Allergic Contact Dermatitis from Vitamin E: The Experience at Mayo Clinic Arizona, 1987 to 2007

Alison K. Adams; Suzanne M. Connolly

Disclosures

Dermatitis. 2010;21(4):199-202. 

In This Article

Results

From June 1987 through December 2007, 2,950 patients were patch-tested with α-tocopherol. For our analysis, we divided the patients into two groups: (1) patients seen from 1987 through 1997 and (2) patients seen from 1998 through 2007. We hypothesized that these groups would represent patients with different levels of exposure to vitamin E and would therefore have differing incidences of positive patch-test reactions to vitamin E.

From June 1987 through December 1997, 1,136 patients were patch-tested with α-tocopherol. Of these, 723 (63.6%) were female. The mean age at the time of patch testing was 60.2 years. Six patients (0.53%) had positive patch-test reactions, and all reactions were considered relevant. Extremities were the most common site of rash (n 5 3) although the following locations were affected in one patient each: generalized, oral, and face and neck. One patient with upper extremity involvement also had facial involvement. Of the patients who had positive reactions, four were female, and the mean age at application was 54.3 years. All but one patient had other positive reactions as well.

From January 1998 through December 2007, patch tests with α-tocopherol were performed on 1,814 patients. Of these, 1,155 patients (63.7%) were female. The mean age at application was 62 years. Twelve patients (0.66%) had positive reactions to either α-tocopherol in petrolatum (n 5 11) or α-tocopherol 100% (n 5 1), and all reactions were considered relevant. Of the patients who had positive reactions, 8 (66.7%) were female, and the mean age was 62.4 years. Extremities were the most common sites of rash involvement (n 5 4). Dermatitis encompassing hands and feet (n 5 3) or the face (n 5 3) was noted, as was generalized dermatitis (n 5 2). Of these patients, all but one had multiple positive patch-test results.

When both data sets were considered, the overall positivity rate was 0.61% (18 of 2,950 patients). As shown in Figure 1, the rate of positive patch-test reaction in the first part of the study (0.53% during a 10.5-year period) and the positive-reaction rate in the second part of the study (0.66% during a 10-year period) were not significantly different (p 5 .69).

Figure 1.

Percentages of patients with positive patch-test reactions.

The dermatology practice group at another campus of our institution began collecting data on α-tocopherol acetate and α-tocopherol in 2000. We compared our overall positivity rate (0.61%) with that of this other group (0.54% from 2000 to 2007) (Fig 2). The difference in rates was not significant (p 5 .51).

Figure 2.

Comparison of overall positivity rates from the institution's home location and another campus. (MCA 5 Mayo Clinic, Arizona; MCR 5 Mayo Clinic, Rochester.)

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