Allergic contact dermatitis in patients with anogenital complaints

OBJECTIVE: Allergic contact dermatitis is a common anogenital disease. STUDY DESIGN: The results of patch testing performed on 1,008 patients eval uated for allergic anogenital contact dermatitis from 21 dermatologic depar tments in the Information Network of Departments of Dermatology (IVDK) from 1992 to 1997 were analyzed. RESULTS: A final diagnosis of allergic contact dermatitis was made in 351 p atients (34.8%). Irritant contact dermatitis was diagnosed in 230 patients (22.8%) and other, nonspecified forms of perianal eczema in 228 patients (2 2.6%). The remaining cases were due to other distinct dermatologic diseases . Analyzing patch test data from this large group of patients showed that t he allergen spectrum resembled that of all patients (54,000) tested from 19 92 to 1997. However, dibucaine HCl ranked fourth among contact allergens in the study population. Positive reactions to (chloro-)-methyl-isothiazolino ne and to benzocaine were observed more frequently among patients with anog enital complaints as compared to the total IVDK population (3.7% vs. 2.5% a nd 2.7% vs. 1.5%, respectively). In general, active agents of topical medic ations and popular remedies, preservatives and ointment bases appeared to c ause allergic reactions most frequently. CONCLUSION: Patients with chronic anogenital diseases seem to have a high r isk of becoming sensitized. For patch testing we recommend the standard ser ies, dibucaine HCl, propolis, bufexamac and other ingredients from topical preparations according to the patient's history.