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Patch-Test Results of the North American Contact Dermatitis Group 2005-2006

Zug, Kathryn A.; Warshaw, Erin M.; Fowler, Joseph F. Jr; Maibach, Howard I.; Belsito, Donald L.; Pratt, Melanie D.; Sasseville, Denis; Storrs, Frances J.; Taylor, James S.; Mathias, Toby C.G.; DeLeo, Vincent A.; Rietschel, Robert L.

doi: 10.2310/6620.2009.08097

Background The North American Contact Dermatitis Group (NACDG) tests patients who have suspected allergic contact dermatitis with a broad series of screening allergens, and publishes periodic reports of its data.

Objective To report the NACDG patch-test results from January 1, 2005, to December 31, 2006, and to compare results to pooled test data from the previous 10 years.

Methods Standardized patch testing with 65 allergens was used at 13 centers in North America. Chi-square statistics were utilized for comparisons with previous NACDG data.

Results NACDG patch-tested 4,454 patients; 12.3% (557) had an occupation-related skin condition, and 65.3% (2,907) had at least one allergic patch-test reaction. The 15 most frequently positive allergens were nickel sulfate (19.0%),Myroxilon pereirae(balsam of Peru, 11.9%), fragrance mix I (11.5%), quaternium-15 (10.3%), neomycin (10.0%), bacitracin (9.2%), formaldehyde (9.0%), cobalt chloride (8.4%), methyldibromoglutaronitrile/phenoxyethanol (5.8%), p-phenylenediamine (5.0%), potassium dichromate (4.8%), carba mix (3.9%), thiuram mix (3.9%), diazolidinylurea (3.7%), and 2-bromo-2-nitropropane-1,3-diol (3.4%). As compared to the 1994-2004 data, there were significant increases in rates of positivity to nickel, quaternium-15, potassium dichromate, lidocaine, and tea tree oil. Of patch-tested patients, 22.9% (1,019) had a relevant positive reaction to a supplementary allergen; 4.9% (219) had an occupationally relevant positive reaction to a supplementary allergen.

Conclusion Nickel has been the most frequently positive allergen detected by the NACDG; rates significantlyincreased in the current study period and most reactions were clinically relevant. Other common allergens were topical antibiotics, preservatives, fragrance mix I and paraphenylenediamine. Testing with an expanded allergen series and supplementary allergens enhances detection of relevant positive allergens.

From Dartmouth-Hitchcock Medical Center & Dartmouth Medical School, Lebanon, NH; University of Minnesota and Minneapolis VAMC, Minneapolis, MN; University of Louisville, Louisville, KY; University of California San Francisco, San Francisco, CA; University of Missouri, Kansas City, MO; University of Ottawa, Ottawa, ON, Canada; McGill University Health Centre, Royal Victoria Hospital, Montreal, QC, Canada; Oregon Health Science University, Portland, OR; Cleveland Clinic, Cleveland, OH; Group Health Associates, Cincinnati, OH; St. Luke's Roosevelt Hospital Center, Columbia University, New York, NY; and Southern Arizona VA Health Care System, Tucson, AZ.

Reprints not available.

©2009American Contact Dermatitis Society, All Right Reserved
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