Allergic contact dermatitis to cosmetics: retrospective analysis of a population subjected to patch tests between 2004 and 2017

Abstract Background: Cosmetics are part of the daily life of the population, and their use can lead to allergic contact dermatitis. Objectives: To assess the profile of patients diagnosed with allergic contact dermatitis to cosmetics treated at a referral center for 13 years, as well as the characteristics of the clinical picture and allergens involved. Methods: This was a retrospective study, with analysis of medical records of patients attended at this service. The individuals included had a diagnostic hypothesis of allergic contact dermatitis to cosmetics and had previously been submitted to epicutaneous tests. Results: A total of 1405 medical records were analyzed, 403 (28.7%) with suspected allergic contact dermatitis to cosmetics and 232 (16.5%) with confirmed diagnosis. Of these, 208 (89.7%) were women, and the age group most affected was 31 − 60 years. The most common locations were face in 195 cases (25.8%), cervical region in 116 (15.3%), and trunk in 96 (12.6%). The main allergens in the contact tests were toluene-sulfonamide-formaldehyde resin in 69 cases (29.7%), paraphenylenediamine in 54 (26.3%), Kathon CG® in 41 (20.7%), and fragrance-mix 1 in 29 (16.4%). In 154 (66.4%) of the 232 patients with a confirmed diagnosis of allergic contact dermatitis to cosmetics it was possible to specify the cosmetic product responsible for the lesions. Study limitations: The absence of some allergens considered important in the world as causes of allergic contact dermatitis, which are not readily accessible among us. Conclusions: The data of the analyzed population (predominance of young women), as well as the location of the lesions (face and cervical area) and the main allergens involved were consistent with those from the world literature.

Sociodemographic and clinical profile of patients with occupational contact dermatitis seen at a work-related dermatology service, 2000 - 2014

Abstract: BACKGROUND: Occupational dermatoses are common, especially contact dermatitis. Epidemiological studies on these dermatoses are scarce in Brazil and they are necessary as part of the public policy to protect workers' health. OBJECTIVES: To identify sociodemographic and clinical profile of patients with occupational contact dermatitis seen between 2000 and 2014 at an occupational dermatology service. METHODS: It is a cross-sectional and retrospective study, based on information obtained from the service's database. RESULTS: Of 560 patients with conclusive patch test, 289 (46.9%) presented occupational dermatoses and 213 occupational contact dermatitis with predominance of the allergic type in relation to the irritative type (149:64 respectively). The odds of occupational dermatoses were higher among men and lower among patients aged 50 years or older and with higher level of education. Regarding the possibility of presenting occupational allergic contact dermatitis, only the gender variable was statistically significant. The professions most seen were cleaners, construction workers, painters, mechanics/metallurgists and cooks. The commonest allergens were nickel sulfate, potassium dichromate, cobalt chloride, carba-mix and formaldehyde. STUDY LIMITATIONS: The main limitations of this study are the fact that it was carried out in a tertiary service of occupational dermatoses and the lack of access to some allergens outside the patch test baseline series. CONCLUSIONS: It was possible to identify the sociodemographic and clinical profile of patients with suspected occupational contact dermatitis seen at the Service, beyond the professional groups and allergens related to a high risk of occupational contact dermatitis in this population.

Assessment of patch test results carried out during ten years in a city in southern Brazil

Abstract: Background: Contact dermatitis affects up to 20% of the population. Patch testing for contact allergy may be needed to confirm the diagnosis. Objectives: To describe and discuss the results of patch tests performed in a city in southern Brazil. Methods: A cross-sectional analysis was performed on all skin test results over ten years. Variables such as gender, age at the time of testing, and test results were evaluated. Triggering factors, duration of complain, and previous medications used related to the clinical history were retrieved for some patients by reviewing their medical records. Results: The sample was composed of 539 patch tests, of which 411 (76.2%) were from women. The age of the tested subjects ranged from 5 to 87 years. The prevalence of positive reactions in the patch tests was 391 (72.5%). The most prevalent positive reaction was to nickel sulfate (196; 36.4%), which had statistical significance when associated with female gender (p<0,001). Study limitations: Database obtained through secondary sources (the reports of the exams and the medical records), occurring the incomplete registration of some information. Conclusions: Data analysis at the local level is important to define preventive policies.

Pattern of presentation of pompholyx at a principal referral point in Port Harcourt over a period of ten years

Background: Pompholyx is a type of hand eczema which is characterized by recurrent vesicles and bullae.It is seen commonly in the age group 20 -40 years, affects all races and has an equal sex distribution. It is commonly associated with contact allergic dermatitis and contact irritant dermatitis and atopy. Other associated factors include emotional stress, chronic illness such as HIV and physiological states like pregnancy. Pompholyx is said to be common in warm climate. In which the study area can be classified as such being a tropical climate in the Sub Saharan Africa. Pompholyx is a disease that reduces the quality of living of affected individuals and can bea cause of social stigmatization, often mistaken for a contagious infection such as scabies. It can also be a cause great discomfort to the body and mind leading to work and school absenteeism. Methodology:It was a retrospective cross sectional study of new pompholyx cases within the period of January 2006 to December 2015 from the new patient clinical register. Folders were retrieved and data was extracted using a semi-structured questionnaire developed from standard written medical literature on pompholyx. Data was analyzed using Statistical Package for Social Sciences version 20.Results:Thirty six new cases of pompholyx were seen within the period with an average incidence of 0.59% over the ten year period consisting of 22 females and 14 males with age range of 2- 65years.There was no statistical significant relationship between age categories and sex. The majority of cases were seen amongst students. The age 20-45 group constituted the highest number. 61% had a history of contact dermatitis with the major triggers being detergents, chemicals and metals. All patients were counseled and improved after receiving treatment from at least two of the five major classes of drugs- corticosteroids, antifungal, antibiotics, antihistamines and astringents. Conclusion:Pompholyx is a recurrent hand dermatitis characterized by vesicles and bullae though not common as the study reflects; it can be a source of mental and physical discomfort leading to a poor quality of life in affected individuals

Incidence of allergic contact sensitization in central Chinese subjects with chronic urticaria

Abstract BACKGROUND: Chronic urticaria (CU) can be provoked by a wide variety of causes. Some studies suggest contact sensitization may play a role in the disease. OBJECTIVE: To investigate the incidence and distribution characteristics of allergic contact sensitization in central Chinese subjects with CU, and assess contact allergen avoidance measures in managing CU. METHODS: Patch tests were performed, following the recommended standard procedure, with 20 selected allergens, in line with the European baseline series. All subjects with positive results were prescribed appropriate avoidance measures for the sensitizing substances, while subjects with negative results served as the control group. CU severity was assessed daily from week1 to week4 and for each subject, applying the Urticaria Activity Score. RESULTS: 42.9% (233/543) of subjects with CU showed positive reactions to one or more contact allergen(s). Potassium dichromate, benzene mix and carba mix were more common in male patients, while nickel sulfate was more frequent in females. The positive rates for different allergens varied with age and occupation. The median (interquartile range) severity scores at week 1 were 20 (14-21) and 15 (14-27) for the allergen avoidance group and control group, respectively (P>0.05); and 12 (7-15) and 14 (12-17) at week 4 (P<0.001). CONCLUSION: The incidence of allergic contact sensitization in CU patients was high, and appropriate contact allergen avoidance measures benefitted CU management. Contact allergens may play a role in the pathogenic mechanism of CU and patch tests are an option for CU patients.

Nickel allergy: blood and periodontal evaluation after orthodontic treatment / Alergia ao níquel: avaliação periodontal e sanguínea após o tratamento ortodôntico

The aim of this study was to assess periodontal status and bloodparameters in orthodontic patients with nickel allergy one monthafter removal of brackets. Ninety-six randomly selected patientswere initially evaluated. Allergy to nickel was diagnosed using apatch test. After determining the prevalence of subjects allergic tonickel, two groups were formed: 16 allergic (experimental) and 16non-allergic (control) patients. Their periodontal status wasdetermined regularly by a single, blinded, duly calibrated examinerusing the Lõe Index (GI) and their blood was tested (complete bloodtest, including nickel and IgE levels) after nine months oforthodontic treatment and again one month after removing theorthodontic appliances. Statistical analyses included paired andnon-paired t-tests, Mann-Whitney, Wilcoxon, McNemar and lineartrend chi-square tests (p≤0.05). Comparison of the values recordedduring orthodontic treatment and one month after removing theappliances showed that in the allergic group there was significantincrease in eosinophils (p=0.046), basophils (p=0.001) andmonocytes (p=0.002), and decrease in number of bands (p=0.000),while in the control group, there was increase in lymphocytes(p=0.039) and decrease in segmented neutrophils (p=0.030) andIgE levels (p=0.001). In both groups, plasma nickel levels increased(p=0.010; p=0.039) and GI scores decreased. One month afterremoving the brackets, blood and periodontal parameters frompatients with and without nickel allergy were similar.

O objetivo do presente estudo foi avaliar a condição periodontal eos parâmetros sanguíneos em pacientes alérgicos ao níquel, ummês após remoção dos aparelhos. Noventa e seis pacientesselecionados aleatoriamente foram inicialmente avaliadas. Alergiaao níquel foi diagnosticada usando um teste de contato. Após adeterminação da prevalência de alergia ao níquel, formaram-sedois grupos: 16 pacientes alérgicos (experimental) e 16 nãoalérgicos (controle). Condição periodontal foi diagnosticadaatravés do Índice de Lõe (IG). Parâmetros sanguíneos foramdeterminados por meio de um exame de sangue completo,incluindo a quantificação de níquel e níveis de IgE. Avaliações doestado periodontal foram realizados por um único examinador deforma cega, devidamente calibrado e amostras de sangue foramtomadas depois de nove meses de tratamento e um mês após aremoção dos aparelhos ortodônticos. Análise estatística utilizadafoi testes t pareado e não pareado, Mann-Whitney, Wilcoxon,McNemar e qui-quadrado de tendência linear (p≤0,05). Emcomparação com os valores observados durante o tratamento, onúmero de eosinófilos (p=0,046), basófilos (p=0,001) e monócitos(p=0,002) aumentou significativamente depois da remoção dosaparelhos ortodônticos, ao passo que o número de bastões(p=0,000) diminuiu entre os períodos no grupo alérgico. O númerode linfócitos (p=0,039) aumentou no grupo controle e o número desegmentados (p=0,030) diminuiu. A diminuição dos níveis de IgE(p=0,001) entre os períodos ocorreu no grupo de controle. Níveisde níquel no plasma aumentou após a remoção de aparelhosortodônticos em ambos os grupos (p=0,010; p=0,039). O IGdiminuiu em ambos os grupos. Parâmetros periodontais esanguíneos de pacientes com alergia ao níquel foram semelhantesaos não alérgicos um mês após a remoção dos aparelhos.

Weekly azathioprine pulse versus daily azathioprinein the treatment of Parthenium dermatitis: A non-inferiority randomized controlled study.

Background: Azathioprine in daily doses has been shown to be effective and safe in the treatment of Parthenium dermatitis. Weekly pulses of azathioprine (WAP) are also effective, but there are no reports comparing the effectiveness and safety of these two regimens in this condition. Aims: To study the effi cacy and safety of WAP and daily azathioprine in Parthenium dermatitis. Methods: Sixty patients with Parthenium dermatitis were randomly assigned to treatment with azathioprine 300 mg weekly pulse or azathioprine 100 mg daily for 6 months. Patients were evaluated every month to assess the response to treatment and side effects. Results: The study included 32 patients in the weekly azathioprine group and 28 in the daily azathioprine group, of whom 25 and 22 patients respectively completed the study. Twenty-three (92%) patients on WAP and 21 (96%) on daily azathioprine had a good or excellent response. The mean pretreatment clinical severity score decreased from 26.4 ± 14.5 to 4.7 ± 5.1 in the WAP group, and from 36.1 ± 18.1 to 5.7 ± 6.0 in the daily azathioprine group, which was statistically signifi cant and comparable (P = 0.366). Patients on WAP had a higher incidence of adverse effects (P = 0.02). Limitations: The study had a small sample size and the amount of clobetasol propionate used in each patient was not determined, though it may not have affected the study outcome due to its comparable use in both groups. Conclusions: Azathioprine 300 mg weekly pulse and 100 mg daily dose are equally effective and safe in the treatment of Parthenium dermatitis.

Dermatitis alérgica de contacto por cosméticos en un consultorio alergoinmunologico / Allergic dermatitis of contact by cosmetics in a alego-immunological doctor`s office

La dermatitis de contacto (DC) es una respuesta inflamatoria de la piel, como resultado del contacto de la misma con múltiples factores externos, frecuentemente contenidos en cosméticos. Las pruebas del parche son el pilar diagnostico. Se evaluó la prevalencia de la dermatitis alérgica de contacto por cosméticos, determinando las relaciones epidemiológicas como: edad, sexo, localización, ocupación y sensibilización. El 70% de los pacientes estudiados fueron DAC y el 30% fuerondermatitis irritativas por contacto (DIC). El 57% de las dermatitis alérgicas estaban asociadas a cosméticos,predominando en el sexo femenino.

Contact dermatitis (AD) is an inflammatory response of the skinas a result of contact with multiple external factors, often containedin cosmetics. Patch tests are the diagnostic pillar. Prevalence of allergic contact dermatitis to cosmetics was evaluatedby determining the epidemiological relationships as age, sex, location, occupation and awareness.70% of the patients studied were DAC and 30% were irritant contact dermatitis (ICD).57% of allergic dermatitis were associated with cosmetics, predominantly in females.

Pattern of contact dermatitis in a tertiary level hospital in Bangladesh

To evaluate the pattern of contact dermatitis [CD] among patients in a tertiary care hospital in Dhaka, Bangladesh. In this cross-sectional study, 120 patients of contact dermatitis, diagnosed clinically were evaluated by detail history and clinical examination. The clinical patterns were correlated with the likely sources of allergens. Mean age was 32.8 +/- 14.0 years and majority of the patients were housewives 36 [30.0%] and students 33 [27.5%]. 60.0% of the patients came from low-middle class. Itching 117 [97.5%] and disfigurement 89 [74.2%] were chief complaints of the patients. 63 [52.5%] patients showed erythematous rash, 42 [35%] vesicular eruption, 34 [28.3%] pustular eruption and 16 [13.3%] post-inflammatory hyperpigmentation. Both hands 69 [57.5%], right hand 41 [34.2%], both feet 50 [41.7], neck and ear 42 [35%] and face 30 [25.0%] were the commonly involved sites. Allergic contact dermatitis [52.5%] was more common than photocontact CD [26.7%] and irritant CD [20.8%]. Regarding the source of contact dermatitis, detergents 88 [73.3%], cooking materials 67 [55.8%], shoes or sandals 61 [50.8%], cosmetics 42 [35%], gold/jewellery 38 [31.7%], insects 29 [24.2%] were the main etiological factors of contact dermatitis. The study highlighted that contact dermatitis depends on patients' occupational exposure of different substances.

Contact sensitivity to metals (chromium, cobalt and nickel) in childhood / Alergia de contato aos metais (cromo, cobalto e níquel) na infância

Metals, especially nickel, are the most common contact allergens in children. Recent data has shown increased incidence of allergy in industrialized countries. Sensitization can occur at any age, even in neonates. Costume jewelry, particularly earrings, is linked to increased sensitization to nickel. Sensitization to cobalt often occurs by the use of costume jewelry. The most common source of sensitization to chromium is leather. Due to the absence of a specific therapy, the main treatment is to identify and avoid the responsible allergens. This article presents an updated view on the epidemiological and clinical aspects of contact allergy to metals, focusing on prevention strategies and risk factors, and warns about possible and new sources of contact.

Os metais, especialmente o níquel, são os sensibilizantes de contato mais comuns em crianças. Dados recentes revelam aumento na incidência da alergia deste em países industrializados. A sensibilização pode ocorrer em qualquer idade, mesmo em recém-nascidos. Bijuterias, especialmente brincos nas orelhas, são ligadas ao aumento da sensibilização ao níquel. A sensibilização ao cobalto geralmente ocorre pelo uso de bijuterias. A fonte mais comum de sensibilização ao cromo é o couro. Devido à ausência de terapia específica, o principal tratamento consiste em identificar e evitar os alérgenos responsáveis. Este artigo pretende apresentar uma visão atualizada sobre os aspectos epidemiológicos e clínicos da alergia de contato aos metais, focando estratégias de prevenção e fatores de risco, além de alertar sobre as possíveis e novas fontes de contato.

Dermatite alérgica de contato a medicamentos de uso tópico / Contact dermatitis to topical medications

Fundamentos: A dermatite de contato é uma dermatose comum e suas múltiplas causas dificultam o tratamento. Objetivos: Avaliar a freqüência de sensibilização aos medicamentos tópicos em um serviço universitário; estudar as características da população afetada e identificar os principais sensibilizantes. Métodos: Realizou-se um estudo retrospectivo dos pacientes com hipótese diagnóstica de dermatite alérgica de contato e que foram submetidos a testes epicutâneos. Avaliaram-se os que tiveram diagnóstico final de dermatite alérgica de contato a medicamentos tópicos. Resultados: Em um grupo de 889 pacientes submetidos a testes de contato, 98 (11%) tiveram testes de contato positivos e relevantes para medicamentos tópicos, pelo princípio ativo e/ou por outros componentes. Entre os testes positivos, 79 (57%) corresponderam aos princípios ativos e 60 (43%) aos excipientes, com alguns pacientes apresentando mais de um teste positivo. Entre os princípios ativos, a neomicina foi o mais freqüente. Conclusões: Entre os pacientes estudados, a sensibilização aos medicamentos tópicos ocorreu em 11% dos casos, com discreta preferência pelo sexo feminino. Houve elevada freqüência de dermatite alérgica de contato pela neomicina, agente de uso comum como automedicação e também como prescrição médica.

Caracterización epidemiológica de pacientes con sospecha de atopía, evaluados mediante Prick test: IX Región (2007-2009) / Epidemiological characterization of patients with suspicion of atopy, evaluated through Prick test: IX Region (2007-2009)

Las enfermedades alérgicas constituyen una importante causa de morbilidad en la población general. OBJETIVO: Describir la distribución de la sensibilización para AI y AA mediante Prick test (PT), en una población seleccionada de pacientes de la Región de la Araucanía con sospecha clínica de atopía, según sexo, edad, etnia y estación del año durante los años 2007 al 2009. PACIENTES Y MÉTODO: Estudio de corte transversal, en un muestreo no probabilístico por conveniencia de 3055 pacientes, derivados para estudio mediante PT, al Centro de Diagnóstico y Tratamiento de Enfermedades Respiratorias desde Enero 2007 a Diciembre 2009. El PT se realizó con técnica estandarizada para AI y/o AA. Los datos fueron ingresados en el programa Microsoft Excel y analizados con el programa Stata 10.0. RESULTADOS: De un total de 3055 pacientes, 53,9 por ciento son mujeres, 4,8 por ciento son de etnia mapuche. El promedio de edad 20,7+/-19,13 años con un rango de 1 a 93 años. Del total de pacientes, 45,2 por ciento presentaron sensibilización para AI, 2,3 por ciento para AA y un 21 por ciento para ambos. CONCLUSIONES: En la población estudiada, se observó mayor sensibilización al polvo de habitación. Destaca la sensibilización a Dermatofagoide pteronyssinus en la población masculina, presentando una diferencia estadísticamente significativa con respecto a la población femenina.

The allergic diseases constitute an important reason of morbidity in the general population. AIM: Describe the distribution of the sensitization for AI and AA through Prick test (PT), in a selected population of patients from the Araucanía Region with clinical suspicion of atopy, according to sex, age, ethnic group and season of the year, during the years 2007 to 2009. PATIENTS AND METHODS: Transversal cut study, in a non-probability sample of 3055 patients, derived for study through PT to the Center of Diagnosis and Treatment of Respiratory Diseases from January 2007 to December 2009. The PT was realized by standardized technique for AI and / or AA. The information was ingresed by the program Microsoft Excel and analyzed by the program Stata 10.0. RESULTS: Of a total of 3055 patients, 53,9 percent are women, 4,8 percent are Mapuche. The average of age 20,7 +/-19,13years with a range from 1 to 93 years. Of the total of patients, 45,2 percent presented sensitization for AI, 2,3 percent for AA and 21 percent for both. CONCLUSIONS: In the population studied, we observed increased sensitization to house dust. Stresses the Dermatophagoides pteronyssinus sensitization in the male population, showing a statistically significant difference compared to the female population.

Frequência da dermatite de contato ocupacional em ambulatório de alergia dermatológica / Frequency of occupational contact dermatitis in an ambulatory of dermatologic allergy

FUNDAMENTOS: A dermatite de contato ocupacional (DCO) corresponde a 80 por cento dos casos de dermatoses relacionadas ao trabalho. OBJETIVOS: Determinar: a frequência de DCO em pacientes atendidos em ambulatório de alergia, não específico de dermatose ocupacional; o perfil dos pacientes de acordo com idade, sexo, cor, profissão, antecedentes atópicos, duração e localização da dermatose; os tipos de dermatite de contato; os principais alérgenos; e comparar as frequências dos principais sensibilizantes com os resultados obtidos em pacientes atendidos no mesmo período, sem DCO. MÉTODOS: Durante o período 2003-2006, 630 pacientes foram atendidos e submetidos à bateria padrão de testes de contato. Selecionaram-se aqueles com DCO. RESULTADOS: Sessenta e nove (10,9 por cento) pacientes apresentaram DCO. A média de idade foi de 44,5 anos. As mãos foram acometidas em 48 (70 por cento) casos. As profissões prevalentes foram do lar (27,39 por cento) e construção civil (23; 33,5 por cento). Dermatite alérgica de contato (DAC) ocorreu em 48 (70 por cento) casos, e dermatite irritativa de contato (DIC), em 21 (30 por cento). Os principais sensibilizantes foram o bicromato de potássio (28; 41 por cento), sulfato de níquel (16; 23 por cento) e carba-mix (16; 23 por cento). CONCLUSÕES: A DCO foi diagnosticada em 10,9 por cento dos pacientes, sendo mais comum na faixa etária produtiva da população. DAC esteve presente em 48 casos, provavelmente influenciada pelo longo tempo de evolução da dermatose. Os metais e os componentes da borracha foram os principais sensibilizantes.

BACKGROUND: Occupational contact dermatitis (OCD) corresponds to 80 percent of the cases of skin diseases related to work. OBJECTIVES: To determine: the frequency of OCD in an ambulatory of allergy not specific for occupational dermatosis; the profile of these patients according to age, gender, color, profession, atopic history, duration and localization of the dermatosis; the diagnosed types of contact dermatitis; the main allergens and to compare the frequency of the main antigens with the results obtained from patients examined in the same period of time, without DCO. METHODS: During the three-year period from 2003 to 2006, 630 patients were examined and submitted to a battery of standardized contact patch tests and those who were diagnosed with OCD were selected. RESULTS: Sixty-nine out of the 630 patients were diagnosed with OCD. The average age was 44.5 years. Forty-eight patients (70 percentof the cases) presented the disease on the hands. The most prevalent activities of patients suffering from the disease were household tasks (39 percent) and building construction (33 percent). The allergic contact dermatitis (ACD) occurred in 48 cases which represent 70 percent of the total number of cases and irritant contact dermatitis in 21 cases corresponding to 30 percent of the total number of cases. The main allergens were potassium dichromate 28 (41 percent), nickel sulfate 16 (23 percent) and carba-mix 16 (23 percent). CONCLUSION: OCD was present in 10.9 percent of the patients. Concerning age the group in which the disease was more commonly found corresponded to the most productive group of the population. ACD corresponded to 48 cases, probably influenced by the long period of evolution of the dermatosis. Metal and rubber chemicals were the commonest allergens.

Perfuração dos lóbulos das orelhas como fator de risco para o desenvolvimento de alergia de contato ao níquel / Ear piercing as a risk factor for contact allergy to nickel

OBJETIVOS: Determinar a prevalência da alergia de contato aos metais em crianças que frequentam um centro de saúde e caracterizar o subgrupo com alergia em relação aos fatores de risco. MÉTODOS: Estudo transversal não controlado, conduzido em um centro de saúde de Belo Horizonte (MG). Foram incluídas crianças com idades entre 0 e 12 anos que se apresentaram para consulta pediátrica de rotina, sendo aplicados testes de contato para o cromo, o cobalto e o níquel. As análises estatísticas foram realizadas com base na leitura do teste em 96 horas. Leituras classificadas como fraca (+), forte (++) ou extrema (+++) foram consideradas como reação, enquanto as classificadas como duvidosa, negativa ou irritativa foram consideradas como não reação. RESULTADOS: Completaram o estudo 144 crianças. Destas, 4,9 por cento apresentaram reação ao cromo, 9,7 por cento ao cobalto e 20,1 por cento ao níquel. Os pacientes com orelha perfurada tiveram mais chance de reação ao níquel do que aqueles sem essa característica (p = 0,031 e odds ratio = 2,8). CONCLUSÕES: Em face da tendência atual ao aumento da alergia ao níquel, familiares devem ser alertados sobre a sua associação com a perfuração das orelhas. Estudos posteriores são necessários para avaliar a idade ideal para a perfuração das orelhas e o material ideal para brincos.

OBJECTIVES: To determine the prevalence of metal contact allergy among the children seen at a health center and to characterize children with metal allergies in terms of risk factors. METHODS: This was an uncontrolled cross-sectional study undertaken at a health center in Belo Horizonte, Brazil. Children aged from 0 to 12 years were recruited when they presented at the health center for routine pediatric consultations and were given contact tests for chrome, cobalt and nickel. Statistical analyses were conducted on test readings taken at 96 hours. Results classed as weak (+), strong (++) or extreme (+++) were defined as "reaction," while those classed as doubtful, negative or irritant were defined as "no reaction." RESULTS: A total of 144 children completed the study protocol. Of these, 4.9 percent exhibited a reaction to chrome, 9.7 percent to cobalt and 20.1 percent to nickel. Patients with pierced ears were more likely to react to nickel than those without pierced ears (p = 0.031 and odds ratio = 2.8). CONCLUSIONS: In view of the current tendency for the prevalence of nickel allergy to increase, parents should be warned about its association with ear piercing. Further studies are needed to determine the ideal age for ear piercing and the ideal materials for earrings.

Características clínicas y epidemiológicas de la dermatitis de contacto de manos en una clínica médica de la ciudad de Lima, enero 2004 - diciembre 2008 / Clinical and epidemiological characteristics of hand contact dermatitis at a clinic in Lima, January 2004 - December 2008

Objetivos: determinar las características clínicas y epidemiológicas de los pacientes con dermatitis de contacto en manos diagnosticada en una clínica médica de Lima, así como determinar los alérgenos más frecuentes y relevantes en el grupo de pacientes con dermatitis de contacto alérgica. Material y métodos: estudio descriptivo de serie de casos. Se revisaron las fichas clínicas y resultados de pruebas de parche epicutáneo de pacientes atendidos por dermatitis de contacto entre los meses de enero del 2004 y diciembre del 2008 en la clínica médica Cayetano Heredia de la ciudad de Lima. Se recogió información demográfica, clínica y relacionada a la prueba del parche epicutáneo. Resultados: se observó un total de 118 pacientes de 32,5 +/- 15.8 años, 70.3% de sexo femenino, 87.3% presentaban dermatitis de contacto alérgica. Ser ama de casa y estudiante universitario fueron las ocupaciones más frecuentes (22.0% cada una). La media del tiempo de enfermedad fue de 56.8 +/- 7.5 meses, 78% de casos tenían un tiempo de enfermedad mayor a seis meses. El prurito fue el síntoma más frecuente (75.4%), la localización más común fue las palmas (87.3%) y la historia de alergias el antecedente personal más reportado (31.1%). Las sustancias de contacto más frecuentes fueron los detergentes, perfumes y cosméticos. Los cinco alérgenos más frecuentes con la prueba de parche y clínicamente relevantes fueron el sulfato de níquel (61% y 58% respectivamente), dicromato potásico (41.7% y 40.8%), cloruro de cobalto (34% y 33%), mezcla de fragancias a 18% (12.6% y 8.7%) y mezcla de fragancias al 14% (10.7% y 7.8%). Conclusiones: la dermatitis de contacto alérgica fue la forma más frecuente de dermatitis de manos en este estudio. Los alérgenos más relevantes fueron sulfato de níquel...

Objective: to determine the clinical epidemiological characteristics of patients with hand contact dermatitis diagnosed in a clinic in Lima, and to identify the most common and relevant allergens in a group of patients with allergic contact dermatitis. Methods: descriptive case series study. We reviewed clinical charts and results of epicutaneous patch test from patients seen by contact dermatitis between January 2004 and December 2008, at Cayetano Heredia Clinic in Lima. We collected demographic and clinical information and also information related to epicutaneous patch test. Results: we obtained a total of 118 patients with hands contact dermatitis with a media of 32.5 +/- 15.8 years of age, 70.3% were female, and 87.3% had allergic dermatitis. Being a housewife and a college student were the most frequent occupations (22.0% each). The mean disease duration was 56.8 +/- 7.5 months, 78% of cases had disease duration longer than six months. Pruritus was the most common symptom (75.4%). the most common location was the palms (87.3%) and history of allergies most reported personal history (31.1%). The most frequent contact substances were detergents, perfumes and cosmetics. The five most common allergens to the patch test and clinically relevant were nickel sulphate (61% and 58% respectively), potassium dichromate (41.7% and 40.8%), cobalt chloride (34% and 33%), mixed fragrances at 8% (12.6% and 8.7%) and fragrance mix at 14% (10.7% and 7.8%). Conclusions: allergic contact dermatitis was the most common type of hand dermatitis in this study. The most relevant allergens were nickel sulfate, potassium dichromate and cobalt chloride. The most frequent contact substances were detergents, perfumes and cosmetics.

Dermatite alérgica de contato a medicamentos de uso tópico: uma análise descritiva / Allergic contact dermatitis to topical drugs: a descriptive analysis

FUNDAMENTOS: A dermatite de contato é uma dermatose comum e suas múltiplas causas dificultam seutratamento. OBJETIVO: O objetivo do estudo foi avaliar a frequência da sensibilização aos medicamentos de uso tópico, em serviço universitário; estudar as características da população afetada e identificar os principais sensibilizantes relacionados aos medicamentos tópicos. MÉTODOS: Realizou-se um estudo retrospectivo dos pacientes com hipótese diagnóstica de dermatite alérgica de contato e que foram submetidos a testes epicutâneos. Avaliaram-se os que tiveram diagnóstico final de dermatite alérgica de contato a medicamentos tópicos. RESULTADOS: Em um grupo de 329 pacientes submetidos a testes de contato, 42 (13%) tiveram testes de contato positivos e relevantes para medicamentos tópicos, pelo princípio ativo e/ou por outros componentes. Entre os testes positivos, 36 (85,7%) corresponderam aos princípios ativos e 28 (66,7%), a outros componentes das fórmulas, com alguns pacientes apresentando mais de um teste positivo. Entre os princípios ativos, a neomicina foi o mais frequente. CONCLUSÕES: Entre os pacientes estudados, a sensibilização aos medicamentos tópicos ocorreu em 13% dos casos, com discreta preferência pelo sexo feminino e maior número de casos entre pacientes brancos. Houve elevada frequência de dermatite alérgica de contato pela neomicina, agente de uso comum como automedicação e também como prescrição médica.

BACKGROUND: Allergic Contact Dermatitis is a common type of dermatitis, but its multiple etiologies hinder its management. OBJECTIVE: the objective of this study was to evaluate the frequency of sensitization to topical drugs in a university center, to study the main characteristics of the affected population, and to identify the allergens related with the dermatitis. METHODS: a retrospective and descriptive study with patients submitted to patch tests. The study was conducted with subjects whose patch test to topical drugs was positive. RESULTS: 329 patients were submitted to patch tests and 42 (13%) had positive and relevant patch tests to topical drugs. Among these patients, 36 (85.7%) had positive patch tests to the principal component and 28 (66.7%) to the other components. Some patients had more than one sensitization. Neomycin was the most importantallergen. CONCLUSIONS: Among the studied patients, sensitization to topical agents happened in 13% of the cases, with slight preference for females and Caucasians. There was elevated sensitization to neomycin, a popular agent among patients and medical doctors.