Department of Dermatology, George Washington University School of Medicine, Washington, District of Columbia, USA.
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA.
Contact Dermatitis. 2021 Jul;85(1):46-57. doi: 10.1111/cod.13824. Epub 2021 Mar 16.
Few studies have examined the relationship between nummular (discoid) eczema (NE) and allergic contact dermatitis (ACD).
To examine trends, associations, and clinical relevance of ACD in patients with NE who were referred for patch testing.
Retrospective analysis of 38 723 patients from the North American Contact Dermatitis Group.
Overall, 748 patients (1.9%) were diagnosed with NE; 23.9% had a concomitant diagnosis of ACD. The prevalence of NE fluctuated over time between 2001 and 2016, with no overall change in prevalence in diagnosed NE. In multivariable logistic regression models, NE increased steadily with age and was associated with male sex and Asian and other race/ethnicity, and inversely associated with a history of atopic dermatitis (AD) and hay fever. Patients with NE had lower proportions of one or more positive allergic reactions and lower odds of a positive reaction in multiple individual allergens. The most commonly relevant allergens in patients with NE were formaldehyde 2.0% aq., methylisothiazolinone, quaternium 15, fragrance mix I, and propylene glycol.
NE is a heterogeneous disorder with distinct subsets of lesional distributions and a profile of relevant allergens, especially formaldehyde and formaldehyde releasers. Nearly one in four patients with NE had ACD, supporting the role of patch testing in patients with NE.
鲜有研究探讨钱币状（盘状）湿疹（NE）与过敏性接触性皮炎（ACD）之间的关系。
研究因贴斑试验而就诊的 NE 患者中 ACD 的趋势、相关性及临床相关性。
回顾性分析 38723 名来自北美接触性皮炎组的患者。
总体而言，748 名患者（1.9%）被诊断为 NE；23.9%的患者同时诊断为 ACD。2001 年至 2016 年间，NE 的患病率呈波动变化，确诊 NE 的患病率无总体变化。在多变量逻辑回归模型中，NE 随年龄稳步增长，与男性、亚洲及其他种族/民族有关，与特应性皮炎（AD）和干草热病史呈负相关。NE 患者的单一或多种阳性过敏反应比例较低，多个个体过敏原阳性反应的可能性较低。在 NE 患者中，最常见的相关变应原是 2.0%甲醛水剂、甲基异噻唑啉酮、季铵盐 15、香料混合物 I 和丙二醇。
NE 是一种异质性疾病，具有不同的皮损分布亚型和相关变应原特征，尤其是甲醛和甲醛释放剂。近四分之一的 NE 患者患有 ACD，支持对 NE 患者进行贴斑试验。
