Duarte Ida, Mendonça Rodolfo Ferreira, Korkes Karen Levy, Lazzarini Rosana, Hafner Mariana de Figueiredo Silva
Dermatology Clinic, Santa Casa de São Paulo - São Paulo (SP), Brazil.
An Bras Dermatol. 2018 Jan-Feb;93(1):59-62. doi: 10.1590/abd1806-4841.20186047.
Metals are common agents of allergic contact dermatitis, occupational or not, with decreasing incidence over the last years in some countries that have regulated the amount of nickel in objects.
To analyze and compare with previous studies the profile of metal sensitization between 2003-2015.
Patients who underwent patch testing between 2003-2015 were evaluated retrospectively regarding the sensitization rates to metals, the associations between them, the relationship with profession and epidemiology.
Of the 1,386 patients tested, 438 (32%) had positive test to some metal, similar results to the 404/1,208 (33%) of the previous study (1995-2002) performed at the same service (p=0.32). The frequency of nickel (77%), cobalt (32%) and chromium (29%) changed slightly (p=0.20). Most cases of sensitization to chromium were related to the occupation (64%), in contrast to nickel and cobalt (p<0.0001). There was a predominance of females among those sensitized to metal in both studies (p=0.63) and the age group of 20-49 years old (p=0.11); the number of fair-skinned individuals increased (p<0.001), as well as the lesions in the cephalic segment (50.5%; p<0.0001) and hands (45%; p<0.0001), which are not the most frequent location anymore. The number of cleaners decreased (39% vs. 59%; p<0.0001), which still lead in front of bricklayers/painters, which increased (14% vs. 9%; p=0.013). The frequency of wet work reduced (65% vs. 81%; p<0.0001).
The study included a single population group; only patients with positive tests to metals were considered - the others were not evaluated for the possibility of false negatives.
The sensitization to metals, occupational or not, has been significant over the last 21 years, with few epidemiological changes.
金属是过敏性接触性皮炎的常见诱因，无论是否为职业性接触，在一些对物品中镍含量进行管控的国家，其发病率在过去几年有所下降。
分析并与之前的研究比较2003年至2015年期间金属致敏情况。
对2003年至2015年期间接受斑贴试验的患者进行回顾性评估，内容包括对金属的致敏率、它们之间的关联、与职业的关系以及流行病学情况。
在1386例接受检测的患者中，438例（32%）对某些金属斑贴试验呈阳性，与之前在同一科室进行的研究（1995年至2002年，404/1208例，33%）结果相似（p = 0.32）。镍（77%）、钴（32%）和铬（29%）的致敏频率变化不大（p = 0.20）。大多数对铬致敏的病例与职业有关（64%），而镍和钴致敏情况则不同（p < 0.0001）。在两项研究中，金属致敏者中女性均占主导（p = 0.63），年龄组以20至49岁为主（p = 0.11）；皮肤白皙者数量增加（p < 0.001），头面部皮损（50.5%；p < 0.0001）和手部皮损（45%；p < 0.0001）增多，而这些部位不再是最常见的发病部位。清洁工数量减少（39% 对59%；p < 0.0001），但仍领先于砖匠/油漆工，后者数量增加（14% 对9%；p = 0.013）。从事湿作业的频率降低（65% 对81%；p < 0.0001）。
该研究仅纳入了单一人群组；仅考虑了金属斑贴试验呈阳性的患者，未评估其他患者出现假阴性结果的可能性。
在过去21年中，无论是否为职业性接触，金属致敏情况一直较为显著，流行病学变化较少。
