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Sandoval A, Jung Y, Kim I, Sadigh N, Kwon J, Demirdag YY, Naderi AG, Jean T. Evaluation of atopic diseases in patients with allergic contact dermatitis. Allergy Asthma Proc 2024; 45:262-267. [PMID: 38982608 DOI: 10.2500/aap.2024.45.240019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Background: There is controversy on whether allergic contact dermatitis (ACD) is associated with atopy. Research on eczema and the risk of ACD is mixed, and there is sparse literature on other atopic conditions. Objective: Our study examined the prevalence of several atopic conditions, including allergic rhinitis, eczema, asthma, and food allergies in patients with ACD, and compared these to patients without ACD. Methods: We retrospectively reviewed adult patients ages ≥ 18 years with ACD (n = 162) with positive patch testing results and documented any history of atopy, including childhood eczema, asthma, allergic rhinitis, and immunoglobulin E-mediated food allergy. The prevalence of atopic conditions was compared between our ACD cohort and controls without ACD (n = 163) from our electronic medical records system (age and gender matched). Results: Among our patients with ACD, 53 (33%) had allergic rhinitis, 22 (14%) had childhood eczema, 32 (20%) had asthma, and 8 (5%) had food allergies. We observed that the odds of atopy overall (n = 76) in the ACD group compared with the control group were increased (odds ratio [OR] 1.88; p = 0.007). Allergic rhinitis was the highest risk factor (n = 53) with an OR of 12.64 (p < 0.001). Childhood eczema (n = 22) was also increased in the ACD group (OR 2.4; p = 0.026). The odds of asthma and food allergy in the ACD group were also increased; however, the difference was not statistically significant from the control group (OR 1.76 [p = 0.071] and OR 2.76 [p = 0.139], respectively). Conclusion: Patients with ACD had increased odds of eczema, allergic rhinitis, and atopic conditions overall. Asthma and food allergies were not found to have a statistically significant correlation. Larger studies that delve into atopic risk factors in ACD would be important to confirm these findings.
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Affiliation(s)
- Ashley Sandoval
- From the Division of Basic and Clinical Immunology, Department of Medicine, University of California Irvine, Orange, California
| | - Yela Jung
- From the Division of Basic and Clinical Immunology, Department of Medicine, University of California Irvine, Orange, California
| | - Iris Kim
- From the Division of Basic and Clinical Immunology, Department of Medicine, University of California Irvine, Orange, California
| | - Nina Sadigh
- Department of Allergy, Asthma, and Clinical Immunology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Jimmy Kwon
- Department of Statistics, University of California Irvine, Irvine, California, and
| | - Yesim Yilmaz Demirdag
- From the Division of Basic and Clinical Immunology, Department of Medicine, University of California Irvine, Orange, California
| | - Asal Gharib Naderi
- Division of Geriatric, Hospital, Palliative and General Internal Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Tiffany Jean
- Department of Allergy, Asthma, and Clinical Immunology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
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Guarneri F, Belloni Fortina A, Corazza M, Cristaudo A, Foti C, Parodi A, Pigatto P, Stingeni L, DE Pità O. Topical non-pharmacological treatment of eczema: an Italian consensus. Ital J Dermatol Venerol 2022; 157:402-413. [PMID: 36213968 DOI: 10.23736/s2784-8671.22.07283-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Eczematous diseases (contact dermatitis, atopic dermatitis, hand eczema) are among the most frequent findings in dermatological clinical practice. A large body of evidence exists on structural and functional skin barrier damage in eczematous diseases, and on the importance of interventions aimed to repair such damage. While there is substantial agreement on pharmacological treatment, more sparse data are available on role, indications and usefulness of topical non-pharmacological treatments, despite significant research and progress in the composition and technology of emollients, cleansers and barrier creams significantly changed and expanded the functional activities of these products. This often leads to inadequate prescription and/or use, which increase individual and social costs of the disease and make the products useless or, in some cases, even counterproductive. This consensus document, discussed and compiled in a series of meetings by a group of Italian dermatologists experienced in the field of eczematous diseases, summarizes epidemiology and clinical features of the nosological entities of the "eczema family", illustrates the chemical/biochemical structure of emollients, cleansers and barrier creams, and aims to help physicians to exploit the full potential of available products, by providing a detailed but practical guide on characteristics, indications and correct use of non-pharmacological treatments currently available for eczematous diseases.
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Affiliation(s)
- Fabrizio Guarneri
- Unit of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy -
| | - Anna Belloni Fortina
- Unit of Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Monica Corazza
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Caterina Foti
- Department of Biomedical Sciences and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Paolo Pigatto
- Unit of Dermatology, Department of Surgical and Odontoiatric Biomedical Sciences, Galeazzi IRCCS Orthopedic Institute, Milan, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Ornella DE Pità
- Unit of Clinical Pathology, Inflammatory and Autoimmune Skin Diseases, Cristo Re Hospital, Rome, Italy
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Patruno C, Potestio L, Napolitano M. Clinical phenotypes of adult atopic dermatitis and related therapies. Curr Opin Allergy Clin Immunol 2022; 22:242-249. [PMID: 35786802 DOI: 10.1097/aci.0000000000000837] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To report current knowledge on the different clinical phenotypes of adult atopic dermatitis. Possible therapeutic intervention in relation to phenotype is also evaluated. RECENT FINDINGS Atopic dermatitis is a chronic inflammatory disease affecting up to 10% of adults. It can manifest with different clinical phenotypes, causing diagnostic difficulties. Long-term is often required and systemic drugs are needed for moderate-to-severe forms. However, few drugs are registered for atopic dermatitis in many countries. Furthermore, limited data exist regarding the treatment in relation to individual clinical phenotypes. SUMMARY Currently, the most relevant data are those for cyclosporine, alitretinoin, and dupilumab. Cyclosporine and dupilumab showed to be effective in the treatment of atopic dermatitis, although in trials and real-life experiences the different phenotypes treated are usually not reported. However, cyclosporine appears to be effective in prurigo nodularis. Alitretinoin is reported to be particularly efficacious for atopic dermatitis of the hands, while it is ineffective for other locations of the disease. Dupilumab demonstrated its efficacy in prurigo nodularis and nummular eczema phenotypes of atopic dermatitis; moreover, especially in elderly patients, its effectiveness seems to be faster if the folds of the limbs are involved.
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Affiliation(s)
- Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples
| | - Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
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Yüksel YT, Nørreslet LB, Thyssen JP. Allergic Contact Dermatitis in Patients with Atopic Dermatitis. CURRENT DERMATOLOGY REPORTS 2021. [DOI: 10.1007/s13671-021-00335-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Piquero-Casals J, Carrascosa JM, Morgado-Carrasco D, Narda M, Trullas C, Granger C, Fabbrocini G. The Role of Photoprotection in Optimizing the Treatment of Atopic Dermatitis. Dermatol Ther (Heidelb) 2021; 11:315-325. [PMID: 33582977 PMCID: PMC8019014 DOI: 10.1007/s13555-021-00495-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/23/2021] [Indexed: 01/31/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with an estimated prevalence of 10-15% in children and 2-10% in adults. Clinically, there is notable phenotypic variability driven by a complex interaction between genetics, immune function, and the environment. Impairment of the skin barrier plays a significant role in the pathogenesis of AD. The apparent beneficial effect of sunlight in patients with atopic eczema is questioned due to its capacity to disrupt the skin barrier and generate free radicals that can damage proteins, lipids, and DNA. The sum of the external factors that an individual is exposed to throughout their lifetime is termed the exposome. Environmental factors such as sun exposure, temperature, and humidity contribute to both AD flares and regional prevalence variation. Literature on photoprotection in atopic dermatitis is very scarce. The use of adequate sunscreens in atopic dermatitis can ensure the level of photoprotection required to prevent skin photoaging and skin cancer and to mitigate skin barrier dysfunction, decrease inflammation, and neutralize facial redness. Herein we discuss and review the role of UV radiation and the exposome in the etiology of AD, as well as the role of adequate photoprotection.
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Affiliation(s)
| | - José Manuel Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma of Barcelona, IGTP, Badalona, Spain
| | - Daniel Morgado-Carrasco
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | | | | | | | - Gabriella Fabbrocini
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
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Patch Test Results to European Baseline Series in Turkey: A Prospective and Multicenter Study. Dermatitis 2021; 32:397-405. [PMID: 33731647 DOI: 10.1097/der.0000000000000631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Patch testing with the European Baseline Series (EBS) is an essential diagnostic tool for the assessment of allergic contact dermatitis. OBJECTIVE The aims of the study were to describe the most common contact allergens identified with patch testing in Turkey and to establish the distribution of contact allergens among different regions in Turkey. PATIENTS AND METHODS Twelve centers consisting of tertiary health care institutions were included in the study. A total of 1169 patients were patch tested with the EBS from 2015 to 2017. RESULTS A total of 596 patients (51.0%) had 1 or more positive patch test reactions to the EBS. A total of 30.2% (n = 353) of those tested had clinical relevance. Contact sensitivity was more common in young patients. The most common 10 allergens were nickel sulfate (20.4%), followed by textile dye mix (8.6%), cobalt chloride (8.3%), potassium dichromate (8.0%), p-phenylenediamine base (4.5%), balsam of Peru (4.3%), methylchloroisothiazolinone/methylisothiazolinone (3.8%), thiuram mix (3.6%), fragrance mix I (3.0%), and methylisothiazolinone (2.9%). CONCLUSIONS This study provides a comprehensive profile of patch test results with the EBS in Turkey. An ongoing decrease in contact allergy to methylchloroisothiazolinone/methylisothiazolinone and methylisothiazolinone was observed. Textile dye mix and p-phenylenediamine are beginning to pose a new risk in Turkey.
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Ferrillo M, Patruno C, Villani A, Scalvenzi M, Fabbrocini G, D'Andrea M, Napolitano M. Dermoscopic assessment of long-term systemic therapy with dupilumab in adult atopic dermatitis. J Eur Acad Dermatol Venereol 2020; 34:e701-e703. [PMID: 32239552 DOI: 10.1111/jdv.16409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- M Ferrillo
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - C Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - A Villani
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - M Scalvenzi
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - M D'Andrea
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - M Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
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Patruno C, Amerio P, Chiricozzi A, Costanzo A, Cristaudo A, Cusano F, Foti C, Girolomoni G, Guarneri F, Naldi L, Offidani A, Pigatto P, Prignano F, Stingeni L, Calzavara-Pinton P. Optimizing a clinical guidance for diagnosis of atopic dermatitis in adults: joint recommendations of the Italian Society of Dermatology and Venereology (SIDeMaST), Italian Association of Hospital Dermatologists (ADOI), and Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA). GIORN ITAL DERMAT V 2019; 155:1-7. [PMID: 31840484 DOI: 10.23736/s0392-0488.19.06522-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Atopic dermatitis (AD) places significant burden not only on quality of life, but is also associated with considerable costs to healthcare systems. Diagnosis of AD may be challenging when it starts in adolescence or adulthood, and is further complicated as its manifestations are different from those generally seen in children. Accordingly, better definition of diagnostic criteria for adult onset AD is needed to avoid misdiagnosis and undertreatment in adult patients. To provide practical guidance for clinicians to reliably diagnose AD in adult patients, representatives from three Italian dermatology scientific societies (Italian Society of Dermatology and Venereology [SIDeMaST], Italian Association of Hospital Dermatologists [ADOI], Italian Society of Allergological, Occupational and Environmental Dermatology [SIDAPA]) carried out a joint consensus meeting to develop useful indications for improving diagnosis of moderate to severe AD in adult patients in routine clinical practice. The most representative criteria for morphological criteria, localization, clinical history, and differential diagnosis were identified by the experts. The most frequent clinical presentations are those on the flexural areas, hands, face/neck, and trunk, with itch and eczema as key manifestations. The diagnostic path defined herein can form a sort of "check list" for physicians to adopt when evaluating patients with suspected AD, which can help in refining a diagnosis and refer the patient for specialist dermatological care. It is hoped that the practical guidance developed by the consensus group will help to improve outcomes, lower overall costs of care, and ameliorate the patient's quality of life, even though validation in a large cohort of patients is still needed.
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Affiliation(s)
- Cataldo Patruno
- Section of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy -
| | - Paolo Amerio
- Department of Medicine and Aging Sciences, Clinic of Dermatology, G. D'Annunzio Chieti-Pescara University, Chieti, Italy
| | - Andrea Chiricozzi
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Catholic University, Rome, Italy
| | | | - Antonio Cristaudo
- Department of Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | | | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Fabrizio Guarneri
- Department of Clinical and Experimental Medicine-Dermatology, University of Messina, Messina, Italy
| | - Luigi Naldi
- Department of Dermatology, San Bortolo Hospital, Vicenza, Italy
| | - Annamaria Offidani
- Unit of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Paolo Pigatto
- Unit of Dermatology, Department of Biomedical, Surgical and Dental Sciences, Galeazzi Orthopedic Institute IRCCS, University of Milan, Milan, Italy
| | - Francesca Prignano
- Unit of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
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