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Contact Sensitization in Patients with Chronic Leg Ulcers

Results of a 5-Year Retrospective Analysis

Raudonis, Tadas MD; Vankeviciute, Rasa Aurelija MD; Lideikaite, Andre MD; Grigaityte, Anna Greta; Grigaitiene, Jurate PhD, MD

doi: 10.1097/01.ASW.0000582628.52901.43

OBJECTIVES To determine the frequency of contact sensitization among patients with chronic leg ulcers; to identify the most common allergens; and to examine possible relationships to ulcer duration, itching, exudate, and leg eczema.

METHODS Researchers conducted a 5-year retrospective analysis of 145 patients diagnosed with chronic leg ulcers who underwent skin patch testing with S-1000, LU-1000, and the commonly used dressing and antiseptic series.

RESULTS Investigators included 88 females (60.7%) aged 64 ± 15.1 years and 57 males (39.3%) aged 61 ± 16.4 years. Of these, 62.8% (n = 91) of patients were sensitized to at least one substance (2.6 ± 1.4 allergens on average). The most common allergens were benzalkonium chloride (18.6% [n = 27]), balsam of Peru (17.9% [n = 26]), and povidone-iodine 10% (17.2% [n = 25]). Finally, 40% (n = 58) of patients presented with pruritus around the ulcer, which was strongly associated with a positive patch test reaction (74.1% [n = 43] vs 55.2% [n = 48]; P = .021) and polysensitization (3.5 sensitivities [95% confidence interval, 2.4–4.6] vs 2 [95% confidence interval, 1.2–2.8]).

CONCLUSIONS Contact sensitization is very common in patients with chronic leg ulcers, and pruritus around the ulcer is associated with contact allergy as well as polysensitization.

At the Clinic of Infectious Diseases and Dermatovenereology, Vilnius University, in Vilnius, Lithuania, Tadas Raudonis, MD, is a junior researcher, Faculty of Medicine; Rasa Aurelija Vankeviciute, MD, is a graduate, Faculty of Medicine; Andre Lideikaite, MD, is a graduate, Faculty of Medicine; Anna Greta Grigaityte, is a medical student, Faculty of Medicine; and Jurate Grigaitiene PhD, MD, is Associate Professor of Dermatology, Faculty of Medicine.

The authors have disclosed no financial relationships related to this article.

Submitted October 7, 2018; accepted in revised form December 11, 2018; published ahead of print October 26, 2019.

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Online date: October 29, 2019

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