North American Contact Dermatitis Group patch test results for the detection of delayed-type hypersensitivity to topical allergens
North American Contact Dermatitis Group patch test results for the detection of delayed-type hypersensitivity to topical allergens
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DOI：
10.1016/s0190-9622(98)70587-0
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发表时间：
1998-06-01
影响因子：
13.8
通讯作者：
Taylor, JS
中科院分区：
文献类型：
--
作者：
Marks, JG;Belsito, DV;Taylor, JS
背景：变应性接触性皮炎是影响许多个体的皮肤疾病的重要原因。斑贴试验，如果使用得当，往往提供支持的诊断变应性接触dermatitis.Objective：本文报告斑贴试验结果，从1994年7月1日至1996年6月30日，由北美接触性皮肤病组（NACDG）。通过使用标准化斑贴试验技术，对在我们斑贴试验诊所接受评估的患者进行相同过敏原筛选系列试验。从这些患者的数据记录在一个标准的计算机录入表单和analysed.Results：49过敏原进行了测试3120例。布地奈德于1995年7月加入到该系列中，并在1678名患者中进行了测试。在这些患者中，66.5%的患者过敏斑贴试验反应阳性，57%的患者至少有一种过敏反应，被认为与目前或过去的皮炎临床相关。美国皮肤科医生在过敏原斑贴试验试剂盒中可获得的20种筛选过敏原仅占过敏反应阳性患者的54.1%。NACDG筛查系列中的另外30种过敏原占过敏反应阳性患者的47%。如果单独使用过敏原贴片测试试剂盒，12.4%的受试患者可能会将其疾病错误分类为非过敏性疾病，另外34.4%的受试患者不会完全确定其过敏。在对补充过敏原有阳性反应的患者中，81%的反应与现在或过去有关。12种最常见的接触性过敏原为硫酸镍、香料混合物、硫汞、季铵-15、硫酸新霉素、甲醛、杆菌肽、秋兰姆混合物、秘鲁香脂、氯化钴、对苯二胺和卡巴混合物。目前的相关性与特异性过敏原从10.7%（硫柳汞）到85.7%（季戊四醇-15）。在较新的过敏原中，甲基二溴戊二腈/苯氧乙醇（化妆品防腐剂）导致2%的患者出现阳性过敏反应;替索可托-21-特戊酸酯和布地奈德（皮质类固醇），分别为2.0%和1.1%的患者;乙烯脲/三聚氰胺甲醛混合物（纺织树脂），在5%的患者。结论：斑贴试验的有用性随着测试的过敏原的数量而增强，因为在美国商业上可获得的筛选系列中未发现的过敏原经常引起相关的过敏反应。
Background: Allergic contact dermatitis is a significant cause of cutaneous disease affecting many individuals. Patch testing, when used properly, often provides support for the diagnosis of allergic contact dermatitis.Objective: This article reports patch testing results from July 1, 1994, to June 30, 1996, by the North American Contact Dermatitis Group (NACDG).Methods: Patients evaluated in our patch test clinics were tested with the same screening series of allergens by the use of a standardized patch testing technique. The data from these patients were recorded on a standard computer entry form and analyzed.Results: Forty-nine allergens were tested on 3120 patients. Budesonide was added to the series in July 1995 and tested on 1678 patients. Of these patients, 66.5% had positive allergic patch test reactions, and 57% bad at least one allergic reaction that was felt to be clinically relevant to the present or past dermatitis. The 20 screening allergens commercially available to United States dermatologists in the Allergen Patch Test Kit, accounted for only 54.1% of the patients with positive allergic reactions. The additional 30 allergens on the NACDG screening series accounted for 47% of patients with positive allergic reactions. Had the Allergen Patch Test Kit alone been used, 12.4% of all patients tested may have had their disease misclassified as a nonallergic disorder, and an additional 34.4% of all tested patients would not have had their allergies fully defined. Among those patients with positive responses to the supplemental allergens, 81% of the responses were of present or past relevance. The 12 most frequent contact allergens were nickel sulfate, fragrance mix, thimerosal, quaternium-15, neomycin sulfate, formaldehyde, bacitracin, thiuram mix, balsam of Peru, cobalt chloride, para-phenylenediamine, and carba mix. The present relevance varied with the specific allergen from 10.7% (thimerosal) to 85.7% (quaternium-15). Among newer allergens, methyldibromoglutaronitrile/phenoxyethanol (cosmetic preservative) caused positive allergic reactions in 2% of the patients; tixocortol-21-pivalate and budesonide (corticosteroids), in 2.0% and 1.1% of the patients, respectively; and ethylene urea/melamine formaldehyde mix (textile resin), in 5% of the patients.Conclusion: The usefulness of patch testing is enhanced with the number of allergens tested, because allergens not found on the commercially available screening series in the United States frequently give relevant allergic reactions.