Reichert-Pénétrat S, Barbaud A, Weber M, Schmutz J L
Service de Dermatologie, Hôpital Fournier, Nancy.
Ann Dermatol Venereol. 1999 Feb;126(2):131-5.
Leg ulcers are a common disease in dermatology. Their social and economic implications are important, especially when contact dermatitis complicates these wounds.
In this study a total of 359 patients had contact dermatitis investigations over a period of 5 years. Patch-tests were performed on 116 men and 243 women hospitalized with venous and/or arterial leg ulcers, with or without clinical appearance of periulcerous contact dermatitis. Standard patch-tests of the ICDRG (International Contact Dermatitis Research Group) were systematically performed as well as a specific series of 40 tests.
Positive patch tests were observed in 82.5 p. 100 of the patients, indicating a very high rate of contact allergy in patients with leg ulcers. Peru balsam, lanolin and neomycin were the most frequent culprits of positive patch-tests in this population. Five percent of patch-tests with eosin were positive in our study. This is not common in the literature. Moreover, we highlight the high rate of contact sensitization to corticosteroids in this population. According to these results and to the literature, a new series of patch-tests for leg ulcers is suggested.
Polysensitization in patients with chronic wounds is very frequent. A series of patch-tests in leg ulcers may lead to some interesting conclusions but a good questioning of the patient is always necessary to complete this series.
腿部溃疡是皮肤科的常见疾病。其社会和经济影响重大,尤其是当接触性皮炎使这些伤口复杂化时。
在本研究中,共有359名患者在5年期间接受了接触性皮炎检查。对116名男性和243名女性进行了斑贴试验,这些患者因静脉性和/或动脉性腿部溃疡住院,有或没有溃疡周围接触性皮炎的临床表现。系统地进行了国际接触性皮炎研究组(ICDRG)的标准斑贴试验以及一系列特定的40项试验。
82.5%的患者斑贴试验呈阳性,表明腿部溃疡患者的接触性过敏率非常高。秘鲁香脂、羊毛脂和新霉素是该人群斑贴试验阳性最常见的原因。在我们的研究中,5%的含曙红斑贴试验呈阳性。这在文献中并不常见。此外,我们强调该人群对皮质类固醇的接触致敏率很高。根据这些结果和文献,建议为腿部溃疡设计一系列新的斑贴试验。
慢性伤口患者的多致敏现象非常常见。对腿部溃疡进行一系列斑贴试验可能会得出一些有趣的结论,但始终需要对患者进行详细询问以完善该系列试验。