Environmental exogenous factors and facial dermatitis: A case control study

Abstract 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 self-reported 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  = 0.008), ingestion of spicy food ( p  = 0.025), or alcohol ( p  = 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.