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Adv Skin Wound Care. 2019 Dec;32(12):558-562. doi: 10.1097/01.ASW.0000582628.52901.43.

Contact Sensitization in Patients with Chronic Leg Ulcers: Results of a 5-Year Retrospective Analysis.

Author information

1
At the Clinic of Infectious Diseases and Dermatovenereology, Vilnius University, in Vilnius, Lithuania, Tadas Raudonis, MD, is a junior researcher, Faculty of Medicine; Rasa Aurelija Vankeviciute, MD, is a graduate, Faculty of Medicine; Andre Lideikaite, MD, is a graduate, Faculty of Medicine; Anna Greta Grigaityte, is a medical student, Faculty of Medicine; and Jurate Grigaitiene PhD, MD, is Associate Professor of Dermatology, Faculty of Medicine.

Abstract

OBJECTIVES:

To determine the frequency of contact sensitization among patients with chronic leg ulcers; to identify the most common allergens; and to examine possible relationships to ulcer duration, itching, exudate, and leg eczema.

METHODS:

Researchers conducted a 5-year retrospective analysis of 145 patients diagnosed with chronic leg ulcers who underwent skin patch testing with S-1000, LU-1000, and the commonly used dressing and antiseptic series.

RESULTS:

Investigators included 88 females (60.7%) aged 64 ± 15.1 years and 57 males (39.3%) aged 61 ± 16.4 years. Of these, 62.8% (n = 91) of patients were sensitized to at least one substance (2.6 ± 1.4 allergens on average). The most common allergens were benzalkonium chloride (18.6% [n = 27]), balsam of Peru (17.9% [n = 26]), and povidone-iodine 10% (17.2% [n = 25]). Finally, 40% (n = 58) of patients presented with pruritus around the ulcer, which was strongly associated with a positive patch test reaction (74.1% [n = 43] vs 55.2% [n = 48]; P = .021) and polysensitization (3.5 sensitivities [95% confidence interval, 2.4-4.6] vs 2 [95% confidence interval, 1.2-2.8]).

CONCLUSIONS:

Contact sensitization is very common in patients with chronic leg ulcers, and pruritus around the ulcer is associated with contact allergy as well as polysensitization.

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