Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare drug reaction characterized by a skin rash, eosinophilia, and organ involvement. Objective: Our purpose is to focus on the clinical and epidemiological characteristics of DRESS in the elderly and to identify the incriminated drugs. Methods: This is a retrospective study including patients, hospitalized for DRESS with a RegiSCAR ≥4. The population was divided into 2 groups according to age: 65 years or older (G1) and <65 years (G2). The statistical study was performed using the comparative and multivariate analysis. Results: We included 55 patients (30.9% G1 and 69.1% G2). Skin manifestations were comparable in both groups. Lymphadenopathy was less common in G1 with a statistically significant difference (P = 0.012). Renal impairment was more frequent in the elderly with a statistically significant result (P = 0.005). DRESS in the elderly group was significantly associated with the occurrence of sepsis (P = 0.008). Allopurinol was the most common culprit associated with DRESS in G1 (P = 0.001). Relapses and recurrences were comparable in both groups (P = 0.71). Conclusions: DRESS in the elderly is associated with a high risk of complications, mainly kidney involvement and sepsis. Allopurinol is the most incriminated drug.
{"title":"Characteristics of DRESS Syndrome in the Elderly: A Comparative Study of 55 Patients.","authors":"Emna Bahloul, Khaoula Trimeche, Khadija Sellami, Fatma Hammami, Faten Hayder, Rim Chaabouni, Meriem Amouri, Abderrahmen Masmoudi, Madiha Mseddi, Sonia Boudeya, Hamida Turki","doi":"10.1089/derm.2022.0032","DOIUrl":"10.1089/derm.2022.0032","url":null,"abstract":"<p><p><u><b><i>Background:</i></b></u> Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare drug reaction characterized by a skin rash, eosinophilia, and organ involvement. <u><b><i>Objective:</i></b></u> Our purpose is to focus on the clinical and epidemiological characteristics of DRESS in the elderly and to identify the incriminated drugs. <u><b><i>Methods:</i></b></u> This is a retrospective study including patients, hospitalized for DRESS with a RegiSCAR ≥4. The population was divided into 2 groups according to age: 65 years or older (G1) and <65 years (G2). The statistical study was performed using the comparative and multivariate analysis. <u><b><i>Results:</i></b></u> We included 55 patients (30.9% G1 and 69.1% G2). Skin manifestations were comparable in both groups. Lymphadenopathy was less common in G1 with a statistically significant difference (<i>P</i> = 0.012). Renal impairment was more frequent in the elderly with a statistically significant result (<i>P</i> = 0.005). DRESS in the elderly group was significantly associated with the occurrence of sepsis (<i>P</i> = 0.008). Allopurinol was the most common culprit associated with DRESS in G1 (<i>P</i> = 0.001). Relapses and recurrences were comparable in both groups (<i>P</i> = 0.71). <u><b><i>Conclusions:</i></b></u> DRESS in the elderly is associated with a high risk of complications, mainly kidney involvement and sepsis. Allopurinol is the most incriminated drug.</p>","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10152503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2023-07-11DOI: 10.1089/derm.2023.0116
Nicholas Battis, Samuel F Ekstein, Erin M Warshaw
{"title":"Patch Testing to the Rescue! Lesional Testing for Diagnosis of Fixed Drug Eruption to Pamabrom.","authors":"Nicholas Battis, Samuel F Ekstein, Erin M Warshaw","doi":"10.1089/derm.2023.0116","DOIUrl":"10.1089/derm.2023.0116","url":null,"abstract":"","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9767680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2023-07-17DOI: 10.1089/derm.2023.0128
Nicholas Battis, Sara Hylwa
{"title":"Allergic Contact Dermatitis From 100% Mineral Oil Supported by Repeated Open Application Test.","authors":"Nicholas Battis, Sara Hylwa","doi":"10.1089/derm.2023.0128","DOIUrl":"10.1089/derm.2023.0128","url":null,"abstract":"","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9830023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2023-07-12DOI: 10.1089/derm.2022.0086
Jeremiah S Truel, Cynthia X Wang, Daniel I Schlessinger, David M Sheinbein, Caroline M Mann
{"title":"Cetrimonium Bromide Patch Test Positivity Is Found With a High Frequency in a Cohort of Patients With Frontal Fibrosing Alopecia.","authors":"Jeremiah S Truel, Cynthia X Wang, Daniel I Schlessinger, David M Sheinbein, Caroline M Mann","doi":"10.1089/derm.2022.0086","DOIUrl":"10.1089/derm.2022.0086","url":null,"abstract":"","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9947486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonathan I Silverberg, Marjolein de Bruin-Weller, Brian M Calimlim, Xiaofei Hu, Sarah A Ofori, Andrew M Platt, Henrique D Teixeira, Kilian Eyerich, Jacob P Thyssen
Background: In patients with moderate-to-severe atopic dermatitis (AD), greater skin clearance and itch reduction are associated with more pronounced improvements in quality of life (QoL). Objective: To characterize the aggregate response benefit with upadacitinib versus dupilumab or placebo in patients with moderate-to-severe AD. Methods: Degree of skin clearance and itch response in 3 phase 3 studies (Heads Up [NCT03738397] and Measure Up 1/2 [integrated; NCT03569293/NCT03607422]) were assessed by the Eczema Area and Severity Index (EASI) and Worst Pruritus Numerical Rating Scale (WP-NRS), respectively, using mutually exclusive categories. The aggregate response benefit with upadacitinib over dupilumab or placebo was determined by summing incremental differences for each EASI or WP-NRS category across the full distribution of patient responses. Results: Comparisons across EASI improvement threshold distributions, EASI severity levels, and WP-NRS categories demonstrated an aggregate response benefit favoring upadacitinib over dupilumab as early as week 4 and continuing at weeks 16 and 24. Similar trends were observed for upadacitinib 15 and 30 mg versus placebo. Conclusions: The aggregate response benefit in skin clearance and itch reduction favored upadacitinib 30 mg over dupilumab and upadacitinib 15 or 30 mg over placebo. These benefits may translate to overall greater improvements in patient QoL.
背景：在中重度特应性皮炎（AD）患者中，皮肤清除率越高、瘙痒程度越轻，生活质量（QoL）的改善就越明显。研究目的描述中重度特应性皮炎患者使用达帕替尼相对于杜比鲁单抗或安慰剂的总体反应获益情况。方法在3项3期研究（Heads Up [NCT03738397]和Measure Up 1/2 [整合；NCT03569293/NCT03607422]）中，通过湿疹面积和严重程度指数（EASI）和最差瘙痒数字评定量表（WP-NRS）分别评估皮肤清除程度和瘙痒反应，采用相互排斥的类别。达帕替尼相对于杜比鲁单抗或安慰剂的总体应答获益是通过在患者应答的全部分布中求和每个EASI或WP-NRS类别的增量差异来确定的。结果对不同的EASI改善阈值分布、EASI严重程度和WP-NRS类别进行比较后发现，早在第4周时，达帕替尼就比杜比鲁单抗更有总体应答优势，并在第16周和第24周时持续存在。达帕替尼 15 毫克和 30 毫克与安慰剂相比也观察到类似的趋势。结论在皮肤清除率和瘙痒减轻方面，达达替尼30毫克优于杜比鲁单抗，达达替尼15或30毫克优于安慰剂。这些益处可能会使患者的 QoL 整体上得到更大改善。
{"title":"Aggregate Response Benefit in Skin Clearance and Itch Reduction With Upadacitinib or Dupilumab in Patients With Moderate-to-Severe Atopic Dermatitis.","authors":"Jonathan I Silverberg, Marjolein de Bruin-Weller, Brian M Calimlim, Xiaofei Hu, Sarah A Ofori, Andrew M Platt, Henrique D Teixeira, Kilian Eyerich, Jacob P Thyssen","doi":"10.1089/derm.2023.0153","DOIUrl":"https://doi.org/10.1089/derm.2023.0153","url":null,"abstract":"<u><b><i>Background:</i></b></u> In patients with moderate-to-severe atopic dermatitis (AD), greater skin clearance and itch reduction are associated with more pronounced improvements in quality of life (QoL). <b><i><u>Objective</u>:</i></b> To characterize the aggregate response benefit with upadacitinib versus dupilumab or placebo in patients with moderate-to-severe AD. <b><i><u>Methods</u>:</i></b> Degree of skin clearance and itch response in 3 phase 3 studies (Heads Up [NCT03738397] and Measure Up 1/2 [integrated; NCT03569293/NCT03607422]) were assessed by the Eczema Area and Severity Index (EASI) and Worst Pruritus Numerical Rating Scale (WP-NRS), respectively, using mutually exclusive categories. The aggregate response benefit with upadacitinib over dupilumab or placebo was determined by summing incremental differences for each EASI or WP-NRS category across the full distribution of patient responses. <b><i><u>Results</u>:</i></b> Comparisons across EASI improvement threshold distributions, EASI severity levels, and WP-NRS categories demonstrated an aggregate response benefit favoring upadacitinib over dupilumab as early as week 4 and continuing at weeks 16 and 24. Similar trends were observed for upadacitinib 15 and 30 mg versus placebo. <b><i><u>Conclusions</u>:</i></b> The aggregate response benefit in skin clearance and itch reduction favored upadacitinib 30 mg over dupilumab and upadacitinib 15 or 30 mg over placebo. These benefits may translate to overall greater improvements in patient QoL.","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138743511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Environmental dermatology is the study of how environmental factors affect the integumentary system. The environment includes natural and built habitats, encompassing ambient exposure, occupational exposures, and lifestyle exposures secondary to dietary and personal care choices. This review explores common toxins found in personal care products and packaging, such as bisphenols, parabens, phthalates, per- and poly-fluoroalkyl substances, p-phenylenediamine, and formaldehyde. Exposure to these toxins has been associated with carcinogenic, obesogenic, or proinflammatory effects that can potentiate disease. In addition, these compounds have been implicated as endocrine-disrupting chemicals that can worsen dermatological conditions such as acne vulgaris, or dermatitis. Certain pollutants found in personal care products are not biodegradable and have the potential to bioaccumulate in humans. Therefore, even short-term exposure can cause long-lasting issues for communities. The skin is often the first point of contact for environmental exposures and serves as the conduit between environmental toxins and the human body. Therefore, it is important for dermatologists to understand common pollutants and their acute, subacute, and chronic impact on dermatological conditions to better diagnose and manage disease.
{"title":"Toxic Ingredients in Personal Care Products: A Dermatological Perspective.","authors":"Rachel R Lin, Deborah A Lin, Andrea D Maderal","doi":"10.1089/derm.2023.0215","DOIUrl":"https://doi.org/10.1089/derm.2023.0215","url":null,"abstract":"<b><i><u/></i>Environmental dermatology is the study of how environmental factors affect the integumentary system. The environment includes natural and built habitats, encompassing ambient exposure, occupational exposures, and lifestyle exposures secondary to dietary and personal care choices. This review explores common toxins found in personal care products and packaging, such as bisphenols, parabens, phthalates, per- and poly-fluoroalkyl substances, p-phenylenediamine, and formaldehyde. Exposure to these toxins has been associated with carcinogenic, obesogenic, or proinflammatory effects that can potentiate disease. In addition, these compounds have been implicated as endocrine-disrupting chemicals that can worsen dermatological conditions such as acne vulgaris, or dermatitis. Certain pollutants found in personal care products are not biodegradable and have the potential to bioaccumulate in humans. Therefore, even short-term exposure can cause long-lasting issues for communities. The skin is often the first point of contact for environmental exposures and serves as the conduit between environmental toxins and the human body. Therefore, it is important for dermatologists to understand common pollutants and their acute, subacute, and chronic impact on dermatological conditions to better diagnose and manage disease.</b>","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138743509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-02-16DOI: 10.1089/derm.2022.0091
Hee Jeong Han, Hee Young Kang
{"title":"Facial Contact Urticaria Caused by a Moisturizer Containing 1,2-Hexanediol.","authors":"Hee Jeong Han, Hee Young Kang","doi":"10.1089/derm.2022.0091","DOIUrl":"10.1089/derm.2022.0091","url":null,"abstract":"","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9465373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-06-06DOI: 10.1089/derm.2023.0077
Erin M Warshaw, Joohee Han, Sara A Kullberg, Joel G DeKoven, Brandon L Adler, Jonathan I Silverberg, Marie-Claude Houle, Melanie D Pratt, Donald V Belsito, Jiade Yu, Nina C Botto, Margo J Reeder, James S Taylor, Amber R Atwater, Cory A Dunnick, Vincent A DeLeo, Chris M Mowad
Background: Chlorhexidine is an antiseptic that may cause allergic contact dermatitis. Objectives: To describe the epidemiology of chlorhexidine allergy and characterize positive patch test reactions. Methods: This retrospective study analyzed patients patch tested to chlorhexidine digluconate 1% aqueous by the North American Contact Dermatitis Group, 2015-2020. Results: Of 14,731 patients tested to chlorhexidine digluconate, 107 (0.7%) had an allergic reaction; of these, 56 (52.3%) reactions were currently clinically relevant. Most (59%) reactions were mild (+), followed by strong (++, 18.7%) and very strong (+++, 6.5%). Common primary dermatitis anatomic sites in chlorhexidine-positive patients were hands (26.4%), face (24.5%), and scattered/generalized distribution (17.9%). Compared with negative patients, chlorhexidine-positive patients were significantly more likely to have dermatitis involving the trunk (11.3% vs 5.1%; P = 0.0036). The most commonly identified source category was skin/health care products (n = 41, 38.3%). Only 11 (10.3%) chlorhexidine reactions were occupationally related; of these, 81.8% were in health care workers. Conclusions: Chlorhexidine digluconate allergy is uncommon, but often clinically relevant. Involvement of the hands, face, and scattered generalized patterns was frequent. Occupationally related reactions were found predominantly in health care workers.
背景:氯己定是一种可能引起过敏性接触性皮炎的防腐剂。目的:了解氯己定变态反应的流行病学特点，并对阳性斑贴试验反应进行定性分析。方法:本回顾性研究分析2015-2020年北美接触性皮炎组进行1%二光酸氯己定贴片试验的患者。结果:14731例患者中，107例(0.7%)出现过敏反应;其中，56例(52.3%)反应是目前临床相关的。大多数(59%)反应为轻度(+)，其次是强烈(++，18.7%)和非常强烈(+++，6.5%)。氯己定阳性患者常见的原发性皮炎解剖部位为手部(26.4%)、面部(24.5%)和散点/全身分布(17.9%)。与阴性患者相比，氯己定阳性患者发生累及躯干皮炎的可能性显著增加(11.3% vs 5.1%;p = 0.0036)。最常见的来源类别是皮肤/保健产品(n = 41, 38.3%)。只有11例(10.3%)氯己定反应与职业相关;其中，81.8%是卫生保健工作者。结论:二光酸氯己定过敏不常见，但常与临床相关。手、脸和分散的广义模式的参与是常见的。职业相关反应主要见于卫生保健工作者。
{"title":"Patch Testing to Chlorhexidine Digluconate, 1% Aqueous: North American Contact Dermatitis Group Experience, 2015-2020.","authors":"Erin M Warshaw, Joohee Han, Sara A Kullberg, Joel G DeKoven, Brandon L Adler, Jonathan I Silverberg, Marie-Claude Houle, Melanie D Pratt, Donald V Belsito, Jiade Yu, Nina C Botto, Margo J Reeder, James S Taylor, Amber R Atwater, Cory A Dunnick, Vincent A DeLeo, Chris M Mowad","doi":"10.1089/derm.2023.0077","DOIUrl":"10.1089/derm.2023.0077","url":null,"abstract":"Background: Chlorhexidine is an antiseptic that may cause allergic contact dermatitis. Objectives: To describe the epidemiology of chlorhexidine allergy and characterize positive patch test reactions. Methods: This retrospective study analyzed patients patch tested to chlorhexidine digluconate 1% aqueous by the North American Contact Dermatitis Group, 2015-2020. Results: Of 14,731 patients tested to chlorhexidine digluconate, 107 (0.7%) had an allergic reaction; of these, 56 (52.3%) reactions were currently clinically relevant. Most (59%) reactions were mild (+), followed by strong (++, 18.7%) and very strong (+++, 6.5%). Common primary dermatitis anatomic sites in chlorhexidine-positive patients were hands (26.4%), face (24.5%), and scattered/generalized distribution (17.9%). Compared with negative patients, chlorhexidine-positive patients were significantly more likely to have dermatitis involving the trunk (11.3% vs 5.1%; P = 0.0036). The most commonly identified source category was skin/health care products (n = 41, 38.3%). Only 11 (10.3%) chlorhexidine reactions were occupationally related; of these, 81.8% were in health care workers. Conclusions: Chlorhexidine digluconate allergy is uncommon, but often clinically relevant. Involvement of the hands, face, and scattered generalized patterns was frequent. Occupationally related reactions were found predominantly in health care workers.","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9571198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-07-31DOI: 10.1089/derm.2023.0140
Erin M Warshaw, Malina Yamashita Peterson, Amber R Atwater, Joel G DeKoven, Melanie D Pratt, James S Taylor, Donald V Belsito, Jonathan I Silverberg, Margo J Reeder, Vincent A DeLeo, Marie-Claude Houle, Cory A Dunnick, Jiade Yu, Brandon Adler, Christen Mowad, Nina C Botto
Background/Objectives: Paraphenylenediamine (PPD) is an aromatic amine dye that may cause allergic contact dermatitis. This study examines the epidemiology of allergic patch test reactions to PPD. Methods: This retrospective analysis characterizes individuals tested to PPD (1% petrolatum) by the North American Contact Dermatitis Group (1994-2018). Demographics and dermatitis site(s) were compared between PPD-allergic and PPD-negative patients. PPD reactions were analyzed by reaction strength, clinical relevance, occupational relatedness, and source as well as coreactivity with structurally related compounds. Results: Of 54,917 patients tested to PPD, 3095 (5.6%) had an allergic patch test reaction. Compared with PPD-negative patients, PPD-allergic patients had significantly greater odds of age >40 years (odds ratio [OR] 1.55 [95% confidence interval; CI 1.43-1.69]) and female gender (OR 1.52 [95% CI 1.41-1.66]), but lower odds of being White (OR 0.66 [95% CI 0.60-0.71]). The most common primary anatomic sites of dermatitis were face (25.5%), hands (21.9%), and scattered/generalized pattern (15.5%). Over half (55.3%) of PPD reactions were ++ or +++ at the final reading and 60.9% were currently relevant. Common exposure sources included hair dye (73.5%) and clothing/shoes/apparel (3.9%). Occupationally related reactions occurred in 8.3%, most commonly in hairdressers/cosmetologists (72.8%). The most common coreactions were benzocaine (11.3%), N-isopropyl-N'-phenyl-p-phenylenediamine (6.7%), disperse dye mix (6.5%), and black rubber mix (5.1%). Conclusions: The 24-year percentage of allergic reactions to PPD was 5.6%. PPD allergy was associated with female gender and age >40 years. PPD allergic patients were less likely to be White. Allergic reactions were usually clinically relevant and hair dye was the most frequently identified source.
背景/目的:对苯二胺(PPD)是一种可能引起过敏性接触性皮炎的芳香胺染料。本研究探讨了过敏性斑贴试验对PPD的流行病学反应。方法:回顾性分析北美接触性皮炎组(1994-2018)检测PPD(1%凡士林)的个体特征。比较ppd过敏患者和ppd阴性患者的人口统计学特征和皮炎部位。通过反应强度、临床相关性、职业相关性、来源以及与结构相关化合物的核心活性分析PPD反应。结果:54,917例PPD患者中，3095例(5.6%)出现过敏斑贴试验反应。与ppd阴性患者相比，ppd过敏患者年龄>40岁的几率显著增加(优势比[OR] 1.55[95%可信区间;女性(OR 1.52 [95% CI 1.41-1.66])，但白人的患病几率较低(OR 0.66 [95% CI 0.60-0.71])。皮炎最常见的原发解剖部位为面部(25.5%)、手部(21.9%)和散在/全身型(15.5%)。超过一半(55.3%)的PPD反应在最终读数为++或+++，60.9%是当前相关的。常见的接触源包括染发剂(73.5%)和服装/鞋子/服装(3.9%)。职业相关反应发生率为8.3%，最常见于发型师/美容师(72.8%)。最常见的共反应是苯佐卡因(11.3%)、n -异丙基- n′-苯基-对苯二胺(6.7%)、分散染料混合物(6.5%)和黑色橡胶混合物(5.1%)。结论:PPD患者24年过敏反应发生率为5.6%。PPD过敏与女性、年龄>40岁相关。PPD过敏的患者不太可能是怀特。过敏反应通常与临床相关，染发剂是最常见的来源。
{"title":"Patch Testing to Paraphenylenediamine: The North American Contact Dermatitis Group Experience (1994-2018).","authors":"Erin M Warshaw, Malina Yamashita Peterson, Amber R Atwater, Joel G DeKoven, Melanie D Pratt, James S Taylor, Donald V Belsito, Jonathan I Silverberg, Margo J Reeder, Vincent A DeLeo, Marie-Claude Houle, Cory A Dunnick, Jiade Yu, Brandon Adler, Christen Mowad, Nina C Botto","doi":"10.1089/derm.2023.0140","DOIUrl":"10.1089/derm.2023.0140","url":null,"abstract":"<p><p><u><b><i>Background/Objectives:</i></b></u> Paraphenylenediamine (PPD) is an aromatic amine dye that may cause allergic contact dermatitis. This study examines the epidemiology of allergic patch test reactions to PPD. <u><b><i>Methods:</i></b></u> This retrospective analysis characterizes individuals tested to PPD (1% petrolatum) by the North American Contact Dermatitis Group (1994-2018). Demographics and dermatitis site(s) were compared between PPD-allergic and PPD-negative patients. PPD reactions were analyzed by reaction strength, clinical relevance, occupational relatedness, and source as well as coreactivity with structurally related compounds. <u><b><i>Results:</i></b></u> Of 54,917 patients tested to PPD, 3095 (5.6%) had an allergic patch test reaction. Compared with PPD-negative patients, PPD-allergic patients had significantly greater odds of age >40 years (odds ratio [OR] 1.55 [95% confidence interval; CI 1.43-1.69]) and female gender (OR 1.52 [95% CI 1.41-1.66]), but lower odds of being White (OR 0.66 [95% CI 0.60-0.71]). The most common primary anatomic sites of dermatitis were face (25.5%), hands (21.9%), and scattered/generalized pattern (15.5%). Over half (55.3%) of PPD reactions were ++ or +++ at the final reading and 60.9% were currently relevant. Common exposure sources included hair dye (73.5%) and clothing/shoes/apparel (3.9%). Occupationally related reactions occurred in 8.3%, most commonly in hairdressers/cosmetologists (72.8%). The most common coreactions were benzocaine (11.3%), <i>N</i>-isopropyl-<i>N</i>'-phenyl-<i>p</i>-phenylenediamine (6.7%), disperse dye mix (6.5%), and black rubber mix (5.1%). <u><b><i>Conclusions:</i></b></u> The 24-year percentage of allergic reactions to PPD was 5.6%. PPD allergy was associated with female gender and age >40 years. PPD allergic patients were less likely to be White. Allergic reactions were usually clinically relevant and hair dye was the most frequently identified source.</p>","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9907788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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