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Excited skin syndrome

I Duarte1, F A Almeida, N G Proença

  • 1Dermatology Clinic of Santa Casa de São Paulo, Brazil.

American Journal of Contact Dermatitis : Official Journal of the American Contact Dermatitis Society
|March 1, 1996
PubMed
Summary

Excited skin syndrome (ESS) affects 2.2% of patients with suspected allergic contact dermatitis. This condition involves a loss of positive patch test results upon retesting, with factors like chronic dermatitis duration influencing its occurrence.

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Area of Science:

  • Dermatology
  • Allergology
  • Immunology

Background:

  • Excited skin syndrome (ESS) is characterized by an excessive number of positive patch tests in patients with suspected allergic contact dermatitis.
  • These positive results are not reproducible upon repeat testing, indicating a transient or false-positive phenomenon.

Purpose of the Study:

  • To verify the occurrence of ESS in a population with suspected allergic contact dermatitis.
  • To determine the rate of positive patch test result loss in patients with ESS.
  • To identify potential factors that may initiate ESS.

Main Methods:

  • Patch tests were conducted on 1,500 patients with suspected contact dermatitis between January 1985 and May 1990.
  • Thirty-four patients exhibiting three or more positive results in the initial phase underwent retesting of these substances.

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  • Data on test result reproducibility and patient characteristics were analyzed.

    • Main Results:

    • The frequency of ESS was found to be 2.2% among the 1,500 patients tested.
    • A total of 175 positive test results were lost between the initial and repeat testing phases, representing a 63.5% loss rate.
    • Polysensitized patients had a lower loss rate than monosensitized or bisensitized patients.

    Conclusions:

    • The duration of chronic eczematous dermatitis correlates with a higher tendency to develop ESS.
    • ESS can be initiated by positive patch test results of varying intensity and may be influenced by the proximity of test applications.
    • The study did not find a statistically significant link between the nature of specific substances and ESS induction.