Allergic contact dermatitis in Operation Iraqi Freedom: use of the T.R.U.E. Test in the combat environment.
BACKGROUND
Refractory dermatitis can frequently cause loss of personnel and poses an economic drain on the military due to the evacuation of civilians and soldiers out of theater.


OBJECTIVE
Proof-of-concept retrospective analysis to review the utility of the T.R.U.E. Test in the combat environment.


METHODS
Thirty T.R.U.E. Tests were performed by the dermatology clinic in Baghdad, Iraq, between January 15, 2008, and July 15, 2008. Thirty active-duty and civilian contractors referred to the dermatology clinic for dermatitis were tested and four others were clinically rechallenged for suspected bacitracin contact allergy.


RESULTS
Of the 30 patients tested, 14 (46.7%) had a positive test reaction to at least one antigen. In these positive tests, nickel, neomycin, and thimersol each comprised 17% followed by neomycin, thimerosal, budesonide, epoxy resin, potassium dichromate, p-phenylenediamine, formaldehyde, quaternium-15, fragrance, and balsam of Peru. All four clinical rechallenges for bacitracin allergy were also positive.


CONCLUSIONS
The use of the T.R.U.E. Test in the combat desert environment is an efficient, easy, and clinically relevant method of testing for allergic contact dermatitis. Continued study of the prevalence of allergic contact dermatitis at Ibn Sina Hospital, Baghdad, Iraq, is recommended.
Henning
J Scott
JS
San Antonio Uniformed Services Health Consortium, San Antonio Military Medical Center-South, Lackland AFB, TX 78236, USA. henning.scott@gmail.com
Firoz
Bahar F
BF
Lehman
Kimberly A
KA
D000328:Adult; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis*; D006801:Humans; D054542:Iraq War, 2003-2011; D008887:Military Medicine; D010328:Patch Tests / Q000295:instrumentation*; D012189:Retrospective Studies; D014481:United States