1. Level of contact hypersensitivity response to diphencyprone and keratinocyte cancer.
- Author
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Bullen A, Polcz M, Rowe CJ, Byrom L, Soyer HP, and Khosrotehrani K
- Subjects
- Aged, Dermatitis, Contact etiology, Female, Humans, Immunologic Tests, Male, Prospective Studies, Cyclopropanes immunology, Cyclopropanes pharmacology, Dermatitis, Contact immunology, Keratinocytes, Skin Neoplasms immunology, Skin Neoplasms pathology
- Abstract
Background: Keratinocyte cancers (KC) are common and pose a significant financial burden globally. Ultraviolet radiation is a significant factor in their development, through mutagenesis promotion but also through local and systemic immunosuppression. Although systemic immunosuppression is well understood, cutaneous immunity has been more difficult to evaluate., Objectives: This study used a contact sensitizer, diphencyprone (DPCP), which elicits a contact hypersensitivity reaction in skin, to compare the degree of reactivity to DPCP in patients with a high KC burden versus those with a low KC burden., Methods: A prospective study was performed in immunocompetent patients aged 70 ± 5 years of age, comparing patients with a high KC burden (>10 previous KC) with those with a low KC burden (<2 previous KC). All patients were sensitized with 2% DPCP and then patch tested two weeks later with eight different concentrations of DPCP with the threshold concentration and total degree of reaction recorded., Results: Nine patients were recruited, 5 in the 'high cancer' group and 4 in the 'low cancer' group. All patients were Fitzpatrick skin type 1 or 2. All patients developed a reaction to DPCP. Patients in the low cancer group developed a reaction at a significantly lower threshold DPCP concentration than the high cancer group (P = 0.039). The cumulative intensity of reaction was higher in the low cancer group (P = 0.087)., Conclusion: Patients with a high KC burden required a higher threshold concentration of DPCP to elicit a hypersensitivity reaction, supporting the concept of a lower skin immunity in these patients. DPCP reactivity threshold could be a useful tool in the evaluation of skin immunity and propensity to develop keratinocyte cancers., (© 2019 European Academy of Dermatology and Venereology.)
- Published
- 2019
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