How K N, Tang M M, Kaur R, Johar A
Hospital Kuala Lumpur, Department of Dermatology, Kuala Lumpur, Malaysia.
Med J Malaysia. 2017 Apr;72(2):113-118.
The pattern of contact sensitisation should be monitored in order to detect the changing trend of sensitising allergens. We aim to evaluate contact sensitisation in adults suspected to have allergic contact dermatitis.
This is a five-year retrospective review on contact sensitisation in adults patch-tested with the European Standard and extended series between 2011 and 2015 in the Department of Dermatology, Hospital Kuala Lumpur.
There were 689 adults (M:F= 1:2.04; mean age 40.5 years) who were patch-tested. The majority (175, 25.4%) were white collar workers and 118 (17.1%) were healthcare workers. The provisional diagnoses of patients included contact dermatitis (80.8%); endogenous eczema (7.9%); hand eczema (3.2%); hand and foot eczema (3.5%); foot eczema (1.4%) and photodermatitis (1.2%). The allergens selected for testing were based on past and present history of exposure. Almost all (688, 99.8%) were patch-tested with the European standard allergens and 466 (67.6%) were tested with the extended series. About three quarter (528, 76.6%) developed at least one positive reaction. The top five most frequent reactions were to nickel sulphate (35.3%); potassium dichromate (16.5%); methylchloroisothiazolinone (12.9%), fragrance mix I (12.6%), and cobalt chloride (10.2%). The commonest sensitisations identified in the extended series were palladium chloride (23/105, 21.9%), stannous chloride (18/85, 21.2%), miconazole (7/44, 15.9%), gold(I)sodium thiosulfate (16/105, 15.2%) and thimerosal (29/202, 14.4%).
Contact sensitisation was detected in 76.6% of adults patch-tested. Nickel sulphate was found to be the most frequently sensitising allergen. The rising prevalence of methylchloroisothiazolinone/methylisothiazolinone sensitization poses significant concern.
应监测接触性致敏模式，以检测致敏变应原的变化趋势。我们旨在评估疑似过敏性接触性皮炎的成人的接触性致敏情况。
这是一项对2011年至2015年期间在吉隆坡医院皮肤科接受欧洲标准系列和扩展系列斑贴试验的成人接触性致敏情况进行的为期五年的回顾性研究。
共有689名成人接受了斑贴试验（男：女 = 1:2.04；平均年龄40.5岁）。大多数（175人，25.4%）是白领工人，118人（17.1%）是医护人员。患者的初步诊断包括接触性皮炎（80.8%）；内源性湿疹（7.9%）；手部湿疹（3.2%）；手足湿疹（3.5%）；足部湿疹（1.4%）和光接触性皮炎（1.2%）。选择用于检测的变应原基于过去和当前的接触史。几乎所有患者（688人，99.8%）都接受了欧洲标准变应原的斑贴试验，466人（67.6%）接受了扩展系列的检测。约四分之三（528人，76.6%）出现了至少一种阳性反应。最常见的五种反应分别针对硫酸镍（35.3%）；重铬酸钾（16.5%）；甲基氯异噻唑啉酮（12.9%）、香料混合物I（12.6%）和氯化钴（10.2%）。扩展系列中确定的最常见致敏原是氯化钯（23/105，21.9%）、氯化亚锡（18/85，21.2%）、咪康唑（7/44，15.9%）、硫代硫酸金（I）钠（16/105，15.2%）和硫柳汞（29/202，14.4%）。
在接受斑贴试验的成人中，76.6%检测到接触性致敏。硫酸镍被发现是最常见的致敏变应原。甲基氯异噻唑啉酮/甲基异噻唑啉酮致敏患病率的上升引起了重大关注。
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