3092 Positivity in skin patch test: Differences and similarities among adults and elderly with clinical suspicion of allergic contact dermatitis

Tuesday, 9 December 2014
Exhibition Hall-Poster Area (Sul America)

Nádia Betti , Iamspe, Brazil

Marcela P. L. Sales , Iamspe, Brazil

Larissa Fernandes , Iamspe, Brazil

Clarissa Lopes Batista , Ufam, Manaus, Brazil

Mônica De Melo Betti , Unl, Manaus, Brazil

Maria Elisa Andrade , Iamspe, Brazil

Luciana Kase Tanno, MD , Iamspe, Brazil

Wilson Tartuce Aun , Iamspe, Brazil

João Ferreira Mello , Iamspe, Brazil

Background: Allergic contact dermatitis (ACD) is a frequent condition and the cutaneous immunosenescence has been described as an influencing factor on the positivity of skin patch tests (SPT). Therefore, the aim of this study was to verify the frequency of positive SPT in elderly subjects, as well as to demonstrate the main sensitizers in this group and compare the results with those obtained in adults evaluated in the same period.

Methods: Prospective study performed in the Allergy and Immunology Department between May 2012 and June 2013, including adult (19-59 years) and elderly patients (> 60 years) with suspicion of ACD. For SPT, we used the Brazilian standard battery composed of 30 substances and a cosmetic battery with 15 components both standardized by Brazilian Study Group of Contact Dermatitis. The tests were applied using FINN Chambers containers and the interpretation was according to the International Contact Dermatitis Research Group recommendations. Data were analysed by the parametric method ANOVA (analysis of variance).

Results: We included 211 patients, 72 elderly and 139 adults. Of the 72 elderly, 57 were female (79%) and 107 (77%) had the same gender among all adults. Among the elderly, 46 (63.9%) of tests were positive (p = 0.66). There was no statistical significance regarding the topography of eczema among groups. The upper and lower limbs were the most affected regions in elderly while hands were most important in adults. We showed a higher sensitization in the elderly group of the following substances: Nickel sulphate (22.2%) paraphenylenediamine (15.3%), butyl phenol para tertiary (13.9%) and nitrofurazone (13.9%). Meanwhile, the most significant substances among the adults were: quaternium 15 (p = 0.010), nitrofurazone (p = 0.013), mercapto mix (p = 0.031), and neomycin (p = 0.048).

Conclusions:  Based on the positivity in both adults and elderly patients, we demonstrated that the skin patch test is an important diagnostic tool in ACD regardeless to the age. In the elderly subjects, the sensitizer substances are frequently used in topical drugs, mainly antimicrobial, are important etiologic agents. The nickel sulfate remains a major sensitizer in both groups.