mercuric-chloride--ammoniated and Facial-Dermatoses

Patients with a predisposition to atopic dermatitis often need to be patch tested in order to detect possible contact sensitization. However, it is unknown whether immunologic or other peculiarities of atopic skin are related to altered patch-test reaction patterns. Our study was aimed at answering this question, because patch-test reaction patterns are of considerable practical importance in the reading and interpretation of patch tests. Therefore, we compared patterns of patch-test reactions in patients with a predisposition to atopic dermatitis and in control patients matched for sex, age, reason for testing and test centre. Patch-test results from 9 centres (2322 patients with a disposition to atopic dermatitis and 2126 matched controls) were evaluated retrospectively. All patients were tested with nickel sulfate, fragrance mix, potassium dichromate, lanolin alcohol, formaldehyde and mercury ammonium chloride. Patch tests applied for 1 day with readings on days 1, 2 and 3 were evaluated in order to cover the early phase of the reactions. Not unexpectedly, we found that, compared to the matched controls, patients with a predisposition to atopic dermatitis tended to have more doubtful and irritant reactions on day 1. As a new observation, it turned out that they had less reactions of crescendo pattern and more strong reactions on day 3. All these differences were slight/insignificant. A higher skin irritability in patients with a predisposition to atopic dermatitis is a likely explanation. In conclusion, standard methods for patch testing can be applied in patients with a predisposition to atopic dermatitis, but minor differences in reaction patterns should be considered.

Topics: Adult; Ammonia; Case-Control Studies; Coloring Agents; Dermatitis, Atopic; Disease Susceptibility; Disinfectants; Facial Dermatoses; Female; Fixatives; Formaldehyde; Germany; Humans; Lanolin; Male; Mercuric Chloride; Patch Tests; Perfume; Potassium Dichromate; Retrospective Studies; Rhinitis, Allergic, Perennial

A total of 507 (M 121, F 386) cases of facial dermatitis were investigated, of whom 308 (M 49, F 259) had eczema confined to the face. The prevalence of positive patch tests was 45% (229/507). Among all the patients, the 2 most frequent allergens were nickel (15.2%) and ammoniated mercury (6.1%), with the incidence of nickel sensitivity in men (20%) being greater than in women (13.7%). 56% of the nickel-positive cases were caused by metal spectacle frames. Taiwan's high number of spectacle-wearers, its subtropical climate and the characteristic oriental facial structure are possibly major contributing factors. Most ammoniated mercury (AM)-sensitive cases resulted from cosmetics. Skin-lightening creams are widely used in Taiwan, but their content is poorly controlled. According to consumer reports, 14.9% (48/322) had applied AM-containing cosmetics. Of all the cosmetics tested for mercury, 2.2% (60/2711) were positive.

Topics: Ammonia; Cosmetics; Dermatitis, Contact; Eyeglasses; Facial Dermatoses; Female; Humans; Male; Mercuric Chloride; Nickel; Ointment Bases