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Allergisches Gesichtsekzem

Auswertungen des IVDK und Literaturübersicht

Facial allergic contact dermatitis

Data from the IVDK and review of literature

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Zusammenfassung

Das Gesicht ist zahlreichen Stoffen ausgesetzt, und kann somit auch Schauplatz kontaktallergischer Reaktionen sein. Ziel dieser Arbeit ist die Ermittlung der mit einem Gesichtsekzem assoziierten Faktoren. Dazu wurden die Daten des IVDK der Jahre 1995–2007 ausgewertet. Bei n=18.572 traf die Ekzemlokalisation „Gesicht“ zu. Der Anteil der Frauen und der Patienten mit atopischer Dermatitis war erhöht, derjenige mit Verdacht auf Berufsdermatose erniedrigt. Bei den Frauen sind (neben Nickel) v. a. Allergene signifikant häufiger als bei den Männern vertreten, die in Kosmetika eingesetzt werden: Duftstoff-Mix (10,8/8,3), para-Phenylendiamin (4,0/2,8), Wollwachsalkohole (3,0/2,2), Lyral (3,1/2,0) und Bufexamac (1,8/1,1). Demgegenüber ist bei den Männern lediglich Epoxidharz signifikant häufiger vertreten als bei den Frauen. Beim aerogenen Kontaktekzem wurden folgende Sensibilisierungen signifikant häufiger diagnostiziert: Sesquiterpenlacton-Mix, Kompositen-Mix, Epoxidharz, Methyl(chlor)isothiazolinon und Terpentinöl. Bei Gesichtsekzem sollte neben der privaten Allergenexposition (Kosmetika) eine berufliche Exposition bedacht werden.

Abstract

The face is exposed to many foreign substances and may thus be a site of allergic contact dermatitis. Our aim is to elucidate the spectrum of factors associated with facial dermatitis by analyzing data of patients patch tested in the Information Network of Departments of Dermatology (IVDK) between 1995 and 2007. In 18,572 patients the main anatomical site of dermatitis was the face. Among these, the proportion of females and of patients with past or present atopic eczema was increased, while probable occupational causation was less common than in the overall group. Cosmetic allergens, as well as nickel, were significantly more common in women than men, including fragrance mix (10.8% vs. 8.3%), p-phenylenediamine (4.0% vs. 2.8%), lanolin alcohols (3.0% vs. 2.2%), LyralTM (3.1% vs. 2.0%) and bufexamac (1.8% vs. 1.1%). In comparison, only epoxy resin contact allergy was diagnosed significantly more often in men than women: In patients with airborne contact dermatitis, over-represented allergens included sesquiterpene lactone mix, compositae mix, epoxy resin, (chloro-) methylisothiazolinone and oil of turpentine. In the clinical approach to patients with facial dermatitis, occupational airborne causation should be considered in addition to non-occupational (e.g., cosmetic) allergen exposure.

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  1. Informationsverbund Dermatologischer Kliniken (IVDK), Institut an der Universität Göttingen, Siebold Straße 3, 37075, Göttingen, Deutschland

    A. Schnuch M.D.

  2. Dermatologische Klinik, Krankenhaus Bethesda, Freudenberg, Deutschland

    C. Szliska

  3. Institut für Medizininformatik, Biometrie und Epidemiologie, Universität Erlangen-Nürnberg, Erlangen, Erlangen, Deutschland

    W. Uter

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  1. A. Schnuch M.D.
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Folgende Zentren des IVDK trugen Daten zu der Analyse bei (in alphabetischer Reihenfolge): Aachen (C. Schröder, H. Dickel, J.M. Baron, S. Erdmann), Augsburg (A. Ludwig), Basel (A. Bircher), Berlin B.-Frank. (B. Tebbe, M. Worm, R. Treudler), Berlin BWK (A. Köhler), Berlin Charité (B. Laubstein, M. Worm, T. Zuberbier), Berlin UKRV (J. Grabbe, T. Zuberbier), Bern (D. Simon), Bielefeld (I. Effendy), Bochum (Ch. Szliska, H. Dickel, M. Straube), Bochum BGFA (M. Fartasch), Dermatologikum (K. Reich, V. Martin), Dortmund (B. Pilz, C. Pirker, K. Kügler, P.J. Frosch, R. Herbst), Dresden (A. Bauer, G. Richter, P. Spornraft-Ragaller, R. Aschoff), Duisburg (J. Schaller), Erlangen (K.-P. Peters, M. Fartasch, M. Hertl, T.L. Diepgen, V. Mahler), Essen (H.-M. Ockenfels, U. Hillen), Freudenberg (Ch. Szliska), Göttingen (J. Geier), Gera (J. Meyer), Graz (B. Kränke, W. Aberer), Greifswald (M. Jünger), Göttingen (J. Geier, Th. Fuchs), Halle (B. Kreft, D. Lübbe, G. Gaber), Hamburg (D. Vieluf, E. Coors, M. Kiehn, R. Weßbecher), Hannover (T. Schaefer, Th. Werfel), Heidelberg (A. Schulze-Dirks, M. Hartmann, U. Jappe), Heidelberg AKS (E. Weisshaar, H. Dickel, T.L. Diepgen), Homburg/Saar (C. Pföhler, P. Koch), Jena (A. Bauer, M. Gebhardt, M. Kaatz, S. Schliemann-Willers, W. Wigger-Alberti), Kiel (J. Brasch), Krefeld (A. Wallerand, M. Lilie, S. Wassilew), Lübeck (J. Grabbe, J. Kreusch), Mainz (D. Becker), Mannheim (Ch. Bayerl, D. Booken, H. Kurzen), Marburg (H. Löffler, I. Effendy, M. Hertl), München LMU (B. Przybilla, P. Thomas, R. Eben, T. Oppel, T. Schuh), München Schwabing (K. Ramrath, M. Agathos, M. Georgi), München TU (J. Rakoski, U. Darsow), Münster (B. Hellweg, R. Brehler), Nürnberg (A. Hohl, D. Debus, I. Müller), Osnabrück (Ch. Skudlik, H. Dickel, H.J. Schwanitz (+), N. Schürer, S.M. John, W. Uter), Rostock (Ch. Schmitz, H. Heise, J. Trcka, M.A. Ebisch), Tübingen (G. Lischka, M. Röcken, T. Biedermann), Ulm (G. Staib, H. Gall (+), P. Gottlöber), Ulm, BWK (H. Pillekamp), Wuppertal (J. Raguz, O. Mainusch), Würzburg (A. Trautmann, J. Arnold)

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Schnuch, A., Szliska, C. & Uter, W. Allergisches Gesichtsekzem. Hautarzt 60, 13–21 (2009). https://doi.org/10.1007/s00105-008-1644-6

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