Dinitrochlorobenzene contact sensitization in patients with end-stage renal disease

Sixty-nine patients with end-stage renal disease (ESRD) on maintenance hemodialysis were evaluated by topical application of 2,4 dinitrochlorobenzene (DNCB). The initial sensitization dose consisted of 2,000 micrograms of DNCB; challenge doses consisted of 50 and 100 micrograms. Applications to the contralateral forearm in the absence of a spontaneous flare. Only 71% of the ESRD patients tested could be sensitized to DNCB, compared to 100% of normal controls. There was no correlation between DNCB reactivity and the helper/suppressor ratio of circulating lymphocytes in such patients. This study further documents uremic suppression of T-cell responsiveness as manifested by impaired DNCB contact sensitization.