Environmental exogenous factors and facial dermatitis: A case control study

Background/objective: Facial dermatitis is common and the roles different exogenous factors play between facial and nonfacial dermatitis is unknown. The study aim was to investigate the etiology and selfreported exogenous aggravation factors in facial dermatitis. Methods: There were 89 facial dermatitis patients patch tested in a tertiary hospital during a 1-year period, and 112 patients with nonfacial dermatitis tested in the same period who served as a control. Association of exogenous factors was investigated by multivariate analyses. Results: Of the cases of facial dermatitis, 30.3% were confirmed allergic contact dermatitis, which was higher than that (23.2%) in controls. Cosmetic allergy was much more common in facial than nonfacial allergic contact dermatitis (96.3% vs. 19.2%); 51.9% of facial allergic contact dermatitis cases were caused by facial creams; 6.7% of facial dermatitis were irritant contact dermatitis, compared with 2.7% for controls; 9.0% of cases were seasonal facial dermatitis. The positive patch test reactions to at least one standard allergen were 65.2% in facial dermatitis and 58.0% in controls. Self-reported exogenous aggravation factors in facial dermatitis were spicy food ingestion (24.7%), low moisture (22.5%), sunlight (19.1%), alcohol ingestion (15.7%), seafood ingestion (14.6%), beef or lamb ingestion (12.4%), and high humidity (5.6%). Multivariate logistic regression analysis adjusting for sex, age, disease duration, atopic diathesis, and contact allergy showed that more patients reported aggravation by sunlight exposure (p 1⁄4 0.008), ingestion of spicy food (p 1⁄4 0.025), or alcohol (p 1⁄4 0.044). Conclusions: Contact factors play an important role in facial dermatitis. Aggravation by sunlight exposure, ingestion of spicy food, or alcohol are more reported in facial dermatitis compared with nonfacial dermatitis. Copyright © 2016, Taiwanese Dermatological Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).