Epidemiologic study of contact dermatitis in hemodialysis patients

Hemodialysis (H) implies the application of different topical substances (such as antiseptics, plaster and rubber chemicals, etc.) and the contact with potential allergenic materials (like gloves, catheters, needles, etc.). H patients may present contact dermatitis (allergic or irritant) as a consequence of this procedure. The frequency of this dermatitis is not known, as reports of isolated cases constitute the only source of information. The aim of this study was to evaluate the prevalence of contact dermatitis and positive patch tests (PT) in patients treated with chronic maintenance H. Eighty patients (40 females and 40 males) on chronic H were studied. We found a low frequency of eczematous lesions among our H patients (1.25%). PT were carried out with the GEIDC standard panel and a "dialysis" battery. Fourteen patients (17.5%) had positive PT, 3 of them having polysensitization. The most frequent sensitizing agents were p-phenylenediamine (3.75%), carba mix (3.75%) and Betadine solution (3.75%). Irritative patch test reactions were seen in 29 patients (36.2%), all of them due to Betadine solution (povidone-iodine). There was no relationship between the length of time of H, sex, age, history of contact dermatitis or cutaneous examination for dermatitis, and PT results. Regarding our results one might suggest that H is a low source of sensitization, but one has to take into account the state of anergy typical of uremic patients. Although the H procedure could be responsible for those sensitizations, it is also possible that they were acquired before H treatment.