RESUMO
BACKGROUND: Ammonium persulfate (APS), an oxidizing agent used in hair products, manufacturing, and pool/spa water, can cause skin reactions, including allergic contact dermatitis. OBJECTIVE: To characterize positive patch test reactions to APS (2.5% petrolatum). METHODS: Retrospective analysis of patients tested to the North American Contact Dermatitis Group screening series from 2015 to 2018. RESULTS: Of 10,526 patients, 193 (1.8%) had positive patch test reactions to APS. Compared with APS-negative patients, APS-positive patients were significantly more likely to be male (43.2% vs 28.0%; P < .0001); have primary hand dermatitis (30.2% vs 22.0%; P = .0064), scattered generalized dermatitis (25.5% vs 17.9%; P = .0064), or trunk dermatitis (8.9% vs 4.9%; P = .0123); and have dermatitis that is occupationally related (22.2% vs 10.9%; P < .0001). More than half of the APS-positive reactions were currently relevant (57.0%); 19 (9.8%) were related to occupation, especially hairdressers (68.4%). Swimming pools/spas (23.3%) and hair care products (19.2%) were the most common sources of APS. LIMITATIONS: Immediate reactions and follow-up testing were not captured. CONCLUSION: The proportion of patients positive to APS was 1.8%. APS positivity was significantly associated with male sex and hand dermatitis. Swimming pool/spa chemicals were important sources of APS exposure.
Assuntos
Dermatite Alérgica de Contato , Dermatite Ocupacional , Eczema , Preparações para Cabelo , Alérgenos , Sulfato de Amônio , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/epidemiologia , Dermatite Ocupacional/etiologia , Eczema/complicações , Feminino , Preparações para Cabelo/efeitos adversos , Humanos , Masculino , América do Norte , Oxidantes , Testes do Emplastro/efeitos adversos , Vaselina , Estudos Retrospectivos , ÁguaRESUMO
BACKGROUND: Eyelid dermatitis is a common dermatologic complaint. OBJECTIVE: To characterize patients with eyelid dermatitis. METHODS: Retrospective analysis (1994-2016) of North American Contact Dermatitis Group data. RESULTS: Of 50,795 patients, 2332 (4.6%) had eyelid dermatitis only, whereas 1623 (3.2%) also had dermatitis of the eyelids and head or neck. Compared with patients without eyelid involvement (n = 26,130), groups with eyelid dermatitis only and dermatitis of the eyelid and head or neck were significantly more likely to be female, white, and older than 40 years, and to have a history of hay fever, atopic dermatitis, or both (P < .01). Final primary diagnoses included allergic contact dermatitis (eyelid dermatitis only: 43.4%; dermatitis of the eyelid and head or neck: 53.5%), irritant contact dermatitis (eyelid dermatitis only: 17.0%; dermatitis of the eyelid and head or neck: 9.8%), and atopic dermatitis (eyelid dermatitis only: 13.1%; dermatitis of the eyelid and head or neck: 13.8%). Top 5 currently relevant allergens included nickel sulfate (eyelid dermatitis only: 18.6%; dermatitis of the eyelid and head or neck: 22.5%), fragrance mix I (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 18.3%), methylisothiazolinone (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 17.7%), gold sodium thiosulfate (eyelid dermatitis only: 14.7%; dermatitis of the eyelid and head or neck: 11.4%), and balsam of Peru (eyelid dermatitis only: 11.9%; dermatitis of the eyelid and head or neck: 12.6%). Both eyelid-involvement groups were significantly more likely to react to gold sodium thiosulfate, carmine, shellac, dimethylaminopropylamine, oleamidopropyl dimethylamine, and thimerosal (P < .05) compared with the no eyelid involvement group. LIMITATIONS: Lack of specific distribution patterns of eyelid dermatitis and no long-term follow-up data. CONCLUSION: Patch testing remains a critical tool in evaluating patients with eyelid dermatitis.
Assuntos
Blefarite/epidemiologia , Dermatite Alérgica de Contato/diagnóstico , Dermatite Atópica/diagnóstico , Dermatite Seborreica/diagnóstico , Adulto , Alérgenos/efeitos adversos , Blefarite/etiologia , Cosméticos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatite Atópica/etiologia , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/etiologia , Dermatite Seborreica/etiologia , Europa (Continente)/epidemiologia , Pálpebras/patologia , Feminino , Cabeça/patologia , Humanos , Irritantes/efeitos adversos , Masculino , Metais/efeitos adversos , Pessoa de Meia-Idade , Pescoço/patologia , Especificidade de Órgãos , Testes do Emplastro , Perfumes/efeitos adversos , Conservantes Farmacêuticos/efeitos adversos , Estudos Retrospectivos , Tensoativos/efeitos adversos , Tiazóis/efeitos adversos , Timerosal/efeitos adversos , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Scalp conditions are often multifactorial. OBJECTIVE: To characterize patients with scalp involvement and patch-testing outcomes. METHODS: Retrospective cross-sectional analysis of North American Contact Dermatitis Group data (1996-2016). Study groups included patients with scalp involvement (≤3 anatomic sites coded) with or without additional sites. RESULTS: A total of 4.8% of patients (2331/48,753) had scalp identified as 1 of up to 3 affected anatomic sites. Approximately one-third of "scalp-only" individuals had a specific primary diagnosis of allergic contact dermatitis (38.6%), followed by seborrheic dermatitis (17.2%) and irritant contact dermatitis (9.3%). When adjacent anatomic sites were affected, allergic contact dermatitis was more frequently identified as the primary diagnosis (>50%). The top 5 currently clinically relevant allergens in scalp-only patients were p-phenylenediamine, fragrance mix I, nickel sulfate, balsam of Peru, and cinnamic aldehyde. Methylisothiazolinone sensitivity was notable when adjacent anatomic sites were involved. The top 3 specifically identified sources for scalp-only allergens were hair dyes, shampoo/conditioners, and consumer items (eg, hair appliances, glasses). LIMITATIONS: Tertiary referral population. CONCLUSION: Isolated scalp involvement was less likely to be associated with allergic contact dermatitis than when adjacent anatomic sites were involved. Overlap with multiple diagnoses was frequent, including seborrheic dermatitis, irritant dermatitis, other dermatoses, or all 3. p-Phenylenediamine was the most common allergen.
Assuntos
Dermatite Alérgica de Contato/patologia , Dermatite Irritante/patologia , Testes do Emplastro , Dermatoses do Couro Cabeludo/patologia , Adulto , Idoso , Alérgenos/efeitos adversos , Canadá/epidemiologia , Estudos Transversais , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Dermatite Atópica/patologia , Dermatite Irritante/epidemiologia , Dermatite Irritante/etiologia , Dermatite Seborreica/epidemiologia , Dermatite Seborreica/etiologia , Dermatite Seborreica/patologia , Óculos , Feminino , Tinturas para Cabelo/efeitos adversos , Preparações para Cabelo/efeitos adversos , Humanos , Irritantes/efeitos adversos , Masculino , Pessoa de Meia-Idade , Especificidade de Órgãos , Estudos Retrospectivos , Dermatoses do Couro Cabeludo/epidemiologia , Dermatoses do Couro Cabeludo/etiologia , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Hand eczema (HE) is a heterogeneous and burdensome disorder. OBJECTIVE: To characterize the clinical characteristics, etiologies and allergen relevance in adults with HE referred for patch testing. METHODS: Retrospective analysis (2000-2016) of North American Contact Dermatitis Group data (n = 37,113). RESULTS: Overall, 10,034 patients had HE, with differences of overlap between allergic contact, irritant contact, and atopic dermatitis. Allergic contact HE fluctuated, whereas atopic HE steadily increased, and irritant HE decreased over time. HE was associated with higher proportions of positive patch tests (67.5% vs 63.8%; χ2, P < .0001). The five most common clinically relevant allergens were methylisothiazolinone, nickel, formaldehyde, quaternium-15, and fragrance mix I. HE was associated with significantly higher odds of positive patch test reactions and clinical relevance in 13 and 16 of the 25 most common allergens, respectively, including preservatives, metals, topical medications, and rubber accelerators. LIMITATIONS: No data on HE phenotype. CONCLUSION: HE in adults was associated with higher proportions of positive patch tests, with a heterogeneous profile of allergens. Patch testing remains an important tool in the evaluation of patients with HE.
Assuntos
Dermatite Alérgica de Contato/diagnóstico , Dermatoses da Mão/diagnóstico , Testes do Emplastro , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alérgenos/efeitos adversos , Canadá/epidemiologia , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Dermatite Atópica/diagnóstico , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Dermatite Irritante/diagnóstico , Dermatite Irritante/epidemiologia , Dermatite Irritante/etiologia , Dermatite Seborreica/diagnóstico , Dermatite Seborreica/epidemiologia , Dermatite Seborreica/etiologia , Eczema/diagnóstico , Eczema/epidemiologia , Feminino , Dermatoses da Mão/epidemiologia , Dermatoses da Mão/etiologia , Humanos , Irritantes/efeitos adversos , Masculino , Metais/efeitos adversos , Pessoa de Meia-Idade , Conservantes Farmacêuticos/efeitos adversos , Estados Unidos/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Personal care products (PCPs) are commonly responsible for allergic contact dermatitis and irritant contact dermatitis. PCP use was historically associated with females, but male-targeted PCPs are increasingly being marketed. OBJECTIVE: To characterize and compare males with PCP-related contact dermatitis (MPCPs) and females with PCP-related contact dermatitis (FPCPs). METHODS: This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data (1996-2016). RESULTS: Four thousand six hundred eighty of 16,233 men (28.8%) and 12,730 of 32,222 (39.5%) women had a PCP identified as a source of irritant contact dermatitis or a positive patch test reaction. The proportion of PCP-related dermatitis in both sexes significantly increased (>2.7-fold) over the decade of study. Compared with FPCPs, a larger proportion of MPCPs were older or had trunk or extremity dermatitis (P < .0001). MPCPs were twice as likely to have soaps as a source while FPCPs were twice as likely to have hair care products (P < .0001). The most common PCP-related North American Contact Dermatitis Group allergens for both sexes were methylisothiazolinone (MPCP 28.8% and FPCP 21.5%), fragrance mix I (MPCP 22.3% and FPCP 20.1%), balsam of Peru (MPCP 18.5% and FPCP 14.1%), quaternium-15 (MPCP 16.1% and FPCP 12.3%), and paraphenylenediamine (MPCP 11.5% and FPCP 11.1%). LIMITATIONS: Patient population referred for suspected contact dermatitis. CONCLUSIONS: PCP-related dermatitis is increasing. Sites of involvement and relevant PCP sources are distinct between sexes. Male and female variation in exposure history may explain differences in reactivity to some allergen groups.
Assuntos
Alérgenos/efeitos adversos , Cosméticos/efeitos adversos , Dermatite Alérgica de Contato/epidemiologia , Dermatite Irritante/epidemiologia , Adolescente , Adulto , Cosméticos/administração & dosagem , Estudos Transversais , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Dermatite Irritante/diagnóstico , Dermatite Irritante/etiologia , Feminino , Humanos , Irritantes , Masculino , América do Norte/epidemiologia , Testes do Emplastro , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: Data regarding teledermatology for patch testing are limited. OBJECTIVES: Compare patch test readings and final interpretation by two in-person dermatologists (IPDs) with eight teledermatologists (TDs). METHODS: Patch tested patients had photographs taken of 70 screening series of allergens at 48 hours and second readings. Eight TDs reviewed photos and graded reactions (negative, irritant, doubtful, +, ++, +++) at 48 hours and second readings; in addition, they coded a final interpretation (allergic, indeterminant, irritant, negative) for each reaction. TDs rated overall image quality and confidence level for each patient and patch test reaction, respectively. Percentage of TD-IPD agreement based on clinical significance (success, indeterminate, and failure) was calculated. Primary outcome was agreement at the second reading. RESULTS: Data were available for 99, 101, and 66 participants at 48 hours, second reading, and final interpretation, respectively. Pooled failure (+/++/+++ vs negative) at second reading was 13.6% (range 7.9%-20.4%). Pooled failure at 48 hours and final interpretation was 5.4% (range 2.9%-6.8%) and 24.6% (range 10.2%-36.8%), respectively. Confidence in readings was statistically correlated with quality of images and disagreement. CONCLUSION: For patch testing, teledermatology has significant limitations including clinically significant pooled failure percentages of 13.6% for second readings and 24.6% for final interpretation.
Assuntos
Dermatite Alérgica de Contato/diagnóstico , Dermatite Irritante/diagnóstico , Variações Dependentes do Observador , Testes do Emplastro/métodos , Testes do Emplastro/normas , Consulta Remota , Alérgenos/administração & dosagem , Competência Clínica , Dermatologistas/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Visita a Consultório Médico , Fotografação/normas , AutoimagemRESUMO
BACKGROUND: Few studies have examined the relationship between nummular (discoid) eczema (NE) and allergic contact dermatitis (ACD). OBJECTIVE: To examine trends, associations, and clinical relevance of ACD in patients with NE who were referred for patch testing. METHODS: Retrospective analysis of 38 723 patients from the North American Contact Dermatitis Group. RESULTS: Overall, 748 patients (1.9%) were diagnosed with NE; 23.9% had a concomitant diagnosis of ACD. The prevalence of NE fluctuated over time between 2001 and 2016, with no overall change in prevalence in diagnosed NE. In multivariable logistic regression models, NE increased steadily with age and was associated with male sex and Asian and other race/ethnicity, and inversely associated with a history of atopic dermatitis (AD) and hay fever. Patients with NE had lower proportions of one or more positive allergic reactions and lower odds of a positive reaction in multiple individual allergens. The most commonly relevant allergens in patients with NE were formaldehyde 2.0% aq., methylisothiazolinone, quaternium 15, fragrance mix I, and propylene glycol. CONCLUSION: NE is a heterogeneous disorder with distinct subsets of lesional distributions and a profile of relevant allergens, especially formaldehyde and formaldehyde releasers. Nearly one in four patients with NE had ACD, supporting the role of patch testing in patients with NE.
Assuntos
Alérgenos , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Eczema/epidemiologia , Eczema/etiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , América do Norte/epidemiologia , Testes do Emplastro , Prevalência , Estudos Retrospectivos , Fatores de RiscoRESUMO
BACKGROUND: Little is known about the relationship between psoriasis and allergic contact dermatitis (ACD). OBJECTIVE: To examine the associations with ACD, related clinical characteristics, and common positive and clinically relevant allergens of patients with a final diagnosis of psoriasis who were referred for patch testing. METHODS: Retrospective analysis of 38 723 patients from the North American Contact Dermatitis Group. RESULTS: Patients with a final diagnosis of psoriasis had lower proportions of ACD than those without psoriasis (32.7% vs 57.8%). In multivariable logistic regression models, psoriasis was inversely associated with female sex, Black or Asian race, and history of atopic dermatitis and hay fever. Patients with a final diagnosis of psoriasis were less likely to have one or more positive allergic patch-test reactions or to have a current clinically relevant patch-test reaction to the majority of the most commonly positive and/or relevant allergens. The most clinically relevant allergens included nickel sulfate, methylisothiazolinone, and fragrance mix I. CONCLUSION: Approximately one-third of patients who were referred for patch testing with a final diagnosis of psoriasis were also diagnosed with ACD. In select patients with suspected psoriasis who also have a clinical presentation suggestive of ACD, patch testing may be helpful.
Assuntos
Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Psoríase/diagnóstico , Psoríase/epidemiologia , Adolescente , Adulto , Comorbidade , Dermatite Alérgica de Contato/complicações , Feminino , Humanos , Masculino , América do Norte/epidemiologia , Testes do Emplastro , Prevalência , Psoríase/complicações , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: Little is known regarding the characteristics of patients with negative patch test (NPT) results. OBJECTIVE: To characterize patients with NPT results. METHODS: Retrospective cross-sectional analysis of 34,822 patch tested patients. NPT results were defined as negative or irritant final interpretations of all North American Contact Dermatitis Group screening allergens and no relevant allergens on supplemental series. RESULTS: Almost one-third of patients (n = 10,888 [31.3%]) had NPT results. Patients with NPT results were significantly more likely to be male (P < .0001), be age 40 years or younger (P = .0054), be nonwhite (P = .0005), and have dermatitis primarily having a scattered generalized distribution (P = .0007) or primarily located on the lips (P = .0214) or eyelids (P = .0364). However, the absolute differences in age, race, and site were small and may not be clinically meaningful. Patients with NPT results were significantly less likely to have occupationally related skin disease (P < .0001). Overall, 8.3% of patients with NPT results had occupationally related skin disease, with precision production worker/machine operator (28.5%), health care worker (17.0%), and mechanic/repairer (7.5%) being the most commonly related occupations. In all, 22.9% of patients with NPT results had relevant irritants and 41.6% of irritants were occupationally related; cosmetics/health care products and soaps were common sources for both occupationally related and non-occupationally related irritants. LIMITATIONS: Retrospective cross-sectional study of tertiary referral population. CONCLUSIONS: Patients with NPT results have distinct characteristics.
Assuntos
Dermatite de Contato/diagnóstico , Testes do Emplastro , Adulto , Idoso , Alérgenos/efeitos adversos , Animais , Comorbidade , Materiais de Construção/efeitos adversos , Estudos Transversais , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite de Contato/epidemiologia , Dermatite Irritante/diagnóstico , Dermatite Irritante/epidemiologia , Dermatite Ocupacional/diagnóstico , Diagnóstico Diferencial , Feminino , Hipersensibilidade Alimentar/epidemiologia , Produtos Domésticos/efeitos adversos , Humanos , Hipersensibilidade Imediata/epidemiologia , Masculino , Pessoa de Meia-Idade , Especificidade de Órgãos , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: Nickel is a common allergen. OBJECTIVE: To examine the epidemiology of nickel sensitivity in North America. METHODS: Retrospective, cross-sectional analysis of 44,097 patients patch tested by the North American Contact Dermatitis Group from 1994 to 2014. Nickel sensitivity was defined as a positive patch test for nickel. We evaluated the frequency of nickel sensitivity and patient demographics. For each positive reaction to nickel, we tabulated clinical relevance, occupational relatedness, and exposure sources. RESULTS: The average frequency of nickel sensitivity was 17.5% (1994-2014). Nickel sensitivity significantly increased over time (from 14.3% in 1994-1996 to 20.1% in 2013-2014 [P < .0001]). Nickel-sensitive patients were significantly more likely to be female, young, nonwhite, and atopic (have eczema and asthma) and/or have dermatitis affecting the face, scalp, ears, neck, arm, or trunk (P values ≤ .0474). Overall, 55.5% of reactions were currently clinically relevant; this percentage significantly increased over time (from 44.1% in 1994-1996 to 51.6% in 2013-2014 [P < .0001]). The rate of occupational relatedness was 3.7% overall, with a significant decrease over time (from 7.9% in 1994-1996 to 1.9% in 2013-2014 [P < .0001]). Jewelry was the most common source of nickel contact. LIMITATIONS: Tertiary referral population. CONCLUSIONS: Nickel allergy is of substantial public health importance in North America. The frequency of nickel sensitivity in patients referred for patch testing has significantly increased over a 20-year period.
Assuntos
Dermatite Alérgica de Contato/epidemiologia , Níquel/efeitos adversos , Doenças Profissionais/epidemiologia , Adolescente , Adulto , Vestuário/efeitos adversos , Cosméticos/efeitos adversos , Estudos Transversais , Dermatite Alérgica de Contato/etiologia , Feminino , Humanos , Joias/efeitos adversos , Masculino , Pessoa de Meia-Idade , Níquel/imunologia , América do Norte/epidemiologia , Doenças Profissionais/etiologia , Testes do Emplastro , Prevalência , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: Nickel is a common allergen responsible for allergic contact dermatitis. OBJECTIVE: To characterize nickel sensitivity in children and compare pediatric cohorts (≤5, 6-12, and 13-18 years). METHODS: Retrospective, cross-sectional analysis of 1894 pediatric patients patch tested by the North American Contact Dermatitis Group from 1994 to 2014. We evaluated demographics, rates of reaction to nickel, strength of nickel reactions, and nickel allergy sources. RESULTS: The frequency of nickel sensitivity was 23.7%. Children with nickel sensitivity were significantly less likely to be male (P < .0001; relative risk, 0.63; 95% confidence interval, 0.52-0.75) or have a history of allergic rhinitis (P = .0017; relative risk, 0.74; 95% confidence interval, 0.61-0.90) compared with those who were not nickel sensitive. In the nickel-sensitive cohort, the relative proportion of boys declined with age (44.8% for age ≤5, 36.6% for age 6-12, and 22.6% for age 13-18 years). The most common body site distribution for all age groups sensitive to nickel was scattered/generalized, indicating widespread dermatitis. Jewelry was the most common source associated with nickel sensitivity (36.4%). LIMITATIONS: As a cross-sectional study, no long-term follow-up was available. CONCLUSIONS: Nickel sensitivity in children was common; the frequency was significantly higher in girls than in boys. Overall, sensitivity decreased with age. The most common source of nickel was jewelry.
Assuntos
Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Níquel/efeitos adversos , Adolescente , Distribuição por Idade , Criança , Pré-Escolar , Estudos Transversais , Bases de Dados Factuais , Feminino , Humanos , Hipersensibilidade/epidemiologia , Hipersensibilidade/etiologia , Hipersensibilidade/fisiopatologia , Incidência , Masculino , Níquel/imunologia , América do Norte/epidemiologia , Testes do Emplastro , Estudos Retrospectivos , Medição de Risco , Distribuição por SexoAssuntos
Dermatite Alérgica de Contato , Dermatite Seborreica , Alérgenos/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Seborreica/diagnóstico , Dermatite Seborreica/epidemiologia , Humanos , América do Norte , Testes do Emplastro , Estudos RetrospectivosAssuntos
Dermatite Alérgica de Contato/epidemiologia , Dermatite Ocupacional/epidemiologia , Tinturas para Cabelo/efeitos adversos , Testes do Emplastro/métodos , Fenilenodiaminas/imunologia , Adulto , Fatores Etários , Comorbidade , Estudos Transversais , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/imunologia , Dermatite Irritante/epidemiologia , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/imunologia , Feminino , Seguimentos , Tinturas para Cabelo/química , Humanos , Masculino , Pessoa de Meia-Idade , América do Norte/epidemiologia , Fenilenodiaminas/administração & dosagem , Estudos Retrospectivos , Fatores SexuaisAssuntos
Dermatite Alérgica de Contato , Tatuagem , Humanos , Tinta , Testes do Emplastro , Estudos Retrospectivos , Estados UnidosAssuntos
Dermatite Alérgica de Contato/etiologia , Dermatite Irritante/etiologia , Dermatite Ocupacional/etiologia , Equipamento de Proteção Individual/efeitos adversos , Adolescente , Adulto , Indústria da Construção , Feminino , Pessoal de Saúde , Humanos , Hipersensibilidade ao Látex/etiologia , Masculino , Indústria Manufatureira , Pessoa de Meia-Idade , Testes do Emplastro , Adulto JovemRESUMO
BACKGROUND: Relatively little is known about the epidemiology of allergic contact dermatitis in older individuals. OBJECTIVES: We sought to determine the frequency of positive and clinically relevant patch test reactions in older individuals (≥ 65 years old) referred for patch testing, and to compare these results with those of adults (≤ 64-19 years) and children (<18 years). DESIGN: This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1994 to 2008. RESULTS: A total of 31,942 patients (older n = 5306; adults n = 25,028; children n = 1608) were patch tested. The overall frequency of at least one allergic reaction in older individuals was 67.3% as compared with 66.9% for adults (P = .5938) and 47% for children (P = .0011). Reaction rates that were statistically higher in older individuals as compared with both adults and children included: Myroxylon pereirae, fragrance mix I, quaternium-15, formaldehyde, imidazolidinyl urea, diazolidinyl urea, neomycin, bacitracin, methyldibromo glutaronitrile, methyldibromo glutaronitrile/phenoxyethanol, ethyleneurea melamine formaldehyde mix, and carba mix (P values < .0004). Patch test reaction rates that were significantly lower in older individuals than both comparison groups included: nickel, thimerosal, and cobalt (P values < .0001). LIMITATIONS: Referral population was a limitation. CONCLUSIONS: Older individuals were more likely to have at least one positive patch test reaction as compared with children, but had similar rates to adults. The frequency of positive reactions to specific allergens differed by age group, most likely as a result of exposures.
Assuntos
Dermatite Alérgica de Contato/epidemiologia , Testes do Emplastro , Adolescente , Adulto , Idoso , Alérgenos/imunologia , Antibacterianos/imunologia , Cobalto/imunologia , Estudos Transversais , Ditiocarb , Guanidinas/imunologia , Humanos , Metenamina/análogos & derivados , Metenamina/imunologia , Pessoa de Meia-Idade , Myroxylon/imunologia , Níquel/imunologia , Testes do Emplastro/métodos , Conservantes Farmacêuticos/efeitos adversos , Estudos Retrospectivos , Tiram/imunologiaRESUMO
BACKGROUND/OBJECTIVES: Carvone, a flavoring agent, may cause allergic contact dermatitis. This study summarizes patch test reactions to carvone in patients tested by the North American Contact Dermatitis Group, 2009 to 2018. METHODS: This was a retrospective analysis of patients positive to carvone (5% petrolatum). Demographics were compared with those of patients who were negative. Other analyses included reaction strength, clinical relevance, coreactivity with other fragrance/flavor allergens, and exposure sources. RESULTS: Of 24,124 patients tested to carvone, 188 (0.78%) were positive. As compared with carvone-negative patients, carvone-positive patients were significantly more likely older than 40 years (P = 0.0284). Women (76.1%) and/or facial involvement (33.0%) were common in the carvone-positive group but not statistically different from carvone-negative patients; 73.3% (n = 138) of the reactions were currently relevant. Relevant sources were personal care products (46.3%, n = 87) and food (14.3%, n = 27). Coreactivity with other fragrance/flavor markers was present in 60.6% of carvone-positive patients, most commonly fragrance mix I (34.6%), balsam of Peru (24.5%), and cinnamic aldehyde (15.4%). CONCLUSIONS: Ten-year prevalence of carvone sensitivity was 0.78%. Most carvone-positive patients were female, were older than 40 years, and/or had facial dermatitis. Personal care products were the most common source. Two-fifths of carvone reactions would have been missed by relying on other fragrance/flavoring allergens.
Assuntos
Cosméticos/efeitos adversos , Monoterpenos Cicloexânicos/efeitos adversos , Aromatizantes/efeitos adversos , Testes do Emplastro/métodos , Adulto , Distribuição por Idade , Alérgenos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , América do Norte , Perfumes/efeitos adversos , Estudos Retrospectivos , Distribuição por SexoRESUMO
BACKGROUND: Hair care products (HCPs) may cause both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD). OBJECTIVES: The aims of the study were to determine the prevalence of HCP-associated ICD/ACD and to characterize relevant allergens. METHODS: This study is a retrospective analysis of North American Contact Dermatitis Group (NACDG) patch test data, 2001-2016. RESULTS: Of 38,775 patients tested, 3481 (9.0%) had positive patch test reactions associated with HCPs. The HCP-positive patients were significantly more likely to be female (79.9% vs 66.0%) and/or have primary sites of dermatitis on the face (32.0% vs 27.8%) or scalp (15.4% vs 2.2%) compared with the HCP-negative patients (P < 0.0001). Of 4908 HCP-associated positive patch test reactions, 86.9% (n = 4263) were due to allergens on the NACDG screening series; p-phenylenediamine (35.8%), methylisothiazolinone (9.7%), methylchloroisothiazolinone/methylisothiazolinone (8.7%), and cocamidopropyl betaine (5.9%) were the most frequent. Most reactions (87.7%, 3736/4263) were currently clinically relevant. The most common job associated with 366 occupationally related NACDG HCP-associated allergens was hairdresser/cosmetologist (71.9%). Two hundred eighty-two patients (0.7%) had ICD associated with HCPs. Shampoo/conditioners were the most frequent source of NACDG HCP-associated reactions (47.3%) and HCP-associated ICD (45.0%). CONCLUSIONS: Of the HCP-positive patients, 18.5% had HCP reactions to allergens not on the NACDG screening series, underscoring the importance of patch testing to expanded series in patients suspected of HCP allergy.