Garval E, Plee J, Lesage C, Grange-Prunier A, Bernard P, Perceau G
Service de dermatologie, CHU, avenue du Général-Koenig, 51100 Reims, France.
Service de dermatologie, CHU, avenue du Général-Koenig, 51100 Reims, France.
Ann Dermatol Venereol. 2018 May;145(5):339-346. doi: 10.1016/j.annder.2018.01.048. Epub 2018 Apr 17.
Allergic contact dermatitis around chronic leg ulcers (CLU) is a common complication in patients presenting CLU and prolongs healing times. The aim of this study was to describe the rate of sensitization to modern dressings (MD) used in these patients and to assess whether there is a relation between the number of sensitizations and ulcer type, the time from onset of the ulcer, and patient age and gender.
We conducted a retrospective study at Reims University Hospital between 2010 and 2014 that included all patients with CLU of vascular etiology surrounded by eczematous lesions, and who had one of the patch-tests in the following 3 series: European baseline±leg ulcers±corticosteroids.
Among the 73 patients included, 43 % were polysensitized. Thirty-three patients (45 %) were sensitized to MD (38 % to hydrocolloids, 18 % to hydrogels, 7 % to hydrocellular dressings, 7 % to hydrofiber dressings, 5 % to contact layers and 3 % to alginates). Median age and sex did not differ between "polysensitized" patients and "non-polysensitized" patients (P=0.84 and P=0.25, respectively). Polysensitization was more frequent among patients presenting ulcers for more than 5 years (P=0.032).
Practically half of all patients presenting CLU with surrounding contact dermatitis had sensitization to modern dressings (mostly hydrocolloids and hydrogels). The rate of sensitization increased with the length of presence of CLU.
慢性腿部溃疡(CLU)周围的过敏性接触性皮炎是CLU患者常见的并发症,会延长愈合时间。本研究的目的是描述这些患者对现代敷料(MD)的致敏率,并评估致敏次数与溃疡类型、溃疡发病时间、患者年龄和性别之间是否存在关联。
我们于2010年至2014年在兰斯大学医院进行了一项回顾性研究,纳入所有血管性病因的CLU患者,其周围有湿疹样病变,且在以下3组系列中进行了一项斑贴试验:欧洲基线±腿部溃疡±皮质类固醇。
在纳入的73例患者中,43%为多致敏患者。33例患者(45%)对MD致敏(对水胶体致敏的占38%,对水凝胶致敏的占18%,对水细胞敷料致敏的占7%,对水纤维敷料致敏的占7%,对接触层致敏的占5%,对藻酸盐致敏的占3%)。“多致敏”患者和“非多致敏”患者的年龄中位数和性别无差异(分别为P = 0.84和P = 0.25)。溃疡出现超过5年的患者中多致敏情况更为常见(P = 0.032)。
实际上,所有患有CLU并伴有周围接触性皮炎的患者中,近一半对现代敷料(主要是水胶体和水凝胶)致敏。致敏率随CLU存在时间的延长而增加。