特应性皮炎患者中与个人护理产品和局部药物相关的接触性皮炎。
Allergic contact dermatitis to personal care products and topical medications in adults with atopic dermatitis.
机构信息
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois.
出版信息
J Am Acad Dermatol. 2018 Dec;79(6):1028-1033.e6. doi: 10.1016/j.jaad.2018.07.017. Epub 2018 Jul 25.
BACKGROUND
Atopic dermatitis (AD) is associated with skin-barrier disruption, immune dysregulation, and application of emollients and topical medications that might predispose a person toward developing allergic contact dermatitis.
OBJECTIVE
To determine the predictors of allergic contact dermatitis and relevant allergens in AD.
METHODS
A retrospective chart review was performed for 502 adults (age ≥18 years) who were patch tested to an expanded allergen series during 2014-2017.
RESULTS
Overall, 108 (21.5%) had current AD and 109 (21.7%) had past AD. Patients with and without current AD had similar proportions of any positive (+, ++, or +++ 80 [74.1%] vs 254 [64.5%], respectively, chi-squared P = .06); strong-positive (++ and +++ 34 [31.5%] vs 102 [25.9%], respectively, P = .25); and irritant (56 [51.9%] vs 188 [47.7%], respectively, P = .45) patch-test reactions. AD patients had significantly higher rates of positive reactions to ingredients in their personal care products and topical medications, including fragrance mix II (P = .04), lanolin (P = .03), bacitracin (P = .04), cinnamal (P = .02), budesonide (P = .01), tixocortol (P = .02), and chlorhexidine (P = .001); relevance was established in >90% of these reactions. Polysensitization occurred more commonly in patients with AD than without (35 [32.4%] vs 75 [19.0%]; P = .01).
LIMITATION
Study was performed at a single center.
CONCLUSION
AD patients had more positive patch-test reactions to ingredients in their personal care products, topical steroids, and antibiotics.
背景
特应性皮炎（AD）与皮肤屏障破坏、免疫失调以及使用保湿剂和局部药物有关，这些因素可能使患者易患过敏性接触性皮炎。
目的
确定 AD 患者发生过敏性接触性皮炎的预测因素和相关过敏原。
方法
对 2014-2017 年期间接受过扩展过敏原系列斑贴试验的 502 名（年龄≥18 岁）成年人进行回顾性病历分析。
结果
总体而言，108 名（21.5%）患者目前患有 AD，109 名（21.7%）患者曾患有 AD。有和无当前 AD 的患者的阳性（+、++或+++）斑贴试验反应比例相似（分别为 80 [74.1%]例和 254 [64.5%]例，卡方检验 P=0.06）；强阳性（++和+++）反应比例相似（分别为 34 [31.5%]例和 102 [25.9%]例，P=0.25）；以及刺激性（56 [51.9%]例和 188 [47.7%]例，P=0.45）斑贴试验反应比例相似。AD 患者对个人护理产品和局部用药中的成分的阳性反应率明显更高，包括香薰混合 II（P=0.04）、羊毛脂（P=0.03）、杆菌肽（P=0.04）、肉桂醛（P=0.02）、布地奈德（P=0.01）、地塞米松（P=0.02）和氯己定（P=0.001）；这些反应的相关性超过 90%。AD 患者比无 AD 患者更常出现多敏反应（35 [32.4%]例和 75 [19.0%]例；P=0.01）。
局限性
该研究在单中心进行。
结论
AD 患者对个人护理产品、局部类固醇和抗生素中的成分的斑贴试验阳性反应更多。
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