Contact sensitivity in patients with leg ulcerations: a North American study.
OBJECTIVE
(1) To determine the prevalence of allergen sensitivity in patients with past or present leg ulcers in 2 North American study centers vs European study findings and the North American Contact Dermatitis Group (NACDG) database and (2) to delineate a standard battery of allergens for patch testing in North American patients that is representative of the newer dressings and wound care products.


METHODS
Fifty-four patients, with or without dermatitis, were prospectively entered in the study. The patients were patch tested to the NACDG standard series and a comprehensive supplemental series of 52 allergens.


METHODS
Wound healing clinics at Boston University Roger Williams Medical Center and University of Ottawa.


RESULTS
Sixty-three percent (n = 34) of patients had 1 or multiple positive patch test results, and 37% (n = 20) had no positive patch test result. The most common allergens were Myroxylon pereirae (balsam of Peru) (30% [16/54]), bacitracin (24% [13/54]), fragrance mix (20% [11/54]), wood tar mix (20% [11/54]), propylene glycol (14% [7/52]), neomycin sulfate (13% [7/54]), benzalkonium chloride (13% [7/54]), carba mix (11% [6/54]), nickel sulfate (11% [6/54]), and control gel hydrocolloid (11% [6/54]).


CONCLUSIONS
Comparable to European study findings, there is a high incidence of positive patch test results in patients with past or present leg ulcerations. The incidences of the most common allergens in our patient population were higher than those seen in the NACDG, except for nickel. Using a modified leg ulcer series along with the standard NACDG series is important in evaluating patients with leg ulcers.
Saap
Liliana
L
Department of Dermatology and Skin Surgery, Boston University Roger Williams Medical Center, Providence, RI 02908, USA.
Fahim
Simone
S
Arsenault
Emily
E
Pratt
Melanie
M
Pierscianowski
Tad
T
Falanga
Vincent
V
Pedvis-Leftick
Anita
A
D000368:Aged; D000485:Allergens; D001900:Boston / Q000453:epidemiology; D016208:Databases, Factual / Q000706:statistics & numerical data; D017449:Dermatitis, Allergic Contact / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007871:Leg Ulcer / Q000150:complications*; D008297:Male; D009864:Ontario / Q000453:epidemiology; D010328:Patch Tests; D015995:Prevalence
D000485:Allergens