Incidence of allergic contact sensitization in central Chinese subjects with chronic urticaria

Chen, Hao; Liu, Guanghui; Huang, Nan; Li, Wenjing; Dong, Xiang; Zhu, Rongfei

doi:10.1590/abd1806-4841.20164606

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Investigation • An. Bras. Dermatol. 91 (2) • Mar-Apr 2016 • https://doi.org/10.1590/abd1806-4841.20164606 copy

Incidence of allergic contact sensitization in central Chinese subjects with chronic urticaria^* * Work performed at the Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology - Wuhan, Hubei, China.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

BACKGROUND:

Chronic urticaria (CU) can be provoked by a wide variety of causes. Some studies suggest contact sensitization may play a role in the disease.

OBJECTIVE:

To investigate the incidence and distribution characteristics of allergic contact sensitization in central Chinese subjects with CU, and assess contact allergen avoidance measures in managing CU.

METHODS:

Patch tests were performed, following the recommended standard procedure, with 20 selected allergens, in line with the European baseline series. All subjects with positive results were prescribed appropriate avoidance measures for the sensitizing substances, while subjects with negative results served as the control group. CU severity was assessed daily from week1 to week4 and for each subject, applying the Urticaria Activity Score.

RESULTS:

42.9% (233/543) of subjects with CU showed positive reactions to one or more contact allergen(s). Potassium dichromate, benzene mix and carba mix were more common in male patients, while nickel sulfate was more frequent in females. The positive rates for different allergens varied with age and occupation. The median (interquartile range) severity scores at week 1 were 20 (14-21) and 15 (14-27) for the allergen avoidance group and control group, respectively (P>0.05); and 12 (7-15) and 14 (12-17) at week 4 (P<0.001).

CONCLUSION:

The incidence of allergic contact sensitization in CU patients was high, and appropriate contact allergen avoidance measures benefitted CU management. Contact allergens may play a role in the pathogenic mechanism of CU and patch tests are an option for CU patients.

Keywords:
Allergens; China; Patch tests; Urticaria

Allergen	Positive reaction rate
Allergen	n	%
Cobalt chloride	34	6.26
Mercapto mix	3	0.55
Imidazolidinyl urea	2	0.37
p-Phenylenediamine	14	2.58
N-cyclohexyl-ylthio	7	1.29
phthalocyanine lactone
Potassium dichromate	57	10.5
Ethylenediamine	8	1.47
dihydrochloride
Colopony	10	1.84
Formaldehyde	35	6.45
Epoxy resin	4	0.74
Bronopol	8	1.47
Thiuram mix	2	0.37
Benzene mix	18	3.31
Nickel sulfate	41	7.55
Sesquiterpene lactone mix	11	2.03
Fragrance mix	40	7.37
Cl+Me-Isothiazole	18	3.31
Black rubber mix	3	0.55
Carba mix	54	9.94
Quaternium-15	6	1.1

Allergens	Gender		Age					Occupation
	M	F	Ch	Ad	Yo	Mi	El	OW	TS	Fa	MS	CW	Sp	UE
	165	378	15	30	185	272	41	113	130	34	42	36	31	157
	Percentage (%)
Cobalt chloride	6.67	6.08	0.00	3.33	8.65	6.25	0.00	11.50^* * P<0.05;	6.15	0.00	7.14	8.33	9.68	2.55
Mercapto mix	0.00	0.79	0.00	0.00	0.00	1.10	0.00	0.00	0.00	0.00	0.00	0.00	0.00	1.91
Imidazolidinyl urea	0.00	0.53	0.00	0.00	0.00	0.37	2.44	0.00	0.00	0.00	0.00	0.00	0.00	1.27
p-Phenylenediamine	2.42	2.65	0.00	0.00	0.00	4.41	4.88	1.77	0.00	5.88	0.00	5.56	6.45	3.82
N-cyclohexyl-ylthio phthalocyanine lactone	2.42	0.79	0.00	0.00	0.54	1.47	4.88	0.88	0.77	2.94	0.00	2.78	0.00	1.91
Potassium dichromate	14.55^* * P<0.05;	8.73	0.00	6.67	11.35	12.50	0.00	17.70	5.38	17.65	9.52	19.44^ P<0.01.	0.00	8.28
Ethylenediamine dihydrochloride	0.61	1.85	0.00	0.00	1.62	1.10	4.88	1.77	0.00	0.00	2.38	0.00	3.23	2.55
Colopony	1.21	2.12	0.00	0.00	0.54	3.31	0.00	3.54	0.00	0.00	0.00	2.78	3.23	2.55
Formaldehyde	4.24	7.41	0.00	0.00	4.32	9.93^* * P<0.05;	0.00	8.85	4.62	0.00	0.00	13.89	12.90	6.37
Epoxy resin	1.21	0.53	0.00	0.00	0.54	0.37	4.88^* * P<0.05;	0.00	0.00	0.00	0.00	5.56	0.00	1.27
Bronopol	1.82	1.32	0.00	0.00	1.62	1.84	0.00	1.77	0.00	11.76^ P<0.01.	0.00	0.00	0.00	1.27
Thiuram mix	1.21	0.00	0.00	0.00	0.00	0.37	2.44	0.00	0.00	2.94	0.00	2.78	0.00	0.00
Benzene mix	6.67^ P<0.01.	1.85	26.67	3.33	2.70	2.94	0.00	2.65	5.38	0.00	4.76	8.33	0.00	1.91
Nickel sulfate	3.64	9.26^* * P<0.05;	0.00	3.33	11.35	6.62	2.44	9.73	4.62	11.76	0.00	11.11	16.13	7.01
Sesquiterpene lactone mix	1.21	2.38	0.00	3.33	1.62	2.21	2.44	0.00	2.31	0.00	4.76	5.56	6.45	1.27
Fragrance mix	6.06	7.94	6.67	0.00	4.86	8.09	19.51^* * P<0.05;	6.19	0.77	32.35^ P<0.01.	4.76	11.11	12.90	7.01
Cl+Me-Isothiazole	1.82	3.97	0.00	3.33	1.62	4.41	4.88	4.42	2.31	0.00	4.76	2.78	0.00	4.46
Black rubber mix	1.21	0.26	6.67	0.00	0.00	0.37	2.44	0.00	1.54	0.00	0.00	2.78	0.00	0.00
Carba mix	18.79^ P<0.01.	6.08	0.00	6.67	11.35	8.46	19.51	10.62	8.46	14.71	11.90	19.44	0.00	8.92
Quaternium-15	1.21	1.06	0.00	0.00	1.62	0.74	2.44	1.77	0.00	0.00	0.00	5.56	0.00	1.27

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Incidence of allergic contact sensitization in central Chinese subjects with chronic urticaria* * Work performed at the Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology - Wuhan, Hubei, China.

Abstract

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Incidence of allergic contact sensitization in central Chinese subjects with chronic urticaria^* * Work performed at the Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology - Wuhan, Hubei, China.