Occupational autoeczematization or atopic eczema precipitated by occupational contact dermatitis?

Williams, Jason D.; Cahill, Jennifer; Nixon, Rosemary

doi:10.1111/j.1600-0536.2007.01005.x

Cited by 34 publications

(15 citation statements)

References 25 publications

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“…AD is the most common cause of occupational dermatitis and doubles the risk of developing irritant dermatitis, particularly in occupations involving wet work 57 . In atopic adults, occupational contact dermatitis can precipitate generalized eczema with an AD pattern 58 . Eczema can persist even after removal from a high‐risk occupation 57,58 .…”

Section: Triggers Of Admentioning

confidence: 99%

“…In atopic adults, occupational contact dermatitis can precipitate generalized eczema with an AD pattern 58 . Eczema can persist even after removal from a high‐risk occupation 57,58 . Thus, pre‐employment counselling of adolescents and adults with atopic eczema is important 57,58 …”

Section: Triggers Of Admentioning

confidence: 99%

“…Eczema can persist even after removal from a high‐risk occupation 57,58 . Thus, pre‐employment counselling of adolescents and adults with atopic eczema is important 57,58 …”

Section: Triggers Of Admentioning

confidence: 99%

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Atopic dermatitis in older patients: particular points

Κατσαρού

Armenaka

2010

Journal of the European Academy of Dermatology and Venereology

103

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We review the particular characteristics of atopic dermatitis (AD) in adult life, and compare findings with those of AD in childhood. AD affects 1-3% of adults world-wide, and can present as adult-onset AD, or as infantile/childhood AD that persists, or recurs after many years. Eczema in adults usually exists for years, compromising quality of life, sex life and occupational choices. The flexural areas, shoulders, head-and-neck, and hands are typically affected. In elderly adults, eczematous erythroderma is common. The intrinsic (non-IgE-allergic) eczema subtype affects 5-15% of cases. Classical food allergy has a low importance, although non-IgE-mediated and pseudoallergic reactions can cause eczema. Sensitivity to aeroallergens, especially dust mite, is demonstrated in the majority of adult AD patients, including elderly adults, by immunoglobulin E-mediated tests and/or atopy patch tests. Occupational allergic and irritant contact dermatitis is increased. In adults, as in children, Staphylococcus aureus colonization is very high, whereas adult skin is more heavily colonized with Malassezia yeasts. Immediate and delayed sensitization to Malassezia sympodialis is specific for intrinsic and extrinsic AD, occurring especially in head-and-neck eczema. Concerning therapy, older patients are prone to certain adverse drug effects. In conclusion, differences exist between childhood and adult disease. As we should be seeing more adults with AD in the future, there is a need for more clinical and immunological studies in older patients.

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Section: Triggers Of Admentioning

confidence: 99%

Section: Triggers Of Admentioning

confidence: 99%

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Atopic dermatitis in older patients: particular points

Κατσαρού

Armenaka

2010

Journal of the European Academy of Dermatology and Venereology

103

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“…Thus, it is of great interest to scale up occupational education and prevention measures in this group [25]. Additionally, Williams et al [27] have described cases of occupational contact dermatitis that interact with atopy to cause endogenous-like eczema, even in people who have been asymptomatic since childhood [12,15]. This scenario is probably not rare, as we have seen patients with acute episodes of AD brought on by working conditions (eg, heat, dust, and other contaminants) whose disease subsided completely after changing job responsibilities.…”

Section: Clinical Patternsmentioning

confidence: 99%

Atopic Dermatitis in Adults: A Diagnostic Challenge

Salvador¹,

Romero‐Pérez²,

Encabo-Durán³

2017

J Investig Allergol Clin Immunol

150

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Atopic dermatitis (AD) has a prevalence of 1%-3% in adults. Adult-onset AD has only been defined recently, and lack of familiarity with this condition and confusion regarding the appropriate terminology persist. AD may first appear in childhood or de novo in adults and is characterized by pronounced clinical heterogeneity. The disease often deviates from the classic pattern of flexural dermatitis, and there are forms of presentation that are specific to adults, such as head-and-neck dermatitis, chronic eczema of the hands, multiple areas of lichenification, or prurigo lesions. Although diagnosis is clinical, adult-onset AD frequently does not fit the traditional diagnostic criteria for the disease, which were developed for children. Thus, AD is often a diagnosis of exclusion, especially in de novo cases. Additional diagnostic tests, such as the patch test, prick test, skin biopsy, or blood test, are usually necessary to rule out other diseases or other types of eczema appearing concomitantly with AD. This article presents an update of the different forms of clinical presentation for AD in adults along with a proposed diagnostic approach, as new treatments will appear in the near future and many patients will not be able to benefit from them unless they are properly diagnosed. Key words: Atopic dermatitis. Adult. Diagnosis. Patch testing. Prick testing. ResumenLa dermatitis atópica (DA) en el adulto tiene una prevalencia del 1-3%. Es una entidad de reciente acuñamiento, que no todo el mundo conoce y sobre la que existe una gran confusión terminológica. Puede iniciarse en la infancia o presentarse de "novo" en el adulto. Presenta una gran heterogeneidad clínica y con frecuencia no sigue el patrón clásico de dermatitis flexural. Además, existen formas de presentación más propias de adulto como son la dermatitis de la cabeza y el cuello, eczema crónico de manos, áreas de liquenificación múltiple o lesiones de prurigo. Aunque su diagnóstico es clínico, muchas veces la DA del adulto no cumple los criterios diagnósticos "clásicos" de DA, pues están pensados para niños. Por eso, suele ser un diagnóstico de exclusión, sobre todo los casos de "novo". Suele precisar de la realización de pruebas diagnósticas para descartar otras enfermedades distintas u otro tipo de eczema sobreañadido a la DA. Las pruebas diagnósticas que pueden resultar útiles para ello son: pruebas epicutáneas, prick test, biopsia cutánea y una analítica sanguínea. Realizamos una actualización de las distintas formas de presentación clínica de la DA del adulto y establecemos unas pautas para llegar a su diagnóstico, pues en un futuro inmediato, con la aparición de nuevos tratamientos, muchos de estos pacientes no podrán beneficiarse de los mismos por no estar adecuadamente diagnosticados. Palabras clave: Dermatitis atópica. Adulto. Diagnóstico. Pruebas epicutáneas. Prick test.

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“…Thus, repeated topical exposure of mice to haptenic chemicals is associated with atopic dermatitis‐like skin lesions . Moreover, occupational exposure to irritants and/or haptenic chemicals has been reported to cause a localized flare of previously inactive atopic dermatitis . Oral consumption of haptenic drugs such as antibiotics and paracetamol has also been implicated in the subsequent development of atopic disease.…”

Section: Discussionmentioning

confidence: 99%

The hapten-atopy hypothesis III: the potential role of airborne chemicals

et al. 2014

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One explanation for the large increase in the prevalence of atopic disease in developed countries during the last 50 years is the 'hygiene hypothesis'. This proposes that a reduced exposure to pathogenic microorganisms at a key period(s) during development results in the maintenance or acquisition of an atopic phenotype. Alternatively, or additionally, we have postulated that increased exposure to chemicals generally, and to irritant/haptenic chemicals in particular, during critical windows of maternal pregnancy/early life have also contributed to changes in the prevalence of atopic disease. Having previously reviewed the potential roles of oral and cutaneous exposure to chemicals on the subsequent diagnosis of atopic disease, we here consider possible evidence of a role for exposure to airborne chemicals as a contributory factor in acquired susceptibility to atopic allergy. After controlling for known confounders, five specific maternal occupations during pregnancy have been implicated as being associated with subsequent atopic disease in the offspring. Each of these occupations is characterized by high and persistent exposure to airborne chemicals. High-level exposure to volatile organic compounds in the domestic environment, either during pregnancy or in early life, is also associated with development of childhood atopic disease. Similarly, sustained exposure to airborne chlorinated chemicals from swimming pools during childhood has been associated with the development of atopic allergy. A possible immunological basis for these associations is that exposure to certain airborne chemicals, even at low levels, can result in the delivery of 'danger' signals that, in turn, bias the immune response towards the selective induction or maintenance of preferential T helper 2-type immune responses consistent with the acquisition of allergic sensitization.

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Occupational autoeczematization or atopic eczema precipitated by occupational contact dermatitis?

Cited by 34 publications

References 25 publications

Atopic dermatitis in older patients: particular points

Atopic dermatitis in older patients: particular points

Atopic Dermatitis in Adults: A Diagnostic Challenge

The hapten-atopy hypothesis III: the potential role of airborne chemicals

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