Dermatitis®

Allergic contact dermatitis can be manifest as an eruption confined to the eyelids. In regard to this specific presentation, only limited information on which to base the selection of patch tests for proper evaluation is available.

To identify the contact allergens most frequently found to be both patch test positive and relevant when only the eyelids are involved.

Data collected from 2003 to 2004 by the North American Contact Dermatitis Group (NACDG) were analyzed for relevant allergens in the setting of dermatitis on the eyelids only. Data on eyelid dermatitis patients whose relevant allergens were not among the 65 allergens used for screening during this study period were also tabulated.

Data showed that 268 patients had only eyelid dermatitis and a final diagnosis of allergic contact dermatitis. In 193 (72%) of these, reactions were of current relevance and were identified from a screening series of 65 allergens. The top 26 allergens identified 65% of cases (175 cases). Gold was the most frequently encountered allergen (22 of 175 cases [12.5%]). Of the 268 cases, 33 showed relevant reactions to an allergen that was not among the 65 NACDG standard screening allergens. No specific allergen was identified in the remaining 42 cases.

The top 26 allergens identified in this study represent a potential eyelid dermatitis screening series.

Eczema and atopic dermatitis (AD) are recognized as major health problems worldwide. Prevalence estimates are as high as one-third of the population, depending on the country studied, the age range of the subjects, and the diagnostic criteria used. National estimates of prevalence for the US population are lacking.

To examine the public health problem posed by eczema, AD, and eczematous conditions in the United States by analyzing disease and symptom prevalence, estimating the number of undiagnosed cases, and assessing comorbidities.

A self-administered questionnaire was sent to a sample of households (N = 60,000) representative of the US population. A designated member responded with information on symptoms, diagnoses, and impact for affected household members; 42,249 households (70%) responded, representing 116,202 individuals. Empirical eczema was defined by itching/scratching and red/inflamed rash or excessive dryness/scaling. Empirical AD was defined by itching/scratching and red/inflamed rash, excessive dryness/scaling, skinfold location, early onset, symptoms lasting ≥ 14 days, or a physician diagnosis of asthma or of allergic rhinitis or hay fever.

Of the population studied, 17.1% reported at least one of four eczematous symptoms; empirically defined eczema was found in 10.7%, and empirically defined AD was found in 6%. Prevalence decreased with increasing income. Approximately two-thirds of individuals with an empirical diagnosis of eczema or AD had moderate to severe symptoms, one-third had sleep disturbances, and one-quarter had chronic unremitting symptoms. Just over one-third (37.1%) of those with symptoms reported a physician diagnosis. Peak onset for empirical AD occurred in the group of subjects aged ≤ 5 years. For empirical eczema, peak onset occurred in the group aged 18 to 29 years, and comorbid asthma and hay fever/allergic rhinitis were more prevalent.

A substantial proportion of the US population has symptoms of eczema or eczematous conditions; 31.6 million met the empirical symptom criteria for eczema, and 17.8 million met the empirical criteria for AD. Most cases are not diagnosed by a physician, which indicates that these conditions are undertreated and/or managed with nonprescription remedies.

Contact allergy to formaldehyde, Bioban, and other formaldehyde releasers and cross-reactivity between them have been reported in the literature; however, not many studies have data on this cross-reactivity.

To study (1) the rates of allergy to formaldehyde and to Bioban and other formaldehyde releasers and (2) the rates of cross-reactivity between them.

We present a retrospective chart analysis of patch-test results for all patients referred for allergic contact dermatitis testing at the Milton S. Hershey Medical Center from June 2004 to September 2005. Anyone allergic to formaldehyde, Bioban, or other formaldehyde releasers was included. Cross-reactivity between the agents was then analyzed.

The charts of 210 patients were analyzed. Of these patients, 24 (11%) were allergic to formaldehyde, Bioban, or other formaldehyde-releasing agents. Seventeen (8.1%) of the patients were allergic to formaldehyde, 15 (7.1%) were allergic to Bioban, and 20 (9.5%) were allergic to other formaldehyde-releasing agents. Eleven (65%) of the 17 formaldehyde-allergic patients were also allergic to Bioban. Of the 20 patients allergic to formaldehyde-releasing agents, 14 (70%) were also allergic to one of the three Bioban products tested. Of the 15 patients allergic to Bioban, 11 (73%) were allergic to formaldehyde, 14 (93%) were allergic to formaldehydereleasing agents, and 11 (73%) were allergic to both formaldehyde and formaldehyde-releasing agents.

A high cross-reactivity rate between formaldehyde, Bioban, and other formaldehyde-releasing agents was found.