Using Patch Testing to Improve Therapeutic Outcome in the Treatment of Hand Eczema in Vietnamese Patients

Authors

  • Phuong Pham Thi Minh National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • Trang Thi Minh National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • Doanh Le Huu National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • Thuong Nguyen Van National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • Sau Nguyen Huu National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • Tung Vu Thanh National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • Mai Le Thi National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • Giang Quach Thi Ha National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • Nghi Dinh Huu National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • Van Tran Cam National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • My Le Huyen National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • Khang Tran Hau National Hospital of Dermatology and Venereology, Hanoi, Vietnam
  • Marco Gandolfi Unit of Dermatology, University of Parma, Parma, Italy
  • Francesca Satolli Unit of Dermatology, University of Parma, Parma, Italy
  • Claudio Feliciani Unit of Dermatology, University of Parma, Parma, Italy
  • Michael Tirant University of Rome G. Marconi, Rome, Italy; Psoriasis Eczema Clinic, Melbourne, Australia
  • Aleksandra Vojvodic Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Belgrade, Serbia
  • Torello Lotti University of Rome G. Marconi, Rome, Italy

DOI:

https://doi.org/10.3889/oamjms.2019.051

Keywords:

Hand eczema, allergic contact dermatitis, atopic dermatitis

Abstract

BACKGROUND: Hand eczema is a common chronic and relapsing skin disease with various clinical features. Hand eczema aetiology can be allergic contact dermatitis (ACD), irritant contact dermatitis (ICD), atopic dermatitis (AD) and unknown or combination causes. If the causative agents are not detected treatment of hand eczema will be a failure. A patch test can be useful to detect causative agents in suspected allergic contact hand eczema. Then patients will avoid contacting them. This results in the improvement of hand eczema. In Vietnam, patch test has not been used before, so we conduct this study.

AIM: To identify causative allergens by using patch test with 28 standard allergens in consecutive patients.

METHODS: A group of 300 HE patients from the National Hospital of Dermatology and Venereology (NHDV) in Vietnam were enrolled in this study. They were divided into 4 groups-ACD, ICD, AD and unknown aetiology. The patient was patch tested with 28 standard allergens to identify the causative agents.

RESULTS: Among the 300 HE enrolled patients, ACD accounted for 72.7%, AD and ICD had the same rate of 12.7%. 39.3% of the patients had a positive patch test. Reaction to nickel sulfate was the most common (10.3%), followed by potassium dichromate (9.7%), cobalt (4%) and fragrance mix (3.1%). About one-third of the cases had relevant clinical reactions correlated with the contact agents and clinical history. Males reacted to cement, thiuram mix and formaldehyde more than females, while females reacted to a nickel more than males.

CONCLUSIONS: Hand eczema has variable clinical features and diverse aetiology. ACD is an important cause of hand eczema that can be managed with a patch test to detect causative allergens. Nearly 40% of HE cases had positive patch test. Relevant patch test reactions were seen in one-third of the patients. We propose using patch test detect causative agents in suspected allergic contact hand eczema. Then patients will avoid contacting them. This results in the improvement of hand eczema.

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Published

2019-01-23

How to Cite

1.
Thi Minh PP, Thi Minh T, Le Huu D, Nguyen Van T, Nguyen Huu S, Vu Thanh T, Le Thi M, Thi Ha GQ, Dinh Huu N, Cam VT, Le Huyen M, Tran Hau K, Gandolfi M, Satolli F, Feliciani C, Tirant M, Vojvodic A, Lotti T. Using Patch Testing to Improve Therapeutic Outcome in the Treatment of Hand Eczema in Vietnamese Patients. Open Access Maced J Med Sci [Internet]. 2019 Jan. 23 [cited 2022 May 27];7(2):204-7. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2019.051

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