Clinical Analysis Of 44 Cases Facial Dermatitis Patients With Patch Test Result: European Standard And Cosmetic Allergens

Objective:Facial dermatitis occurring in young and middle-aged women is the one of common diseases. Facial inflammation often for unknown reason, resulted in recurrent disease. Face is the predilection site of contact dermatitis. Previous research from home and abroad indicates that facial contact dermatitis is closely related with the use of cosmetics, but these studies have explicitly limited to cosmetics in patients with contact factors. It is very common to young women with facial dermatitis in clinic manifested as mild erythema, papules, scaling like chaff may subside on its own, recurrent, with or without seasonal changing. Case history didn't include a clear history of cosmetics allergy or a history of exposure to other substances. We will define such patients as "facial dermatitis of unknown causes." From the pathogenesis, clinical manifestations and prognosis in terms of illness, the disease should be classified to allergic contact dermatitis in most cases. We studied these patients who had suffered facial dermatitis for a long time with European standards and cosmetics allergen-related allergen patch test, to identify potential allergens, and to outline the features of the disease.Methods:1. Questionnaire: Formulate a uniform questionnaire, record information in patients with a history.2. Patch tests were carried out with the European standard allergen (26 kinds) and cosmetic-related allergens (37 species) respectively, on people of unknown causes of facial dermatitis group (dermatitis group) and normal group (control group). Wipe off the patch after 48h, and observed first skin reaction after the disappearance of indentation in 30min. Observed the second skin reaction in 24h after wiping off the patch. Determine test results according to the International Contact Dermatitis Research Group (ICDRG) recommend standards.Results:1. Dermatitis group: 44 people completed a total of 2513 patch test, including the 1144 European standard allergen patch test, 1369 cosmetics-related allergen patch test. Positive patch test allergens were 137 (5.5%), including 10 much strong positive (0.4%), 16 strong positive reactions (0.6%), 111 positive (4.4%). The others included 112 suspicious reaction (4.5%) and 35 stimulating reaction (1.4 %).2. Control group: 10 people completed a total of 630 patch tests, including 260 European standard allergen patch tests, 370 of cosmetics-related allergen patch tests. There were 4 positive results (0.63%), positive rate of the patch test was significantly lower than Dermatitis Group (X~2 = 27.2742, P <0.001).3. Of the dermatitis group, the highest positive rate of the European standards are the metals allergens, namely, cobalt chloride 26 cases (59.09%), 15 cases of nickel sulfate (34.09%), potassium dichromate in 13 cases (29.55%), followed by the Fragrance mixture 11 cases (25.00%).4. Of the dermatitis group, the highest positive rate of the Cosmetics-related allergens are the emulsifier, such as Cocamidoprpyl betaine (17 cases 45.95%), Sorbitan sesquioleate 16 cases (43.24%), Ammonium persulfate 13 cases (35.14%), tert-Butylhydroquinone 12 cases(32.43%)and Fragrance mixII 5 cases(13.51%) .Conclusions:Compared with the normal population, positive rate of facial dermatitis of unknown causes with two standard screening antigen patch test was significantly higher, which indicated a hypersensitive situation of the patient froup. The results of European standard patch test showed that the major categories of allergens to patients with facial dermatitis of unknown causes are heavy metals such as cobalt chloride, nickel sulphate and potassium dichromate, etc, the second is mixture of aromatic raw materials used in cosmetics, which is somehow different from that of literature reports.Cosmetics-associated antigens patch test results showed that patients with facial dermatitis of unknown causes show relatively high positive rate on the ordinary cosmetics raw materials, such as emulsifier, which is also different from reported in the literature.General conclusions can be drown from above statements that patients with facial dermatitis of unknown causes showed high sensitivity status, allergens were broad and complex, with the exception of heavy metal-type substances, cosmetics raw material is still the major allergens. Because patients who had a clear diagnosis for cosmetic allergy were excluded when choosing the subjects, the cosmetic allergen aromatic mixture which is common in the literature is not dominant in cases of this group, while the ordinary raw materials for cosmetics such as emulsion type showed a higher positive rate.