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[Contact sensitization in leg ulcers]

C J Le Coz1, Y Scrivener, F Santinelli

  • 1Clinique Dermatologique des Hôpitaux Universitaires de Strasbourg.

Annales De Dermatologie Et De Venereologie
|December 4, 1998
PubMed
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High rates of contact sensitization occur in leg ulcer patients, with Balm of Peru being the most common allergen. Many patients react to excipients like lanolin, highlighting the need for detailed allergy testing with topical leg ulcer treatments.

Area of Science:

  • Dermatology
  • Allergology
  • Wound Care

Background:

  • Peri-lesional eczema is a frequent complication of leg ulcers.
  • Diagnosing the cause of eczema is challenging due to the variety of topical agents used.
  • Identifying allergens in topical treatments is crucial for effective leg ulcer management.

Purpose of the Study:

  • To investigate the prevalence of contact sensitization in patients with leg ulcers.
  • To identify common allergens responsible for contact dermatitis in this patient group.
  • To assess the role of topical agents and their excipients in leg ulcer complications.

Main Methods:

  • Fifty patients with leg ulcers underwent patch testing using the standard European Extended Contact Dermatitis Research Group (EECDRG) battery.

Related Experiment Videos

  • Eighteen potential allergens and the specific topical agents used by patients were tested.
  • Patch test readings were performed at 48, 72, 96, or 120 hours.

    • Main Results:

    • A high sensitization rate of 76% was observed in leg ulcer patients.
    • Balm of Peru (40%) and fragrance-mix (28%) were the most frequent allergens.
    • Thirty percent of patients were sensitized to at least one excipient, commonly lanolin alcohols (14%).
    • Positive reactions were noted for commercial formulations like Biafine and Parfenac.

    Conclusions:

    • Contact sensitization is prevalent in leg ulcer patients, often linked to topical treatments.
    • Balm of Peru is the primary allergen, followed by excipients like lanolin.
    • Comprehensive patch testing, including a complementary battery tailored to leg ulcer prescriptions, is essential for accurate diagnosis.