Gender differences in topical treatment of allergic contact dermatitis.

Sir, Females report skin disease more often than males (1–3), and female gender is a predisposing factor to allergic contact dermatitis because of gender differences in exposure patterns (4–6). No significant differences in quality of life (QoL) scores have been reported between males and females with allergic contact dermatitis, but females report a higher degree of emotional distress (7, 8) and a higher degree of discomfort from eczema than males (3). Recent data on QoL in patients with hand eczema showed that QoL was equally affected in males and females, although disease severity was higher in males (9). The negative cosmetic influence of dermatitis may traditionally be expected to cause more distress in females, and was recently reported to do so in female patients with atopic dermatitis (10). Data on treatment of allergic contact dermatitis is limited, and differences between males and females with respect to treatment are not well described. Although the clinical experience is that females are more familiar with and more willing to use topical treatments, this has not been investigated or documented. The aim of this study was to compare treatment patterns among males and females with respect to conventional therapy. A second aim was to compare treatment patterns among healthcare workers and non-healthcare workers. MeThoDS The present study is based on a questionnaire survey among patients with contact allergy to preservatives and/or fragrances in consumer products. Questions were formulated based either on previously used questions or on interviews with patients with allergic contact dermatitis (11). A preliminary questionnaire, which consisted of 95 questions, was tested in a pilot group of 10 outpatients (4 men and 6 women, age range 26–65 years, mean 48 years). The relevance and understanding of each question in the completed questionnaire were discussed with the participants. Categories were added or removed, ambiguous questions were omitted or changed, which left 83 questions in the final questionnaire. The questionnaire included questions about the duration, location and severity of the eczema. Severity was assessed by the patient on a 100-mm visual analogue scale (VAS), with numbers from 0 to 10. The exact wording of the question was: " how would you grade your eczema on a scale from 0 to 10? " , where 0 = no eczema and 10 = severe eczema. Marks placed between numbers were registered as the lowest number plus 0.5. Questions also included frequency of eruptions (no eruptions, few …