Evaluation of Patch Test Findings in Patients With Anogenital Dermatitis.
Abstract | Importance: Objectives: Design, Setting, and Participants: A retrospective, cross-sectional analysis was conducted of the North American Contact Dermatitis Group database among 28 481 patients who underwent patch testing from January 1, 2005, to December 31, 2016, at outpatient referral clinics in the United States and Canada. Exposure: Main Outcomes and Measures: Currently relevant allergic patch test reactions in patients with anogenital dermatitis. Results: Of 28 481 patients tested during the study period, 832 patients (336 men and 496 women; mean [SD] age, 50.1 [26.5] years) had anogenital involvement and 449 patients (177 men and 272 women; mean [SD] age, 49.6 [17.4] years) had anogenital dermatitis only. Compared with those without anogenital involvement, there were significantly more male patients in the group with anogenital dermatitis (177 [39.4%] vs 8857 of 27 649 [32.0%]; relative risk, 1.37; 95% CI, 1.14-1.66; P < .001). In the group with anogenital involvement, female patients were significantly less likely than male patients to have allergic contact dermatitis as a final diagnosis (130 [47.8%] vs 107 [60.5%]; relative risk, 0.78; 95% CI, 0.64-0.94; P = .01), whereas a final diagnosis of other dermatoses (eg, lichen planus, lichen sclerosus, or lichen simplex chronicus) was more frequent for female patients than for male patients (67 [24.6%] vs 28 [15.8%]; relative risk, 1.54; 95% CI, 1.02-2.31; P = .03). Of the 449 patients in the group with anogenital involvement only, 227 (50.6%) had 1 or more relevant reaction with patch testing. Allergens that were statistically significantly more common in patients with anogenital involvement compared with those without anogenital involvement included medicaments such as dibucaine (10 of 250 patients tested [4.0%] vs 32 of 17 494 patients tested [0.2%]; relative risk, 22.74; 95% CI, 11.05-46.78; P < .001) and preservatives such as methylchloroisothiazolinone and methylisothiazolinone (30 of 449 patients tested [6.7%] vs 1143 of 27 599 patients tested [4.1%]; relative risk, 1.61; 95% CI, 1.14-2.41; P = .008). A total of 152 patients met the definition for anogenital allergic contact dermatitis, which is defined as anogenital involvement only, allergic contact dermatitis as the only diagnosis, and 1 or more positive reaction of current clinical relevance. Conclusions and Relevance:
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Authors | Erin M Warshaw, Rebecca S Kimyon, Jonathan I Silverberg, Donald V Belsito, Joel G DeKoven, Howard I Maibach, Kathryn A Zug, Amber R Atwater, Toby Mathias, Denis Sasseville, Joseph F Fowler Jr, James G Marks Jr, Margo J Reeder, Vincent A DeLeo, Melanie D Pratt, Matthew J Zirwas, James S Taylor, Anthony F Fransway |
Journal | JAMA dermatology
(JAMA Dermatol)
Vol. 156
Issue 1
Pg. 85-91
(01 01 2020)
ISSN: 2168-6084 [Electronic] United States |
PMID | 31774454
(Publication Type: Journal Article)
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Chemical References |
- Allergens
- Anesthetics
- Cosmetics
- Glucocorticoids
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Topics |
- Administration, Cutaneous
- Adult
- Aged
- Allergens
(immunology)
- Anesthetics
(adverse effects)
- Anus Diseases
(diagnosis, epidemiology, immunology)
- Cosmetics
(adverse effects)
- Cross-Sectional Studies
- Dermatitis, Allergic Contact
(diagnosis, epidemiology, immunology)
- Female
- Genital Diseases, Female
(diagnosis, epidemiology, immunology)
- Genital Diseases, Male
(diagnosis, epidemiology, immunology)
- Glucocorticoids
(adverse effects)
- Humans
- Male
- Middle Aged
- North America
(epidemiology)
- Patch Tests
(statistics & numerical data)
- Quality of Life
- Retrospective Studies
- Young Adult
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