HIGH SENSITIZATION RATE TO EMULSIFIERS IN PATIENTS WITH CHRONIC LEG ULCERS

Emulsifiers are common constituents of most topical preparations. To s tudy the sensitization rate in a population with frequent use of these agents, we selected 47 patients with chronic or recurrent (> 1 year) inflammatory skin disease (leg ulcers, contact dermatitis, atopic derm atitis, psoriasis) for patch testing with the following emulsifiers: T ween 40 (polyoxyethylene sorbitan monopalmitate), Tween 80 (polyoxyeth ylene sorbitan monooleate), Span 60 (sorbitan monostearate), Span 80 ( sorbitan monooelate), Arlacel 83 (sorbitan sesquioleate), Atlas G 2162 (polyoxyethylene oxypropylene stearate), Atlas G 1441 (polyoxyethylen e sorbitol lanolin derivative), triethanolamine, Lanette O (cetylstear yl alcohol), Lanette N. 12 patients had at least 1 positive reaction ( 25.5%) at 3 or 4 days. Among them, 10 had leg ulcers (43.4% of the leg ulcer group), and 2 had contact dermatitis (13.3% of the contact derm atitis group). No positive reaction was observed in the other patients . When the patients were tested with their own topical preparations or wound dressings, 6 of them, all with leg ulcers, had positive reactio ns. These results show a surprisingly high prevalence of sensitization to emulsifiers in patients with chronic leg ulcers, in contrast to pa tients with other inflammatory skin diseases.