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Facial dermatitis: patch test results and final diagnoses.

A S Katz1, E F Sherertz

  • 1Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-01071,USA.

American Journal of Contact Dermatitis : Official Journal of the American Contact Dermatitis Society
|August 12, 1999
PubMed
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Allergic contact dermatitis (ACD) frequently causes facial dermatitis. However, other diagnoses often contribute, highlighting the need for comprehensive patch testing beyond standard series for accurate diagnosis and allergen identification.

Area of Science:

  • Dermatology
  • Allergology
  • Contact Dermatitis

Background:

  • Facial dermatitis has diverse etiologies, including allergic contact dermatitis (ACD), irritant contact dermatitis, and endogenous conditions like atopic or seborrheic dermatitis.
  • Accurate diagnosis is crucial as facial dermatitis can stem from a single cause or a combination of factors.

Purpose of the Study:

  • To ascertain the final diagnoses for patients referred with facial dermatitis.
  • To identify relevant allergens in patients diagnosed with allergic contact dermatitis (ACD).

Main Methods:

  • Retrospective analysis of patient charts from an Occupational and Contact Dermatitis referral clinic.
  • Inclusion criteria: patients patch tested for facial dermatitis over a two-year period (October 1995 - October 1997).

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  • Total of 383 patients patch tested; 85 (22%) presented with facial dermatitis.

    • Main Results:

    • Facial dermatitis presentations included diffuse/spotty involvement (65%), eyelid-only (25%), and lip-only (10%).
    • Final diagnoses were evenly distributed: one-third ACD, one-third ACD with other factors, and one-third other diagnoses.
    • Common allergens in ACD cases: personal care products, preservatives, and fragrances.

    Conclusions:

    • Allergic contact dermatitis (ACD) is a significant cause of facial dermatitis in specialized clinics.
    • Non-ACD diagnoses or contributing factors are present in up to two-thirds of patients.
    • Personal care products, preservatives, and fragrances are key allergens; standard patch test series may miss reactions.