ABSTRACT
BACKGROUND: It is well known that patients with chronic wounds frequently acquire clinically relevant contact sensitizations to skin care products. OBJECTIVES: The aim of our study was to find out the actual frequency of contact sensitivities in patients with chronic wounds in Germany with particular attention to components of products used in modern wound therapy. METHODS: We examined the results of a prospective clinical investigation on skin patch tests of patients with chronic wounds. RESULTS: Altogether, 45 patients with chronic wounds were tested. In 25 (55.5%) of the examined patients, contact sensitization to at least one substance was detected. The most frequent contact sensitizations were to PVP-iodine (20%), balsam of Peru (15.6%) patients, fragrance mix (11.1%), colophony (8.8%) and potassium dichromate (6.7%). We also found sensitization to the wound dressings Varihesive (11.1%), Iruxol N (6.7%) and Comfeel (2.2%). CONCLUSIONS: We would like to propagate that therapists who are involved in wound treatment should also pay attention on the ingredients of applied modern wound dressings.
Subject(s)
Dermatitis, Contact/etiology , Wounds and Injuries/complications , Chronic Disease , Female , Germany , Humans , Male , Middle Aged , Patch Tests , Prospective StudiesABSTRACT
Patients with chronic wounds frequently acquire clinically relevant contact sensitization. We examined the results of the skin patch tests in patients with chronic wounds, who were treated between 1999-2004 in the Department of Dermatology, University School of Medicine, Essen, Germany. Altogether 105 patients with chronic wounds underwent patch testing. In 68 individuals, contact sensitization to at least one substance was detected. The most frequent contact allergens were to balsam of Peru, Amerchol L-101, fragrance mix, wool wax alcohols and rosins. Contact sensitization to wound dressing materials was also identified in 4 patients. Our results demonstrate the current spectrum of contact sensitization of patients with chronic wounds. Our results show the importance of paying attention to the ingredients in wound dressings and performing patch testing if there is any clinical suggestion of allergic contact dermatitis.
Subject(s)
Dermatitis, Allergic Contact/epidemiology , Varicose Ulcer/epidemiology , Adult , Aged , Aged, 80 and over , Bandages/adverse effects , Comorbidity , Cross-Sectional Studies , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Female , Germany , Humans , Male , Middle Aged , Patch Tests/statistics & numerical data , Retrospective Studies , Varicose Ulcer/therapyABSTRACT
A 62-year-old female patient with a venous leg ulcer developed massive eczema during wound bed preparation with the hydrocolloid dressing Varihesive. The patch testing confirmed a pronounced sensitization to the hydrocolloid dressing apart from the sensitization to colophony. After review of the current literature we found several case reports from the last 10 years about sensitization to hydrocolloids which were identical but distributed under different brand names in different countries. These dressings contain the pentaerythritol ester of hydrogenated rosin as the tackifying agent which is the substance retaining the sensitizing potential of colophony. Especially patients with chronic wounds frequently tend to contact sensitizations, and colophony currently represents the 4th most frequent allergen in Germany. Therefore, highly potent allergens such as colophony should be strictly avoided as a content material of modern wound dressings.
