The Lifestyle and the Usefulness of Patch Tests among Elderly Male Patients; Reflections on the Role of T Helper 2 Profile in Allergic Contact Dermatitis

Abstract

Allergic contact dermatitis (ACD), a T-cell-mediated inflammatory disease, appears in predisposed individuals as a result of exposure to allergens in the environment. This condition is frequently seen as a feminine problem. This investigation presents three examples of male subjects over 60 who recently experienced ACD onset, as determined by the standard series of the European Baseline Series. Our data demonstrate that due to their actual lifestyle and repeated exposures, elderly male patients can develop an ACD to “traditionally female allergens”. Patch tests (PT) in older participants indicate equal effectiveness as compared to every adult. However, allergists should consider the additional reading outside the 48 hours following PT application and interpret mild reactions as positive ones. Our data support the idea that when an initial disease history is ineffective, patch testing may help allergists identify the responsible allergen(s) and help patients further prevent exposure to them. In line with literature reports, our findings indicate that the penetration of concentrated allergens into subepithelial tissue, particularly when the epithelial layer is damaged, may result in an allergic reaction and even the development of ACD, which is probably linked to a T helper 2 response (including the synthesis of IgE). Due to the IgE-mediated antitoxic effect, this alternative might assist organisms by allowing exposure to increased allergen levels. However, further research must be done before this thesis can be evaluated.