中华皮肤科杂志 ›› 2020, Vol. 53 ›› Issue (11): 895-899.doi: 10.35541/cjd.20200050

• 论著 • 上一篇    下一篇

化妆品相关皮肤不良反应512例临床特点及致病成分分析

江阳    王禹毅    邓抒琴    王莎    刁庆春    朱瑾瑜    宁春竹    吕静   

  1. 重庆市中医院皮肤科  400011
  • 收稿日期:2020-02-02 修回日期:2020-08-04 发布日期:2020-11-03
  • 通讯作者: 吕静 E-mail:171942413@qq.com

Clinical characteristics of 512 cases of cosmetics-related skin adverse reactions and analysis of allergenic components of cosmetics

Jiang Yang, Wang Yuyi, Deng Shuqin, Wang Sha, Diao Qingchun, Zhu Jinyu, Ning Chunzhu, Lyu Jing   

  1. Department of Dermatology, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400011, China
  • Received:2020-02-02 Revised:2020-08-04 Published:2020-11-03
  • Contact: Lyu Jing E-mail:171942413@qq.com

摘要: 【摘要】 目的 分析化妆品相关皮肤不良反应的临床特点及主要致病成分,为化妆品不良反应起到预警作用并提供客观的风险评估依据。方法 收集2018年3月至2019年10月在重庆市中医院门诊就诊的512例化妆品不良反应可疑患者,男14例,女498例,通过填写统一制定的化妆品不良反应报告卡,记录患者的病史资料和所使用化妆品的相关信息;对其中103例(男3例,女100例)进行化妆品原物斑贴试验及化妆品成分斑贴试验,结合48和72 h斑贴试验结果综合判定并汇总分析。结果 512例可疑化妆品不良反应病例中,主要表现类型为接触性皮炎(495例,96.7%)。化妆品不良反应的皮损形态主要为红斑501例(97.9%)、丘疹313例(61.1%)、水肿249例(48.6%)、鳞屑166例(32.4%);症状主要为瘙痒480例(93.8%),其次为灼热感359例(70.1%)和紧绷感297例(58.0%)。103例化妆品成分斑贴试验显示,阳性71例,最易引起化妆品不良反应的变应原分别为硫柳汞(31例,30.1%)、十二烷基硫酸钠(29例,28.2%)、秘鲁香脂(17例,16.5%)、布罗波尔(12例,11.7%)及三乙醇胺(10例,9.7%)。将化妆品变应原系列分为14个类别,阳性率前4位的类别分别为乳化剂54例(45.8%)、防腐剂47例(39.8%)、芳香剂17例(14.4%)和表面活性剂10例(8.5%)。2例男性和69例女性斑贴试验阳性,男女阳性率差异无统计学意义(2/3比69/100,χ2 = 0.01,P > 0.05);18 ~ 29岁组、30 ~ 49岁组及50 ~ 70岁组阳性率分别是34%、34%、32.4%,各组间阳性率差异无统计学意义(χ2 = 0.693,P > 0.05)。结论 化妆品不良反应最常见的表现为接触性皮炎,致病成分具有多样性,最易引起化妆品皮肤不良反应的变应原分别为硫柳汞、十二烷基硫酸钠、秘鲁香脂、布罗波尔及三乙醇胺。

关键词: 化妆品, 变应原, 不良反应, 斑贴试验

Abstract: 【Abstract】 Objective To analyze clinical characteristics of cosmetics-related adverse reactions and main allergenic components of cosmetics, to provide guidance for cosmetics-related adverse reaction monitoring, and to provide an objective basis for risk assessment. Methods A total of 512 patients with suspected cosmetic adverse reactions were collected from the outpatient clinic of Chongqing Traditional Chinese Medicine Hospital from March 2018 to October 2019, including 14 males and 498 females. A uniform cosmetic adverse reaction report card was filled in, and medical history of patients and related information about the used cosmetics were recorded; 103 patients (3 males and 100 females) were subjected to patch test with their own cosmetics or cosmetic ingredients, and 48- and 72-hour patch test results were combined for comprehensive determination and analysis. Results Among the 512 cases of suspected cosmetic adverse reactions, contact dermatitis (495 cases, 96.7%) was the most common manifestation. Cosmetic adverse reactions mainly manifested as erythema (501 cases, 97.9%), papules (313, 61.1%), edema (249, 48.6%), and scaling (166, 32.4%); main symptoms included itching (480,93.8%), burning sensation (359, 70.1%), and tense sensation (297, 58.0%). Patch test with cosmetic ingredients showed positive reactions in 71 of 103 cases, and thimerosal was the allergen mostly liable to cause adverse reactions (31 cases, 30.1%), followed by sodium dodecyl sulfate (29 cases, 28.2%), Peru balsam (17 cases, 16.5%), bronopol (12 cases, 11.7%) and triethanoamine (10 cases, 9.7%). The cosmetic allergens were divided into 14 categories, and the top 4 categories with high positive patch test rates were emulsifiers (54 cases, 45.8%), preservatives (47 cases, 39.8%), fragrances (17 cases, 14.4%) and surfactants (10 cases, 8.5%). Positive patch test reactions were observed in 2 males and 69 females, and there was no significant difference in the positive rate between males and females (2/3 vs. 69/100, χ2 = 0.01, P > 0.05); there was also no significant difference in the positive rate among the groups aged 18 - 29 years (34%), 30 - 49 years (34%) and 50 - 70 years (32.4%; χ2 = 0.693, P > 0.05). Conclusions Contact dermatitis is the most common adverse reaction to cosmetics. Among the diverse allergenic components of cosmetics, thimerosal is the allergen that is mostly liable to cause adverse reactions, followed by sodium dodecyl sulfate, Peru balsam, bronopol and triethanoamine.

Key words: Cosmetics, Allergens, Adverse reactions, Patch test

引用本文

江阳 王禹毅 邓抒琴 王莎 刁庆春 朱瑾瑜 宁春竹 吕静. 化妆品相关皮肤不良反应512例临床特点及致病成分分析[J]. 中华皮肤科杂志, 2020,53(11):895-899. doi:10.35541/cjd.20200050

Jiang Yang, Wang Yuyi, Deng Shuqin, Wang Sha, Diao Qingchun, Zhu Jinyu, Ning Chunzhu, Lyu Jing. Clinical characteristics of 512 cases of cosmetics-related skin adverse reactions and analysis of allergenic components of cosmetics[J]. Chinese Journal of Dermatology, 2020, 53(11): 895-899.doi:10.35541/cjd.20200050