RESUMO
BACKGROUND: Patients with allergic contact dermatitis to 1 antigen have been shown to be at increased risk of developing delayed type hypersensitivity reactions to additional antigens. Both environmental and genetic factors likely influence the risk of sensitization. OBJECTIVE: The aim of this study was to determine whether polysensitization occurs at a higher frequency than would be expected based on chance and whether polysensitization occurs more often in subsets of patients with hand involvement and atopic dermatitis. METHODS: From a database of patch test results from a single practitioner, the probability of having positive reactions to 3 or more unrelated allergens was calculated under the assumption that positive reactions are independent and compared with the observed proportion having positive reactions to 3 or more unrelated allergens. The analysis was repeated excluding patients with leg involvement as a proxy for venous insufficiency dermatitis. The proportion of patients from the polysensitized and nonpolysensitized cohorts with either hand involvement or a history of atopic dermatitis was also calculated. CONCLUSIONS: Polysensitization occurs more often than expected based on chance. Polysensitized patients were more likely to have hand dermatitis. Atopic dermatitis was not significantly associated with polysensitization in this analysis. Polysensitized individuals may represent a phenotype with increased genetic susceptibility to sensitization.
Assuntos
Alérgenos/imunologia , Dermatite Alérgica de Contato/imunologia , Dermatoses da Mão/imunologia , Estudos de Coortes , Bases de Dados Factuais , Dermatite Alérgica de Contato/epidemiologia , Dermatite Atópica/epidemiologia , Dermatite Atópica/imunologia , Dermatoses da Mão/epidemiologia , Humanos , Hipersensibilidade Tardia/epidemiologia , Hipersensibilidade Tardia/imunologia , Testes do Emplastro , Estudos Retrospectivos , Fatores de RiscoRESUMO
BACKGROUND: Lower leg edema is a common side effect of amlodipine therapy, but is often unrecognized as a contributor to stasis dermatitis. OBJECTIVE: To determine whether amlodipine therapy is more common among patients with stasis dermatitis than age-matched controls. METHODS: In this retrospective chart review study, the medication lists of all subjects with stasis dermatitis from a single practice site over the past 2 years were compared to alphabetically consecutive charts of patients with basal cell carcinoma to determine the relative usage of amlodipine. RESULTS: Patients with stasis dermatitis (n=43) are more likely to take amlodipine than are basal cell carcinoma patients (n=117) of similar age (19% vs. 5%, P<.02), even when controlled for the use of any antihypertensive medications (25% vs. 10%, P=.05). CONCLUSION: Amlodipine therapy is associated with stasis dermatitis and discontinuing amlodipine should be considered when stasis dermatitis is diagnosed.