Need for new strategies to improve the recall and avoidance rates of contact allergens: A retrospective cohort study from Turkey

Background: Previous studies reported a low-to-moderate benefit from patch testing regarding allergen recall and avoidance.Objectives: To determine the allergen recall and avoidance rates of patients with allergic contact dermatitis (ACD) in Turkey.Methods: This was a retrospective cohort study based on a phone questionnaire of 465 patients diagnosed with ACD from major allergen groups, that is, metals, preservatives, rubber, fragrances (ubiquitous allergens) and hair dye/black henna, topical drug and resins (nonubiquitous allergens), at our tertiary referral centre between 1996 and 2018.Results: Among 176 responders, allergen groups were remembered better (53.4%) than the individual allergens (36.9%). Age <40 years and keeping the allergy pass had a significantly positive impact on the recall rate of methylchloroisothiazolinone/methylisothiazolinone and nickel, particularly non-occupational nickel allergy from metal jewellery in females, respectively. Exacerbations of ACD (56.3%) were mainly due to reexposures to ubiquitous allergens. 42.9% of patients with occupational ACD changed or quit their job, most of them being construction workers and hairdressers, showing a high share (83.3%) of benefit.Conclusions: The overall rates of allergen recall and avoidance were moderate. New strategies are needed to improve the recall and avoidance rates of contact allergens, such as increased use of allergy pass, smartphone applications and legal precautions.