Patch Test Results Among Older Adults: A Retrospective Analysis of the North American Contact Dermatitis Group Data (2009-2020)

JiaDe Yu; Hadley Johnson; Joel G DeKoven; Erin M Warshaw; James S Taylor; Donald V Belsito; Brandon L Adler; Jonathan I Silverberg; Amber R Atwater; Margo J Reeder; Nina Botto; Marie-Claude Houle; Christen M Mowad; Melanie D Pratt; Cory A Dunnick

doi:10.1089/derm.2023.0130

Patch Test Results Among Older Adults: A Retrospective Analysis of the North American Contact Dermatitis Group Data (2009-2020)

Dermatitis. 2023 Aug 17. doi: 10.1089/derm.2023.0130. Online ahead of print.

Authors

JiaDe Yu¹, Hadley Johnson^{1

2}, Joel G DeKoven³, Erin M Warshaw^{4

5

6}, James S Taylor⁷, Donald V Belsito⁸, Brandon L Adler⁹, Jonathan I Silverberg¹⁰, Amber R Atwater¹¹, Margo J Reeder¹², Nina Botto¹³, Marie-Claude Houle¹⁴, Christen M Mowad¹⁵, Melanie D Pratt¹⁶, Cory A Dunnick¹⁷

Affiliations

¹ From the Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
² Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota, USA. .
³ Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
⁴ Department of Dermatology, Park Nicollet/Health Partners Health Services, Minneapolis, Minnesota, USA.
⁵ Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA.
⁶ Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.
⁷ Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA.
⁸ Department of Dermatology, Columbia University Irving Medical College, New York, New York, USA.
⁹ Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, USA.
¹⁰ Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
¹¹ Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA.
¹² Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
¹³ Department of Dermatology, University of California San Francisco, San Francisco, California, USA.
¹⁴ Division of Dermatology, Centre Hospitalier Universitaire de Québec, Laval University, Québec, Canada.
¹⁵ Division of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA.
¹⁶ Division of Dermatology, University of Ottawa, Ontario, Canada; and.
¹⁷ Department of Dermatology, University of Colorado, Aurora, Colorado, USA.

PMID: 37590477
DOI: 10.1089/derm.2023.0130

Abstract

Background: Allergic contact dermatitis (ACD) in older adults (OA) represents a significant health burden, but few studies examine the prevalence and characteristics of contact allergy and ACD in this population. Objective: To compare positive and clinically relevant patch test results in OA versus younger adults (YA) and children. Methods: Retrospective analysis of patch test results obtained in OA (≥65 years), YA (19-64 years), and children (≤18 years) by the North American Contact Dermatitis Group, 2009 to 2020. Results: Of 28,177 patients patch tested, 5366 (19.0%) were OA. OA were more likely to have a final primary diagnosis of ACD as compared with YA (50.8% vs 49.2%, P = 0.035) and children (44.6%, P < 0.0001). The primary site of dermatitis also differed by age group, with OA having a higher proportion of dermatitis affecting the trunk, scalp, anogenital region, and "under clothing," and a lower proportion of dermatitis affecting the face, lips, and feet. Limitations: Retrospective design, lack of follow-up, and referral population. Conclusion: OA were as likely and were statistically even more likely to have a final primary diagnosis of ACD compared with YA and children. Anatomic site of dermatitis also differed by age group. This underscores the need for patch testing in OA when ACD is suspected.