Frequency of Allergic Contact Dermatitis in Patients with Chronic Eczema

Abstract

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Introduction:  Various types of eczemas have the propensity to become chronic and then be complicated by allergic contact dermatitis to various allergens and topical medicaments. Patch testing can identify the sensitizing agent by applying multiple standard patch test series.

Objective:  To determine the frequency of allergic contact dermatitis in patients with chronic eczema by applying medi-cament, corticosteroid and European standard series.

Materials and Methods:  This is a descriptive case study being conducted at the Dermatology Department Unit-II, King Edward Medical University / Mayo Hospital, Lahore. It is an ongoing study in which 40 patients have been enrolled till date. Forty patients, aged 12 years and above, of either sex having chronic eczema have been included. Patients using oral corti-costeroids and other immunosuppressive drugs during the last 15 days as well as pregnant females were excluded from the study. Each patient was patch tested with allergens of medicament, corticosteroid and European standard series. Positive reactions were observed and recorded according to International Contact Dermatitis Research Group Criteria.

Results:  There were a total of 40 patients, 14 males, and 26 females. Their age ranged from 13 to 45 years. Mean duration of the disease was 2.25 years. Regarding occupation, there were 16 housewives, 14 students, 6 laborers and 4 technicians. A family or personal history of atopy was seen in 12 (30%) patients. Hand eczema was seen in 20 patients, nummular eczema in 16 patients and 4 cases had eczema on the face. Thirty (75%) patients reacted positively to various allergens; 10 (25%) patients to nickel sulphate, eight (20%) to potassium dichromate, 4 (10%) to cobalt, 4 (10%) to para phenylene diamine, 2 to miconazole and 2 patients showed positive result to both fragrance mix and sesquiterpene lactone mix.

Conclusion:  Patients with chronic eczema should be patch tested with various allergens to determine its cause.

Key words:  Chronic eczema, patch test, European standard series, medicament series, corticosteroid series.