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The Frequency and Causes of Photoallergic Contact Dermatitis among Dermatology Outpatients
Radoslaw Spiewak
; Jagiellonian University Medical College, Krakow
Abstract
Too many patients with photoallergy remain undiagnosed
due to unsatisfactory knowledge among doctors and limited access to
photopatch testing. The objectives of this study were to analyze the
frequency of patients requiring diagnostic work-up for photoallergic
contact dermatitis among dermatology patients, and to identify the
causative photosensitizers. This prospective study involved 1000 consecutive,
first-referred dermatology outpatients. All patients with a
history of dermatitis induced or aggravated by exposure to light were
qualified for photopatch testing. In the study group, 36 (3.6%; 95%CI:
2.4-4.8%) persons required photopatch testing based on their clinical
symptoms. As the total number of patients requiring patch tests of
any kind amounted to 205, the percentage of photopatch tested patients
among all patch-tested patients was 17.5% (95%CI: 12.2-22.8%).
Photoallergic contact dermatitis was ultimately confirmed in 15 (1.5%;
0.7-2.3%) persons: 7 females and 8 males aged 6-60 (median 33) years.
Nine patients turned out photoallergic to at least one nonsteroidal antiinflammatory
drug, with ketoprofen photoallergy being most frequent
(5 patients, in each case clinically relevant), followed by etofenamate
(4 non-relevant reactions) and diclofenac (1 relevant reaction). Five patients
were positive to at least one organic sunscreen, most frequently
to benzophenone-3 (2 patients). “Classical” contact allergy to tested
photohaptens was found in 15 persons, including 7 with coexisting
photoallergy. In conclusion, patients requiring diagnostic work-up for
photoallergy constitute a relevant group among dermatology patients,
therefore, it seems advisable that all second-level dermatology referral
centers be capable of photopatch testing. Due attention should also be
paid to photoallergy in dermatology training.
Keywords
photoallergy; photopatch test; photoallergic contact dermatitis; epidemiology
Hrčak ID:
115995
URI
Publication date:
13.1.2014.
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