Patch Testing for Cheilitis: A 10-Year Series.

BACKGROUND: The etiology of cheilitis includes endogenous, irritant, and allergic dermatitis; lichenoid and granulomatous disorders; infection; trauma; and actinic damage. Patch testing is indicated for refractory cases (other than actinic cheilitis). OBJECTIVE: The aim of the study was to review demographics and allergens in patients patch tested for cheilitis at 2 sites in Sydney, Australia. METHODS: Records for patients patch tested for a 10-year period from 2007 to 2017 were reviewed. Baseline characteristics and patch test results were compared for patients with and without cheilitis. CONCLUSIONS: There were 1584 patients including 91 with cheilitis. Patients with cheilitis were more likely to be female, younger, and atopic and have concurrent eyelid involvement than those presenting with other dermatoses. Seventeen percent of patients with cheilitis had a post-patch test diagnosis of allergic contact cheilitis, and the most frequent relevant reactions were to patients' own products, fragrances, and sunscreens. Those with cheilitis had more positive reactions to sunscreens, especially benzophenones, compared with those without cheilitis (P < 0.001). This is an important finding in Australia where high rates of melanoma and nonmelanoma skin cancer necessitate promotion of strict sun protection measures.

Persistent photosensitivity after allergic contact dermatitis to epoxy resin.

BACKGROUND: Persistent photosensitivity after allergic contact dermatitis (ACD) to epoxy resin has rarely been described. OBJECTIVE: The aim of this study was to create awareness that ACD to epoxy may be a trigger for persistent photosensitivity. METHODS: We present a series of 5 patients who developed ACD to epoxy resin and later a photodistributed eczematous eruption when exposed to sunlight, with a documented decrease in minimal erythema dose to UVA and UVB. RESULTS: The age of patients ranged from 34 to 71 years, and there were 3 men and 2 women. Each patient had occupational exposure to epoxy. Symptoms of epoxy ACD preceded photosensitivity by 5 months to 12 years in 3 cases and occurred simultaneously in 2 cases. Patch testing to epoxy resin was positive in all patients. Phototesting revealed a decreased minimal erythema dose to UVA and UVB in each of the 3 patients who were phototested. Photopatch testing was positive for epoxy resin in 1 of the 2 patients tested. All patients remained photosensitive for at least 2 years after diagnosis, with only 1 case of photosensitivity resolving with extended avoidance of epoxy. CONCLUSIONS: There is an association between ACD to epoxy resin and development of persistent photosensitivity. Possible mechanisms to explain the relationship between the 2 phenomena are discussed.