Tamagawa-Mineoka Risa, Masuda Koji, Ueda Sachiko, Nakamura Naomi, Hotta Eri, Hattori Junko, Minamiyama Rina, Yamazaki Akiko, Katoh Norito
Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
J Dermatol. 2015 Jul;42(7):720-2. doi: 10.1111/1346-8138.12866. Epub 2015 Mar 21.
Patients with atopic dermatitis are usually responsive to conventional treatment such as topical steroids; however, they are sometimes refractory to the treatment. The influence of contact sensitivities on the course of patients with recalcitrant atopic dermatitis is not known. The aim of this study was to investigate whether contact sensitivities affect the course of patients with recalcitrant atopic dermatitis. We evaluated 45 patients with atopic dermatitis who had failed conventional therapy. Patch testing was performed with the Japanese standard series, metal series and/or suspected items. A total of 15 patients had a positive patch test reaction to at least one allergen. The most common allergens were nickel, topical drugs and rubber accelerators. Avoidance of products or food containing allergic substances greatly or partially improved skin symptoms in nine patients. These results suggest that contact allergens and metals may be critical factors causing eczematous lesions in patients with recalcitrant atopic dermatitis.
特应性皮炎患者通常对局部用类固醇等传统治疗有反应；然而，他们有时对治疗也会产生耐药性。接触性过敏对顽固性特应性皮炎患者病程的影响尚不清楚。本研究的目的是调查接触性过敏是否会影响顽固性特应性皮炎患者的病程。我们评估了45例传统治疗失败的特应性皮炎患者。采用日本标准系列、金属系列和/或可疑物品进行斑贴试验。共有15例患者对至少一种过敏原的斑贴试验反应呈阳性。最常见的过敏原是镍、局部用药和橡胶促进剂。避免使用含有过敏物质的产品或食物，9例患者的皮肤症状得到了显著或部分改善。这些结果表明，接触性过敏原和金属可能是导致顽固性特应性皮炎患者出现湿疹样皮损的关键因素。
