使用斑贴试验改善越南手部湿疹患者的治疗效果。
Using Patch Testing to Improve Therapeutic Outcome in the Treatment of Hand Eczema in Vietnamese Patients.
作者信息
Minh Phuong Pham Thi, Minh Trang Trinh, Huu Doanh Le, Van Thuong Nguyen, Huu Sau Nguyen, Thanh Tung Vu, Thi Mai Le, Ha Giang Quach Thi, Huu Nghi Dinh, Cam Van Tran, Huyen My Le, Hau Khang Tran, Gandolfi Marco, Satolli Francesca, Feliciani Claudio, Tirant Michael, Vojvodic Aleksandra, Lotti Torello
机构信息
National Hospital of Dermatology and Venereology, Hanoi, Vietnam.
Unit of Dermatology, University of Parma, Parma, Italy.
出版信息
Open Access Maced J Med Sci. 2019 Jan 23;7(2):204-207. doi: 10.3889/oamjms.2019.051. eCollection 2019 Jan 30.
BACKGROUND
Hand eczema is a common chronic and relapsing skin disease with various clinical features. Hand eczema aetiology can be allergic contact dermatitis (ACD), irritant contact dermatitis (ICD), atopic dermatitis (AD) and unknown or combination causes. If the causative agents are not detected treatment of hand eczema will be a failure. A patch test can be useful to detect causative agents in suspected allergic contact hand eczema. Then patients will avoid contacting them. This results in the improvement of hand eczema. In Vietnam, patch test has not been used before, so we conduct this study.
AIM
To identify causative allergens by using patch test with 28 standard allergens in consecutive patients.
METHODS
A group of 300 HE patients from the National Hospital of Dermatology and Venereology (NHDV) in Vietnam were enrolled in this study. They were divided into 4 groups-ACD, ICD, AD and unknown aetiology. The patient was patch tested with 28 standard allergens to identify the causative agents.
RESULTS
Among the 300 HE enrolled patients, ACD accounted for 72.7%, AD and ICD had the same rate of 12.7%. 39.3% of the patients had a positive patch test. Reaction to nickel sulfate was the most common (10.3%), followed by potassium dichromate (9.7%), cobalt (4%) and fragrance mix (3.1%). About one-third of the cases had relevant clinical reactions correlated with the contact agents and clinical history. Males reacted to cement, thiuram mix and formaldehyde more than females, while females reacted to a nickel more than males.
CONCLUSIONS
Hand eczema has variable clinical features and diverse aetiology. ACD is an important cause of hand eczema that can be managed with a patch test to detect causative allergens. Nearly 40% of HE cases had positive patch test. Relevant patch test reactions were seen in one-third of the patients. We propose using patch test detect causative agents in suspected allergic contact hand eczema. Then patients will avoid contacting them. This results in the improvement of hand eczema.
背景
手部湿疹是一种常见的慢性复发性皮肤病，具有多种临床特征。手部湿疹的病因可能是过敏性接触性皮炎（ACD）、刺激性接触性皮炎（ICD）、特应性皮炎（AD）以及不明原因或多种原因共同作用。如果未检测到致病因素，手部湿疹的治疗将会失败。斑贴试验有助于检测疑似过敏性接触性手部湿疹的致病因素。然后患者可避免接触这些因素，从而使手部湿疹得到改善。在越南，此前尚未使用过斑贴试验，因此我们开展了这项研究。
目的
通过对连续的患者使用含28种标准变应原的斑贴试验来确定致病变应原。
方法
来自越南国家皮肤病与性病医院（NHDV）的300例手部湿疹患者纳入本研究。他们被分为4组——ACD、ICD、AD和病因不明组。对患者进行含28种标准变应原的斑贴试验以确定致病因素。
结果
在纳入研究的300例手部湿疹患者中，ACD占72.7%，AD和ICD的比例相同，均为12.7%。39.3%的患者斑贴试验呈阳性。对硫酸镍的反应最为常见（10.3%），其次是重铬酸钾（9.7%）、钴（4%）和香料混合物（3.1%）。约三分之一的病例有与接触物及临床病史相关的临床反应。男性对水泥、秋兰姆混合物和甲醛的反应比女性更常见，而女性对镍的反应比男性更常见。
结论
手部湿疹具有多样的临床特征和多种病因。ACD是手部湿疹的一个重要病因，可通过斑贴试验检测致病变应原进行处理。近40%的手部湿疹病例斑贴试验呈阳性。三分之一的患者出现了相关的斑贴试验反应。我们建议在疑似过敏性接触性手部湿疹中使用斑贴试验检测致病因素。然后患者可避免接触这些因素，从而使手部湿疹得到改善。
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