Duration of Dermatitis Before Patch Test Appointment Is Associated With Distance to Clinic and County Poverty Rate

BACKGROUND Contact dermatitis is a common disease that is associated with impaired quality of life. OBJECTIVE We examined the effect of travel distance and other socioeconomic factors on duration of dermatitis before presentation at the Duke Contact Dermatitis and Patch Testing Center. METHODS This is a retrospective study of patients who underwent patch testing from March 1, 2012, to August 1, 2018. Associations between duration of dermatitis, distance to clinic, and socioeconomic factors (age, race, payor group, county poverty rate, rural-urban status) were examined. RESULTS The median duration of dermatitis was 14 months (Q1 = 7 months; Q3 = 36 months), and the median distance to clinic was 18 miles (Q1 = 7 miles; Q3 = 45.9 miles). For a 50-mile increase in the distance from the patient's zip code to the clinic, the median duration of dermatitis increased by 17.9% (P < 0.001). For every 5% increase in the county poverty rate, the median duration of dermatitis increased by 16.3% (n = 29; P = 0.032). Trends were noted for a longer duration of dermatitis based on insurance payor, rural-urban status, and race. CONCLUSIONS Distance to patch test provider and county poverty status are important measures of access for patients with dermatitis.