Goh C L, Ling R
Institute of Dermatology, National Skin Centre, Singapore.
Singapore Med J. 1998 Oct;39(10):442-6.
The aim of this study was to examine the epidemiology of contact eczema in the elderly patients attending a skin clinic in Singapore.
This is a retrospective study on patients attending our skin clinic at the National Skin Centre. All patients older than 49 years old attending our Contact and Occupational Dermatoses Clinic between 1990 and 1993 were included in the study. The prevalence of contact eczema among different age groups (50-59 years, 60-69 years, and 70-79 years) were compared. Diagnosis of contact dermatitis was based on the clinical history, physical examination and relevant patch test reactions. Demographic data of the patients were collected and analysed. Chi-square test was used for statistical analysis.
Two hundred and one patients who were older than 49 years old, were included in the study. There was no significant difference in the prevalence of personal history of atopy among the 3 age groups. There was no significant difference in the racial distribution of the 3 age groups. The proportion of patients who were occupationally active decreased with age (50% vs 23% vs 0% respectively). There was no significant difference in the proportion of patients with positive patch test reactions in the 3 age groups although the proportion appears to increase with age (68% vs 75% vs 75% respectively). Similarly, the proportion of patients with allergic contact dermatitis was slightly higher in the older age group although the difference was not statistically significant among the 3 age groups (32% vs 45% vs 39% respectively). The face (54%) and hands (31%) were the commonest sites of eczema in the younger age group (50-59 years age group) whereas the lower limbs (41%) and the upper limbs (33.3%) were the commonest sites of eczema in the older patients (70-79 years age group). Nickel allergy was significantly more common in the younger age group (23% vs 17% vs 14% respectively). Medicament allergy (clioquinol-mix) and medicament related allergens e.g. balsam of Peru and fragrance-mix and para-phenylenediamine were slightly more prevalent in the older patients.
The findings appear to indicate that the prevalence of allergic contact dermatitis is higher in older patients and that contact dermatitis tends to occur on the extremities in older patients than younger patients.
本研究旨在调查新加坡一家皮肤诊所老年患者中接触性湿疹的流行病学情况。
这是一项针对在国家皮肤中心我们的皮肤诊所就诊患者的回顾性研究。1990年至1993年间在我们的接触性和职业性皮肤病诊所就诊的所有49岁以上患者均纳入研究。比较了不同年龄组（50 - 59岁、60 - 69岁和70 - 79岁）中接触性湿疹的患病率。接触性皮炎的诊断基于临床病史、体格检查及相关斑贴试验反应。收集并分析了患者的人口统计学数据。采用卡方检验进行统计分析。
201名49岁以上患者纳入研究。3个年龄组中特应性个人史的患病率无显著差异。3个年龄组的种族分布无显著差异。职业活跃患者的比例随年龄下降（分别为50%、23%、0%）。3个年龄组中斑贴试验反应阳性患者的比例虽似乎随年龄增加（分别为68%、75%、75%），但无显著差异。同样，老年组中过敏性接触性皮炎患者的比例略高，尽管3个年龄组间差异无统计学意义（分别为32%、45%、39%）。在较年轻年龄组（50 - 59岁）中，面部（54%）和手部（31%）是湿疹最常见的部位，而在老年患者（70 - 79岁）中，下肢（41%）和上肢（33.3%）是湿疹最常见的部位。镍过敏在较年轻年龄组中显著更常见（分别为23%、17%、14%）。药物过敏（氯碘羟喹合剂）以及与药物相关的变应原，如秘鲁香脂、香料合剂和对苯二胺，在老年患者中略更常见。
研究结果似乎表明，老年患者中过敏性接触性皮炎的患病率较高，且与年轻患者相比，老年患者的接触性皮炎更倾向于发生在四肢。
