化妆品变应性接触性皮炎93例临床分析

目的了解化妆品变应原的种类,为预防化妆品过敏提供流行病学资料和临床依据。方法对疑似有接触过敏史的患者做斑贴试验和进行问卷调查。结果共入选599例,其中93例为临床诊断为化妆品变应性接触性皮炎,48例为试验确证为化妆品变应性接触性皮炎,面霜和染发剂是主要的过敏化妆产品。结论对苯二胺、芳香混合物、阿莫醇和阿必醇是化妆品变应性接触性皮炎的主要致敏原。     

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。     

230例使用化妆品的接触性皮炎患者接触过敏原分析

目的:分析使用化妆品的接触性皮炎患者的临床特点与接触变应原的分布。方法:应用标准变应原斑贴试剂盒检测230例使用化妆品的接触性皮炎患者的可疑致敏原,并比较是否伴有特应性素质者斑贴试验阳性率有无差异。结果:230例患者中女性占87.83%,21~50岁占76.09%,文员占38.26%,大部分(57.46%)由一般护肤品引起。230例使用化妆品的接触性皮炎患者中斑贴试验呈阳性反应的有173例,阳性率为75.22%,位列前6位的致敏原依次为芳香混合物(25.22%)、硫酸镍(23.04%)、Cl+Me-异噻唑(20.86%)、氯化钴(19.13%)、重铬酸钾(10.43%)、甲醛(8.70%)。伴有特应性素质者55例,斑贴试验阳性率(58.18%)明显低于无特应性素质者(80.57%),差异具有统计学意义(x~2=11.25,P<0.05)。结论:使用化妆品的接触性皮炎患者以中青年女性为主,文员最多见,一般护肤品为主要的可疑致敏化妆品;最常见的致敏原是芳香混合物和防腐剂;伴有特应性素质的患者可能对接触致敏原的反应降低。     

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。     

关于接触性皮炎斑贴试验标准抗原的研究

按照TROLAB欧洲标准抗原(简称欧抗)的成分和浓度,用国产试剂配制了一套仿制抗原(筒称仿抗).通过显微镜下对仿抗中12种抗原颗粒分布均匀性及颗粒大小这两项质量指标的检测,并与欧抗进行对比.又通过临床204例皮炎患者两套抗原同时斑试对比,结果证实仿抗完全达到欧抗质量水平.临床204例欧抗斑试总阳性率为58.33%,其中阳性率在2%以上的有13种抗原.对85例欧抗斑试阴性者中36例还根据病史进行可疑物斑试.     

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。     

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.     

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。     

对化妆品不良皮肤反应的临床诊断和皮肤试验若干问题的看法

对化妆品不良皮肤反应的临床诊断和皮肤试验若干问题的看法王学民①乐嘉豫①化妆品皮肤不良反应（ｓｋｉｎａｄｖｅｒｓｅｒｅ－ａｃｔｉｏｎｄｕｅｔｏｃｏｓｍｅｔｉｃｓ）在临床上已成为一类较常见的疾病，这一现象已引起了广大皮肤科医生、化妆品科学工作者、生产商、...     

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…     

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。     

面部不明原因皮炎接触过敏原分析

目的 对面部不明原因皮炎患者的接触过敏物质进行分析.方法 对106例面部不明原因皮炎患者进行中国筛查系列斑贴试验,对其中20例可疑的化妆品致敏患者进行化妆品系列斑贴试验,按照国际接触性皮炎研究组推荐的标准为依据.结果 中国筛查系列斑贴试验总阳性率54.72％,阳性率较高的前5位变应原是硫酸镍(18.87％)、甲醛(13.21％)、5-氯-2-甲基-4-异噻唑啉-3-酮(CL+Me-异噻唑)(12.26％)、氯化钴(9.43％)和芳香混合物(8.49％).化妆品系列斑贴试验总阳性率100％,阳性率较高的前3位变应原是山梨糖醇酐倍半油酸酯(司盘-83)(40.00％)、月桂醇葡萄苷(30％)和十二烷酸盐(25％).结论 面部不明原因皮炎患者多数存在接触过敏原,中国筛查系列的斑贴试验结果反映该类群体普遍存在体质敏感的现象;化妆品相关变应原的斑贴试验结果显示此类患者主要对乳化剂、表面活性剂、抗氧化剂原料过敏.     

Contact allergens in patients with leg ulcers

Background Contact dermatitis can complicate the treatment of leg ulcers and is an acquired phenomenon resulting from the use of topical medications.
Objective To show the incidence of contact dermatitis reactions to topical medications applied to leg ulcers and to evidence changing trends in such reactions through comparison of two case series about 20 years apart.
Subjects and methods We studied two groups of patients with leg ulcers that were patch tested with contact allergens in 1973–1974 and in 1994–1995.
Results One or more positive patch tests was present in 75% and 40% of the patients, respectively. A decrease in the incidence of positive reactions to neomycin, local anesthetics and parabens mix was seen in 1994–1995. The most important contact allergens in 1994–1995 were fragrance mix, colophony and the excipients wool alcohols and amerchol. Other relevant sensitizers were formaldehyde, neomycin and gentamycin.
Conclusion The changing trends in contact allergens over the last 20 years may be explained by changes in the components of topical agents used for treatment.     

Cyclosporin A in the treatment of severe allergic contact dermatitis

Background Allergic contact dermatitis is sometimes difficult to treat because the patients are unable to effect prevention. Contact dermatitis can then become chronic and progressive, posing serious therapeutic problems. Patients and Method Fifteen patients with severe allergic contact dermatitis were treated with cyclosporin A (CyA). All patients were polysensitized and unable to avoid with haptens for socioeconomic reasons. The drug was given orally at a dose of 5 mg/kg/day for 4 weeks followed by 3 mg/kg/day for a further 2 months. In three patients the treatment was continued for a further period of 60 days at 2 mg/kg/day. Results All patients responded well to the therapy and no side effects were observed. The manifestations of acute inflammation improved rapidly, whereas the signs of chronic reaction took longer to regress. At the end of treatment some subjects remained without lesions for up 6 months while others relapsed with mild forms. The recurrent dermatitis responded to a further cycle of CyA. Patch test reactions were only slightly modified after 30 days of treatment. Conclusion Our results qualify CyA as a new drug for the treatment of allergic contact dermatitis. It cannot be regarded as the elective treatment but it can be extremely useful in chronic and severe cases.     

Comparative Analysis of Cutaneous Fungi in Atopic Dermatitis Patients and Healthy Individuals

BackgroundAtopic dermatitis (AD) is a chronic relapsing inflammatory skin disease triggered by diverse factors. Microbes are one of the crucial risk factors for AD development or exacerbation. However, the effect of a fungal burden on AD has been overlooked compared to bacteria.ObjectiveThis study aimed to comparatively analyze cutaneous fungal distribution between AD patients and healthy individuals by polymerase chain reaction (PCR)-based analysis.MethodsSkin samples of AD outpatients and healthy individuals collected at the Chung-Ang University were analyzed. Representative AD-associated fungal genera, Candida, dermatophytes, and Malassezia , were analyzed using specific primer and amplification methods. Amplicons were sequenced, and the fungal distribution of both groups were compared.ResultsTotally, 211 patients and 23 healthy individuals were studied. Of the 211 patients, 10.90% (23/211) had Candida species, whereas 0% (0/23) healthy individuals showed its presence. The most frequently detected species in patients was Candida albicans (5.21%) followed by Candida parapsilosis (3.79%). For dermatophytes, 1.42% (3/211) of patients showed positive results, whereas 0% (0/23) healthy individuals showed positive results. Malassezia species were identified in 20.85% (44/211) and 8.70% (2/23) in patients and healthy individuals, respectively. Malassezia restricta was the most frequently identified species in the AD patient group, and the only species found in the healthy control group.ConclusionThe distribution of Candida spp., dermatophytes, and Malassezia spp. are altered with AD development.