Allergic Contact Dermatitis in Skin of Color: A Retrospective Study from a Comprehensive Patch Testing Center

There are few studies reporting patch test results in skin of color patients, especially for Hispanic, Asian, and Indigenous populations. To characterize patch testing results in patients with skin of color at our center. A retrospective study of patients demonstrating at least 1 allergenic reaction in comprehensive patch testing (+, ++, +++, or +/-) with final interpretation as allergic by a board-certified dermatologist specializing in contact dermatitis. Results were stratified by self-reported race and the most common reactions for each group were characterized and compared to those of White patients. A total of 1389 patients were identified; 270 (19.4%) having skin of color (1119 White, 102 Asian, 115 Black or African American, 44 Hispanic, 9 Indigenous). Most common reactions among Asian patients were nickel, methylisothiazolinone (MI), and hydroperoxides of linalool. In Black patients, MI, nickel, and p-phenylenediamine were most common. In Hispanic patients, MI, nickel, and formaldehyde were most common. The positivity of acrylates (P < 0.001) and propylene glycol (P < 0.05) in Asians as well as dyes and rubber accelerators in Black patients (P < 0.05) was significantly higher than in White patients. Nickel and MI are common allergens in all groups, with certain allergens being overly represented in some groups. Differing cultural practices may result in these variations, emphasizing the need to capture patch testing trends in these populations.