Allergen change in stasis dermatitis*

Abstract

Stasis dermatitis of the lower leg is very often complicated by secondary contact allergy. A comparison of seven reported studies with our recent personal series of 118 cases revealed a difference in the incidence of sensitization between 39.5-90.5 %, due to selection for clinical reasons. The true incidence of contact allergy lies between 50'-60 %. The importance of the individual allergens is nevertheless changing. In the last 10 years neomycin allergy has doubled; gentamycin has become an important primary allergen rather than a cross reactor.In 1972 I published a study on 326 patients suffering from stasis dermatitis of the lower leg which I had investigated at the University of Munich in 1967/68 (Breit 1972). The overall incidence of contact allergy was 71.5

A Retrospective Study of Patch Test Results from 163 Patients with Stasis Dermatitis or Leg Ulcers

“…Breit [4] suggests that substitution by other preservatives may be the explanation, but we tend to think that their sensitizing properties have been overrated. Replacing them by other hazardous substances such as chlorocresol and benzyl alcohol which are represented in our pharmaceutical test series and for which relatively high indices were obtained, may not be an improvement.…”

Contact sensitization in venous eczema: Preliminary results of patch testing with Indian standard series and topical medicaments

“…The real incidence of contact dermatitis in stasis dermatitis perhaps lies between 50 and 60% if all patients of venous eczema are patch tested. [1] Fifty percent of our patients showed patch test positivity to one or more antigens.…”

“…According to Fraki et al, [11] the PPD sensitivity is quite uncommon. However, according to Breit, [1] the incidence of PPD sensitivity in venous eczema patients has remained steady over time. This probably reflects differences in the use of these compounds across countries.…”

“…The reported prevalence of contact sensitivity in these patients is 57.8-71.5%. [1,[8][9][10] This higher incidence may be due to selection of patients during exacerbations or when the dermatitis is not responding to treatment. The real incidence of contact dermatitis in stasis dermatitis perhaps lies between 50 and 60% if all patients of venous eczema are patch tested.…”

“…Allergic contact dermatitis due to topically applied medicaments is a common complication of venous eczema, with an estimated incidence of contact sensitization as high as 40-90%. [1] Dissemination of dermatitis may occur to face or hands, occasionally progressing to erythroderma. Patches of eczema may also develop on the other leg even when it is not affected by obvious venous insufficiency due to dissemination or secondary sensitization from medications applied on the affected leg.…”