Patch-testing North American lip dermatitis patients: data from the North American Contact Dermatitis Group, 2001 to 2004.
BACKGROUND
The most common differential diagnoses for patients presenting with lip dermatitis or inflammation include atopic, allergic, and irritant contact dermatitis. Patch testing can be performed to identify the allergic contact conditions.


OBJECTIVE
To report North American Contact Dermatitis Group (NACDG) patch-test results of patients who presented for patch testing with only lip involvement from 2001 to 2004. Patient characteristics, allergen frequencies, relevance, final diagnoses, and relevant allergic sources not in the NACDG screening series were evaluated.


METHODS
The NACDG 2001-2004 database was used to select patients presenting with only lip involvement.


RESULTS
Of 10,061 patients tested, 2% (n = 196) had lips as the sole involved site. Most (84.2%) were women. After patch testing, 38.3% (n = 75) were diagnosed with allergic contact cheilitis. Fragrance mix, Myroxilon pereirae, and nickel were the most common relevant allergens. Of 75 patients, 27 (36%) had relevant positive patch-test reactions to items not on the NACDG series; lipstick and cosmetics were the predominant sources.


CONCLUSIONS
Patch testing is valuable in the evaluation and identification of contact allergy in patients referred for lip dermatitis. The use of supplementary allergens based on history and exposure is important in the identification of additional relevant allergens. Over a third of patients with contact allergy had other factors, such as irritant dermatitis, considered relevant to their condition.
Zug
Kathryn A
KA
Dartmouth Medical School, Hanover, NH, USA.
Kornik
Rachel
R
Belsito
Donald V
DV
DeLeo
Vincent A
VA
Fowler
Joseph F
JF
Maibach
Howard I
HI
Marks
James G
JG
Mathias
C G Toby
CG
Pratt
Melanie D
MD
Rietschel
Robert L
RL
Sasseville
Denis
D
Storrs
Frances J
FJ
Taylor
James S
JS
Warshaw
Erin M
EM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000009:adverse effects*; D001453:Balsams / Q000009:adverse effects; D002613:Cheilitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D003358:Cosmetics / Q000009:adverse effects*; D019992:Databases as Topic; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects; D009656:North America / Q000453:epidemiology; D010328:Patch Tests / Q000379:methods; D010476:Perfume / Q000009:adverse effects; D011237:Predictive Value of Tests; D015995:Prevalence; D012737:Sex Factors
D000485:Allergens; D001453:Balsams; D003358:Cosmetics; D010476:Perfume; C029938:nickel sulfate; D009532:Nickel; C025080:Peruvian balsam