Clinical characteristics of patients with chromium allergy in a single university hospital in Korea

Abstract

Background: Chromium is one of the most common metal allergens that cause allergic contact dermatitis. European regulation of chromium (VI) content in cement was first implemented in 2005, and regulation of chromium in leather in 2015. Objective: This clinical study was performed to obtain basic data on subjects with allergic contact dermatitis due to chromium in Korea. We investigated the clinical characteristics of patients with chromium allergy among subjects with contact dermatitis who underwent patch tests. Methods: Patch test data from June 1998 to January 2014 were retrospectively analyzed (n=975; men=290, women= 685). Patients who showed positive reactions to potassium dichromate (chromium [+] group; n=58) and who showed positive reactions to other allergens except potassium dichromate (others [+] group; n=497) were identified and the characteristics of both groups were compared. Patients who only reacted to chromium (only chromium group; n=17) were identified, and their clinical characteristics were investigated. The prevalence of chromium allergy was analyzed in each 4-year period to study the changes over time. Results: The sensitization rate of potassium dichromate was 5.9% (n=58) and women comprised 72.4% (n=42) of the chromium (+) group. Hands and feet were more frequently affected in the chromium (+) group (p=0.002 and 0.019, respectively). Occupational dermatitis was significantly less common in the chromium (+) group. Chromium allergy was the most prevalent in patients in their 50s (8.4%). The only chromium group had significantly more number of patients aged 40 years or older (p=0.004). The prevalence of chromium allergy was 13.5% during 1998-2002, but decreased to 5.4% during 2010∼2014. Conclusion: The characteristics of patients with chromium allergy suggests that chromium exposure in daily activities, including leather exposure, is more relevant than occupational exposure for most patients. The prevalence of chromium allergy has been decreasing in Korea, which may be an effect of voluntary regulation of chromium content in cement by manufacturers.