斑贴试验筛查化妆品变应性接触性皮炎可疑致病物质的临床对照研究

目的:比较生物共振法和斑贴试验筛查化妆品变应性接触性皮炎可疑致病物质的一致性,探讨应用MORA生物物理治疗仪进行化妆品接触性皮炎的可疑致病物质早期筛查的可行性.方法:按卫生部化妆品接触性皮炎诊断标准,将83例临床可疑为化妆品变应性接触性皮炎患者的286个可疑致病物质利用生物共振法进行筛查和斑贴试验.结果:两种检测方法符合率为77.68%,Kappa指数为0.46.结论:生物共振法检测安全、快速、无创,有可能用于化妆品接触性皮炎可疑致病物质的早期筛查.     

多种斑贴试验在化妆品接触性皮炎诊断中的应用

目的探讨多种斑贴试验在化妆品接触性皮炎诊断中的作用。方法对本院皮肤科门诊的化妆品接触性皮炎患者进行化妆品原物斑贴试验、标准变应原斑贴试验、化妆品成分斑贴试验、化妆品原物稀释斑贴试验及重复性开放性应用试验,汇总数据并进行分析。结果化妆品原物斑贴试验阳性比率为37.35%(31/83),阳性化妆品主要为护肤类化妆品;标准变应原、化妆品成分斑贴试验阳性比率为57.47%(50/87),阳性反应物质主要为Cl+Me-异噻唑(卡松CG)、硫柳汞、硫酸镍、甲醛、氯化钴等;17例化妆品原物斑贴试验阳性患者完成了化妆品原物稀释斑贴试验,阳性比率为35.29%(6/17);31例化妆品原物斑贴试验阳性患者完成了重复性开放性应用试验,阳性比率为25.81%(8/31);8例重复性开放性应用试验阳性患者中6例化妆品浓度稀释试验同时为阳性。结论化妆品原物斑贴试验是诊断化妆品接触性皮炎的有效方法,必要时可联合标准变应原或化妆品成分斑贴试验进一步明确致病成分;原物稀释斑贴试验及重复性开放性应用试验有助于区分化妆品刺激性接触性皮炎与变应性接触性皮炎,后者更适合化妆品接触性皮炎患者自行完成并作出评价。     

变应性接触性皮炎167例变应原分析

目的 分析变应性接触性皮炎患者的变应原.方法 对167例变应性接触性皮炎患者做斑贴试验.结果 面部变应性接触性皮炎92例,占55.1％.斑贴试验阳性者148例,占88.6％.前6位变应原依次为:硫酸镍、芳香混合物、对苯二胺、硫柳汞、辛酸盐和阿必醇.结论 斑贴试验是确证变应性接触性皮炎病因的有效手段.     

68例接触性皮炎斑贴试验结果分析

职业性变应性接触性皮炎（OACD）是指皮肤接触非刺激浓度的化学物后而激发炎症反应的职业性皮炎。为探讨OACD的常见致敏原及斑贴试验的临床作用,本文分析了我院门诊近3年来68例OACD患者的斑贴试验结果,部分患者还用病史提供的可疑物加做斑试。现将结果报道如下。     

84例皮炎湿疹类皮肤病斑贴试验结果分析

分析本地区皮炎湿疹患者斑贴试验的结果及临床意义,并比较成人组与儿童组阳性结果的异同.对东营市人民医院门诊确诊的84例变应性接触性皮炎和湿疹患者进行斑贴试验,对结果进行统计学分析.斑贴试验总阳性率60.71%,成人组阳性率为64.81%,儿童组阳性率53.33%,两组间差异无统计学意义(P>0.05).20种变应原中总阳性率排前5名的分别是氯化钴、重铬酸钾、硫酸镍、对苯二胺、芳香混合物.成人组阳性率较高的分别是氯化钴、重铬酸钾、硫酸镍;儿童组阳性率较高的分别是:硫酸镍、甲醛、芳香混合物.氯化钴、重铬酸钾、硫酸镍是东营地区变应性接触性皮炎和湿疹的常见变应原,斑贴试验对寻找变应原及日常防护均有意义.     

植物致变应性接触性皮炎73例分析

目的　分析观赏植物引起的变应性接触性皮炎的临床特点、诊断及治疗。方法　回顾性分析 95 0例皮炎 湿疹患者的临床特点并用斑贴试验筛选 ,对可疑植物所致者进行植物原物斑贴试验和光斑贴试验。结果　植物所致者 73例 ,占 7.7% ,植物 19种 ,以洒金桃叶珊瑚、变叶木为多。结论　观赏植物是变应性接触性皮炎的常见原因之一。     

脐周变应性接触性皮炎121例斑贴试验结果分析

目的探讨脐周变应性接触性皮炎的致敏原特点。方法采用斑贴试验分析121例脐周变应性接触性皮炎患者的致敏原。结果斑贴试验结果主要的致敏原是硫酸镍98.35%,白降汞18.18%,重铬酸钾17.36%,橡胶Ⅳ(促进剂:D.P.G.TMTD混合物)8.26%,新霉素7.44%和对苯二胺5.79%。结论硫酸镍是脐周变应性接触性皮炎最主要的致敏原。     

重庆地区193例化妆品变应性接触性皮炎患者斑贴试验结果分析

 目的:分析重庆地区化妆品变应性接触性皮炎患者主要化妆品成分变应原,以便指导患者合理选择和使用化妆品,降低皮炎的发生率。方法:选取我院皮肤科门诊确诊为化妆品变应性接触性皮炎的193例患者进行化妆品成分斑贴试验,并对结果作统计学分析。结果:斑贴试验总阳性率为69.43%,合并2种及2种以上变应原的患者占50.26%,阳性率前5位的变应原分别为硫柳汞、十二烷基硫酸钠、尼泊金酯、三乙醇胺和乙二胺;女性斑贴试验阳性率为73.33%,明显高于男性,差异有统计学意义(X²=9.67,P<0.05）;青年组明显高于其他年龄组,差异有统计学意义（ X²=36.79,P<0.05）。结论：硫柳汞、十二烷基硫酸钠、尼泊金酯、三乙醇胺和乙二胺5种物质是重庆地区化妆品变应性接触性皮炎患者主要的致敏成分。化妆品变应性接触性皮炎患者以女性为主,中青年多见。     

中药接触性皮炎临床及斑贴试验分析

为了探讨中药接触性皮炎的致病药物、临床表现、检测方法等因素，对１４例中药接触性皮炎患者及３５１例非中药致湿疹皮炎类皮肤病患者（其中包括８０例诊断明确的非中药引起的接触性皮炎患者）进行了临床及斑贴试验分析。结果发现中药接触性皮炎的致病药物多为外用消炎止痛类中药；中药接触性皮炎组对香料及松香斑贴试验的阳性率均高达５５．６％（５／９），明显高于非中药所致的可疑接触性皮炎组及诊断明确的非中药引起的接触性皮炎患者组中香料及松香的阳性率（２×Ｋ表Ｘ２检验，香料及松香的Ｘ２分别为９．２３及３５．６，Ｐ值均＜０．０１）；对另外二种常见接触变应原橡胶促进剂及白降汞三组间无统计学差异，提示芳香类中药可能容易致敏。中药接触性皮炎临床表现包括刺激性接触性皮炎、变应性接触性皮炎、速发型接触性反应及系统性接触性反应等，使用原药作斑贴试验多可获阳性结果。     

Environmental contact factors in eczema and the results of patch testing Chinese patients with a modified European standard series of allergens

Environmental contact factors in eczema were investigated in China by clinical questionnaire and patch testing patients with a modified European standard series of allergens. 217 consecutive eczema patients were studied. Contact dermatitis (CD) was clinically diagnosed in 30% of the patients. Among the patients patch tested, 46 patients had clinically diagnosed allergic CD (ACD), 20 patients clinically had non-ACD (NACD) (including 16 cases of irritant contact dermatitis, 1 case of phototoxic contact reaction and 3 cases of asteatotic eczema) and 115 patients had clinically suspected ACD. 45 patients (98%) in the ACD group went on to have relevant patch test results. The most common ACD was from metals, fragrance materials, cosmetics and rubber materials. The most common contact allergens identified were nickel, fragrance mix, para-phenylenediamine (PPD), carba mix and thimerosal. No adverse reactions were observed to patch testing, except for pruritus in patch-test-positive patients. The positive rate of patch testing in ACD was much higher than that in NACD (98% versus 15%, P < 0.05, chi(2)-test). 60 (28%) patients had facial dermatitis (FD). Among these, 20 (33%) were confirmed as having ACD. 48 (22%) patients had hand dermatitis (HD). Among these, 7 (15%) were confirmed as having ACD. Fewer patients were confirmed as having ACD in the HD group than in the FD (15% versus 33%, P < 0.05, chi(2)-test). Although the difference was not significant, the total positivity rate in the HD group (55%) was lower than in the other groups. 65 (30%) patients had unclassified endogenous eczema (UEE). The total positive rate of patch testing in the UEE group (56%) was no different from that in the FD or HD groups. However, the relevance of positive patch tests was hard to determine in UEE. These results indicate that CD is common in eczema; relatively more patients with FD have ACD, while other factors, such as irritation, may play more of a role in HD. The total positive rate of patch testing in the UEE group was no different from that in the FD or HD groups, suggesting that patch testing should be stressed in UEE and the relevance of positive patch test results in UEE should be studied further. It is effective and safe to patch eczema patients with a modified European standard series of allergens in China.     

Common contact sensitizers in the Czech Republic. Patch test results in 12,058 patients with suspected contact dermatitis*

The patch test results of 12 058 patients (4416 male and 7642 female) referred to 9 clinics in the Czech Republic between January 1997 and December 2001 were evaluated. Patients were tested with the same series of allergens by using the standardized patch testing method. The current standard tool for diagnosing allergic contact dermatitis (ACD) in the Czech Republic is the Trolab test panel (Hermal, Reinbeck, Germany) which consists of 23 allergens. Only a few data exists on ACD in the Czech Republic. All patients were tested with the 23 allergen European standard series. Of these patients, 7661 (63.5%) had 1 or more positive reactions. On average, there were 2.8 positive reactions per patient. ACD, according to clinical relevance, was diagnosed in 5339 (69.7%) of these patients. The most frequent allergens were metals (22.9%), especially nickel sulfate (13.8%), and followed by Myroxylon pereirae resin (balsam of Peru) (7.3%), fragrance mix (5.8%), formaldehyde (4.2%) and lanolin alcohol (3.0%). Our results were compared with results from other countries. We conclude that the European standard series is suitable for detection of ACD in the Czech Republic.     

Patch testing in allergic contact dermatitis: is it useful to perform the cosmetic series in addition to the European standard series?

Background Cosmetics are the causative agents in 8–15% of patients suspected of having allergic contact dermatitis. Patch testing with standard series identifies 70–80% of the responsible allergens in all contact dermatitis; however, many important cosmetic‐related allergens may be missed by using standard series alone. Objective The aim of this study was to determine the value of using cosmetic series in addition to the European standard series in patients with suspected allergic contact dermatitis. Methods In this prospective study, 93 consecutive patients suspected of having allergic contact dermatitis were patch tested with the European standard series, and simultaneously with cosmetic series. Positive allergic reactions were further interpreted as clinically relevant or irrelevant. The clinically relevant reactions were subsequently stratified into three subgroups: (i) reactions only to allergen/allergens in the European standard series; (ii) reactions only to allergen/allergens in cosmetic series; and (iii) reactions both to allergen/allergens in the European standard and cosmetic series. Results A total of 74 positive reactions were observed in 93 patients. However, only 46 (62.2%) of the total positive reactions were found to be clinically relevant. Of all the clinically relevant positive reactions, 27 (58.7%) were caused by the allergens in the European standard series; 19 (41.3%) were caused by the allergens in cosmetic series. Of the 93 patients tested, 44 (47.3%) had at least one positive allergic reaction, 30 (68.2%) of whom had clinically relevance. Of the 30 patients with clinically relevant positive tests, 16 (53.3%) reacted only to allergens in the European standard series; nine (30%) reacted only to cosmetic series allergens; and five (16.7%) reacted both to the European standard and cosmetic series allergens. Among the 45 cosmetic series allergens tested, 15 (33.3%) gave positive reactions of which 14 (93.3%) of those were found to be clinically relevant. The clinically relevant cosmetic series allergens which were found to be over the critical incidence of 1% included methyldibromo glutaronitrile, Euxyl K400, and isopropyl myristate. Conclusion Patch testing with cosmetic series in addition to the European standard series increased the capability to detect the relevant allergen/allergens, particularly in patients with a suspicion of cosmetic allergy. However, it is not practical and cost‐effective to test those patients routinely with all 45 allergens in the cosmetic series. As the European baseline series which includes methyldibromo glutaronitrile is now widely used as the guideline minimum set of allergens for routine diagnostic patch test investigations, we additionally recommend Euxyl K400 and isopropyl myristate as the candidates for patch testing.     

Patch testing and aeroallergen intradermal testing in suspected allergic contact dermatitis, unclassified endogenous eczema and non-atopic chronic urticaria

The purpose of this study was to investigate the significance of contact allergen and aeroallergen sensitization in suspected allergic contact dermatitis (ACD), unclassified endogenous eczema (UEE) and non‐atopic chronic urticaria (NACU). 63 cases of suspected ACD, 140 cases of suspected UEE and 21 cases of suspected NACU were patch tested with the standard series of Beijing Medical University and, if available, suspected materials as is. 22 such cases of ACD, 104 such cases of UEE and 42 such cases of NACU were intradermally tested with common aeroallergens. Patients with non‐allergic skin disease served as controls. 85.7% of the suspected ACD patients, 57.9% of the suspected UEE patients and 52.4% of the suspected NACU patients were positive on patch testing, and the results in 81.0% of the suspected ACD patients and 23.6% of the suspected UEE patients were considered relevant. No patch test reactions in the NACU patients were considered relevant. 27.1% of the suspected UEE patients, 41.3% of the suspected ACD patients and 14.3% of the suspected NACU patients reacted to 2 or more contact allergens. High positive rates on aeroallergen intradermal testing were also found in suspected NACU (69.0%), UEE (49.0%) and ACD (59.1%) patients. These results support the conclusions that patients with allergic skin diseases will develop multiple sensitization, and that early detection and avoidance of sensitizing allergens is necessary. The exact rôle of aeroallergen sensitization in these diseases needs further study.     

Footwear contact dermatitis from dimethyl fumarate

Background Dimethyl fumarate (DMF) is an effective inhibitor of mold growth. In very low concentrations, DMF is a potent sensitizer that can cause severe allergic contact dermatitis (ACD). It has been identified as the agent responsible for furniture contact dermatitis in Europe. The aim of this study was to evaluate patients in Slovakia with footwear ACD associated with DMF, with regard to clinical manifestations, patch test results, and results of chemical analysis of their footwear. Methods Nine patients with suspected footwear contact dermatitis underwent patch testing with the following allergens: samples of their own footwear, commercial DMF, the European baseline, shoe screening, textile and leather dye screening, and industrial biocides series. The results were recorded according to international guidelines. The content of DMF in footwear and anti‐mold sachets was analyzed using gas chromatography and mass spectrometry. Results Acute ACD was observed in nine Caucasian female patients. All patients developed delayed sensitization, as demonstrated by positive patch testing using textile footwear lining. Seven patients were patch tested with 0.1% DMF, and all seven were positive. Chemical analysis of available footwear showed that DMF was present in very high concentrations (25–80 mg/Kg). Conclusions Dimethyl fumarate is a new footwear allergen and was responsible for severe ACD in our patients. To avoid an increase in the number of cases, the already approved European preventive measures should be accepted and commonly employed.     

Results of patch testing with a special series of rubber allergens

The purpose of this study was to examine the results of patch testing with the rubber components on a standard screening tray and compare them with the results of testing with a special series of 27 rubber components (rubber tray). 1670 patients were patch tested with the screening tray and 317 of these were also tested with the rubber tray 16% of those tested with the rubber tray had a positive response to at least 1 of the rubber allergens on the screening tray and 22% had a positive response to at least 1 of the allergens on the rubber tray. The most common positive response to the rubber tray allergens was to tetramethylthiuram monosulfide. There were no responses to 3 of the components on the rubber tray and there was only 1 positive response to a further 4 components. The diagnostic test characteristics of the rubber components on the screening tray were examined using the rubber tray as the gold standard. The sensitivity of the screening tray was 94%, specificity 51%, positive predictive value 87%, and negative predictive value 71% Of the 317 tested. 11%, were found to have a positive to a substance on the rubber tray that was not evident from the results of the screening tray patch testing technique: allergic contact dermatitis; rubber allergens: false-negative reactions: fake-positive reactions.     

Contact sensitivity to standard series allergens in 1038 patients with contact dermatitis in Turkey

We planned to determine the frequency of sensitivity to European standard patch test allergens in 1038 patients with contact dermatitis. From 1992 to 2004, 1038 patients with the diagnosis of contact dermatitis were patch tested with the European standard series. Seven hundred and five patients were female (67.9%) and 333 patients were male (32.1%). A total of 336 patients (32.3%) had one or more positive patch test reactions. The most common allergens were nickel (17.6%), cobalt chloride (5.3%), potassium dichromate (4.6%), neomycin (2.4%), fragrance mix (2.1%) and balsam of Peru (2.1%). Contact sensitivity to potassium dichromate and thiuram was significantly more frequent in male patients, whereas nickel and primin sensitivity was significantly more frequent in female patients. Higher sensitivity rates for potassium dichromate, neomycin, balsam of Peru, wool alcohol, fragrance mix and primin were noted in patients over 40 years of age. Sensitivity rates of the standard series allergens were all similar in atopic patients and in non-atopic patients. Metals, neomycin and fragrances are the leading allergens in Turkey. Although fragrances are among the most important sensitizers, sensitivity rates to fragrances and also to preservatives are much lower than the rates in Europe and the US.     

European Standard Series patch test results from a contact dermatitis clinic in Israel during the 7-year period from 1998 to 2004

The results of a 7-year retrospective study (1998-2004) from patch testing with the European Standard Series (ESS) establishing the frequency of sensitization in a contact dermatitis clinic in Israel are presented. 23 allergens were patch tested on 2156 patients, 1462 females (67.8%) and 694 males (32.2%). Atopy and asthma were present in 21.9% of the patients. One or more allergic reactions were observed in 937 patients (43.5%). The highest yield of patch test positives from the 1076 positive reactions were obtained from nickel sulfate (13.9%), fragrance mix (7.1%), potassium dichromate (3.8%), Balsam of Peru (3.6%), CL+Me-isothiazolinone (3.4%) and cobalt chloride (3.4%). Allergens which produced the least amount of positive results were primin and clioquinol. Allergic contact dermatitis (ACD) was established in 32.8%, whereas occupationally related allergic (8.0) and irritant contact dermatitis (5.6%) affected a total of 13.6% of the cases studied. The most common clinical forms of dermatitis were chronic dermatitis (47.7%) followed by acute dermatitis (22.8%), and lichenification and hyperkeratosis (7.9%). The hands (30.7%), face and neck (23.9%) and extremities (11.3%) were the most frequently affected areas. Four allergens in our study differed from the top 10 allergens in Europe namely: Cl+Me-isothiazolinone, formaldehyde, 4-tert-butylphenol formaldehyde resin and sesquiterpene lactone mix reflecting an existing difference in environmental exposure. Our study is the first to provide data on the frequency of sensitization and important allergens in the aetiology of ACD in Israel. In spite of the existing differences with Europe, we conclude that ESS is an appropriate screening system for the diagnosis of ACD in Israel.     

Patch testing by additional series of allergens: results of further experiences.

BACKGROUND: Patch testing with additional series (AS) of allergens may be a useful tool in diagnosing allergic contact dermatitis (ACD). OBJECTIVE: Aim of the study was to verify the usefulness, to check the reliability in clinical practice and to evaluate the economic costs of AS previously built up. METHODS: A total of 281 patients with suspicious ACD underwent patch test with the standard series (SS) and with one or more AS (51 among 71 built up). RESULTS: A total of 170 patients (60.5%) showed positive reactions to SS; 116 (41.3%) to AS. Among 582 nonstandard allergens used, 113 (19.4%) elicited 1 or more positive reactions: out of 10,916 patch tests carried out, 260 (2.4%) positive reactions were observed. The correlation between SS and AS indicated that 8.2% patients resulted SS-/AS+, 27.7% SS+/AS-, 32.7% SS+/AS+, 31.3% SS-/AS-. The most frequently used AS showed the following percentages of patients with 1 or more positive reactions: clothes 41.4%, building industry 51.8%, hairdressers 77.3%, textile industry 42.1%, shoes 36.8%. Positive reactions to the most frequently used nonstandard allergens resulted: propylene glycol 0.4%, cobalt chloride 12.6%, phenylmercuric nitrate 2.2%, p-aminophenol 4.5%. The approximate economic cost of patch testing with AS has been evaluated in 1.3 euro per single patch test. CONCLUSION: The cost of patch testing AS is not irrelevant, but it can be compensated by the advantages deriving from the increase of data concerning ACD etiology. A reduction in the number of allergens included in single AS should be performed. Cobalt chloride, taking into account the high percentage of positive reactions observed and its presence in a large number of AS, could be (re)introduced in the standard series.