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Retrospective Analysis of Cross-sectional Data From the North American Contact Dermatitis Group, 1994-2004

Erin M. Warshaw, MD, MS; Laura M. Furda, BA; Howard I. Maibach, MD; Robert L. Rietschel, MD; Joseph F. Fowler Jr, MD; Donald V. Belsito, MD; Kathryn A. Zug, MD; Vincent A. DeLeo, MD; James G. Marks Jr, MD; C. G. Toby Mathias, MD; Melanie D. Pratt, MD; Denis Sasseville, MD; Frances J. Storrs, MD; James S. Taylor, MD

Arch Dermatol. 2008;144(6):749-755.

Objectives  To characterize patients with anogenital dermatitis referred for patch testing by the North American Contact Dermatitis Group, to identify common allergens, and to explore sex associations.

Design  Retrospective, cross-sectional analysis of the North American Contact Dermatitis Group database, 1994-2004.

Patients  Five hundred seventy-five patients with anogenital signs or symptoms were referred for patch testing; 347 had anogenital disease only.

Main Outcome Measure  Currently relevant allergic patch test reaction in patients with anogenital signs or symptoms.

Results  Sex percentages and mean age were not significantly different in patients with anogenital involvement only compared with those without anogenital involvement. In patients with anogenital involvement only, a final diagnosis of "other dermatoses" was statistically significantly more common in female patients compared with male patients (n = 347; relative risk, 1.99; 95% confidence interval, 1.37-2.91), but the diagnosis of allergic contact dermatitis was not associated with sex. Specific allergens that were statistically significantly more common in patients with anogenital involvement included cinnamal (or cinnamic aldehyde), dibucaine, benzocaine, hydrocortisone-17-butyrate, and budesonide (all P < .005). Those that were statistically significantly less frequent included quaternium-15, cobalt chloride, formaldehyde, p-phenylenediamine, and thiuram mix (all P < .04). Seventy-three patients had anogenital allergic contact dermatitis, defined as anogenital involvement only, allergic contact dermatitis as the only diagnosis, and at least 1 positive reaction of current clinical relevance. In that subgroup, the most common allergen sources were cosmetics, medications, and corticosteroids.

Conclusion  In patients in the North American Contact Dermatitis Group with anogenital involvement only, male and female patients were equally likely to have allergic contact dermatitis but female patients were more likely to have other dermatoses. Common allergens and sources consisted of those likely to have contact with the anogenital area.

Author Affiliations: Departments of Dermatology, University of Minnesota, and Veterans Affairs Medical Center (Dr Warshaw), Minneapolis; University of California at San Francisco (Dr Maibach); University of Missouri, St Louis (Dr Belsito); St Luke's Roosevelt Hospital Center, Columbia University, New York, New York (Dr DeLeo); Pennsylvania State University, University Park (Dr Marks); Cleveland Clinic, Cleveland, Ohio (Dr Taylor); University of Ottawa, Ottawa, Ontario, Canada (Dr Pratt); and Oregon Health Science University, Portland (Dr Storrs); University of Minnesota Medical School (Ms Furda), Minneapolis; Department of Dermatology Group Health Associates, University of Cincinnati, Cincinnati, Ohio (Dr Mathias); Sections of Dermatology, University of Arizona and the Southern Arizona Veterans Affairs Health Care System, Tucson (Dr Rietschel); Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (Dr Zug); and Divisions of Dermatology, University of Louisville, Louisville, Kentucky (Dr Fowler); and McGill University, Montreal, Quebec, Canada (Dr Sasseville).

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