Chen Hao, Liu Guanghui, Huang Nan, Li Wenjing, Dong Xiang, Zhu Rongfei
Huazhong University of Science and Technology, Hubei, China.
An Bras Dermatol. 2016 Apr;91(2):168-72. doi: 10.1590/abd1806-4841.20164606.
Chronic urticaria (CU) can be provoked by a wide variety of causes. Some studies suggest contact sensitization may play a role in the disease.
To investigate the incidence and distribution characteristics of allergic contact sensitization in central Chinese subjects with CU, and assess contact allergen avoidance measures in managing CU.
Patch tests were performed, following the recommended standard procedure, with 20 selected allergens, in line with the European baseline series. All subjects with positive results were prescribed appropriate avoidance measures for the sensitizing substances, while subjects with negative results served as the control group. CU severity was assessed daily from week1 to week4 and for each subject, applying the Urticaria Activity Score.
42.9% (233/543) of subjects with CU showed positive reactions to one or more contact allergen(s). Potassium dichromate, benzene mix and carba mix were more common in male patients, while nickel sulfate was more frequent in females. The positive rates for different allergens varied with age and occupation. The median (interquartile range) severity scores at week 1 were 20 (14-21) and 15 (14-27) for the allergen avoidance group and control group, respectively (P>0.05); and 12 (7-15) and 14 (12-17) at week 4 (P<0.001).
The incidence of allergic contact sensitization in CU patients was high, and appropriate contact allergen avoidance measures benefitted CU management. Contact allergens may play a role in the pathogenic mechanism of CU and patch tests are an option for CU patients.
慢性荨麻疹(CU)可由多种原因引发。一些研究表明接触致敏可能在该疾病中起作用。
调查中国中部地区慢性荨麻疹患者中过敏性接触致敏的发生率及分布特征,并评估在慢性荨麻疹管理中避免接触变应原的措施。
按照推荐的标准程序,使用符合欧洲基线系列的20种选定变应原进行斑贴试验。所有结果呈阳性的受试者都针对致敏物质采取了适当的避免措施,而结果呈阴性的受试者作为对照组。从第1周开始至第4周,每天使用荨麻疹活动评分评估每位受试者的慢性荨麻疹严重程度。
42.9%(233/543)的慢性荨麻疹患者对一种或多种接触变应原呈阳性反应。重铬酸钾、混合苯和卡巴混合物在男性患者中更常见,而硫酸镍在女性中更常见。不同变应原的阳性率随年龄和职业而变化。变应原避免组和对照组在第1周的严重程度评分中位数(四分位间距)分别为20(14 - 21)和15(14 - 27)(P>0.05);在第4周分别为12(7 - 15)和14(12 - 17)(P<0.001)。
慢性荨麻疹患者中过敏性接触致敏的发生率较高,适当的避免接触变应原措施有助于慢性荨麻疹的管理。接触变应原可能在慢性荨麻疹的发病机制中起作用,斑贴试验是慢性荨麻疹患者的一种选择。