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BACKGROUND: Referral for patch testing is important in managing patients with eczema/dermatitis. These referrals come from many different sources. OBJECTIVES: To assess the appropriateness of referrals from general practitioners (GPs) to a dedicated patch test clinic. METHODS: Referral sources were recorded for patch testing in a dedicated contact dermatitis unit for a 4-month period between November 2002 and February 2003. RESULTS: Of 217 referrals reviewed, 45 (21%) were received from GPs. There was no significant difference in the percentages of positive patch test results and of relevant positive patch test results obtained from GP referrals compared with those received from other sources, including dermatology departmental referrals. CONCLUSIONS: Referrals from GPs, if selected appropriately, can be seen directly in the patch test clinic without prior assessment in a general dermatology clinic.  相似文献   

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Previous studies have shown that the prevalence of specific allergens varies by geographic area, population, age and sex. The objective of the present study was to determine the relative frequency of positive reactions to different sensitizers in Israeli patients with clinically suspected contact dermatitis (CD) and to identify possible sex and age differences. A total of 943 consecutive patients were tested for CD using the European standard patch test series. The most frequent allergen was nickel sulfate followed by potassium dichromate and fragrance mix. Positive reactions to nickel sulfate were more common among women, especially those in the younger age group (younger than 40 years). Positive reactions to balsam of Peru were more common among men, especially those in the older age group (40 years or older). This study presents the result of the standard patch test in Israel with stratification according to age and sex. The findings of the present study, combined with reports on geographic/population differences in the prevalence of specific allergens in CD, indicate the need for further investigations to identify prominent local allergens for better adaptation of the standard patch test to local needs.  相似文献   

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Background: Propolis is widely used in 'natural' cosmetics, remedies, and over-the-counter products. The incidence of propolis allergy is increasing, and cross-reaction with fragrance mix I (FMII), colophonium, and Myroxylon pereirae can occur.
Objectives: To find out the prevalence and clinical relevance of positive patch tests to propolis and assess cross-reactions with Myroxylon pereirae , colophonium, FMI, and beeswax.
Methods: Two thousand eight hundred and twenty-eight subjects in 10 UK centres were patch tested with propolis and beeswax. Generic data were acquired from British Contact Dermatology Society (BCDS) database and further relevant information was requested by survey of participating centres.
Results: The prevalence of propolis allergy was 1.9% (55/2828). Out of these 55 subjects, only 4 (7.2%) were allergic to beeswax, 22 (40%) to Myroxylon pereirae , 15 (27.2%) to colophonium, and 6 (10.9%) to FMI. Additional data for 41 propolis allergic subjects were collected by questionnaire. Hands were the most common sites of involvement, and cosmetics were the most common source of contact. Eight out of 12 subjects reported improvement in eczema following avoidance of propolis.
Conclusions: Propolis is an important allergen of increasing frequency and its inclusion in BCDS baseline series is appropriate. Cross-sensitivity to beeswax is rare.  相似文献   

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Contact allergy to corticosteroids now seems frequent among patients being patch tested. As corticosteroids are intrinsically anti-inflammatory, we investigated whether patch tests with a potent corticosteroid might suppress simultaneous adjacent patch test reactions to another allergen. Nickel-sensitive subjects were patch tested with an aqueous dilution series of nickel in duplicate, adjacent to patch tests with clobetasol propionate 1% in ethanol and with ethanol, respectively. Statistical evaluation of the results obtained in 2 different centers, using their own patch test techniques, did not reveal any suppression of the positive nickel patch test reactions.  相似文献   

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Background. Tannery workers are at considerable risk of developing occupational contact dermatitis. Occupational skin diseases in tannery workers in newly industrialized countries have been reported, but neither the prevalence of occupational allergic contact dermatitis nor the skin‐sensitizing agents were specifically examined in those studies. Objectives. To assess the prevalence of occupational allergic contact dermatitis in Indonesian tanneries, identify the causative allergens, and propose a tannery work series of patch test allergens. Patients/methods A cross‐sectional study in all workers at two Indonesian tanneries was performed to assess the prevalence of occupational contact dermatitis via a questionnaire‐based interview and skin examination. Workers with occupational contact dermatitis were patch tested to identify the causative allergens. Results. Occupational contact dermatitis was suspected in 77 (16%) of the 472 workers. Thirteen (3%) of these 472 workers were confirmed to have occupational allergic contact dermatitis. Potassium dichromate (9.2%), N,N‐diphenylguanidine (5.3%), benzidine (3.9%) and sodium metabisulfite (2.6%) were found to be the occupationally relevant sensitizers. Conclusions. The sensitization pattern showed some differences from the data in studies reported from other newly industrial countries. We compiled a ‘tannery work series' of allergens for patch testing. A number of these allergens may also be considered for patch testing in patients with (leather) shoe dermatitis.  相似文献   

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 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。  相似文献   

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Background:  Persistent vulval pruritus is a frequent problem and patients may not show signs of a primary vulval dermatosis. Allergic contact sensitivity is an important factor in such patients but may also occur as a secondary event in women with vulval dermatoses.
Objectives:  We aim to describe women with vulval pruritus who were evaluated for vulval dermatoses. We patch tested to help define or exclude allergens.
Methods:  In a 3-year period, 50 women with vulval pruritus were examined for existence of vulval dermatosis. All the patients were patch tested to the European Baseline Series, medicaments, preservatives, vehicles, cosmetics and products they routinely used.
Results:  Ages of the patients ranged from 22 to 62 years (mean 39.9 ± 9 years) and duration of the diseases ranged from 0.5–360 months (mean 56.1 ± 65.6 months). 52% of the women had at least 1 positive patch test. 8 patients (16%) had 1 or more relevant allergic positive reactions. The relevant allergens were usually cosmetics, preservatives and medicaments.
Conclusions:  Women with vulval pruritus were patch tested to help define or rule our allergens. Contact allergy incidence in these patients is high. The relevant allergens were usually cosmetics, preservatives and medicaments.  相似文献   

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Topical corticosteroids are an emerging cause of allergic contact dermatitis in children that may often be missed. It is important to consider patch testing with corticosteroids to detect allergic contact dermatitis in patients with persistent or worsening of dermatitis despite topical corticoseroid treatment. However, delayed reactions (>7 days) to topical corticosteroids may occur, leading to false-negative reactions and misdiagnosis. Herein, we report a case of an 8-year-old girl who developed a positive reaction to budesonide on day 12 of patch testing.  相似文献   

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Periorbital dermatitis is common and can be due to the external use of ophthalmic drugs. We evaluated patch test results of the Information Network of the Departments of Dermatology. During a 5-year period (1995-99), of a total 49,256 patch-tested patients, 1053 (2.1%) were eventually diagnosed as allergic periorbital contact dermatitis (APD) and 588 (1.2%) as non-allergic periorbital dermatitis (NAPD). Patient characteristics between APD, NAPD and other cases (OCs) differed with respect to sex (19.7% male in both periorbital groups versus 36.3% in OCs), atopic dermatitis (10.4% in APD versus 60.2% in NAPD versus 16.9% in OCs) and age, APD being substantially more often (68.2%) aged 40 and above than NAPD (52.6%). Several of the top allergens in OCs [such as fragrance mix, Myroxylon pereirae resin (balsam of Peru), lanolin alcohol and potassium dichromate] caused significantly fewer positive test reactions in both periorbital groups. In contrast, thimerosal, phenylmercuric acetate, sodium disulfite, gentamicin sulfate, phenylephrine hydrochloride and benzalkonium chloride tested positively significantly more often in APD but not in NAPD, verifying them as true ophthalmic allergens. Finally, in 42 cases (4%) of APD patients, additional allergens were identified by testing of the patients' own substances (mostly beta-blockers, oxybuprocaine and dexpanthenol), supporting the necessity of testing with ophthalmic drugs as is where individual substances are not readily available.  相似文献   

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The reproducibility of patch tests is an important determinant of the clinical value of this diagnostic procedure. The aim of the present study was to delineate comparatively the efficiency and reproducibility of identical test reagents from 2 different commercial sources. Purchased in duplicate from brial and Boots-Hermal, 30 allergens from the European standard and an extension series were simultaneously applied to Finn Chambers and affixed next to each other. Out of 2070 paired patch tests in 71 patients, 97.2% presented with concordant-negative results. 60 patch tests were classified as allergic with 95% concordant-positive results. From these paired positive patches, a subgroup of 13 (22.8%) corresponding allergens presented with minor differences in the visible strength of the allergic reaction. Generated by cobalt chloride, formaldehyde and 2-bromo-2-nitropropane-1,3-diol in 1 patient each, discordant results, i.e. 1 positive and 1 negative test in parallel, were found in only 5%. Taken together, we were able to demonstrate that patch test preparations from 2 different companies exhibited a high level of reproducibility. This standardized quality of test reagents from different suppliers provides useful information on several aspects of everyday practice.  相似文献   

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