关键词: 化妆品, 不良反应, 皮肤表现, 斑贴试验, 危险因素, 皮炎, 接触性, 染发剂, 对苯二胺

Abstract: 【Abstract】 Objective To analyze the clinical characteristics of and risk factors for cutaneous adverse reactions to cosmetics, and to provide evidence and recommendations for the scientific prevention and management of these reactions. Methods A retrospective study was conducted based on data from outpatients diagnosed with cutaneous adverse reactions to cosmetics at the People's Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2019. Clinical data and patch test results were recorded, and a comprehensive analysis was performed to analyze the clinical characteristics of and risk factors for these reactions. Results A total of 674 patients were included, accounting for 0.15% （674/450 000） of all outpatients; there were 25 male patients and 649 female patients, with ages of 35.29 ± 12.42 years. Among them, 95.40% （643/674） were diagnosed with contact dermatitis to cosmetics, which typically occurred within 3 days after using cosmetics （80.27%, 541/674）. Among all the patients, 56 underwent patch tests with the cosmetics they used, resulting in a positive rate of 57.14% （32/56）, while 243 completed the patch tests with European Standard cosmetic ingredients, showing a positive rate of 69.96% （170/243）. Among the 674 patients, 97.33% （656/674） had facial lesions, with erythema （86.94%, 586/674）, papules （36.65%, 247/674）, and edema （35.01%, 236/674） as the main clinical signs, and with itching （86.80%, 585/674）, dryness （63.20%, 426/674）, and burning sensation （62.46%, 421/674） as the common subjective symptoms. The types of cosmetics were related to the symptoms of cutaneous adverse reactions and the morphology of skin lesions. Compared with the patients using special cosmetics, those using ordinary cosmetics had a higher incidence rate of dryness （P = 0.001）, but lower incidence rates of erosions （P = 0.001）, scabbing （P = 0.005）, and exudative lesions （P = 0.01）. p-Phenylenediamine was the most common registered ingredient in hair dyes （72.22%, 13/18）, with a relatively high positive rate in the ingredient patch testing （4.53%, 13/243）. Conclusion In Xinjiang region, contact dermatitis was the most common type of cutaneous adverse reactions to cosmetics, with itching, dryness, and erythema as the predominant symptoms; allergic constitution and special cosmetics appeared to be key risk factors; p-phenylenediamine was an important hazardous substance in hair dyes.

Key words: Cosmetics, Adverse reactions, Skin manifestations, Patch tests, Risk factors, Dermatitis, contact, Hair dyes, P-phenylenediamine