北美接触性皮炎组斑贴试验结果：2017-2018 年。

North American Contact Dermatitis Group Patch Test Results: 2017-2018.

机构信息

From the Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.

Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC.

出版信息

Dermatitis. 2021;32(2):111-123. doi: 10.1097/DER.0000000000000729.

DOI:10.1097/DER.0000000000000729

PMID:33970567

Abstract

BACKGROUND

Patch testing is an important diagnostic tool for assessment of allergic contact dermatitis (ACD).

OBJECTIVE

This study documented the North American Contact Dermatitis Group (NACDG) patch testing results from March 1, 2017, to December 31, 2018.

METHODS

At 14 centers in North America, patients with dermatitis were tested in a standardized manner with a screening series of 70 allergens and supplemental allergens as clinically indicated. Data were manually verified and entered into a central database. Descriptive statistics were estimated, and trends were analyzed using χ2 test.

RESULTS

Overall, 4947 patients were tested. There were 3235 patients (65.4%) who had at least 1 positive reaction and 2495 patients (50.4%) had a primary diagnosis of ACD. Five hundred eighty-one patients (11.7%) had occupationally related dermatitis. There were 10,122 positive patch test reactions. Nickel remained the most commonly detected allergen (16.2%), followed by methylisothiazolinone 0.2% aqueous (15.3%) and methylchloroisothiazolinone/methylisothiazolinone 0.02% aqueous (200 ppm, 11.0%). Compared with the previous reporting periods (2015-2016 and 2007-2016), the proportion of positive reactions for the top 20 screening allergens statistically increased for only 1 allergen, propolis (3.4%; risk ratios = 2.05 [confidence interval = 1.66-2.54] and 1.82 [confidence interval = 1.57-2.11]).Four newly added allergen preparations, hydroperoxides of linalool (8.9%), benzisothiazolinone (7.3%), sodium metabisulfite (2.7%), and hydroperoxides of limonene (2.6%), all had a prevalence of greater than 2%. Approximately 1 (19.7%) in 5 tested patients had 1 or more clinically relevant reactions to an allergen not on the NACDG screening series; 13.2% of these were occupationally related. T.R.U.E. TEST (SmartPractice Denmark, Hillerød, Denmark) would have hypothetically missed 30% to 40% of reactions detected by the NACDG screening series.

CONCLUSIONS

These results demonstrate the importance of a regularly updated screening allergen series. Methylisothiazolinone continues to be a significant allergen in North America. Patch testing with allergens beyond a screening tray is necessary for complete evaluation of occupational and non-occupational ACD.

摘要

背景

斑贴试验是评估过敏性接触性皮炎（ACD）的重要诊断工具。

目的

本研究记录了 2017 年 3 月 1 日至 2018 年 12 月 31 日北美接触性皮炎组（NACDG）的斑贴试验结果。

方法

在北美 14 个中心，以标准化的方式对皮炎患者进行筛查系列 70 种过敏原和临床指示的补充过敏原检测。数据由人工验证并输入中央数据库。使用 χ2 检验估计描述性统计数据，并分析趋势。

结果

共有 4947 名患者接受了测试。有 3235 名患者（65.4%）至少有 1 个阳性反应，2495 名患者（50.4%）被诊断为 ACD。581 名患者（11.7%）患有职业性皮炎。有 10122 个阳性斑贴试验反应。镍仍然是最常见的过敏原（16.2%），其次是甲基异噻唑啉酮 0.2%水溶液（15.3%）和甲基氯异噻唑啉酮/甲基异噻唑啉酮 0.02%水溶液（200ppm，11.0%）。与前几个报告期（2015-2016 年和 2007-2016 年）相比，前 20 种筛查过敏原中仅有 1 种过敏原（蜂胶）的阳性反应比例统计学上有所增加（3.4%；风险比=2.05[置信区间=1.66-2.54]和 1.82[置信区间=1.57-2.11]）。四种新添加的过敏原制剂，芳樟醇过氧化物（8.9%）、苯并异噻唑啉酮（7.3%）、亚硫酸氢钠（2.7%）和柠檬烯过氧化物（2.6%）的流行率均大于 2%。大约有 1（19.7%）名接受测试的患者对 NACDG 筛查系列中未包含的过敏原存在 1 种或多种临床相关反应；其中 13.2%与职业有关。T.R.U.E. TEST（丹麦 SmartPractice，Hillerød）可能会错过 NACDG 筛查系列检测到的反应的 30%至 40%。