Uter Wolfgang, Lessmann Holger, Geier Johannes, Schnuch Axel
Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen-Nürnberg, D-91054 Erlangen, Germany.
Contact Dermatitis. 2008 Jun;58(6):359-63. doi: 10.1111/j.1600-0536.2008.01327.x.
Benzalkonium chloride (BAC) is a well-recognized irritant. However, doubts exist that it is also a contact allergen.
Analysis of clinical patch test data addressing the reaction profile and synchronous reproducibility of BAC 0.1% in petrolatum (pet.) and possible increases in risk of BAC contact allergy in certain (occupationally exposed) subgroups. PATIENTS /METHODS: Data of 42 898 patients tested with BAC 0.1% in pet. in 3 different series (topical drugs, ophthalmics, and disinfectants) in the departments of the Information Network of Departments of Dermatology (http://www.ivdk.org) between 1996 and 2006 was analysed.
Overall, morphologically 'positive' reactions were rare, 0.6-1.5%, with a total of 41 stronger positive reactions. Concordance, assessed in 3322 patients tested in duplicate, was low (kappa coefficient 0.15, 95% CI: 0-0.31). Positive test reactions were observed significantly more often in the disinfectants series compared with the 2 other series, indicating that suspected exposure to disinfectants may be associated with sensitization. However, variation of stronger BAC test positivity across potentially relevant (occupational) groups was non-significant.
This analysis of routine clinical data and a number of previous reports add further, if weak, evidence to the notion that BAC is a contact allergen, albeit a very rare one.
苯扎氯铵（BAC）是一种公认的刺激物。然而，人们怀疑它也是一种接触性过敏原。
分析临床斑贴试验数据，以研究0.1%BAC凡士林制剂的反应特征和同步再现性，以及某些（职业暴露）亚组中BAC接触性过敏风险的可能增加情况。患者/方法：分析了1996年至2006年间在皮肤病学部门信息网络（http://www.ivdk.org）的3个不同系列（局部用药、眼科用药和消毒剂）中对42898例患者进行0.1%BAC凡士林制剂测试的数据。
总体而言，形态学上“阳性”反应很少见，为0.6 - 1.5%，共有41例更强的阳性反应。在3322例重复测试的患者中评估的一致性较低（kappa系数0.15，95%CI：0 - 0.31）。与其他两个系列相比，消毒剂系列中观察到阳性试验反应的频率明显更高，这表明疑似接触消毒剂可能与致敏有关。然而，在潜在相关（职业）组中更强的BAC试验阳性率的差异不显著。
对常规临床数据的这一分析以及一些先前的报告进一步（尽管证据薄弱）支持了BAC是一种接触性过敏原的观点，尽管它非常罕见。
