Evaluating the effect of chlorpheniramine on patch test reactions amongst eczema patients sensitised to nickel
Discontinuing antihistamines for patch testing (PT) in allergic contact dermatitis (ACD) is more conventional than evidence based. Data suggests that non-sedating antihistamines do not interfere with PT. Investigating the effects of sedating antihistamines are more relevant as these are recommend...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Pusat Perubatan Universiti Kebangsaan Malaysia
2018
|
| Online Access: | http://journalarticle.ukm.my/20200/ http://journalarticle.ukm.my/20200/1/7_ms0167_pdf_17766.pdf |
| Summary: | Discontinuing antihistamines for patch testing (PT) in allergic contact dermatitis
(ACD) is more conventional than evidence based. Data suggests that non-sedating
antihistamines do not interfere with PT. Investigating the effects of sedating
antihistamines are more relevant as these are recommended for eczema. We aimed
to evaluate the effect of chlorpheniramine on PT, to determine the prevalence of
nickel sensitization and common sensitizing allergens. An open labeled cohort study
was conducted at two dermatology clinics. Patients indicated for PT underwent
standard protocol where antihistamines were discontinued. Patients sensitised to
nickel were subjected to a second nickel PT while taking chlorpheniramine. Results
were evaluated using the North American Contact Dermatitis Research Group
(NACDRG) score, a Mexameter measured erythema and pruritus was assessed
using a visual analogue score. A total 82 patients were recruited, 28 (34.1%) were
sensitised to nickel. The mean age was 40 ± 17.7 years with 22(26.8%) males and
60 (73.2%) females. Indications for PT included suspected ACD (57.3%), hand
and feet eczema (34.1%) and severe eczema with suspected superimposed ACD
(6.1%). The commonest sensitizing allergens were methyldibromoglutaronitrile
(40.2%) nickel sulphate (34.1%), potassium dichromate (29.3%) and formaldehyde
(24.4%). A second PT was performed on 23 patients. There was no difference in the
NACDRG score with chlorpheniramine or without chlorpheniramine (p=0.968).
Pruritus score was reduced by 1.39 ± 2.9, p=0.031 with chlorpheniramine. The
degree of erythema was 611.46 ± 21.59 with chlorpheniramine versus 613.87 ±
27.5 without chlorpheniramine, p=0.671. Chlorpheniramine did not affect PT
based on clinical and objective scorings. It has the additional benefit of reducing
test-induced itch. |
|---|