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Patch test reactions in atopic patients.

K Lammintausta1, K Kalimo, V L Fagerlund

  • 1Department of Dermatology, University of Turku, Finland.

Contact Dermatitis
|April 1, 1992
PubMed
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Patch testing revealed frequent allergic and irritant reactions in atopic dermatitis patients. Diluting substances did not fully resolve irritant reactions, highlighting challenges in allergy testing for skin conditions.

Area of Science:

  • Dermatology
  • Allergology
  • Contact Dermatitis Research

Background:

  • Atopic patients, including those with atopic dermatitis (AD), allergic rhinitis (AR), allergic conjunctivitis (AC), and asthma (A), undergo patch testing to identify allergens.
  • Previous studies indicate a prevalence of allergic and irritant reactions in these patient groups, necessitating further investigation into testing methodologies.

Purpose of the Study:

  • To evaluate the frequency of allergic and irritant reactions in atopic dermatitis patients compared to those with allergic rhinitis/conjunctivitis or asthma.
  • To assess the efficacy of 50% dilutions of test substances in reducing irritant reactions during patch testing.
  • To identify common allergens and investigate the prevalence of contact allergy to topical medicaments in AD patients.

Main Methods:

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  • Patch testing was conducted on 851 atopic patients.
  • A subset of 181 atopic dermatitis patients were additionally tested with 50% dilutions of test substances.
  • Allergic and irritant reactions were recorded and analyzed across different patient groups and age demographics.

    • Main Results:

    • Allergic reactions were frequent in AD patients (57% in 28-41 years, 33% in 19-27 years), and also observed in AR/AC/A patients (25-30%).
    • Irritant reactions were common in AD patients (33% in 28-41 years, 24% in 19-27 years) and AR/AC/A patients (24%).
    • Nickel, fragrance-mix, balsam of Peru, and neomycin were identified as the most frequent allergens across all groups. Contact allergy to topical medicaments was common in AD patients, particularly those with severe, long-lasting dermatitis, though multiple substance sensitivity was infrequent.

    Conclusions:

    • Patch testing reveals a high incidence of both allergic and irritant reactions in atopic dermatitis patients, with specific common allergens identified.
    • The use of 50% dilutions of test substances did not fully resolve the issue of considerable irritant reactions.
    • Contact allergy to topical medicaments is a significant concern in AD patients, especially those with chronic dermatitis.