110例手部湿疹斑贴试验临床分析

目的：探讨手部湿疹患者的潜在病因及其对常见的接触性致敏原的敏感性。方法：应用“瑞敏”斑贴试剂盒检测手部湿疹患者对常见接触性致敏原的敏感性。结果：受检的110例患者中有94例（85．45％）斑贴试验出现阳性反应,位列前5种最常见的致敏原分别为重铬酸钾、硫酸镍、氯化钴、芳香混合物和甲醛,从事某些特定职业的患者阳性率明显较高。男性患者中对苯二胺基质及秋兰姆混合物阳性检出率明显高于女性。结论：手部湿疹患者对接触性变应原的斑贴试验阳性率高,斑贴试验有助于明确手部湿疹患者的接触性致敏原。     

30例手部湿疹斑贴试验临床分析

目的:探讨手部湿疹患者对常见的接触性致敏原的敏感性。方法:用瑞敏斑贴试剂盒对30例手部湿疹患者、31例正常人作斑贴试验,并进行比较。结果:手部湿疹及正常对照组斑贴试验阳性率分别为96.7%、25.8%,手部湿疹组阳性率明显高于对照组(x~2=32.08,P0.01);手部湿疹患者最常见变应原分别是芳香混合物(33.3%)、重铬酸钾(30%)。结论:手部湿疹患者对接触性变应原的斑贴试验阳性率高,斑贴试验有助于明确手部湿疹患者的接触性致敏原。     

302例面部皮炎和手部湿疹患者60种中国基准系列半抗原斑贴试验结果分析

目的:探讨面部皮炎及手湿疹患者常见的接触性过敏原.方法:选取来自我科门诊的302例诊断为面部皮炎和手部湿疹的患者进行新型60项瑞敏中国基准系列半抗原斑贴试验,对结果进行统计分析.结果:217例面部皮炎患者中,斑贴试验总阳性率为83.87％,阳性率排名前6位的依次是硫酸镍(29.95％)、氯化钴(23.04％)、芳樟醇氢...     

337例接触性皮炎湿疹致病因素分析

应用“辨敏”牌20种标准抗原，对337例接触性皮炎、湿疹的患者进行斑贴试验，并选择50例健康者作对照。接触性皮炎组136例，对一种以上抗原呈阳性反应者79例，阳性率58．09％，硫酸镍是其主要的致敏原。湿疹组201例，对一种以上抗原呈阳性反应者85例，阳性率42．29％，氯化钴是其主要的致敏原。健康对照组阳性率为6％。结论：接触性皮炎和湿疹对斑试抗原的敏感性高于健康对照组，接触性皮炎与湿疹的主要致敏原不尽相同。     

手部湿疹100例血清总IgE及斑贴试验检测结果分析

目的探讨手部湿疹患者的常见病因及其常见的变应原。方法采用ImmunoCAPl00全自动过敏原体外检测系统检测手部湿疹患者的血清总IgE,采用斑贴试剂盒检测接触性变应原。结果 100例患者中,血清总IgE≤60KU/L者73例(73.00%),>60KU/L共27例(27.00%),其斑贴试验均为阳性;其中具有特应性素质的20例手部湿疹患者,总IgE>60KU/L,并且对两种及以上变应原过敏;受检的100例患者中94例(94.00%)斑贴试验出现阳性反应,前5位的常见变应原依次为:橡胶Ⅰ、重铬酸钾、硫酸镍、香料混合物、白降汞。结论手部湿疹主要与接触性变应原有关,斑贴试验有助于明确变应原种类。手部湿疹与血清总IgE的关系尚需进一步研究。     

326例接触性皮炎和湿疹患者斑贴试验分析

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者进行斑贴试验,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著高于湿疹组(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...     

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…     

威海地区182例接触性皮炎、湿疹患者斑贴试验结果分析

材料与方法 斑试对象：为我院门诊拟诊为接触性皮炎患者102例，湿疹患者80例，共182例。其中男58例，年龄4～78岁，女124例，年龄3～64岁。所有患者在试验前2周和斑贴试验过程中均未服用糖皮质激素及抗组胺药物。     

手部湿疹的病因诊断和原发刺激性接触性皮炎

手部湿疹是皮肤科的常见疾病,其病因错综复杂,目前国外临床医师普遍认为外界接触性因素是手部湿疹的常见病因,而以刺激性因素为主^(1,2),常因多种因索共同作用而发病.儿童期有特应性皮炎及有特应性病史的人容易发生手部湿疹.本研究的目的在于对手部湿疹的病因进行调查分析并探讨诊断问题,重点放在目前国内尚少论及的慢性原发刺激性接触性皮炎上.     

Patients with atopic eczema do become sensitized to contact allergens

Sensitization to contact allergens in atopics was assessed by grouping 989 patients, who were routinely patch tested, by their personal atopic status. Sensitization to ≥1 allergens occurred in 38% of the 191 patients with existing atopic eczema, in 53% of the 120 with a past history of atopic eczema, in 54% of the 156 with only mucous membrane atopy and in 50% of the 510 who were not atopic. Sensitization to perfume, a common environmental allergen, was similar in all 4 groups, as was nickel among women. Patients with atopic eczema should be patch tested.     

Pattern of contact sensitivity in Indian patients with hand eczema

One hundred consecutive patients with hand eczema were patch tested with the Indian Standard Series and indigenous antigens after a detailed history and clinical examination. Both sexes were involved and the majority of them were in the age group between 20-39 years (56%). Their occupational profile varied in order of frequency from household work (37%), to masons (14%), students (11%), factory workers (7%), and others (31%). Itching was the most common presenting complaint (93%). A history of atopy was found in 36% of the patients. The predominant sites involved were the palms (43%), followed by fingers (32%), dorsum (17%), and the entire hand (8%). Dry, scaly skin was the most common morphological picture, followed by hyperpigmentation, fissuring, and lichenification. Based on history, clinical examination and patch test results, the diagnosis was made as allergic contact dermatitis in 67% of cases and irritant contact dermatitis in 15% of cases. Positive patch tests with one or more allergens were noted in 67% of the patients. Vegetables (21%) were found to be the most common sensitizers, followed by nickel sulphate (20%), potassium dichromate (18%), and others. Wet work, soaps, and detergents were found to be the most offending irritants. The present study confirmed the fact that hand eczema is a multifactorial disease caused by both irritants and allergens.     

Allergens associated with severe symptoms of hand eczema and a poor prognosis

Background: Contact allergy is frequent among persons with hand eczema and may be associated with a poor prognosis.
Objectives: To identify allergens associated with the most severe initial clinical symptoms and the worst prognosis in a cohort of hand eczema patients followed for 6 months.
Methods: The study population comprised 799 consecutive hand eczema patients enrolled during January 2006–February 2007. All patients were patch tested with the European baseline series. Severity assessment of the hand eczema was performed initially and at the 6-month follow-up using a validated scoring system (HECSI). With logistic regression analyses, associations of severe hand eczema or a poor prognosis with 15 individual allergens were analysed and adjusted for by sex, age, atopic dermatitis and other allergens.
Results: At baseline, greater severity of hand eczema was associated with a positive patch test to formaldehyde, methyldibromo glutaronitrile, sesquiterpene lactone mix, nickel sulfate and potassium dichromate. A poor prognosis was associated with chromate allergy, odds ratio: 4.18 (95% CI: 1.42–12.28).
Conclusions: Nickel, chromate, formaldehyde, methyldibromo glutaronitrile and sesquiterpene lactone mix were allergens associated with the greatest severity of hand eczema. Patients with chromate allergy had the worst prognosis.     

Patch testing in children with hand eczema. A 5-year multicentre study in Spain

Background. Hand eczema is common in children, but affected children are seldom patch tested. Relatively few studies have assessed patch testing in the paediatric population, and none has specifically evaluated its use in hand eczema in children. Objectives. The aim of this study was to determine the prevalence of contact allergy in children with hand eczema, and to identify the most frequent allergens and their relevance. Material and methods. We performed a 5‐year retrospective study of children (aged 0–15 years) with hand eczema tested with the Spanish baseline series at the Dermatology Departments of 11 Spanish hospitals. Results. During the study period, 11 729 patients were patch tested, of whom 480 were children. Hand eczema was present in 111 (23.1%) of the children and in 3437 (30.5%) of the adults. Of the children with hand eczema, 46.8% had at least one positive reaction in the patch tests. Current relevance was found for 78% of the allergens detected. The most common allergens were nickel sulfate, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix I. Allergic contact dermatitis was the most frequent diagnosis (36%), followed by atopic dermatitis. Conclusions. Allergic contact dermatitis was the most usual diagnosis in our series of children with hand eczema. We recommend patch testing of all children with chronic hand eczema, as is already performed in adults.     

Nickel allergy and hand eczema

A clinical study was performed in 66 female patients with hand eczema and contact allergy to nickel. They were drawn from a basic material of 165 patients with nickel allergy in which hand eczema occurred in 86 cases (52%). The hand eczema started at an average age of 32 years and it had been preceded by a metal hypersensitivity for an average of 6 years. The eczema was found to be chronic with a mean duration up to the time of examination of 8 years. It was associated with secondary eruptions in half of the cases. The hand eczema showed a low degree of relevance with regard to dependance of occupation or vacation, as well as to exacerbation of the dermatitis after a direct contact with nickel-coated objects. The clinical examination disclosed in 77% a pompholyx, i.e. a symmetric vesicular eruption mainly located on the palms and volar aspects of fingers, and sides of fingers. The eczema often showed a periodic activity, with about 15 annual eruptions in the pompholyx cases. It is concluded that simple external contact with the metal can hardly explain the most common clinical pattern of the hand eczema in nickel allergy.     

Etiology and prognosis of hand eczema in a dermatology clinic in China: a follow-up study

Background:  Prognosis of hand eczema (HE) has not been reported in China.
Objectives:  To investigate the etiology and outcome of HE in 655 consecutive patients patch tested with European standard series in Peking University Hospital in a 2-year period.
Methods:  All patients were re-examined at 1 year after patch testing, and prognosis of dermatitis was evaluated by the rate of clearance of skin symptoms for at least 3 months without relapse before the evaluation.
Results:  Of 599 patients examined, 82 (13.7%) were HE. Allergic, irritant, and unclassified HE accounted for 23.2%, 17.1%, and 51.3% of HE, respectively. The overall clearance rate of HE was much lower than that of eczema elsewhere (18.3% versus 29.6%, P  < 0.05, chi-squared test). 35.7% of patients with allergic HE and 26.3% with irritant HE cleared their lesions, of those with unclassified HE only 11.9% ( P  < 0.05, chi-squared test). The lowest healing rate (5.7%) was found in unclassified HE patients with disease duration over 6 months.
Conclusions:  The outcome of HE was worse than eczema elsewhere. Allergic HE had a better prognosis than unclassified HE. Longer disease duration was the main risk factor for poor prognosis of unclassified HE.     

Filaggrin null alleles are not associated with hand eczema or contact allergy

BACKGROUND: The filaggrin protein is a key component of stratum corneum and homo- or heterozygotes for the filaggrin variant alleles R501X and 2282del4 have varying degrees of impaired skin barrier. The variant alleles have repeatedly been shown to be associated with atopic dermatitis. Any possible association with hand eczema or contact allergy are unexplored. OBJECTIVES: To explore associations between the variant alleles, hand eczema, contact allergy and atopic dermatitis. METHODS: In total, 183 adult individuals participated in a clinical examination of the hands, patch testing and filaggrin genotyping. Children without any evidence of atopic dermatitis from the Copenhagen Prospective Study on Asthma in Childhood (COPSAC) study were used as controls. The chi(2) test was used for comparison of allele frequencies. RESULTS: The majority (73%) had hand eczema, 25% had contact allergy and 14% had a diagnosis of atopic dermatitis. The association between atopic dermatitis and the filaggrin variant alleles was confirmed (odds ratio 3.5, P = 0.015). Allele frequencies in individuals with hand eczema or contact allergy were not statistically significantly increased. CONCLUSION: There is no association between the variant alleles and hand eczema or contact allergy.     

Role of contact allergens in pompholyx

Fifty patients of both sexes with clinically suspected pompholyx were patch tested with the Indian Standard Patch Test Battery approved by the Contact & Occupational Dermatosis Forum of India (CODFI). Most of these patients were young adults between 20-39 years of age with a mean age of 30 years. The mean duration of symptoms was 4 years. The occupational profile of the patients included students (20%), housewives (16%), housewives engaged in farming (12%), labourers (12%), farmers (12%) and paramedical workers (6%). The miscellaneous group, including salesmen, teachers and photographers, accounted for the remaining 22%. The clinical patterns of presentation of pompholyx included cheiropompholyx (60%), cheiropompholyx and podopompholyx (36%) and podopompholyx alone (4%). Patch test analysis of these patients revealed that, out of the 50 subjects tested, 20 (40%) reacted to one or more allergens. Nickel sulphate was the commonest offending allergen (14%) followed by potassium dichromate and phenylene diamine and nitrofurazone (8% each), fragrance mix (6%) and cobalt chloride (4%), in descending order of frequency. Hence, patch testing may be considered for all patients with recurrent episodes of pompholyx as allergic contact dermatitis may be relatively common in such patients and the avoidance of offending allergens may be of substantial benefit to these patients.     

新疆地区皮炎及湿疹患者斑贴试验结果分析

目的：确定新疆地区皮炎及湿疹患者的常见接触性变应原.方法：采用斑贴试验试剂盒对202例患者进行了斑贴试验.结果：202例患者中有122例至少对一种物质过敏,总阳性率为60.40%,阳性率较高的几种变应原依次为硫酸镍39例（19.31%）,白降汞31例（15.35%）和橡胶24例（11.88%）.结论：新疆地区皮炎及湿疹主要变应原为3种化学物质.