The persistence of allergic contact sensitivity: a 10-year follow-up in 100 patients

Abstract

One hundred patients with 161 positive patch test reactions to a nximber of common allergic sensitizers were re-examined after a period of 10 years, using the same patch test technique. Out of 161 positive patch test reactions, ninety-four (59%) remained positive, forty-four (27%) had diminished reactivity and twenty-two (14%) had become negative.There have been few reports on the persistence of allergic contact sensitivity in the literature which is surprising considering the amount of new knowledge accumulated over the past 50 years in the field of contact dermititis. Table i summarizes the findings of previous investigators. Early investigators thought that epidermal hypersensitivity, once acquired, would persist indefinitely. Ukrainczyk (1932) followed up fifteen patients with skin tests for up to 4 years and found no diminution of hypersensitivity, despite avoidance of the offensive agents. Gomez-Orbaneja & Barrientos (1938), on re-examination of 106 patients after 1-35 years, found that if the offensive agent was removed, the hypersensitivity subsided, or disappeared completely in a large proportion of cases. Bonnevie (1939), however, followed up twenty cases with repeated patch tests for several years without finding any reduction in their hypersensitivity. Thus started a controversy which is still with us today. MATERIALS AND METHODSFrom 1967 to 1970, 863 patients were patch tested at the Department of Dermatology at Hull Royal Infirmary. Of these, 364 gave positive reactions to one or more of the test substances. In 1980 letters were written asking them to attend for re-patch testing. 100 patients (161 positive reactions) complied with the request and were subsequently re-patch tested (a compliance rate of about 27%).In this investigation all patch tests used were closed ones. Results were read 48 h after the

Occupational contact dermatitis: Etiology, prevalence, and resultant impairment/disability

“…Numerous studies have documented the existence of allergic contact hypersensitivity for periods of up to 10 years after diagnosis. [123][124][125][126] Although the intensity of the allergy may wane with lack of exposure, it is lifelong and will recur under proper conditions. 28 Thus, although the disease ACD exists only when symptomatic, the underlying pathophysiology (eg, allergic contact hypersensitivity or delayed-type hypersensitivity) remains.…”

Contact Dermatitis in Older Adults

“…[42] Therefore, it is of utmost importance to assess whether reactions are of current, past, or questionable relevance. Furthermore, elderly patients have been found to have a slower onset of reactivity, less intense reactions, and prolonged recovery with patch testing.…”

Effect of age and sex on the induction and elicitation of allergic contact dermatitis

“…In 1938, Gomez-Orbaneja and Barrientos stated that there was a decrease in positive re-patch tests when patients avoided the allergens ( 40).…”