Clark A R, Sherertz E F
Department of Dermatology, Bowman-Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA.
Am J Contact Dermat. 1998 Jun;9(2):96-9.
Contact dermatitis is said to be rare in psoriasis patients, possibly because of accelerated epidermal turnover, the isomorphic (Koebner) response, and lymphocyte functional alterations.
To identify contact allergy in patients with psoriasis.
A written questionnaire was completed by 100 patients with psoriasis about contact history, flare factors for psoriasis, topical skin care, medications, and occupational/hobby exposures. Of these patients, 20 agreed to be patch tested with a standard screening series (Hermal) and a 20-item psoriasis patch-test series that included ingredients that might be found in topical psoriasis products.
Of the 100 patients, eight suspected a topical medication caused a reaction that worsened their psoriasis, 29 gave a history of atopy, 11 reported reactions to metal jewelry, and 29 reported an allergy to poison ivy. Patch-test results identified four of the 20 patients with six positive patch tests to the materials tested: three of the six positive tests were interpreted as relevant to the patient's psoriasis (coal tar, ethylenediamine and dithranol), two patients tested positive to nickel and one to thimerosal. Five patients had irritant reactions to dithranol.
In this small study, 20% of self-selected psoriasis patients had positive allergic reactions on patch testing. A screening contact and atopic history in psoriasis patients may help to identify a subset of patients who could benefit from a search for more relevant contact allergens with patch test evaluation. This could improve treatment strategies and possibly reduce disability.
接触性皮炎在银屑病患者中据说较为罕见，可能是由于表皮更替加速、同形（科布内）反应以及淋巴细胞功能改变。
确定银屑病患者中的接触性过敏。
100例银屑病患者填写了一份关于接触史、银屑病发作因素、局部皮肤护理、用药情况以及职业/爱好接触情况的书面问卷。其中20例患者同意接受标准筛查系列（赫尔曼）和一个包含局部银屑病产品中可能含有的成分的20项银屑病斑贴试验系列。
100例患者中，8例怀疑某种局部用药引起了使银屑病加重的反应，29例有特应性病史，11例报告对金属首饰有反应，29例报告对毒葛过敏。斑贴试验结果显示，20例患者中有4例对所测试材料有6次阳性斑贴试验结果：6次阳性试验中有3次被判定与患者的银屑病相关（煤焦油、乙二胺和地蒽酚），2例患者对镍试验呈阳性，1例对硫柳汞试验呈阳性。5例患者对地蒽酚有刺激性反应。
在这项小型研究中，20%自行选择的银屑病患者斑贴试验出现阳性过敏反应。对银屑病患者进行接触和特应性病史筛查可能有助于识别一部分可通过斑贴试验评估寻找更相关接触性变应原而受益的患者。这可能改善治疗策略并可能减少残疾。
