Istanbul Faculty of Medicine, Department of Dermatology and Venereology, Istanbul University, Istanbul, Turkey.
Faculty of Medicine, Department of Dermatology and Venereology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
Contact Dermatitis. 2023 Jul;89(1):37-45. doi: 10.1111/cod.14309. Epub 2023 Mar 30.
Allergic contact dermatitis (ACD) from topical ophthalmic medications (TOMs) poses an additional disease burden to patients who already suffer from eye problems.
To investigate the epidemiological/clinical profile of patients with periorbital ACD from TOMs in Turkey.
This was a retrospective, cross-sectional, single tertiary centre study based on files of 75 patch tested patients with suspected periorbital ACD from TOMs among a total of 2801 consecutively patch tested patients with suspected ACD of any origin between 1996 and 2019.
Periorbital ACD was diagnosed in 25 of 75 (33.3%) patients (female:male = 1.8:1; age range: 6-85 years) with suspected ACD from TOMs showing an overall prevalence of 0.9% (25/2801) among the whole patch test population. Atopy was not present. Tobramycin-containing TOMs were the most frequent culprits, followed by antiglaucoma preparations. Their frequency increased, whereas no new cases of neomycin-induced ACD were observed after 2011. Positivities with thimerosal were of unknown clinical relevance, while benzalkonium chloride (BAC) caused ACD in two patients. The diagnosis would be missed in each 20% of patients without performing day (D) 4 and D7 readings and strip-patch testing. Ten culprits were identified only by testing with patients' own TOMs in eight (32%) patients.
Aminoglycosides, particularly tobramycin, were the leading cause of ACD from TOMs. The frequency of ACD from tobramycin and antiglaucoma medications increased after 2011. BAC was a rare but important allergen. Additional D4 and D7 readings, strip-patch testing, and testing with patients' own TOMs seem essential when patch testing with eye medications.
局部眼科药物（TOMs）引起的过敏性接触性皮炎（ACD）给已经患有眼部问题的患者带来了额外的疾病负担。
调查土耳其局部眼科药物引起的眶周 ACD 患者的流行病学/临床特征。
这是一项回顾性、横断面、单中心的研究，基于 1996 年至 2019 年间 2801 例疑似任何来源 ACD 的连续斑贴试验患者中，75 例疑似 TOM 引起的眶周 ACD 患者的档案。
25 例（33.3%）疑似 TOM 引起的 ACD 患者被诊断为眶周 ACD（女性：男性=1.8：1；年龄范围：6-85 岁），在整个斑贴试验人群中，TOM 引起的 ACD 总患病率为 0.9%（25/2801）。无特应性。含妥布霉素的 TOMs 是最常见的罪魁祸首，其次是抗青光眼制剂。它们的频率增加，而在 2011 年后，没有新的新霉素引起的 ACD 病例。硫柳汞的阳性结果与临床相关性不明，而苯扎氯铵（BAC）在 2 例患者中引起 ACD。如果不进行第 4 天（D4）和第 7 天（D7）读数和条斑贴试验，每 20%的患者可能会漏诊。在 8 例（32%）患者中，仅通过测试患者自己的 TOMs 鉴定了 10 种罪魁祸首。
氨基糖苷类药物，特别是妥布霉素，是 TOM 引起 ACD 的主要原因。2011 年后，妥布霉素和抗青光眼药物引起的 ACD 频率增加。BAC 是一种罕见但重要的过敏原。当对眼部药物进行斑贴试验时，额外的 D4 和 D7 读数、条斑贴试验以及测试患者自己的 TOMs 似乎是必要的。
