Publication: Psoriazis, Alopesi Areata ve Kontakt Dermatitteki Yama Testi Sonuçlarının Karşılaştırılması
Abstract
ÖZET Giriş ve Amaç: Allerjik kontakt dermatit antijen spesifik, T lenfosit ilişkili gecikmiş tip hipersensitivite reaksiyonundan kaynaklanmaktadır. Yama (patch) testi hastalığın tanısının konulmasında yardımcı olan önemli bir yöntemdir. Psoriazis ve alopesi areatamn genetik yatkınlığı olan kişilerde, otoimmün süreçlerde T hücre aracılı mekanizmalarla ortaya çıktığı düşünülmektedir. Çevresel faktörler bu iki hastalığı tetikleyebilmektedir. Bu nedenle allerjik kontakt dermatit bu iki hastalıkta tetikleyici bir faktör olarak önemli olabilir. Psoriazis ve allerjik kontakt dermatit arasındaki ilişkiyi gösteren bulgular çelişkilidir. Yöntem: Çalışmamıza yama testi pozitifliğini karşılaştırmak üzere 36 psoriazis, 23 alopesi areata, 40 kontakt dermatit hastası ve 34 kişiden oluşan kontrol grubu alındı. Tüm hastalara Avrupa standart seri allerj enlerini içeren yama testi yapıldı. Sonuçlar International Contact Dermatitis Research Group'un önerdiği şekilde değerlendirildi. Sonuç: Psoriazis grubunda 7 (% 19.4), kontakt dermatit grubunda 21 (% 52.5), alopesi areata grubunda 10 (% 43.5) ve kontrol grubundaki 1 1 (% 32.4) hastada en az bir allerj ene karşı pozitiflik gözlendi. Tartışma: Psoriazis grubundaki pozitiflik oranı diğer gruplara oranla istatistiksel olarak daha az bulundu (p<0.05). Alopesi, kontakt dermatit ve kontrol grupları arasında pozitiflik açısından bir farklılık yoktu (p>0.05). Sonuç olarak psoriazisteki kontakt duyarlılık topluma göre daha az bulunmuştur. Bu nedenle kontakt allerj enlerin psoriazis tablosunun gelişiminde rol oynamayacağı düşünülmektedir. Alopesi areatadaki pozitiflik oram kontakt dermatite benzer olduğundan, kontakt allerjenler alopesi areatada lokal tetikleyici bir faktör olabilir. Anahtar Kelimeler: Allerjik kontakt dermatit, psoriazis, alopesi areata, yama (patch) testi III
ABSTRACT Background: Allergic contact dermatitis results from an antigen specific, T lymphocyte-mediate hypersensitivitiy reaction. The patch test is an important tool in the confirmation and diagnosis of allergic contact dermatitis. Psoriasis and alopecia areata is caused by T-cell- mediated autoimmune mechanism occuring in genetically predisposed individuals. Environmental factors may be responsible for triggering these diseases. Thus allergic contact dermatitis may be an important provoking factor psoriasis and alopecia areata. The evidence is conflicting on the association of allergic contact dermatitis and psoriasis. Many authors have reported an association between psoriasis and allergic contact dermatitis because of the location of lesions or resistance to therapy in certain patients suggesting the involvement of local triggering factors and contact allergy. Objective: In this study our aim was to compare patch test positivity of psoriasis, alopecia areata and contact dermatitis patients with those attending our dermatology clinic for other reasons. Methods: We compared the rates of patch test positivity of 36 psoriasis patients, 23 alopecia areata patients, 40 suspected of having allergic contact dermatitis patients and 34 with other nonallergic skin complaints patients. All patients were tested with European standart patch test allergens. The results were eveluated according to the standart scoring system recommended by International Contact Dermatitis Research Group. Results: Positivity to one or more allergens was observed in 7 (% 19.4) patients in psoriatic group, in 21 (% 52.5) patients in contact dermatitis group, in 10 (% 43.5) patients in alopecia areata group, in 1 1 (% 32.4) patients in control group. The most common allergen were nickel sulphate. Conclusions: The difference in patch test positivity between psoriatic group and other groups were statistically highly significant (p<0.05). The difference between other groups was not significant (p>0.05). Contact sensitivity was less frequent in psoratics compared to normal population. Thus contact allergens did not play an additional etiological role in development of the clinical picture of psoriasis. Contact sensitivity may be an important local triggering factor in alopecia areata because of the IVrates of patch test positivity in alopecia areata patients was smilar to contact dermatitis patients. Key words: Allergic contact dermatitis, psoriasis, alopecia areata, patch test
ABSTRACT Background: Allergic contact dermatitis results from an antigen specific, T lymphocyte-mediate hypersensitivitiy reaction. The patch test is an important tool in the confirmation and diagnosis of allergic contact dermatitis. Psoriasis and alopecia areata is caused by T-cell- mediated autoimmune mechanism occuring in genetically predisposed individuals. Environmental factors may be responsible for triggering these diseases. Thus allergic contact dermatitis may be an important provoking factor psoriasis and alopecia areata. The evidence is conflicting on the association of allergic contact dermatitis and psoriasis. Many authors have reported an association between psoriasis and allergic contact dermatitis because of the location of lesions or resistance to therapy in certain patients suggesting the involvement of local triggering factors and contact allergy. Objective: In this study our aim was to compare patch test positivity of psoriasis, alopecia areata and contact dermatitis patients with those attending our dermatology clinic for other reasons. Methods: We compared the rates of patch test positivity of 36 psoriasis patients, 23 alopecia areata patients, 40 suspected of having allergic contact dermatitis patients and 34 with other nonallergic skin complaints patients. All patients were tested with European standart patch test allergens. The results were eveluated according to the standart scoring system recommended by International Contact Dermatitis Research Group. Results: Positivity to one or more allergens was observed in 7 (% 19.4) patients in psoriatic group, in 21 (% 52.5) patients in contact dermatitis group, in 10 (% 43.5) patients in alopecia areata group, in 1 1 (% 32.4) patients in control group. The most common allergen were nickel sulphate. Conclusions: The difference in patch test positivity between psoriatic group and other groups were statistically highly significant (p<0.05). The difference between other groups was not significant (p>0.05). Contact sensitivity was less frequent in psoratics compared to normal population. Thus contact allergens did not play an additional etiological role in development of the clinical picture of psoriasis. Contact sensitivity may be an important local triggering factor in alopecia areata because of the IVrates of patch test positivity in alopecia areata patients was smilar to contact dermatitis patients. Key words: Allergic contact dermatitis, psoriasis, alopecia areata, patch test
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