1
|
Silverberg JI, Hou A, Warshaw EM, Maibach HI, Belsito DV, DeKoven JG, Zug KA, Taylor JS, Sasseville D, Fransway AF, DeLeo VA, Pratt MD, Reeder MJ, Atwater AR, Fowler JF, Zirwas MJ, Marks JG. Prevalence and trend of allergen sensitization in patients with nummular (discoid) eczema referred for patch testing: North American Contact Dermatitis Group data, 2001-2016. Contact Dermatitis 2021; 85:46-57. [PMID: 33634511 DOI: 10.1111/cod.13824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Few studies have examined the relationship between nummular (discoid) eczema (NE) and allergic contact dermatitis (ACD). OBJECTIVE To examine trends, associations, and clinical relevance of ACD in patients with NE who were referred for patch testing. METHODS Retrospective analysis of 38 723 patients from the North American Contact Dermatitis Group. RESULTS Overall, 748 patients (1.9%) were diagnosed with NE; 23.9% had a concomitant diagnosis of ACD. The prevalence of NE fluctuated over time between 2001 and 2016, with no overall change in prevalence in diagnosed NE. In multivariable logistic regression models, NE increased steadily with age and was associated with male sex and Asian and other race/ethnicity, and inversely associated with a history of atopic dermatitis (AD) and hay fever. Patients with NE had lower proportions of one or more positive allergic reactions and lower odds of a positive reaction in multiple individual allergens. The most commonly relevant allergens in patients with NE were formaldehyde 2.0% aq., methylisothiazolinone, quaternium 15, fragrance mix I, and propylene glycol. CONCLUSION NE is a heterogeneous disorder with distinct subsets of lesional distributions and a profile of relevant allergens, especially formaldehyde and formaldehyde releasers. Nearly one in four patients with NE had ACD, supporting the role of patch testing in patients with NE.
Collapse
Affiliation(s)
- Jonathan I Silverberg
- Department of Dermatology, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Alexander Hou
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Erin M Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA.,Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Donald V Belsito
- Department of Dermatology, Columbia University, New York, New York, USA
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Denis Sasseville
- Division of Dermatology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | | | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California, USA
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Joseph F Fowler
- Division of Dermatology, University of Louisville, Louisville, Kentucky, USA
| | - Matthew J Zirwas
- Department of Dermatology, Ohio State University, Columbus, Ohio, USA
| | - James G Marks
- Department of Dermatology, Pennsylvania State University, State College, Pennsylvania, USA
| |
Collapse
|