Contact dermatitis: Clinical practice findings from a single tertiary referral hospital, a 4-Year retrospective study

Abstract

Background It is estimated that 20% of the general population is sensitized to some kind of contact allergen. Contact dermatitis is one of the major occupational diseases worldwide. This disease has a higher prevalence in the female gender and is more frequently observed in the third or fourth decade of life. The main objective of this study was to describe the main sociodemographic and clinical characteristics of patients with contact dermatitis treated in the Allergy Unit of the San Juan De Dios Hospital – Caja Costarricense de Seguro Social. Methods Clinical records of contact dermatitis outpatients from a single hospital were analyzed, in a 4-year retrospective observational study. Results At the time of the patch testing, patients showed a mean age of 42.2 years. Disease frequency was higher in the female population (female/male ratio of 4.2:1) and in patients mostly dedicated to household workchores. Most patients presented several years of disease history, and the hands were the highest affected body part. Patch testing revealed that nickel sulfate, Cl+Me-Isothiazolinone (Kathon CG), and thimerosal were allergens regularly associated with contact dermatitis in the analyzed population. Conclusions To a great extent, sociodemographic and clinical characteristics identified in these patients resemble what is reported in other regions, including the Americas and worldwide. It is worth highlighting a high female proportion rate probably related to cultural aspects, a smaller percentage of irritant contact dermatitis that may be associated to institutional patient management, and a slight difference in the most common allergens when compared to other published studies.

Prospective study of consecutive patch testing in patients with contact dermatitis using an adapted Latin American baseline series

“…Understanding the epidemiological aspects of a specific population suffering from a particular pathology is essential for an appropriate approach, especially concerning CD, as management can often be as simple as removal of the etiological agent. Therefore, this study constitutes an iniciative, including a population from a single center in which the main clinical and sociodemographic characteristics and the main allergens involved are described (5). In the present research, variables, such as age, sex, occupation, personal and family history of atopy, site of involvement, among others, and their correlation with the patch test results were analyzed.…”

“…The age groups from 18 to 22 years and 33 to 37 years correspond to the age groups in whom more tests were performed. It is usual to observe a higher prevalence in adults after 30 years of age, and a possible explanation could be the need for a prolonged time to develop sensitization to allergens due to repeated exposure (5).…”

“…A reason for the female predominance might be a greater exposure to personal care products, cosmetics, and jewelry. Hormone influence could also be an explanation (1,5). On the other hand, the difference between the sexes could relate to cultural factors, as women seek medical assistance more often and have better control over their health, and, therefore, they have a greater chance of being correctly diagnosed (5).…”

“…Furthermore, the prevalence of ACD in the general population is increasing (4). ACD development is determined mainly by individual susceptibility, allergen physicochemical properties, and allergen exposure (dose and frequency of contact) (5).…”

“…Patch testing is the gold standard for diagnosing CD. During testing, the individual is exposed to various allergens, which cause a skin reaction in sensitized individuals (5). It is an investigative method with well-established foundations and internationally accepted standards (4).…”