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慢性腿部溃疡或淤滞性皮炎患者接触致敏的当前谱——皮肤科科室信息网络(IVDK)的新数据。

The current spectrum of contact sensitization in patients with chronic leg ulcers or stasis dermatitis - new data from the Information Network of Departments of Dermatology (IVDK).

机构信息

Department of Dermatology, University Hospital Erlangen, 91054, Erlangen, Germany.

Information Network of Departments of Dermatology (IVDK), University Medical Centre Göttingen, 37075, Göttingen, Germany.

出版信息

Contact Dermatitis. 2017 Sep;77(3):151-158. doi: 10.1111/cod.12763. Epub 2017 Feb 14.

DOI:10.1111/cod.12763
PMID:28194803
Abstract

BACKGROUND

Patients with lower leg dermatitis, chronic venous insufficiency or chronic leg ulcers have a high prevalence of contact sensitization.

OBJECTIVES

To identify the current spectrum of contact allergens in these patients.

PATIENTS AND METHODS

Data of the Information Network of Departments of Dermatology on 5264 patients with the above diagnoses from the years 2003 to 2014 (study group) were compared with data on 4881 corresponding patients from 1994 to 2003 (historical control group) and with a current control group without these diagnoses (n = 55 510).

RESULTS

Allergic contact dermatitis was diagnosed less frequently in the study group than in the historical control group (25.9% versus 16.9%; p < 0.001), and contact sensitization to most allergens had declined. The allergen spectrum, however, was largely unchanged. Important allergens are Myroxylon pereirae (balsam of Peru) (14.8% positive reactions), fragrance mix I (11.4%), lanolin alcohol (7.8%), colophonium (6.6%), neomycin sulfate (5.0%), cetearyl alcohol (4.4%), oil of turpentine (3.1%), and paraben mix (2.6%). Patch testing with additional series showed sensitization to Amerchol L-101 (9.7%), tert-butyl hydroquinone (8.7%), framycetin sulfate (5.0%), and gentamicin sulfate (3.1%).

CONCLUSIONS

Topical preparations for treating the above-mentioned conditions should not contain fragrances, Myroxylon pereirae, and colophonium. The special allergen spectrum has to be considered in patch testing.

摘要

背景

小腿皮炎、慢性静脉功能不全或慢性腿部溃疡患者接触致敏的患病率较高。

目的

确定这些患者当前接触变应原的范围。

患者和方法

比较了 2003 年至 2014 年期间 5264 例上述诊断患者的皮肤病学信息网络数据(研究组)与 1994 年至 2003 年期间 4881 例相应患者(历史对照组)的数据,并与无这些诊断的当前对照组(n = 55510)的数据进行比较。

结果

与历史对照组相比,研究组的过敏性接触性皮炎诊断频率较低(25.9%比 16.9%;p < 0.001),并且对大多数变应原的致敏作用均有所下降。然而,变应原谱基本保持不变。重要的变应原包括 Myroxylon pereirae(秘鲁香脂)(阳性反应率为 14.8%)、香料混合物 I(11.4%)、羊毛脂醇(7.8%)、松香(6.6%)、硫酸新霉素(5.0%)、十六十八醇(4.4%)、松节油(3.1%)和对羟基苯甲酸酯混合物(2.6%)。使用附加系列进行斑贴试验显示,对 Amerchol L-101(9.7%)、叔丁基对苯二酚(8.7%)、硫酸杆菌素(5.0%)和硫酸庆大霉素(3.1%)致敏。

结论

治疗上述疾病的局部制剂不应含有香料、Myroxylon pereirae 和松香。在斑贴试验中必须考虑特殊的变应原谱。

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