无锡市1065例皮炎湿疹类皮肤病的接触性变应原分析

目的 探讨无锡市皮炎湿疹类皮肤病患者的接触性变应原及其临床意义。 方法 斑贴试剂盒对门诊确诊的1065例皮炎湿疹类皮肤病患者进行斑贴试验,并对结果作统计学处理。 结果 斑贴试验总阳性率83.19%,性别、年龄差异无统计学意义。阳性率居前6位的变应原依次为重铬酸钾、氯化钴、硫酸镍、甲醛、卡巴混合物和芳香混合物。其中重铬酸钾和卡巴混合物的阳性检出率男性显著高于女性,硫酸镍和甲醛的阳性检出率女性显著高于男性,差异有统计学意义（P < 0.01）。氯化钴的阳性检出率中青年组和老年组显著高于儿童组,硫酸镍的阳性检出率中青年组显著高于儿童组,差异有统计学意义（P < 0.05）。结论 重铬酸钾、氯化钴、硫酸镍、甲醛、卡巴混合物和芳香混合物是无锡市引起皮炎湿疹类皮肤病的主要变应原。     

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.     

皮炎湿疹599例致病因素分析

目的探讨环境接触性因素在皮炎湿疹类疾病发病中的作用及影响因素。方法对诊断皮炎湿疹的患者做斑贴试验并进行问卷调查。结果 599例皮炎湿疹患者中变应性接触性皮炎167例(27.88%),在整个患者中所占比例最高。斑贴试验结果变应原呈阳性反应者有441例(73.62%)。阳性率由高到低排列的前6位变应原为:硫酸镍、硫柳汞、辛酸盐、芳香混合物、卡巴混合物和重铬酸钾。结论斑贴试验是寻找皮炎湿疹病因的有效手段。     

不同部位的慢性湿疹与斑贴试验相关性研究

皮炎湿疹与多种变应原之间存在联系,并且发现不同部位的皮炎湿疹的常见变应原各不相同。引起面部湿疹和皮炎的致敏原主要为硫酸镍、重铬酸钾、对苯类、芳香混合物,手部主要为硫柳汞、芳香混合物、重铬酸钾、对苯二胺,脐周主要为硫酸镍。斑贴试验有助于明确慢性湿疹和皮炎患者的接触性致敏原,并发现不同部位皮炎和湿疹常见致敏原的不同。提示临床上应根据不同部位的皮炎湿疹采取不同措施。     

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。     

手部湿疹313例接触过敏原分析

目的:探讨手部湿疹患者接触性变应原的分布及其特点。方法:应用斑贴试剂盒检测手部湿疹患者的接触性变应原,并分析与职业等因素的相关性。结果:受检的313例手部湿疹患者中有257例(82.11%)斑贴试验出现阳性反应,位列前6种最常见的致敏原分别为重铬酸钾、硫酸镍、芳香混合物、氯化钴、卡巴昆合物、甲醛,从事某些特定职业的手部湿疹患者阳性率明显较高。男性手部湿疹患者对重铬酸钾阳性检出率(34.96%)明显高于女性患者(17.37%),女性患者对硫酸镍的阳性检出率(30.00%)明显高于男性患者(13.01%)。结论:斑贴试验有助于查找手部湿疹患者的接触性变应原;手部湿疹与接触过敏原密切相关。     

过敏性皮肤病患者的接触性变应原分析：基于883例斑贴试验

目的 了解过敏性皮肤病患者接触性变应原特点。方法 回顾性分析883例过敏性皮肤病患者斑贴试验结果,并比较不同性别、年龄、疾病诊断的斑贴试验结果阳性率情况。结果 斑贴试验阳性751例(85.05%)。前6位变应原依次为硫酸镍、重铬酸钾、硫柳汞、卡巴混合物、芳香混合物、夸特15。男性患者重铬酸钾(χ²=48.58)和硫柳汞(χ²=4.36)阳性率均高于女性(均P<0.05)。不同年龄组斑贴试验阳性率差异有统计学意义(χ²=22.33,P<0.01),其中18～45岁和46～59岁组硫酸镍阳性率均高于<18岁组(χ²值分别为4.09、12.06,均P<0.01),18～45岁组卡巴混合物阳性率及46～59岁组重铬酸钾阳性率也均高于<18岁组(χ²值分别为7.50、7.47,均P<0.01);18～45岁组硫柳汞阳性率高于>59岁组(χ²=10.28,P<0.01);而18～45岁组夸特15阳性率低于>59岁组...     

慢性皮炎湿疹1058例患者斑贴试验分析

目的调查慢性皮炎湿疹患者常见的接触性变应原,并探讨其与临床特征之间的相关性。方法回顾性分析2011年7月—2016年7月在皮肤科门诊就诊的1 058例慢性皮炎湿疹患者的斑贴试验结果,应用统计学方法比较变应原阳性率与患者的性别、年龄、病程、皮损发生部位和个人过敏史的相关性。结果斑贴试验总阳性率为38.6%,女性阳性率高于男性;60岁以下(非老年组)阳性率高于60岁以上(老年组);有个人过敏史、皮损泛发和病程长(≥3年)的患者阳性率更高。男性患者重铬酸钾、对苯类混合物和卡巴混合物3种变应原的阳性率高于女性;老年组卡巴混合物的阳性率高于非老年组,而硫酸镍的阳性率低于非老年组。结论慢性皮炎湿疹患者斑贴试验的总阳性率40%;变应原阳性率的高低与患者的性别、年龄、病程、个人过敏史及发病部位有一定关联。     

95例学生湿疹患者斑贴试验结果分析

目的探讨学生湿疹的病因及其与变应原的关系,为患者的预防和治疗提供依据。方法采用北京元康医学实用技术有限责任公司提供的中国筛查系列变应原CH-1000斑贴试剂盒,对门诊95例学生诊断为湿疹患者进行斑贴试验。结果95例学生湿疹患者的变应原检测阳性率为67.4%。变应原阳性率位居前5种的分别是氯化钴20例占21.1%、重铬酸钾14例14.7%、咪唑烷基脲和甲醛及芳香混合物各12例各占12.6%。结论氯化钴、重铬酸钾、咪唑烷基脲和甲醛和芳香混合物是目前引起学生湿疹的主要变应原。     

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。     

Concomitant positive reactions to allergens in a patch testing standard series from 1988-1997.

BACKGROUND: Patch testing is a useful diagnostic technique in patients with suspected allergic contact dermatitis (ACD). Concomitant reactions may reflect associations between tested allergens. OBJECTIVE: This study was performed to identify positive correlations between reactions to test substances in a standard screening series. The results of patch testing in patients seen from 1988 to 1997 are described. METHODS: Data were collected from chart review for patients who underwent patch testing to the full standard screening series at the Massachusetts General Hospital Contact Dermatitis Clinic. The Fisher exact test was used to evaluate associations between allergens. RESULTS: A total of 927 patients were patch tested to 22 allergens included in a screening tray. The mean age was 43.9 years, and 68.6% were women. Two or more positive reactions occurred in 36.5% of patients. Reactions to 13 pairs of allergens were found to be significantly correlated: balsam of Peru/fragrance mix, carba mix/thiuram mix, carba mix/paraben mix, cobalt chloride/potassium dichromate, cobalt chloride/nickel sulfate, ethylenediamine/neomycin sulfate, formaldehyde/imidazolidinyl urea, formaldehyde/paraben mix, formaldehyde/quaternium-15, imidazolidinyl urea/quaternium-15, neomycin sulfate/potassium dichromate, paraben mix/quaternium-15, and potassium dichromate/thimerosal. CONCLUSION: Concomitant reactions to 13 pairs of allergens in a standard series occurred at a rate greater than would be predicted by chance. Such associations may reflect cross-sensitization or cosensitization.     

干扰素局部注射和外用药物治疗扁平疣40例疗效观察

目的观察重组人干扰素α-1b局部注射治疗扁平疣的疗效。方法将76例扁平疣患儿随机分为两组,治疗组40例,给予皮损内局部注射重组人干扰素注射液α-1b,每周1次;对照组36例,皮损给予0.1%维A酸软膏和重组人干扰素α-1b凝胶外用。疗程28天。随访6个月。结果治疗组总有效率90.00%,对照组总有效率63.89%。治疗组疗效好于对照组（P〈0.01）。结论重组人干扰素α-1b局部注射治疗扁平疣疗效确切。     

Positive patch tests with a dermatophagoides mix relate to an increased responsiveness to standard patch test allergens

The diagnostic meaningfulness of patch tests with house dust mite allergens is still questionable. Our own impression has been that positive results with a dermatophagoides mix may occur preferentially in patients with a generally enhanced responsiveness to contact allergens. To check this, all of our patients allocated to patch testing with the standard series were additionally patch tested with a dermatophagoides mix by the same technique that was used for standard contact allergens. Out of 571 patients tested, 188 showed delayed responses to this mix that were indistinguishable from typical allergic patch test reactions but of no apparent clinical relevance. No relationship was found between positive dermatophagoides patch tests and an atopic disposition of the patients or characteristics of their eczema. However, 64.4% of the patients with a positive dermatophagoides patch test showed a response to at least 1 contact allergen of the standard series, compared to only 56.4% of the patients without a positive dermatophagoides reaction (p < 0.05). The reactivity to the mite mix was not related to the responsiveness towards any particular contact allergens. We suppose that some unidentified factors may contribute to positive reactions to the dermatophagoides mix that may also favour an enhanced general responsiveness to contact allergens.     

Screening for Compositae sensitization with pure allergens: implications of molecular structure, strength of reaction, and time of testing

Background. The sesquiterpene lactone (SL) mix is the only commercial Compositae allergy screening agent that consists of pure allergens; its detection rate is lower than that of Compositae plant extracts. Objective(s). To report a 15‐year experience with routine screening with SL mix and another allergen, parthenolide, the optimal reading times when testing with SL mix constituents, and the advantages and drawbacks of using pure allergens. Materials and methods. The SL mix 0.1% and parthenolide 0.1% petrolatum were included in the baseline series. Results. Of individuals undergoing routine testing, 157/7163 (2.19%) tested positive to SL mix, 161/7162 (2.25%) to parthenolide, and 141 to both in the 15‐year period. The overall detection rate between the two was 177 persons, and 10% would have been missed without parthenolide testing. Two cases of possible active sensitization to parthenolide were recorded. Costunolide elicited positive reactions most frequently, followed by dehydrocostus lactone, and alantolactone. An important observation was that the prevalence of positive reactions to SL mix constituents was lower if they were applied 3–5 days after application of SL mix in those with 1+ or 2+ reactions. Conclusions. The benefit of detecting 10% more Compositae‐sensitive patients with parthenolide in the baseline series must be weighed against a small risk of active sensitization, which may be reduced by lowering the test concentration.     

P26An epidemiological study of the relevance of the allergens of the standard series of the Spanish Group for the study of contact dermatitis (Grupo Español para la Investigación de la Dermatitis de Contacto, GEIDC)(2001)

An epidemiological study is made to evaluate the present or past relevance of positivity to the allergens pertaining to the GEIDC standard series. A retrospective study was made of patients evaluated with patch tests corresponding to the GEIDC standard series by 14 GEIDC dermatologists in the course of 2001. The following parameters were evaluated: age, sex, positive allergens, and present, past and total relevance. A total of 3343 patients were studied, of which 1892 had at least one positive test (56.59%). The most relevant allergens were mercaptobenzothiazole (93,93%), thiuram mix (93%) and nickel sulfate (92.33%). In women, paraphenylenediamine was moreover also very relevant, while in males epoxy resin, butylphenol formaldehyde resin and colophony were particularly relevant. Among the less relevant allergens in both sexes, we found the following in relation to the total: quinolein (44.44%), lactones (45.45%) and caine mix (48.07%). In 1783 patients with at least one positive test, an evaluation was made of whether allergen relevance was past or present. In 60.78% of the positive tests present relevance was established. The allergens of greatest present relevance were ethylenediamine (100%), budesonide (100%), euxyl K 400 (96.96%), epoxy resin (93.33%), and Quaternium 15 (92.85%). The allergens of least present relevance were nickel sulfate (36.38%), caine mix (40%), and neomycin (41.37%).
Determination of the relevance of positive patch test is fundamental in all cases. In our study nickel and rubbers were the most relevant allergens, though nickel was essentially of past relevance. Few studies have addressed the present or past relevance of the standard allergen series.     

A study of the sensitization rate to sesquiterpene lactone mix in Singapore

We report a study of the sensitization rate to sesquiterpene lactone (SL) mix at the National Skin Centre, Singapore. This is a retrospective review of 1256 patients who were patch tested to SL mix (0.1%) from January 1995 to December 1997. 18 out of 1256 patients (1.43%) reacted positively to SL mix. Their ages ranged from 13 to 58 years (average 33.8 years). There were 15 Chinese, 2 Indian and 1 Malay patients. There was a female preponderance, with a female: male ratio of 3.5:1. The most common clinical presentation were dermatitis of the hands (8; 44%), face (5; 28%), and generalized involvement (5; 28%). After extensive evaluation, only 2 patients had a positive patch test reaction that was of current clinical relevance. 13 patients had concomitant sensitization to other allergens. The 3 commonest concomitant allergens were nickel, balsam of Peru and fragrance mix. In our series, SL allergy is observed to be more common in females and the mean age is lower compared to the classical Compositae dermatitis. The sensitization rate is comparable to other studies, although the clinical relevance is only 11%.     

The British standard series of contact dermatitis allergens: validation in clinical practice and value for clinical governance

BACKGROUND: All centres use an empirically determined set of 'standard' test allergens for patch testing that contain the commoner environmental sensitizers. Objectives To assess the validity of the British standard series of 12 allergens used in addition to the 23 already in the European standard series. PATIENTS AND METHODS: Results for 3062 consecutive patients patch tested in seven centres across the United Kingdom during the year 2000 were analysed. RESULTS: The additional allergens from the British series and positive rates were: methyl dibromoglutaronitrile 2.4%, carba mix 1.6%, tixocortol pivalate 1.5%, ethylenediamine 1.3%, cetearyl alcohol 0.8%, 2-bromo-2-nitropane-1,3-diol 0.8%, diazolidinyl urea 0.7%, chlorocresol 0.6%, budesonide 0.6%, fusidic acid 0.5%, imidazolidinyl urea 0.5%, and chloroxylenol 0.4%. The allergens with the lowest positive rate in the European standard series were primin at 0.6% and isopropyl-phenyl-para-phenylenediamine at 0.4%. CONCLUSIONS: The 12 allergens in the British series should continue being tested as a standard addition to the European series within the U.K. The collection of data in this manner to allow comparisons between centres shows differences that reflect selection criteria and interpretation of results, and offers a useful tool for audit and clinical governance. Testing fewer than 1 : 2150 population may indicate underprovision of service. Similarly, rates of sensitization for nickel contact allergy above 26% and for fragrance mix above 16% (the upper 95% confidence intervals) should stimulate inquiry into the reasons behind this.     

North American Contact Dermatitis Group patch test results for the detection of delayed-type hypersensitivity to topical allergens

Background: Allergic contact dermatitis is a significant cause of cutaneous disease affecting many individuals. Patch testing, when used properly, often provides support for the diagnosis of allergic contact dermatitis. Objective: This article reports patch testing results from July 1, 1994, to June 30, 1996, by the North American Contact Dermatitis Group (NACDG). Methods: Patients evaluated in our patch test clinics were tested with the same screening series of allergens by the use of a standardized patch testing technique. The data from these patients were recorded on a standard computer entry form and analyzed. Results: Forty-nine allergens were tested on 3120 patients. Budesonide was added to the series in July 1995 and tested on 1678 patients. Of these patients, 66.5% had positive allergic patch test reactions, and 57% had at least one allergic reaction that was felt to be clinically relevant to the present or past dermatitis. The 20 screening allergens commercially available to United States dermatologists in the Allergen Patch Test Kit, accounted for only 54.1% of the patients with positive allergic reactions. The additional 30 allergens on the NACDG screening series accounted for 47% of patients with positive allergic reactions. Had the Allergen Patch Test Kit alone been used, 12.4% of all patients tested may have had their disease misclassified as a nonallergic disorder, and an additional 34.4% of all tested patients would not have had their allergies fully defined. Among those patients with positive responses to the supplemental allergens, 81% of the responses were of present or past relevance. The 12 most frequent contact allergens were nickel sulfate, fragrance mix, thimerosal, quaternium-15, neomycin sulfate, formaldehyde, bacitracin, thiuram mix, balsam of Peru, cobalt chloride, para-phenylenediamine, and carba mix. The present relevance varied with the specific allergen from 10.7% (thimerosal) to 85.7% (quaternium-15). Among newer allergens, methyldibromoglutaronitrile/phenoxyethanol (cosmetic preservative) caused positive allergic reactions in 2% of the patients; tixocortol-21-pivalate and budesonide (corticosteroids), in 2.0% and 1.1% of the patients, respectively; and ethylene urea/melamine formaldehyde mix (textile resin), in 5% of the patients. Conclusion: The usefulness of patch testing is enhanced with the number of allergens tested, because allergens not found on the commercially available screening series in the United States frequently give relevant allergic reactions. (J Am Acad Dermatol 1998;38:911-8.)