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Prevalence and trend of allergen sensitization in patients with nummular (discoid) eczema referred for patch testing: North American Contact Dermatitis Group data, 2001–2016
Author(s) -
Silverberg Jonathan I.,
Hou Alexander,
Warshaw Erin M.,
Maibach Howard I.,
Belsito Donald V.,
DeKoven Joel G.,
Zug Kathryn A.,
Taylor James S.,
Sasseville Denis,
Fransway Anthony F.,
DeLeo Vincent A.,
Pratt Melanie D.,
Reeder Margo J.,
Atwater Amber R.,
Fowler Joseph F.,
Zirwas Matthew J.,
Marks James G.
Publication year - 2021
Publication title -
contact dermatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.524
H-Index - 96
eISSN - 1600-0536
pISSN - 0105-1873
DOI - 10.1111/cod.13824
Subject(s) - medicine , allergic contact dermatitis , allergen , dermatology , odds ratio , atopic dermatitis , contact dermatitis , irritant contact dermatitis , patch test , allergy , concomitant , patch testing , logistic regression , sensitization , immunology
Background Few studies have examined the relationship between nummular (discoid) eczema (NE) and allergic contact dermatitis (ACD). Objective To examine trends, associations, and clinical relevance of ACD in patients with NE who were referred for patch testing. Methods Retrospective analysis of 38 723 patients from the North American Contact Dermatitis Group. Results Overall, 748 patients (1.9%) were diagnosed with NE; 23.9% had a concomitant diagnosis of ACD. The prevalence of NE fluctuated over time between 2001 and 2016, with no overall change in prevalence in diagnosed NE. In multivariable logistic regression models, NE increased steadily with age and was associated with male sex and Asian and other race/ethnicity, and inversely associated with a history of atopic dermatitis (AD) and hay fever. Patients with NE had lower proportions of one or more positive allergic reactions and lower odds of a positive reaction in multiple individual allergens. The most commonly relevant allergens in patients with NE were formaldehyde 2.0% aq., methylisothiazolinone, quaternium 15, fragrance mix I, and propylene glycol. Conclusion NE is a heterogeneous disorder with distinct subsets of lesional distributions and a profile of relevant allergens, especially formaldehyde and formaldehyde releasers. Nearly one in four patients with NE had ACD, supporting the role of patch testing in patients with NE.