Atopy Associated With Positive Patch Test and Possible Allergic Contact Dermatitis

2018 ◽  
Vol 22 (4) ◽  
pp. 405-410 ◽  
Author(s):  
Mark G. Kirchhof ◽  
Gillian C. de Gannes

Background: Atopy is a genetic predisposition to the development of allergic reactions and the increased production of immunoglobulin E (IgE) upon exposure to environmental antigens. Clinical manifestations of atopy include asthma, atopic dermatitis (AD), and allergic rhinoconjunctivitis (ARC). Objective: To determine if cutaneous delayed hypersensitivity reactions (CDHRs) as assessed by patch testing are higher among patients with a history of atopy and with a familial predisposition to atopy. Methods: For this study, we reviewed the patch test database of the UBC Contact Dermatitis Clinic over a 4-year time span. A personal history of asthma, AD, and ARC was recorded. In addition, a family history was obtained and manifestations of atopy in family members were noted. Results: A total of 1515 patients were included in this study. Our data show that the odds ratio (OR) of a positive patch test with a personal history of atopy was 1.39, while the OR of a positive patch test with a family history of atopy was 1.69. Conversely, a personal history of respiratory atopy did not significantly affect the probability of a positive patch test, with an OR of 1.03. Conclusion: We conclude from our study that patients with a personal or family history of atopy have an increased risk of allergic contact dermatitis (ACD). These results provide further evidence for the link between atopy and ACD and suggest that children of atopic parents should avoid potential contact allergens and would likely benefit from prophylactic emollient use.

2014 ◽  
Vol 18 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Katie Beleznay ◽  
Gillian de Gannes ◽  
Sunil Kalia

Background: As the use of sunscreens becomes more prevalent, reports of adverse effects to sunscreens have increased. Objective: To analyze a patch test database for the prevalence of allergic contact dermatitis (ACD) to sunscreen. Methods: The database was searched for positive patch test reactions to benzophenone-3. Charts were also reviewed for those who were further tested to the sunscreen series. Results: Twenty-three of the 1,527 patients seen were tested to the sunscreen series. Of these, only 4 patients had a positive reaction to a sunscreen chemical or to the product they were using. In addition, 8 of the 1,527 patients who had no specific history of sunscreen allergy reacted to benzophenone-3. Conclusion: ACD to sunscreen was found to be very uncommon (0.8%). Other final diagnoses included ACD to excipients such as fragrances or preservatives and suspected photosensitive disorders.


2015 ◽  
Vol 19 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Kathleen Fraser ◽  
Melanie Pratt

Background: In allergic contact dermatitis (ACD), polysensitization consists of positive patch test reactions to three or more unrelated allergens. Objective: The purpose of this case report is to document a 27-year-old female with recurrent lip dermatitis, polysensitization, and reactions to a number of clinically relevant exposures. Methods: Patch testing results revealed positive reactions to tixocortol-21-pivalate (3+), lanolin (3+), neomycin (3+), nickel (1+), hydroxyethyl methylacrylate (3+), bacitracin (3+), and abitol (3+). Results: The patient had seven positive reactions, meeting the criteria for polysensitization. Of known clinical relevance, the patient had applied lanolin-containing lip balms and hydrocortisone- and bacitracin-containing products to the lips, all of which she was strongly reactive to on patch testing. Conclusion: Polysensitization occurs when three or more unrelated allergens are positive on patch testing. This case highlights the importance of considering polysensitization in ACD as numerous allergens that were positive on patch testing were clinically relevant.


2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Thacharamban Mansoorali ◽  
Abdulsalam Sarin

Objectives: The objective of the study was to identify the allergens showing positive patch test reaction (using Indian standard battery of allergens) in cement workers with clinically diagnosed allergic contact dermatitis (CD) to cement attending a tertiary referral center. Materials and Methods: We included cement workers with clinically diagnosed allergic CD to cement who attended the dermatology outpatient clinic of our tertiary referral center from January 2013 to December 2013. We did patch testing in all the cases ( after subsidence of active dermatitis) with Indian standard battery of patch test allergens and documented the allergens that showed a positive reaction. Results: Forty-seven (94%) of the 50 study participants showed a positive reaction to one or more of the allergens. The most common allergen that showed a positive reaction was potassium dichromate (43/50, 86%). Twenty-five patients (50%) showed positive reactions to more than 1 allergen. Four patients (8%) showed positive reactions only to allergens that were not seen in cement. Limitations: Small sample size and lack of information on clinical response of dermatitis to avoidance of identified allergen were the major limitations. Conclusion: Twenty-five (50%) patients showing positive reactions to more than 1 allergen tested and 4 (8%) showing positive patch test reaction to none of the allergens in cement (but to other allergens) highlight the role of patch testing in identifying the probable allergens in patients with clinically diagnosed allergic CD to cement.


2019 ◽  
Vol 11 ◽  
pp. 117863451988055
Author(s):  
Eman Omar Khashaba ◽  
Mohammad A Gaballah ◽  
Ahmed Fathy State ◽  
Mona Elwassefy

Objectives: First, this research was instituted to identify common allergens, and second, to test the association between IL16 gene promoter polymorphism rs4778889 T/C and allergic contact dermatitis (ACD). Methods: A case control study was conducted in dermatology outpatients’ clinic. Study subjects received interview-based semi-structured questionnaire, complete skin examination, IL16 gene promoter was investigated by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) analysis, and IQ Ultra™ patch test units (Chemotechnique Diagnostics AB, Sweden) with 10 substances were used. Results: Most of the prevalent cases had positive patch test (93.3%). The most common clinical presentation of ACD in our patients was itching (96.7%), followed by dryness (86.75%), erythema (76.7%), and fissuring (76.7%). There was higher CC gene distribution among cases, but there was no statistically significant difference. IL16 gene distribution was nearly similar among different clinical presentations. Formaldehyde showed statistically significant higher frequency for CC. The most common allergen found was mercury chloride (76.6%), followed by potassium dichromate (26.6%) and cobalt chloride (20%). Conclusions: The current study found prominent metal sensitization (mercury chloride) over the previously known potassium dichromate. There was no statistically significant IL16 gene distribution among cases compared with control. However, C allele was more frequently encountered in cases. Further studies are required to test the association with IL16 genotype and ACD and highlight the new trends in metal sensitization among cement-exposed workers.


2013 ◽  
Vol 104 (2) ◽  
pp. 156-158 ◽  
Author(s):  
A.J. González-Rodríguez ◽  
E.M. Gutiérrez-Paredes ◽  
Á. Revert Fernández ◽  
E. Jordá-Cuevas

2019 ◽  
Vol 77 (3) ◽  
pp. 221-225
Author(s):  
Mariana Ferreira Bastos ◽  
Ricardo Batista ◽  
Diogo Laertes ◽  
Joana Calvão ◽  
Margarida Gonçalo

Introduction. Occupational Allergic Contact Dermatitis is a very common occupational disease and epoxy resins are among its main causes. The aim of this study was to characterize patients with positive patch test reactions to epoxy resin detected in the Coimbra Hospital and University Center between 2012 and 2018 and compare with the results of patients patch tested between 1999 and 2008 at the same Institution. Method and Materials.  Within aretrospective analysis of the files of patients with positive patch test reactions (1+ or more intense) to epoxy resin of bisfenol A tested at 1% pet. within the Baseline Series between 2012 and 2018, we characterized demographic and clinical data of reactive patients, evaluated the relevance of the reaction, sources of exposure to epoxy resin with particular attention to occupational exposures, other positive reactions and the impact of the results of the tests in the work conditions of these patients. Lastly, we compared these results with a previous study performed in the same Hospital between 1999 and 2008. Results. Among 2363 patch tested patients during the study period we found 23 patients (0.97%), 17 males and 6 females, who developed contact allergy to epoxy resins. In 22 cases we identified a relevant occupational exposure: 9 from construction industry; 9 workers from wind-mill turbines factory for Eolic energy; 2 from fiberglass factories; 1 from a chemical factory and 1 from a Wastewater Treatment Plant. In 1 patient (a teacher) no relevance was found. Of these 22 workers, 9 (39.1%) had both hand and airborne lesions, while 8 (34.8%) had lesions exclusively on the hands and 5 (21.7%) had predominately airborne dermatitis. Four of the 23 (17.4%) reacted exclusively to the epoxy resin, and 11 of 18 (61.1%) also reacted to 0.25% hexanediol diglycidyl ether. Avoidance resulted in a significant improvement of symptoms. Compared to the previous period (1999-2008), there are no significative changes apart from a slight increase in the frequency of the allergic reactions to epoxy resins and its main source of exposure. Conclusions. The prevalence of allergic contact dermatitis to epoxy resin has slightly increased in this Portuguese Center mostly due to workers from wind-mill turbines factory for Eolic energy, a recent industry implanted in this region. This allergen still causes almost exclusively occupational dermatitis, either hand, airborne, or both.


2021 ◽  
Vol 23 (1) ◽  
pp. 16-22
Author(s):  
Arnija Rana ◽  
S Shrestha ◽  
AK Jha ◽  
DP Thapa ◽  
S Joshi ◽  
...  

Allergic contact dermatitis (ACD) is one of the most common diseases presenting to the Dermatology department. The one and only method of preventing as well as treating this disease is avoidance of the allergen causing it. The identification of the allergen causing the ACD is possible by performing patch testing. The purpose of this study was to identify common allergens among patients with ACD using Indian standard series (ISS) of patch test. Clinically suspected cases of ACD were included in the hospital based cross-sectional study from January to December 2017. These cases underwent patch testing with the ISS. The study assessed the following variables: sex, age, occupation, site and positive patch test results. There were a total of 58 patients among which, 36.2% were males and 63.8% were females with a mean age of 32.36±12.51 years. Positive patch test reactions were seen in 63.0% of patients. The most common allergens were nickel sulphate (51.4%), fragrance mix (37.8%), potassium dichromate (8.1%), colophony (8.1%) and black rubber mix (8.1%). Among male, most common allergens were fragrance mix (57.1%), nickel sulphate (28.6%) and potassium dichromate (21.4%) while in female, most common allergens were nickel sulphate (65.2%) and fragrance mix (26.1%). In our study, majority of the allergens were positive. Hence, the ISS used in the study might be suitable in the context of Nepalese population. However, further similar studies on large number of patients with multiple allergens are required to determine the exact number of contact allergens prevalent in our population.


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