O'Gorman Susan M, Torgerson Rochelle R
Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Int J Dermatol. 2016 Jul;55(7):e386-91. doi: 10.1111/ijd.13044. Epub 2015 Nov 6.
Recalcitrant non-actinic cheilitis may indicate contact allergy.
This study aimed to determine the prevalence of allergic contact cheilitis (ACC) in patients with non-actinic cheilitis and to identify the most relevant allergens.
We used an institutional database to identify patients with non-actinic cheilitis who underwent patch testing between January 1, 2001, and August 31, 2011, and conducted a retrospective review of patch test results in these patients. Additional data were obtained from institutional electronic medical records.
Ninety-one patients (70 [77%] female; mean age: 51 years) were included in the study. Almost half (41 [45%]) had a final diagnosis of ACC. Patch testing was performed in line with universally accepted methods, with application on day 1, allergen removal and an initial reading on day 3, and the final reading on day 5. The allergens of most significance were fragrance mix, Myroxylon pereirae resin, dodecyl gallate, octyl gallate, and benzoic acid. Nickel was the most relevant metal allergen.
Contact allergy is an important consideration in recalcitrant cheilitis. Fragrances, antioxidants, and preservatives dominated the list of relevant allergens in our patients. Nickel and gold were among the top 10 allergens. Almost half (45%) of these patients had a final diagnosis of ACC. Patch testing beyond the oral complete series should be undertaken in any investigation of non-actinic cheilitis.
顽固性非光化性唇炎可能提示接触性过敏。
本研究旨在确定非光化性唇炎患者中过敏性接触性唇炎（ACC）的患病率，并找出最相关的变应原。
我们利用机构数据库识别出2001年1月1日至2011年8月31日期间接受斑贴试验的非光化性唇炎患者，并对这些患者的斑贴试验结果进行回顾性分析。从机构电子病历中获取了额外的数据。
91例患者（70例[77%]为女性；平均年龄：51岁）纳入本研究。几乎一半（41例[45%]）最终诊断为ACC。斑贴试验按照普遍接受的方法进行，第1天涂抹变应原，第3天去除变应原并进行初次读数，第5天进行最终读数。最具意义的变应原是香料混合物、秘鲁香脂树脂、十二烷基没食子酸酯、辛基没食子酸酯和苯甲酸。镍是最相关的金属变应原。
接触性过敏是顽固性唇炎的一个重要考虑因素。香料、抗氧化剂和防腐剂在我们患者的相关变应原列表中占主导地位。镍和金位列十大变应原之中。这些患者中几乎一半（45%）最终诊断为ACC。在任何非光化性唇炎的调查中，都应进行口服全系列之外的斑贴试验。
