PATCH TESTING IN PATIENTS WITH CONFIRMED ALLERGIC CONTACT DERMATITIS TO COSMETICS IN DR. SARDJITO GENERAL HOSPITAL 2019-2022: A DESCRIPTIVE STUDY

PARAMASTRI C A, dr. Sri Awalia Febriana, M.Kes, Sp.KK(K), Ph.D; dr. Flandiana Yogianti, Ph.D, Sp.DV

2023 | Skripsi | S1 KEDOKTERAN

Latar Belakang: Peningkatan penggunaan kosmetik dapat meningkatkan insidensi dermatitis kontak alergi (DKA) kosmetik. Dalam beberapa waktu terakhir, minat dan kebutuhan akan produk kecantikan lokal dan internasional meningkat di Indonesia. Pada populasi umum, dilaporkan bahwa prevalensi DKA kosmetik pada pasien yang dirujuk untuk uji tempel berkisar antara 2-4%. Uji tempel adalah standar emas untuk mengonfirmasi reaksi alergi dan mendeteksi kemungkinan alergen. Tujuan: Mengetahui prevalensi hasil uji tempel positif pada pasien suspek DKA terhadap kosmetik di Poliklinik Penyakit Kulit dan Kelamin RSUP dr. Sardjito dari tahun 2019-2022 dan mengidentifikasi alergen penyebab DKA dalam produk kosmetik. Metode: Pada studi ini, seri uji tempel yang digunakan meliputi seri standar, seri kosmetik, dan produk kosmetik pasien. Desain penelitian yang digunakan adalah deskriptif cross-sectional dengan menggunakan data retrospektif. Data diambil dari buku register uji tempel pasien dermatitis kontak alergi di Poliklinik Dermatologi (divisi alergi) RSUP dr. Sardjito Yogyakarta. Data dikumpulkan dan dikurasi dalam Microsoft Excel. Hasil: Sebanyak 70 pasien yang memenuhi kriteria inklusi dan eksklusi yang ditetapkan dan diikutsertakan dalam penelitian. Dari 70 subjek pasien suspek DKA dan menjalani uji tempel, 38 (54,3%) pasien dipastikan DKA kosmetik (dikonfirmasi dengan uji tempel). Alergen yang bertanggung jawab pada pasien yang diuji dengan seri kosmetik adalah thimerosal 0,1% (16,67%), ethylenediamine dihydrochloride 1% (16,67%), dodecyl gallate 0,25% (16,67%), tocopherol (16,67%), MDBGN 0,5% (14,3%), dan minyak peppermint 2% (14,3%). Dan lima alergen teratas yang menginduksi reaksi positif dengan seri standar adalah MDBGN 0,5% (25%), lanolin alcohol (13,9%), fragrance mix I (12,7%), balsam of Peru (10,8%), dan fragrance mix II (10,8%). Untuk hasil uji tempel dengan produk kosmetik pasien, pewarna rambut merupakan produk tertinggi yang menimbulkan reaksi positif. Adapun profil epidemiologi pasien yang terkonfirmasi DKA kosmetik, 27 pasien (71%) DKA kosmetik adalah perempuan. Penderita ACD terbanyak ditemukan pada kelompok usia 26-40 tahun. Riwayat atopi diri ditemukan pada 7 pasien (18,42%), sedangkan riwayat atopi keluarga hanya ditemukan pada 3 pasien (7,9%). Kesimpulan: Kejadian DKA pada kosmetik didominasi oleh wanita. Selain menggunakan seri standar dan kosmetik dalam uji tempel, uji tempel dengan produk kosmetik pasien dapat sangat berguna. Kata Kunci: Dermatitis kontak alergi kosmetik, uji tempel, seri standar, seri kosmetik, dan produk kosmetik tambahan.

Background: Increasing use of cosmetics product increase the incidence to ACD to cosmetics. In recent years, consumer demand for international and local beauty products has increased in Indonesia. In general population, it is reported that the prevalence of ACD to cosmetics in patients referred for patch testing ranged from 2-4%. Patch testing is a gold standard to confirm the allergic reaction and detect the possible allergens. Aims and objectives: To determine the prevalence of positive patch test results in patients suspected of allergic contact dermatitis to cosmetics in the Dermatology and Venereology outpatient clinic of dr. Sardjito General Hospital from 2019 to 2022 and identify the responsible allergens in cosmetic ingredients that cause allergic contact dermatitis. Methods: In this study, the patch tested allergens includes the standard series, cosmetic series, and patient�s cosmetic products. The research design is descriptive cross-sectional using retrospective data. The data was collected from the patch test register book of patients with allergic contact dermatitis at the Dermatology Outpatient Clinic (allergy division) of dr. Sardjito General Hospital Yogyakarta. The data collected and curated in Microsoft Excel. Results: A total of 70 patients who met the established inclusion and exclusion criteria and were included in the study. Out of 70 subjects of patients suspected with ACD and underwent patch test, 38 (54.3%) patients were confirmed to have ACD to cosmetic (confirmed by patch test). The responsible allergens in patients tested by cosmetic series are thimerosal 0.1% (16.67%), ethylenediamine dihydrochloride 1% (16.67%), dodecyl gallate 0.25% (16.67%), tocopherol (16.67%), MDBGN 0.5% (14.3%), and peppermint oil 2% (14.3%). And the top five allergens which induces positive reactions with standard series are MDBGN 0.5% (25%), lanolin alcohol (13.9%), fragrance mix I (12.7%), balsam of Peru (10.8%), and fragrance mix II (10.8%). For the additional patient�s cosmetic product results, hair dye was the highest product that induces positive reaction. As for the epidemiologic profile of patients confirmed with ACD to cosmetics, 27 patients (71%) of ACD to cosmetics were women. The most common patients with ACD were found in the 26-40 years age group. The self-atopy history was found in 7 patients (18.42%), while the family atopy history was found in only 3 patients (7.9%). Conclusion: Incidence of ACD to cosmetics was dominated by women. Besides ruling out the patient�s allergens with standard and cosmetic series, it is very useful to test with the patient�s cosmetic product. Keywords: Allergic contact dermatitis to cosmetic, patch testing, standard series, cosmetic series, and additional cosmetic products.

Kata Kunci : Allergic contact dermatitis to cosmetic, patch testing, standard series, cosmetic series, and additional cosmetic products.