Department of Dermatology, Showa University School of Medicine, Tokyo, Japan.
J Dermatol. 2011 Mar;38(3):267-71. doi: 10.1111/j.1346-8138.2010.00980.x. Epub 2010 Nov 11.
Although metals are common contact allergens, clinical findings of metal contact dermatitis have varied. Such patients have subsequently become rare in Japan as gold dermatitis caused by ear piercing or baboon syndrome by broken thermometers. To evaluate such clinical findings and to determine the frequency of metal allergy, we analyzed the results of patch testing with 18 metals from 1990-2009. Nine hundred and thirty-one patients (189 men and 742 women, mean age 39.0years [standard deviation±17.8]) were tested. Metals were applied on the back for 2days, and the results read with the International Contact Dermatitis Research Group (ICDRG) scoring system 3days after application. Reactions of + to +++ were regarded as positive. Differences of positive rates between men and women, and patients from 1990-1999 and those from 2000-2009 were analyzed with the χ(2) -test. Differences were considered significant at P<0.05. The metal to which the most patients reacted was 5% nickel sulfate (27.2%), irrespective of sex and phase. Significantly more women reacted to nickel sulfate (P<0.01), mercuric chloride (P<0.05) and gold chloride (P<0.01) than men. Significantly more patients in the 1990s reacted to palladium chloride, mercuric chloride and gold chloride (all P<0.01) than from 2000-2009. Nickel has been the most common metal allergen and mercury-sensitivity has decreased over 19years in Japan.
尽管金属是常见的接触过敏原,但金属接触性皮炎的临床发现各不相同。由于穿耳引起的金皮炎和破裂温度计引起的狒狒综合征,此类患者在日本已变得罕见。为了评估这些临床发现并确定金属过敏的频率,我们分析了 1990 年至 2009 年期间使用 18 种金属进行斑贴试验的结果。共有 931 名患者(189 名男性和 742 名女性,平均年龄 39.0 岁[标准差±17.8])接受了测试。将金属贴在背部 2 天,应用后 3 天用国际接触性皮炎研究组(ICDRG)评分系统读取结果。+++反应被认为是阳性。用卡方检验分析男性和女性、1990-1999 年和 2000-2009 年患者之间阳性率的差异。差异有统计学意义(P<0.05)。无论性别和阶段,反应最多的金属是 5%硫酸镍(27.2%)。女性对硫酸镍(P<0.01)、氯化汞(P<0.05)和氯化金(P<0.01)的反应明显多于男性。20 世纪 90 年代的患者对钯氯化物、氯化汞和氯化金的反应明显多于 2000-2009 年(均 P<0.01)。镍一直是最常见的金属过敏原,在日本,19 年来对汞的敏感性已降低。