Importance of the patch test for patients with recurrent facial erythema

Background: One of the most frequent symptoms encountered at a dermatology out patient clinic is recurrent or persistent facial erythema (red face). The face is exposed to many allergens including metals, cosmetic ingredients and environmental pollutants, therefore, it is very difficult to treat recurrent or persistent facial erythema patients if they are sensitized by these allergens. Although facial erythema could be a manifestation of various diseases, there have only been a limited number of clinical studies. Objective: To find out how often patients with recurrent facial erythema were sensitized by contact allergens. Methods: A total of 136 patients with recurrent or persistent facial erythema were enrolled and the patch test was done. Results: First clinical impressions were allergic contact dermatitis, rosacea, atopic dermatitis, steroid induced rosacea or seborrheic dermatitis in order of frequency. Patch test was performed on 84 patients, and 70 patients (83.3%) showed positivity to one or more antigens. Common antigens included nickel sulfate, cobalt chloride, and fragrance mix in the standard patch tests, and octyl galate, thimerosal, and dodecyl galate in the cosmetic series patch tests. Conclusion: Based on our results, we strongly recommend patch test for patients with recurrent or persistent facial erythema.