534例变应性接触性皮炎斑贴试验结果分析

目的:了解变应性接触性皮炎常见的过敏原。方法:采用瑞敏斑贴试验器,对2011年2月至2015年7月到我院就诊的534例变应性接触性皮炎患者进行斑贴试验,并对试验结果进行统计分析。结果:534例受试者中1项或1项以上阳性反应的有471例,总阳性率88.20%。阳性反应率较高的变应原依次是:重铬酸钾(61.78%)、氯化钴(53.29%)、硫酸镍(43.10%)、芳香混合物(34.61%)、卡巴混合物(33.33%)。结论:重铬酸钾、氯化钴、硫酸镍、芳香混合物、卡巴混合物是本地变应性接触性皮炎的常见过敏原。斑贴试验是检测变应性接触性皮炎过敏原安全、有效、简便的方法。     

287例变应性接触性皮炎患者斑贴试验结果分析

目的：了解本地区变应性接触性皮炎（ACD）患者常见变应原。方法：采用由瑞典化学诊断AB公司研发生产的中国筛查系列CH-1000对287例ACD患者进行斑贴试验。结果：287例ACD患者中有139例阳性,阳性率48.4%,与健康对照组（阳性率6.7%）相比较,其差异有统计学意义（P〈0.05）,最常见5种变应原依次为：硫酸镍、芳香混合物、氯化钴、CL＋Me异-噻唑（卡松CG）、卡巴混合物。结论：斑贴试验是明确ACD患者变应原的一种安全、有效的方法。     

317例斑贴试验结果分析

目的：探讨皮炎,湿疹类皮肤病接触性病因及发生规律。方法：用辨敏牌标准筛选斑贴试验试剂盒对患者做斑贴试验。结果：317例患者中阳性者218例,阳性率68．77％,其中湿疹,皮炎,荨麻疹的阳性率明显高于其他病种,痤疮,丘疹性荨麻疹,唇部色素沉着亦有阳性结果。结论：斑贴试验对皮炎,湿疹类皮肤病有确定的指导,防治意义,对某些不典型的皮肤病,如寻常痤疮,丘疹性荨麻疹,唇部色素沉着等应做斑试,以排除接触过敏的可能。     

长沙地区188例湿疹及接触性皮炎患者斑贴试验结果分析

为了解长沙地区湿疹皮炎类疾病的常见致病因素，对１８８例拟诊为湿疹及接触性皮炎的患者进行了斑贴试验，现将结果分析如下。１病例资料：１８８例患者中，女１４９例，男３９例；年龄３～６８岁；病程１天～１９年（病程１年以上者１５０例）；湿疹１３０例，接触性皮炎５８例（均有可疑接触史）；皮疹主要发生于手、面部，其中仅手部受累者９６例。所有患者在斑试前２周及斑试过程中未使用过抗组胺类药物和皮质类固醇。所有手足部有皮疹患者真菌检查阴性。２斑贴试验方法：采用南京医科大学附一院提供的“辨敏牌”标准筛选抗原及Finncha…     

200例斑贴试验结果分析

临床资料 自2001年3月～2002年7月我们对200例患者做斑贴试验，男65例，女135例；年龄9～70岁，平均35岁，接触性皮炎61例，湿疹85例，荨麻疹54例。所有患者均在停用抗组胺药2天，停内服糖皮质激素2周后进行，其中接触性皮炎患者在皮疹完全消退2周后进行，湿疹患者在皮疹减轻后进行。     

正红花油所致接触性皮炎25例(附斑贴试验结果)

中药制剂外用可致皮肤过敏。我们在三年的临床观察中发现，中药制剂外用所致接触性皮炎约占该病发病的３０％。现将我们经斑贴试验证实的正红花油所致接触性皮炎２５例报告如下。临床资料２５例均为１９９５年６月～１９９７年６月的住院患者，其中男９例，女１６例，年龄...     

326例接触性皮炎和湿疣患者斑贴试验分析

本科应用瑞典化学技术诊断AB公司提供的斑贴试验标准试剂对326例接触性皮炎和湿疹患进行斑贴试验。阳性率为57.36%。阳性率高的抗原依次为硫酸镍,重铬酸钾,4-苯二胺,芳香混合物,氯化钴和硫柳汞,接触性皮炎组的斑试阳性率显高于湿疹组（P<0.01)。斑试阳性结果与临床接触史的符合率为82.35%,结果提示发生在头面部的皮炎,湿疹应考虑化妆品,染发剂过敏的可能,而发生于手部的皮炎,湿疹应首先考虑刺激性因素所致。     

沈阳地区150例接触性皮炎及湿疹患者斑贴试验分析

沈阳地区１５０例接触性皮炎及湿疹患者斑贴试验分析陆东庆①王亚坤①陈洪铎①王凤贤①白兆震①斑贴试验是诊断外源性皮炎湿疹类疾病的特异检查方法，已在世界各地普遍应用。本文报告沈阳地区１５０例接触性皮炎和湿疹患者斑试结果，以便了解和分析本地区皮炎湿疹类疾病的...     

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。     

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。     

The clinical significance of fungi in atopic dermatitis

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases and is caused by multiple factors including genetic factors, skin barrier defects, host immune responses, allergen sensitivity, environmental effects, and infections. Commonly, bacterial and viral infections are present in the eczematous lesions of AD patients and clearly aggravate the symptoms. However, studies of fungal infections in AD are limited in spite of the fact that there are reports showing that Malassezia, Candida, and some dermatophytes can affect the symptoms of AD. Moreover, certain fungal infections are sometimes overlooked and need to be considered particularly in AD patients with treatment failure as clinical features of those fungal infections could mimic eczematous lesions in AD. Here, we review the epidemiology, pathogenesis, clinical manifestations, and overlooked features of fungal infections associated with the symptoms of AD including the diagnosis and effectiveness of fungal treatments in AD patients.     

Adhesion molecules in atopic dermatitis: patch tests elicited by house dust mite

Different T-helper subsets, which are characterized by the secretion of distinct cytokines (Th1, Th2), have been found in house dust mite-exposed skin of sensitized individuals and in nickel-specific T lymphocytes from nickel contact allergic and non-allergic individuals. In order to evaluate the role which adhesion molecules may play in the homing of different T-cell subsets into allergen-exposed skin of atopic and normal individuals, we compared the expression pattern of adhesion molecules in patch test reactions to house dust mite antigen (D.pt.), nickel sulfate (Ni) and the irritant anthralin. Biopsies were taken al various time points after application of these agents and studied by immuncytochemistry. To exclude an endogenous difference in adhesion molecule expression in atopic and non-atopic skin, sequential biopsies from Ni patch tests of 2 normal individuals were also included in this study. The expression of E-selection. P-selection. CD31, VCAM-1 and ICAM-1 on endothelial cells and other cells in the skin was quantified by microscopic evaluation. Skin homing T cells were also quantified using antibodies toCD3, CD4, CDS, UCHL-I, L-selection and the cutaneous lymphocyte antigen (CLA). Independent of the eliciting substance, all lesions showed an up regulation of all adhesion molecules tested, with the exception of CD62. The appearance of E-selection and an increase in ICAM-1 and VCA M-1 expression were first observed at 12 h after application of the various agents. In parallel, the number of CLA+ and L-selection+ lymphocytes increased steadily. No principle differences could be established between the various types of skin reactions in atopic individuals, nor did the skin of patients with AD differ from normal controls. Our results provide evidence that differential expression of adhesion molecules does not play a major part in observed differential homing of Th1 and Th2-cell subsets into patch test sites provoked by house dust mite and nickel sulfate in atopic and non-atopic individuals.     

Histological findings of patch tests with dermatofagoides antigens in atopic dermatitis of the adult type

Patch testing with Dermatophagoides antigens, mite antigens, and fecal antigens of mites was performed on 34 cases of atopic dermatitis of the adult type. The fecal antigens induced positive reactions more frequently than mice antigens in patients with higher scores of IgE RAST (score 4). Histologically, the positive reaction showed mild perivascular infiltration of lymphocytes and edema in the papillary dermis at 24 hours after the patch test. The lymphocytic infiltration became more prominent and was intermingled by eosinophils at 48 hours. The epidermis showed mild intercellular edema. Eosinophils and lymphocytes infiltrated into the epidermis to form spongiotic bulla at 72 hours.     

Epicutaneous patch test reactions in atopic dermatitis patients

During the 1998-2003 period, patch testing was carried out in 65 atopic dermatitis patients, 20 (31%) male and 45 (69%) female, mean age 34.7 (range 6-77) years. Twenty-six (40%) patients, 7 (27%) male and 19 (73%) female, showed positive reaction to one or more allergens. Allergic reactions were more common in women. The most common allergens were nickel (33.3%), cobalt (11.1%), fragrance mix (11.1%), white mercury precipitate (8.4%), and others (36.1%). There was a significant association between nickel allergy and cobalt allergy. It is concluded that contact hypersensitivity is not rare in patients with atopic dermatitis.     

Adult-onset atopic dermatitis in a patch test population

BACKGROUND: Epidemiological studies about atopic dermatitis (AD) almost exclusively relate to childhood disease with little mention of adult-onset disease. In clinical practice, however, patients who have AD and in whom the onset of disease occurs in adult life are sometimes seen. OBJECTIVE: Because the subjects with a chronic and recalcitrant eczema are frequently patch tested, the aim of this study was to evaluate the prevalence of adult-onset AD in a patch test population and the differences existing between the early- and adult-onset subsets. METHODS: This retrospective analysis was performed on 502 adults (458 males, 44 females) affected by eczematous dermatitis, consecutively examined in the Department of Dermatology of the Italian Navy Hospital in Taranto. In this department, all the eczematous subjects are routinely submitted to the following tests: standard series (GIRDCA or SIDAPA with integrative haptens), prick test with environmental aeroallergens and common food allergens and dosage of total serum IgE. If it is required, additional series of patch tests are also applied. Many patients are also submitted to the atopy patch test (APT) with whole bodies of house dust mites at a concentration of 20%. In the AD patients, diagnosed according to the criteria of Hanifin and Rajka, the ages of onset were subdivided into the following categories: infancy (0-3 years); childhood (4-11 years); adolescence (> or =12 years). We arbitrarily also used the age of 18 years as the cut-off mark to allocate the patients to the adult-onset group (AOG) and defined as early-onset group (EOG) the cases encompassed in the aforesaid categories (i.e. onset < or =17 years). RESULTS: 8.8% of all eczemas were adult-onset ADs. 28 (5.6% of all eczemas) adult-onset ADs were 'sole' ADs, while 22 cases (3.2% of all eczemas) were adult-onset ADs in which a contact sensitization was detected. The mean SCORAD indexes, according to the age-of-onset groups, decreased when the age of onset increased. No statistical difference was detected between the EOG and AOG with regard to true contact sensitization, clinically relevant or non-relevant contact sensitization, prevalence of 'pure' AD and 'mixed' AD, and outcome of the APT. The hands were the most frequently affected site in the AOG. CONCLUSION: A small but significant number of patch-test-negative eczematous cases could be adult-onset ADs and, in this instance, the other two allergological tests (i.e. prick tests and dosage of total serum IgE) and an accurate evaluation according to stated clinical criteria should be performed. However, other studies on large series of patients are required to confirm our observation.     

Pustular patch test reactions in atopic dermatitis.

Pustular patch test reactions to 5% nickel sulfate were regularly produced in patients with atopic dermatitis when patches were placed over areas of skin with (a) follicular papules, (b) erythema, (c) lichenification, and (d) minimal trauma. The pustular patch test reactions seldom occurred in the normal-appearing skin of these patients. However, if the skin was traumatized prior to the patch test, the reaction was produced in the normal-appearing skin of atopic as well as control individuals. No pustular reactions occurred in the follicular lesions of keratosis pilaris, supporting the view that follicular lesions of atopic dermatitis differ from keratosis pilaris. It is suggested that pustular patch test reactions are caused by primary irritation.     

Results of atopy patch tests with house dust mites in adults with ''intrinsic'' and ''extrinsic'' atopic dermatitis

BACKGROUND: The most frequently employed diagnostic criteria of atopic dermatitis (AD) can be fulfilled in the absence of elevated total circulating IgE or specific IgE to food allergens or environmental aeroallergens and/or in the absence of personal or familial history of atopy as well. Therefore a distinction between 'extrinsic' or 'allergic' and 'intrinsic' or 'non-allergic' AD has been suggested. Recently, a patch test with environmental aeroallergens, named atopy patch test (APT), has been proposed for use in the study of AD. OBJECTIVE The aim of this study was to investigate the reactivity to APT in patients with 'extrinsic' and 'intrinsic' AD. PATIENTS, MATERIALS AND METHODS: Two groups of adult male subjects with AD were examined consecutively in our department (Department of Dermatology, Italian Navy Main Hospital, Taranto, Italy) andpatch tested with whole bodies of house dust mites (HDM) at a concentration of 20% in petrolatum (Dermatophagoides pteronyssinus 50%, D. farinae 50%). The groups included: (i) 95 patients affected by the adult clinical form of 'extrinsic' AD; (ii) 12 patients affected by the adult clinical form of 'intrinsic' AD; and (iii) a control group of 49 adult healthy male subjects with a negative anamnesis for eczema and atopy and negative skin prick test to aeroallergens/food allergens and/or normal level of total circulating IgE, also patch tested with the same allergen. The statistical differences were calculated by chi2 test and 95% confidence intervals (CI) were provided. RESULTS: The APT was positive in 47.4% (CI: 37-57%) of'extrinsic'AD, in 66.6% (CI: 41-93%) of'intrinsic' AD and in 12.2% (CI: 3-21%) of healthy subjects. The differences between the two AD subgroups and the control group were statistically significant (P < 0.001). CONCLUSIONS: APT positivity is more frequent in both 'extrinsic' and 'intrinsic' AD than in unaffected subjects. Other studies are needed to confirm our data and to explain why the APT is positive in the 'intrinsic' form.     

Atopy patch tests in young adult patients with atopic dermatitis and controls: dose-response relationship,objective reading,reproducibility and clinical interpretation

The clinical interpretation and reproducibility of atopy patch tests was studied in 23 selected young adult patients with atopic dermatitis and 25 healthy controls using standard inhalant allergens. Non-invasive measurements were used for objective assessment of test reactions and the participants were retested after 6 weeks. Ten of 19 (53%) evaluable patients with atopic dermatitis had at least one positive atopy patch test. However, there was no clear clinical relevance of the atopy patch test results when related to patient history and distribution of dermatitis. Reproducible and dose-dependent results were obtained with Dermatophagoides pteronyssinus, grass and cat with a reproducibility rate of 0.69 to 0.81 in patients and 0.60-0.96 in controls. A unique finding was a significant positive correlation between a positive atopy patch test, allergen dose and increase in transepidermal water loss and erythema, while measurement of capacitance did not distinguish between positive and negative reactions. The results of the present study do not support the routine use of atopy patch tests in the evaluation of adult patients with atopic dermatitis.