Department of Dermatology, CHU, Université Clermont-Auvergne, Clermont-Ferrand, France.
Department of Dermatology, CHU, Université de Lorraine, Nancy, France.
Contact Dermatitis. 2019 May;80(5):304-310. doi: 10.1111/cod.13221. Epub 2019 Mar 4.
Methylisothiazolinone (MI) is a preservative that is responsible for an epidemic of allergic contact dermatitis (ACD). Few studies have been published on the prognosis of patients with MI-induced ACD.
To evaluate relapses of MI-induced ACD and difficulties in avoiding MI in patients who had received avoidance advice.
A retrospective study of patients with MI-induced ACD diagnosed in two specialized dermato-allergology units between 2010 and 2015 was performed. The median follow-up was 3 years.
Relapses were observed in 64% of 139 included patients, and were severe in 18%. Rinse-off cosmetics were responsible for the largest proportion of relapses (27%). The median time to relapse was 5 months. Sixty-nine per cent of relapses were on the hands, and 29% were on the face. Risk factors for relapsing were hand eczema and a personal history of atopy. The main difficulties encountered in the avoidance strategy were hidden sources of MI, the lack of labelling on industrial products, the complexity of cosmetic labelling, and remembering the name of the allergen.
MI-induced ACD has a poor prognosis. Its high rate of relapse is mainly attributable to the difficulties of avoidance. Management needs to be improved. Specialized follow-up in the year following diagnosis is essential to educate patients.
甲基异噻唑啉酮（MI）是一种防腐剂，它是导致过敏性接触性皮炎（ACD）流行的罪魁祸首。目前仅有少数研究报道了 MI 诱导的 ACD 患者的预后情况。
评估接受回避建议的 MI 诱导的 ACD 患者的复发情况以及回避 MI 的困难。
对 2010 年至 2015 年间在两个专门的皮肤过敏科单位诊断为 MI 诱导的 ACD 的患者进行回顾性研究。中位随访时间为 3 年。
139 例纳入患者中，64%观察到复发，18%为严重复发。冲洗型化妆品是导致复发的主要原因（27%）。复发的中位时间为 5 个月。69%的复发发生在手，29%的复发发生在面部。手部湿疹和特应性个人史是复发的危险因素。回避策略中遇到的主要困难包括 MI 的隐匿来源、工业产品缺乏标签、化妆品标签复杂以及过敏原名称的记忆。
MI 诱导的 ACD 预后较差。其高复发率主要归因于回避的困难。需要改进管理。在诊断后的第一年进行专门的随访对教育患者至关重要。
