Contact sensitization in atopic dermatitis: results of a prospective study of 89 cases in Tunisia

Belhadjali, H.; Mohamed, M.; Youssef, M.; Mandhouj, S.; Chakroun, M.; Zili, Jameleddine

doi:10.1111/j.1600-0536.2007.01248.x

Cited by 41 publications

(39 citation statements)

References 7 publications

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“…It has been shown that in a general population patch tested because of ACD suspicion, one of every six to seven ACD patients (14–16%) had multiple allergies 36. The amount of polysensitization we found exceeded this number.…”

Section: Discussionmentioning

confidence: 56%

Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

Boonstra

Rustemeyer

Middelkamp-Hup

2018

Acad Dermatol Venereol

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BackgroundConcomitant allergic contact dermatitis (ACD) has been described as a possible cause of atopic dermatitis (AD) becoming difficult‐to‐treat. However, contact sensitization in this patient group has barely been studied.ObjectiveTo study the occurrence of ACD in a population of difficult‐to‐treat AD children and adults.MethodsClinical and patch test information of 48 patients with difficult‐to‐treat AD unresponsive to conventional outpatient treatments was gathered retrospectively. We studied prevalence and relevance of common allergens, performed dynamic patch test analysis and assessed occurrence of polysensitization.ResultsIn 48 patients with difficult‐to‐treat AD, 75% (n = 36/48) had a concomitant contact allergy, and 39% (n = 14/36) of these patients were polysensitized. ACD and polysensitization prevalences were equal amongst children and adults. The most frequent and relevant reactions were seen against wool alcohols, surfactants cocamidopropyl betaine and dimethylaminopropylamine, bichromate and fragrance mix I. Dynamic pattern analysis showed these reactions to be mostly allergic and not irritative of nature.ConclusionDifficult‐to‐treat AD patients frequently suffer from concomitant (multiple) contact allergies, and this may be a reason why the AD turns into a difficult‐to‐treat disease. Awareness of this phenomenon is necessary, as pragmatic implementation of allergen avoidance strategies may be helpful in getting disease control in this population.

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Section: Discussionmentioning

confidence: 56%

Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

Boonstra

Rustemeyer

Middelkamp-Hup

2018

Acad Dermatol Venereol

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“…In the literature, most studies stated NS as being the most common contact allergen, at a frequency of 14.9%-59.1% in patients with positive patch test reactions (2)(3)5,7,17). Accordingly, in our study population, NS was the most common positive reaction with a frequency of 37.8% (17/45).…”

Section: Discussionmentioning

confidence: 84%

“…These may be taken into account as warning points for investigating children with AD for possible contact sensitization. In the literature, the frequency of contact sensitization of children with AD was reported as 6.2% to 89% in different countries worldwide (2)(3)(4)(5)(6)(7). This wide range of frequency may be due to the usage of different contact allergen panels and inclusion of different age groups of children in different studies.…”

Section: Discussionmentioning

confidence: 99%

The patterns and clinical relevance of contact allergen sensitization in a pediatric population with atopic dermatitis

Akan¹,

Toyran²,

Vezir³

et al. 2015

Turk J Med Sci

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Background/aim: Data about contact allergen sensitization (CAS) in children with atopic dermatitis (AD) are limited. The purpose of this study was to identify the frequency and patterns of CAS in children with AD by using a ready-to-use patch test system. Materials and methods:After receiving the history of CAS in the patients, the severity of AD and IgE-mediated allergen sensitization were determined.Results: Of 134 children with AD, 33.8% (n = 45) had at least 1 positive reaction. The most frequent positive reaction was to nickel sulfate (NS) (37.8%, 17/45), followed by methylchloroisothiazolinone (20.0%, 9/45) and thimerosal (15.6%, 7/45). The total Scoring Atopic Dermatitis (SCORAD) score was significantly higher in the NS-sensitized group (P = 0.036). The patients with NS sensitization had moderate-severe AD more frequently than those without any reaction (P = 0.020). When the SCORAD score was evaluated in detail, extent of eczema, score of sleep loss, and pruritus were significantly higher in the patients with NS sensitization than those without any reaction (P = 0.002, P = 0.001, and P = 0.002, respectively). Conclusion:Our study confirms the necessity of CAS in the management of AD. In particular, NS sensitization should be considered for children with severe AD or larger extent of eczema and trunk involvement.

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“…122 However, more recent studies show that rates of ACD or contact sensitization to common allergens, such as nickel, cobalt, thimerosal, and fragrance mix, are at least as frequent in patients with AD as in the general population, with frequency rates of up to 40%. 11,123-125 A more recent study has reported significantly higher sensitization rates (65.0%) in atopic subjects compared with those seen in nonatopic subjects (57.4%). 126 …”

Section: A Disturbed Barrier Promotes Immune Activation: Experimentalmentioning

confidence: 95%

“…132 Both the extent and severity of AD in children, as measured by the Eczema Area and Severity Index score, as well as the duration of the disease in both children and adults, have been found to correlate with the prevalence of contact sensitization, further underscoring this association between AD and ACD. 123,129 …”

Section: A Disturbed Barrier Promotes Immune Activation: Experimentalmentioning

confidence: 99%

Atopic dermatitis results in intrinsic barrier and immune abnormalities: Implications for contact dermatitis

Gittler

Krueger

Guttman‐Yassky

2013

Journal of Allergy and Clinical Immunology

195

130

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Atopic dermatitis (AD), as well as irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD), are common skin diseases. These diseases are characterized by skin inflammation mediated by activated innate immunity or acquired immune mechanisms. Although AD, ICD, and ACD can be encountered in pure forms by allergists and dermatologists, patients with AD often present with increased frequency of ICD and ACD. Although a disturbed barrier alone could potentiate immune reactivity in patients with AD through increased antigen penetration, additional immune mechanisms might explain the increased susceptibility of atopic patients to ICD and ACD. This review discusses cellular pathways associated with increased skin inflammation in all 3 conditions and presents mechanisms that might contribute to the increased rate of ICD and ACD in patients with AD.

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Contact sensitization in atopic dermatitis: results of a prospective study of 89 cases in Tunisia

Cited by 41 publications

References 7 publications

Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

The patterns and clinical relevance of contact allergen sensitization in a pediatric population with atopic dermatitis

Atopic dermatitis results in intrinsic barrier and immune abnormalities: Implications for contact dermatitis

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