1.Contact sensitisation in adults: a 5-year retrospective review in hospital Kuala Lumpur
Kang Nien How ; Min Moon Tang ; Roshnee Kaur A/P Jagjit Singh ; Asmah Johar
The Medical Journal of Malaysia 2017;72(2):113-118
Background: The pattern of contact sensitisation should be
monitored in order to detect the changing trend of
sensitising allergens. We aim to evaluate contact
sensitisation in adults suspected to have allergic contact
dermatitis.
Methods: This is a five-year retrospective review on contact
sensitisation in adults patch-tested with the European
Standard and extended series between 2011 and 2015 in the
Department of Dermatology, Hospital Kuala Lumpur.
Results: There were 689 adults (M:F= 1:2.04; mean age 40.5
years) who were patch-tested. The majority (175, 25.4%)
were white collar workers and 118 (17.1%) were healthcare
workers. The provisional diagnoses of patients included
contact dermatitis (80.8%); endogenous eczema (7.9%);
hand eczema (3.2%); hand and foot eczema (3.5%); foot
eczema (1.4%) and photodermatitis (1.2%). The allergens
selected for testing were based on past and present history
of exposure. Almost all (688, 99.8%) were patch-tested with
the European standard allergens and 466 (67.6%) were
tested with the extended series. About three quarter (528,
76.6%) developed at least one positive reaction. The top five
most frequent reactions were to nickel sulphate (35.3%);
potassium dichromate (16.5%); methylchloroisothiazolinone
(12.9%), fragrance mix I (12.6%), and cobalt chloride (10.2%).
The commonest sensitisations identified in the extended
series were palladium chloride (23/105, 21.9%), stannous
chloride (18/85, 21.2%), miconazole (7/44, 15.9%),
gold(I)sodium thiosulfate (16/105, 15.2%) and thimerosal
(29/202, 14.4%).
Conclusion: Contact sensitisation was detected in 76.6% of
adults patch-tested. Nickel sulphate was found to be the
most frequently sensitising allergen. The rising prevalence
of methylchloroisothiazolinone/methylisothiazolinone
sensitization poses significant concern.
Dermatitis, Contact