Gender differences in allergic contact dermatitis to common allergens

Abstract

Background: Gender-based differences in skin structure, physiology, and allergen exposure can influence contact dermatitis development. Objective: This study investigated the differences and trends in contact sensitizers, focusing on the top 10 allergens and personal care product (PCP) contact allergies from a gender perspective. Methods: We conducted a retrospective chart review of 5998 patients undergoing patch testing at an occupational and contact dermatitis clinic in a Thai, university-based, tertiary referral hospital from January 2001 to December 2021. Patients' characteristics and patch test results were collected. Results: Females had a higher positive patch test rate than males (71.8% vs. 65%, p < 0.001). However, males showed a greater prevalence of occupationally related allergic contact dermatitis (15.9%). Multivariate analysis revealed associations between being female and allergies to colophonium (aOR 1.46, 95% CI 1.07–1.99, p = 0.019), formaldehyde (aOR 1.97, 95% CI 1.17–13.31, p = 0.010), fragrance mix I (aOR 1.66, 95% CI 1.34–2.07, p < 0.001), MCI/MI (aOR 2.55, 95% CI 1.90–3.44, p < 0.001), neomycin (aOR 4.15, 95% CI 2.54–6.80, p < 0.001), and nickel (aOR 2.62, 95% CI 2.17–3.15, p < 0.001). Conversely, being male correlated with allergies to carba mix (aOR 0.51, 95% CI 0.41–0.64, p < 0.001), epoxy resin (aOR 0.26, 95% CI 0.14–0.47, p < 0.001), n-isopropyl-n-phenyl-4-phenylenediamine (aOR 0.41, 95% CI 0.20–0.83, p = 0.014), paraben mix (aOR 0.42, 95% CI 0.32–0.56, p < 0.001), and potassium dichromate (aOR 0.70, 95% CI 0.58–0.84, p < 0.001). Positive reactions to PCPs stood at 13% overall (males 17.1%, females 12.2%, p < 0.001). Conclusions: Gender plays a pivotal role in contact dermatitis. This work emphasises the importance of considering gender-specific factors when diagnosing and managing contact allergies.