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Choi YJ, Byun JY, Choi YW, Roh JY, Choi HY. Analysis of Positive Patch Test Allergens in Allergic Contact Dermatitis Patients with Atopic Dermatitis. Ann Dermatol 2023; 35:303-312. [PMID: 37550231 PMCID: PMC10407336 DOI: 10.5021/ad.23.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/22/2023] [Accepted: 04/11/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND There has been debate regarding whether patients with atopic dermatitis (AD) have an altered frequency of contact allergen sensitization. Increased exposure to topical medications and moisturizers as well as impaired skin barrier function increase the risk of contact sensitization, whereas the Th2-skewed inflammatory pathway of AD is associated with a reduced risk. OBJECTIVE This retrospective study was performed to determine the characteristics of contact sensitization in allergic contact dermatitis (ACD) patients with a current or past history of AD. METHODS A clinical record review was conducted for patients referred to Ewha Womans University Medical Center, for patch tests between March 2017 and March 2021. We compared the rates of contact sensitization between ACD patients with and without AD. RESULTS In total, 515 patch test results were reviewed and divided into the AD group (n=53) and non-AD group (n=462). The AD group showed decreased any-allergen positivity (1+, 2+, or 3+) (56.6%) compared to the non-AD group (72.9%) (p=0.013). The positivity rate for budesonide was significantly higher in the AD group (p=0.011), while the prevalence of a positive result for balsam of Peru was higher in the non-AD group (p=0.036). Nickel sulfate, cobalt chloride, and potassium dichromate were the most common sensitized allergens in both groups. CONCLUSION Our study shows a decreased prevalence of contact sensitization in AD patients compared to non-AD patients. Clinicians should be aware of the risk of corticosteroid allergies in ACD patients with history of AD.
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Affiliation(s)
- Yoon Jin Choi
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ji Yeon Byun
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea
| | - You Won Choi
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Joo Young Roh
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hae Young Choi
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea.
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Contact Allergy to Topical Drugs. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Someshwar S, Lodha A. Comparative evaluation of steroid sensitivity in various dermatoses with control group through histopathological examination and patch testing. MULLER JOURNAL OF MEDICAL SCIENCES AND RESEARCH 2021. [DOI: 10.4103/mjmsr.mjmsr_18_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Topical Drugs. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_38-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Goossens A, Gonçalo M. Contact Allergy to Topical Drugs. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_38-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Boonstra M, Rustemeyer T, Middelkamp‐Hup M. Both children and adult patients with difficult-to-treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized. J Eur Acad Dermatol Venereol 2018; 32:1554-1561. [PMID: 29578626 PMCID: PMC6175158 DOI: 10.1111/jdv.14973] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/08/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Concomitant 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. OBJECTIVE To study the occurrence of ACD in a population of difficult-to-treat AD children and adults. METHODS Clinical 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. RESULTS In 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. CONCLUSION Difficult-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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Affiliation(s)
- M. Boonstra
- Department of DermatologyVU University Medical CenterAmsterdamThe Netherlands
- Department of DermatologyAcademic Medical CenterAmsterdamThe Netherlands
| | - T. Rustemeyer
- Department of DermatologyVU University Medical CenterAmsterdamThe Netherlands
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Kot M, Bogaczewicz J, Kręcisz B, Woźniacka A. Contact allergy in the population of patients with chronic inflammatory dermatoses and contact hypersensitivity to corticosteroids. Postepy Dermatol Alergol 2017; 34:253-259. [PMID: 28670256 PMCID: PMC5471381 DOI: 10.5114/ada.2017.67848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 11/13/2016] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Clinical studies indicate that contact allergy to glucocorticosteroids (GCS) is not rare and has been increasingly reported over the past decade. Among the risk factors for developing contact hypersensitivity to topical corticosteroids, chronic inflammatory skin diseases and polyvalent contact allergy seem to be most important. AIM To present the structure of contact allergy in the population of patients with chronic inflammatory dermatoses (CID) and contact hypersensitivity to corticosteroids. MATERIAL AND METHODS Twenty-seven patients with contact allergy to GCS and chronic inflammatory dermatoses were patch tested with 28 European Baseline Series allergens and 8 corticosteroid allergens. This study group consisted of 5 patients with atopic dermatitis (AD), 15 patients with contact eczema (CE) and 7 with chronic leg eczema (CLE). Nineteen (70.4%) patients were females and 8 (29.6%) were males. RESULTS In the study group, the most sensitizing non-steroidal allergens were nickel sulfate (51.8%), cobalt chloride (33.3%) and balsam of Peru (29.6%). The most sensitizing corticosteroid allergens were budesonide (77.8%), betamethasone valerate and clobetasol propionate (55.5% each). A total of 77.8% of patients allergic to GCS also showed sensitivity to at least one non-steroidal allergen from the European Baseline Series. CONCLUSIONS The most important risk factors for developing contact allergy to corticosteroids appear to be chronic inflammatory dermatoses, long disease duration, extended on-and-off topical corticosteroid use, patients presenting two or more positive patch test results and polyvalent contact allergy to metal salts and to other non-steroidal haptens.
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Affiliation(s)
- Marek Kot
- Department of Dermatology and Venereology, Medical University of Lodz, Lodz, Poland
| | - Jarosław Bogaczewicz
- Department of Dermatology and Venereology, Medical University of Lodz, Lodz, Poland
| | - Beata Kręcisz
- Faculty of Medicine and Health Science, Jan Kochanowski University, Kielce, Poland
| | - Anna Woźniacka
- Department of Dermatology and Venereology, Medical University of Lodz, Lodz, Poland
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Dumycz K, Osinka K, Feleszko W. Contact allergens in topical corticosteroid vehicles: analysis of product composition. Contact Dermatitis 2017; 76:254-255. [DOI: 10.1111/cod.12693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 08/20/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Karolina Dumycz
- Department of Paediatric Respiratory Diseases and Allergy; The Medical University of Warsaw; 02-091 Warsaw Poland
| | - Katarzyna Osinka
- Department of Paediatric Respiratory Diseases and Allergy; The Medical University of Warsaw; 02-091 Warsaw Poland
| | - Wojciech Feleszko
- Department of Paediatric Respiratory Diseases and Allergy; The Medical University of Warsaw; 02-091 Warsaw Poland
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Deville S, Baré B, Piella J, Tirez K, Hoet P, Monopoli MP, Dawson KA, Puntes VF, Nelissen I. Interaction of gold nanoparticles and nickel(II) sulfate affects dendritic cell maturation. Nanotoxicology 2016; 10:1395-1403. [DOI: 10.1080/17435390.2016.1221476] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Sarah Deville
- Health Unit, Flemish Institute for Technological Research, Mol, Belgium,
- Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium,
| | - Birgit Baré
- Health Unit, Flemish Institute for Technological Research, Mol, Belgium,
- Lung Toxicology, Catholic University Leuven, Leuven, Belgium,
| | - Jordi Piella
- Inorganic Nanoparticles Group, Institut Català de Nanotecnologia, Campus UAB, Bellaterra, Spain,
- Universitat Autònoma de Barcelona, Campus UAB, Bellaterra, Spain,
| | - Kristof Tirez
- Health Unit, Flemish Institute for Technological Research, Mol, Belgium,
| | - Peter Hoet
- Lung Toxicology, Catholic University Leuven, Leuven, Belgium,
| | - Marco P. Monopoli
- Centre for BioNano Interactions, School of Chemistry and Chemical Biology, UCD Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland,
| | - Kenneth A. Dawson
- Centre for BioNano Interactions, School of Chemistry and Chemical Biology, UCD Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland,
| | - Victor F. Puntes
- Inorganic Nanoparticles Group, Institut Català de Nanotecnologia, Campus UAB, Bellaterra, Spain,
- Vall d’Hebron Institute of Research, Barcelona, Spain, and
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Inge Nelissen
- Health Unit, Flemish Institute for Technological Research, Mol, Belgium,
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The Impact of Corticosteroid Allergy. CURRENT TREATMENT OPTIONS IN ALLERGY 2016. [DOI: 10.1007/s40521-016-0089-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pediatric Allergic Contact Dermatitis: Lessons for Better Care. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2015; 3:661-7; quiz 668. [DOI: 10.1016/j.jaip.2015.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 02/17/2015] [Accepted: 02/17/2015] [Indexed: 11/22/2022]
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Correa da Rosa J, Malajian D, Shemer A, Rozenblit M, Dhingra N, Czarnowicki T, Khattri S, Ungar B, Finney R, Xu H, Zheng X, Estrada YD, Peng X, Suárez-Fariñas M, Krueger JG, Guttman-Yassky E. Patients with atopic dermatitis have attenuated and distinct contact hypersensitivity responses to common allergens in skin. J Allergy Clin Immunol 2015; 135:712-20. [DOI: 10.1016/j.jaci.2014.11.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 11/13/2014] [Accepted: 11/17/2014] [Indexed: 01/09/2023]
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