Grange-Prunier A, Couilliet D, Grange F, Guillaume J C
Service de Dermatologie, Hôpital Pasteur, 39, avenue de la Liberté, 68024 Colmar Cedex.
Ann Dermatol Venereol. 2002 May;129(5 Pt 1):725-7.
Allergic contact dermatitis is frequent in patients with chronic leg ulcers. However, it rarely occurs with modern wound dressings and is exceptional with hydrocolloids.
A 66-year-old woman was treated for a leg ulcer with the Comfeel plus(R) transparent hydrocolloid dressing for two months. She developed a pruriginous, erythematous and vesiculous dermatitis under the hydrocolloid plaques. Patch tests for the Comfeel plus(R) transparent hydrocolloid, the Comfeel plus(R) hydrocolloid, balsam of Peru and epoxy resin were positive. Only the positive test for the Comfeel plus(R) transparent hydrocolloid was clinically pertinent. The histological examination of the positive test was suggestive of eczema.
To our knowledge, allergic contact dermatitis to Comfeel plus(R) hydrocolloid dressings has not been reported. Most previous studies which included systematic patch-testings in patients with leg ulcers showed high sensitization rates for various allergens, but no allergy to hydrocolloids. Only isolated cases of allergic contact dermatitis to another hydrocolloid (Duoderm E(R)) have been reported. Our case report shows that allergic contact dermatitis is a possible side-effect of Comfeel plus(R) hydrocolloid dressings. However, it seems exceptional. Since the patch-tests failed to identify the constituent responsible for this allergy in our observation, comprehensive allergologic investigations should be repeated in further cases.
过敏性接触性皮炎在慢性腿部溃疡患者中很常见。然而，在使用现代伤口敷料时很少发生，而在使用水胶体敷料时更是罕见。
一名66岁女性使用康惠尔增强型透明水胶体敷料治疗腿部溃疡两个月。她在水胶体敷料下方出现了瘙痒性、红斑性和水疱性皮炎。对康惠尔增强型透明水胶体敷料、康惠尔增强型水胶体敷料、秘鲁香脂和环氧树脂进行的斑贴试验呈阳性。只有对康惠尔增强型透明水胶体敷料的阳性试验在临床上具有相关性。阳性试验的组织学检查提示为湿疹。
据我们所知，尚未有关于对康惠尔增强型水胶体敷料发生过敏性接触性皮炎的报道。之前大多数对腿部溃疡患者进行系统性斑贴试验的研究显示，对各种过敏原的致敏率很高，但对水胶体无过敏反应。仅报道过个别对另一种水胶体（多爱肤E型）发生过敏性接触性皮炎的病例。我们的病例报告表明，过敏性接触性皮炎是康惠尔增强型水胶体敷料可能出现的副作用。然而，这似乎很罕见。由于在我们的观察中斑贴试验未能识别出导致这种过敏的成分，因此应在更多病例中重复进行全面的变应性学调查。
