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Andre N, Usher A, Ofri M, Horev A. Exploring the relationship between allergic contact dermatitis and atopic dermatitis in children: insights from a retrospective patch testing analysis. Int J Dermatol 2024; 63:795-798. [PMID: 38219262 DOI: 10.1111/ijd.17021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Recent years have seen significant exploration into the potential link between allergic contact dermatitis and atopic dermatitis, yielding contradictory findings. METHODS A retrospective cohort analysis of children aged 2 to 18 who underwent patch testing at the pediatric dermatology clinic at a tertiary medical center in Israel was conducted. RESULTS Overall, 367 patients were included in the study, 31.6% of whom were diagnosed with atopic dermatitis. 160 children (43.6%) exhibited a positive reaction to at least one compound in the European baseline series. There was no statistically significant difference in reactivity between children with atopic dermatitis and those without (P = 0.848). Sub-analyses based on ethnicity, gender, and age did not reveal significant differences in overall European baseline series reactivity (P = 0.612, P = 0.446, P = 0.488, respectively). Sensitivity was notably higher when patch readings were conducted 72 h after application compared to 48 h [0.95 (CI: 0.91-0.97) vs. 0.60 (CI: 0.55-0.66)]. CONCLUSIONS Patch testing is imperative for suspected cases of allergic contact dermatitis in all children, regardless of their atopic background. Further research is warranted to potentially replace the traditional 48-h reading with a single 72-h reading in future guidelines, contributing to enhanced efficiency and cost-effectiveness in clinical practice.
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Affiliation(s)
- Nicolas Andre
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alisa Usher
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Pediatrics Department, Soroka University Medical Center, Beer Sheva, Israel
| | - Mai Ofri
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
| | - Amir Horev
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Dermatology Service, Soroka University Medical Center, Beer Sheva, Israel
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Trimeche K, Lahouel I, Belhadjali H, Salah NB, Youssef M, Zili J. Contact allergy in atopic dermatitis: A prospective study on prevalence, incriminated allergens and clinical insights. Contact Dermatitis 2024; 90:514-519. [PMID: 38151921 DOI: 10.1111/cod.14494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/10/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND The relationship between atopic dermatitis (AD) and allergic contact dermatitis (ACD) is a matter of debate. OBJECTIVES The purpose of our study is to assess the frequency of ACD in patients with AD, the incriminated allergens and the potential risk factors. METHODS This is a prospective study, including cases of AD diagnosed based on Hanifin and Rajka's criteria. All patients were patch tested to the European baseline series and corticosteroid series. RESULTS Ninety-three patients were included. Fifty-six patients (60.2%) had positive patch test results of which 71.4% were relevant. The most frequent allergens were: textile dye mix (24.7%), nickel (20.4%), cobalt (12.9%), isothiazolinone (8.6%), quanterium 15 (4.3%) and balsam of Peru (4.3%). Chromium, fragrance mix I, fragrance mix II and PTBP were positive in three cases (3.2%). Two cases of allergy to corticoids were identified. Facial involvement and duration of AD were significantly associated with contact sensitization (p = 0.04 and p = 0.005, respectively). Avoidance of relevant allergens resulted in a statistically significant decrease in SCORAD (p < 0.001). CONCLUSIONS ACD remains an important co-morbidity of AD. We observed a high frequency of ACD to textile dyes, isothiazolinones and fragrances. Avoidance of relevant allergens has resulted in an improvement of patients' skin symptoms.
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Affiliation(s)
- Khaoula Trimeche
- Dermatology Department, Fattouma Bourguiba Hospital, University of Monastir, Monastir, Tunisia
| | - Ines Lahouel
- Dermatology Department, Fattouma Bourguiba Hospital, University of Monastir, Monastir, Tunisia
| | - Hichem Belhadjali
- Dermatology Department, Fattouma Bourguiba Hospital, University of Monastir, Monastir, Tunisia
| | - Nesrine Ben Salah
- Dermatology Department, Fattouma Bourguiba Hospital, University of Monastir, Monastir, Tunisia
| | - Monia Youssef
- Dermatology Department, Fattouma Bourguiba Hospital, University of Monastir, Monastir, Tunisia
| | - Jameleddine Zili
- Dermatology Department, Fattouma Bourguiba Hospital, University of Monastir, Monastir, Tunisia
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Kalay Yildizhan I, Boyvat A. The Contact Sensitivity of Turkish Children and Adolescents to European Baseline Series Allergens between 2013 and 2023. Dermatol Pract Concept 2024; 14:dpc.1402a151. [PMID: 38810081 PMCID: PMC11135937 DOI: 10.5826/dpc.1402a151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2023] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Increasing the numbers of patch testing in suspected children increases the rate of diagnosis of allergic contact dermatitis and the identification of clinically relevant allergens. OBJECTIVE The aim of this study was to identify the most frequently observed allergens among Turkish children and adolescents patch-tested in 2013-2023. METHODS The patch test results of 160 patients (age ≤18) were analyzed retrospectively. The frequency of contact allergens and distribution of positive results in terms of sex, age group (children and adolescents), and the presence of atopic dermatitis (AD) were identified. RESULTS Forty-nine patients (30.6%) (34 girls and 15 boys) exhibited positive patch test reactions to a minimum of one allergen, and contact sensitivity was statistically significantly higher in girls (P=0.034). The five most frequent allergens were nickel sulfate (10.6%), MCI/MI (8.1%), cobalt chloride (5.6%), p-phenylenediamine (PPD) (5%), and MI (3.5%). No significant association was observed between patch test positivity and age groups (P>.05). Nickel sulfate sensitivity was significantly higher in girls than in boys (P=.043). A positive reaction was detected in 31.3% of patients with AD and in 33.7% of those without (P>.05), and a statistically significant relationship was observed between contact sensitivity to fragrance allergens and AD (P=.046). CONCLUSION Metals and preservatives represent the most frequent allergens in Turkish children and adolescents. Metal sensitivity is expected to decrease as legislation is enforced. Regulatory measures are now required to reduce MI and MCI/MI contact allergy in Turkey.
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Affiliation(s)
| | - Ayse Boyvat
- Department of Dermatology, School of Medicine, Ankara University, Ankara, Turkey
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Stingeni L, Bianchi L, Caroppo ES, Belloni Fortina A, Caroppo F, Corazza M, Borghi A, Gallo R, Trave I, Ferrucci SM, Beretta A, Guarneri F, Martina E, Napolitano M, DE Lucia M, Patruno C, Bennardo L, Romita P, Foti C, Tramontana M, Marietti R, Argenziano G, Hansel K. The new Italian SIDAPA Baseline Series for patch testing (2023): an update according to the new regulatory pathway for contact allergens. Ital J Dermatol Venerol 2024; 159:83-104. [PMID: 38650492 DOI: 10.23736/s2784-8671.24.07733-8] [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: 04/25/2024]
Abstract
Allergic contact dermatitis (ACD) is a common inflammatory skin disease caused by delayed hypersensitivity to chemical and biotic contact allergens. ACD significantly affects the patients' quality of life negatively impacting both occupational and non-occupational settings. Patch testing is the gold standard diagnostic in vivo test to precise the ACD etiology and to correctly perform prevention. According to the Italian Medicines Agency (AIFA) legislative decree no. 178 of 29th May 1991, allergens are defined as medicines and therefore they are subject to strict regulation. In 2017, AIFA (decree no. 2130/2017) started a procedure to regulate contact allergens on the Italian market and actually the contact allergens temporarily authorized are reported in AIFA decree no. 98/2022, valid until November 2023. The availability on the market of contact allergens to diagnose ACD and continuous updating on the basis of new epidemiological trends are mandatory, jointly with the continuous update of the baseline and integrative series for patch testing. For this reason, the scientific community represented in Italy by the Skin Allergies Study Group of SIDeMaST (Italian Society of Dermatology and Venereology) and SIDAPA (Italian Society of Allergological, Occupational and Environmental Dermatology) are constantly working, in close relationship with the European scientific communities with large expertise in this important sector of the modern Dermatology. Herein, we report the setting up of regulatory legislation by AIFA and the new Italian Adult Baseline Series for patch testing.
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Affiliation(s)
- Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy -
| | - Leonardo Bianchi
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elena S Caroppo
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | | | - Monica Corazza
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Borghi
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Rosella Gallo
- Division of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Ilaria Trave
- Division of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Silvia M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Beretta
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabrizio Guarneri
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Emanuela Martina
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mario DE Lucia
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Cataldo Patruno
- Section of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Luigi Bennardo
- Section of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Marta Tramontana
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Rossella Marietti
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, "Luigi Vanvitelli" University of Campania, Naples, Italy
| | - Katharina Hansel
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Barwari L, Rustemeyer T, Franken SM, Ipenburg NA. Patch test results in a Dutch paediatric population with suspected contact allergy: A retrospective cohort study. Contact Dermatitis 2023; 88:120-128. [PMID: 36183152 PMCID: PMC10091938 DOI: 10.1111/cod.14231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) in paediatric patients is on the rise. Continuous identification of emerging allergens is of great importance to ensure accurate patch testing. OBJECTIVES To assess the frequency and relevance of contact sensitivity in children and adolescents and evaluate changes in sensitization rates in the last decade. METHODS All patients with suspected ACD who underwent patch testing at the Amsterdam University Medical Centers between 2015 and 2021 were included. RESULTS Of 439 patients tested with the European Baseline Series (EBS) and additional series, 334 (76%) patients had at least 1 positive reaction and 172 patients (39%) had 1 or more relevant positive reactions. If additional series would have been omitted, 20% of patients would have been underdiagnosed. Compared to patients tested between 1996 and 2013, reactions to metal allergens, isothiazolinones, methyldibromo glutaronitrile, carba mix, amerchol L-101, and benzophenone-4 were more frequently observed. CONCLUSIONS This study confirms the need for patch testing in paediatric patients suspected of having ACD. For accurate patch testing, it is advised to include additional series.
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Affiliation(s)
- Lizan Barwari
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Sylvie M Franken
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Norbertus A Ipenburg
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
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Cattani CAS, Oppermann K, Perazzoli S, Guarda NH, Baréa P, Bonamigo RR. Sensitizing agents found in children and adolescents with recalcitrant atopic dermatitis: a cross-sectional study with a pediatric battery. An Bras Dermatol 2022; 97:307-314. [PMID: 35241316 PMCID: PMC9133262 DOI: 10.1016/j.abd.2021.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Atopic dermatitis is the most common inflammatory skin disease in childhood and has an important impact on quality of life, especially severe cases or those that are recalcitrant to treatments. Sensitization to allergens with the potential for allergic contact dermatitis is a factor associated with cases of recalcitrant atopic dermatitis. Understanding the relationship between atopic dermatitis, allergens, and allergic contact dermatitis is essential. In Brazil, there are no studies on sensitization to allergens found in patch tests with pediatric batteries in patients with atopic dermatitis. OBJECTIVES To verify the main sensitizing agents, the prevalence of allergic contact dermatitis and the epidemiological and clinical profile of children and adolescents with atopic dermatitis. METHODS Cross-sectional, prospective study in patients between 4 and 18 years of age, with recalcitrant atopic dermatitis, treated at the Sanitary Dermatology Outpatient Clinic (RS). All patients underwent patch tests with a battery of pediatric allergens. RESULTS The prevalence of sensitization and allergic contact dermatitis in the evaluated patients was 37.07% (20/54) and 27.7% (15/54), respectively. The most frequent allergens were: nickel sulfate (16.7%), disperse blue (5.6%), and fragrance mix I (5.6%). Nickel was associated with the female sex (p = 0.019). STUDY LIMITATIONS Sample size and selection, absence of a control group. CONCLUSIONS A proportion of patients with recalcitrant atopic dermatitis may be sensitized to different allergens and may even have developed allergic contact dermatitis. Recognizing this context is important in the prevention strategy and management of the disease.
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Affiliation(s)
- Cristiane Almeida Soares Cattani
- Sanitary Dermatology Outpatient Clinic, Secretaria da Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil; Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Kenselyn Oppermann
- Sanitary Dermatology Outpatient Clinic, Secretaria da Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Simone Perazzoli
- Sanitary Dermatology Outpatient Clinic, Secretaria da Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Nathalia Hoffmann Guarda
- Sanitary Dermatology Outpatient Clinic, Secretaria da Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Paula Baréa
- Sanitary Dermatology Outpatient Clinic, Secretaria da Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Renan Rangel Bonamigo
- Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Abstract
BACKGROUND The patch test is the standard for diagnosing allergic contact dermatitis. Standardized trays allow the examination of the most prevalent allergens, whereas customized trays are more appropriate for addressing specific allergens and require expertise. They are therefore usually performed in specialized clinics. METHODS We assessed the results of 4355 patch tests performed between 2012 and 2020 in a contact dermatitis clinic located in a large tertiary medical center. All patients were tested using the European baseline series and additional trays as clinically indicated. We assessed the frequency of relevant positive reactions outside the European baseline series. We then examined the added value and number of tests (NNTs) that need to be performed to elicit one relevant positive reaction per tray and common allergens. RESULTS Nine hundred fifty-four patients (21.9%) had 1 or more positive relevant reactions; 43.3% tested positive for an allergen outside the European baseline series (OEBS). The acrylate and fragrance trays were highly represented among the positive and relevant reactions OEBS with NNTs of 4.4 and 6.8, respectively. 2-Hydroxyethyl methacrylate is the most prevalent allergen OEBS and is considered a marker for acrylate sensitivity with a high rate of cross-reactions and concordance rate of 85%, justifying its addition to the EBS in 2018. Other highly represented allergens include chloramphenicol, 2-hydroxyethyl acrylate, and Amerchol L-101, a lanolin derivative. The cosmetics and textile trays, although often tested, have relatively low added values of 3.7% and 2.3%, respectively. Surprisingly, the cutaneous adverse drug reaction series tray (CAD-1000) yielded no positive reactions, whereas testing the patients' medication yielded positive results in 10.9% of the cases. CONCLUSIONS Expanded patch testing is crucial to accurately diagnose allergic contact dermatitis and almost doubles the number of patients with relevant positive reactions. Acrylate sensitivity is an emerging epidemic with a high positive reaction rate and low NNT, as is sensitivity to the allergens in the fragrance tray. 2-Hydroxyethyl methacrylate is a reliable marker for acrylate sensitivity with a concordance rate of 85%. Chloramphenicol is a common culprit and should be added to the standard tray in countries with a high usage rate. A low NNT was also observed when testing the patients' own cosmetics and medications; this should, therefore, be encouraged. The textile tray yielded a relatively high NNT; however, it should be performed when clinically indicated in the absence of a reliable marker in the EBS.
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Bonamonte D, Hansel K, Romita P, Belloni Fortina A, Girolomoni G, Fabbrocini G, Patruno C, Napolitano M, Patrizi A, Argenziano G, Micali G, Pinton PC, Foti C, Stingeni L. Contact allergy in children with and without atopic dermatitis: an Italian multicenter study. Contact Dermatitis 2022; 87:265-272. [PMID: 35451136 PMCID: PMC9541036 DOI: 10.1111/cod.14130] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/30/2022]
Abstract
Background Contact allergy and atopic dermatitis (AD) are both common inflammatory T cell‐mediated diseases and many factors may influence the prevalence of contact allergy in AD patients. In children, their possible correlation was debated with conflicting results. Objectives The present study aimed to assess the prevalence of contact sensitivity in children and to investigate the association with AD. Materials and methods A retrospective multicentre study on children aged from 0 to 14 years patch tested between January 2017 and December 2018 was performed. Children were consecutively patch tested with the SIDAPA (Società Italiana Dermatologia Allergologica Professionale Ambientale) baseline series. Results Among the 432 children investigated for contact allergy, 125 (28.9%) showed a positive reaction to at least one of the allergens tested, with a higher prevalence of positive patch test reactions in girls (32.3%) than in boys (25.0%). The most frequent contact allergens were nickel sulphate (10.2%), cobalt chloride (6.7%), methylisothiazolinone (3.7%), fragrance mix‐2 (3.2%), potassium dichromate (2.8%), fragrance mix‐1 (2.1%) and methylchloroisothiazolinone/methylisothiazolinone (2.1%). One‐hundred‐three children (23.8%) suffered from AD showing a higher prevalence of positive patch test (36.9%) compared to children without AD (26.4%). Conclusions Despite the topic being still controversial, the present study suggests a consistent prevalence of contact allergy among children with higher sensitivity rate among children with AD than without AD.
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Affiliation(s)
- Domenico Bonamonte
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Katharina Hansel
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Anna Belloni Fortina
- Unit of Pediatric Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Giampiero Girolomoni
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Annalisa Patrizi
- Unit of Dermatology, IRCS Azienda Ospedaliero Universitaria, University of Bologna, Bologna, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | | | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Dupuy E, Miller M, Harter N. What We Have Learned–Milestones in Pediatric Contact Dermatitis. CURRENT DERMATOLOGY REPORTS 2022; 11:1-12. [PMID: 35369649 PMCID: PMC8959272 DOI: 10.1007/s13671-022-00353-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 11/24/2022]
Abstract
Purpose of Review This review highlights recent developments in the field of pediatric allergic contact dermatitis (ACD) and patch testing. We will review updates on the pathophysiology of contact dermatitis, discuss new contact allergens, explore the impact of dupilumab on patch testing, and provide pearls for the diagnosis and management of ACD in children. Recent Findings ACD is not a single immunologic phenomenon but rather has contributions from multiple inflammatory pathways. Emerging contact allergens include ingredients found in “slime” toys, glucose monitors and insulin pumps, and electronic equipment. Data thus far suggests that patch testing results are generally reliable in the face of concurrent dupilumab use. Summary ACD is likely underrecognized and underdiagnosed in pediatric patients, including infants and young children. Providers should keep patient-specific factors and emerging trends in mind when addressing suspected ACD, consider contact dermatitis when they encounter challenging cases of atypical, refractory, or chronic dermatitis, and feel comfortable performing patch testing in children.
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Affiliation(s)
- Elizabeth Dupuy
- Division of Pediatric Dermatology, Children’s Hospital Los Angeles, Los Angeles, CA USA
| | - Melanie Miller
- Department of Dermatology, LAC+USC Keck School of Medicine, Los Angeles, CA USA
| | - Nicole Harter
- Department of Dermatology, University of Nebraska Medical Center, Omaha, NE USA
- Division Chief, Pediatric Dermatology, Children’s Hospital & Medical Center Omaha, 8534 Cass St., Omaha, NE 68114 USA
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Özkaya E, Pehlivan G, Babuna Kobaner G. Sorbitan sesquioleate: A rare contact allergen per se but an important indicator for allergic contact dermatitis from cross-reacting compounds as well as for false-positive fragrance allergy. Clin Exp Dermatol 2022; 47:1291-1297. [PMID: 35245949 DOI: 10.1111/ced.15158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 02/12/2022] [Accepted: 03/01/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Esen Özkaya
- İstanbul University, İstanbul Faculty of Medicine, Department of Dermatology and Venereology, Istanbul, Turkey
| | - Gizem Pehlivan
- İstanbul University, İstanbul Faculty of Medicine, Department of Dermatology and Venereology, Istanbul, Turkey
| | - Goncagul Babuna Kobaner
- İstanbul University, İstanbul Faculty of Medicine, Department of Dermatology and Venereology, Istanbul, Turkey
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Wee C, Tan CH, Zhao X, Yew YW, Goon A. Pattern of contact sensitisation in patients with and without atopic dermatitis in an Asian dermatology centre. Contact Dermatitis 2022; 86:398-403. [PMID: 35133669 DOI: 10.1111/cod.14068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/28/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although the traditional understanding is that contact sensitisation is less frequent in atopic dermatitis (AD) patients, recent studies have shown similar or higher rates of positive patch test results in AD patients. METHODS This was a single-centre, ten-year retrospective review on contact sensitisation in patients who underwent patch testing between 2007 and 2017. The aims were to characterise the pattern of contact sensitisation and to ascertain a link between contact sensitisation and AD. RESULTS There were 4903 patients (males:females = 1:1.4; mean age 40.1 years old) included. About half (2499, 51.0%) of all patients developed at least one positive reaction. The top five frequent reactions were to nickel sulfate (45.4%), potassium dichromate (16.0%), p-phenylenediamine (13.4%), Myroxylon pereirae (11.8%) and fragrance mix I (11.2%). The overall prevalence of contact sensitisation was not significantly different between patients with or without AD. Patients with AD were less likely to develop contact allergies to budesonide and thiuram mix, and more likely to develop contact allergies to potassium dichromate. CONCLUSIONS Contact sensitisation was detected in 50% of patients patch-tested. Nickel sulfate was the most frequently sensitising allergen. The prevalence of contact allergies in atopic patients is comparable to that in non-atopic patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | | | | | - Yik Weng Yew
- National Skin Centre, Singapore.,Lee Kong Chian School of Medicine, Singapore
| | - Anthony Goon
- National Skin Centre, Singapore.,Lee Kong Chian School of Medicine, Singapore
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Noë E, Huygens S, Morren MA, Garmyn M, Goossens A, Gilissen L. Contact allergy in a paediatric population observed in a tertiary referral centre in Belgium. Contact Dermatitis 2021; 86:3-8. [PMID: 34537955 DOI: 10.1111/cod.13975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/03/2021] [Accepted: 09/15/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Contact allergy is increasingly recognized as being important in children with eczema. OBJECTIVES To retrospectively analyse the patch test results in children over the past 10 years, aiming to (1) evaluate demographic characteristics and lesion locations, (2) describe frequencies of positive patch test reactions, and (3) investigate the relationship with atopic dermatitis (AD). METHODS A total of 329 children were patch tested between January 2010 and December 2019 with the European (children) baseline series and/or other series, and the personal product(s) used. RESULTS A total of 119 (36%) children presented with at least one positive reaction. Children with AD had a higher prevalence of positive reactions compared with the non-AD group (P = .002), but without statistically significant difference regarding sensitization to more than one hapten (P = .39). The face (20.2%), hands (19.3%), feet (16.8%), arms (12.6%), and body folds (10.9%) were the most common sites of primary localizations. The most frequent contact allergens were nickel sulfate and linalool hydroperoxide (both 16%), limonene hydroperoxide (13.5%), and para-phenylenediamine (10.9%). No statistically significant difference for nickel sulfate was found between the AD and non-AD group (P = .20). CONCLUSIONS Contact allergy in children with eczema was frequently observed in our tertiary referral centre in Belgium as well, confirming the need for patch testing.
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Affiliation(s)
- Esther Noë
- Department of Dermatology, Contact Allergy Unit, University Hospitals of Leuven, Leuven, Belgium
| | - Sara Huygens
- Department of Dermatology, Contact Allergy Unit, University Hospitals of Leuven, Leuven, Belgium
| | - Marie-Anne Morren
- Unité de Dermatologie Pediatrique, Hôpital des Enfants CHUV Lausanne, Lausanne, Switzerland
| | - Marjan Garmyn
- Department of Dermatology, Contact Allergy Unit, University Hospitals of Leuven, Leuven, Belgium.,Department of Oncology, Laboratory of Dermatology, KU Leuven, Leuven, Belgium
| | - An Goossens
- Department of Dermatology, Contact Allergy Unit, University Hospitals of Leuven, Leuven, Belgium.,Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
| | - Liesbeth Gilissen
- Department of Dermatology, Contact Allergy Unit, University Hospitals of Leuven, Leuven, Belgium.,Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
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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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14
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Yılmaz Z, Özkaya E. Patch-test results in terms of the recently recommended allergens in children and adolescents: A retrospective cohort study over 22 years from Turkey. Contact Dermatitis 2021; 85:198-210. [PMID: 33759232 DOI: 10.1111/cod.13842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/06/2021] [Accepted: 03/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND A European pediatric patch-test series was suggested recently. OBJECTIVES To evaluate the patch-test results in children (<10-years-old) and adolescents (10- to 18-years-old) in Turkey, focusing on the clinical/occupational relevance and the diagnostic value of the recently suggested series. PATIENTS AND METHODS A retrospective cohort study on 317 consecutively patch-tested patients ≤18 years of age, between 1996 and 2017. RESULTS The contact sensitization rate was 46.1%. Allergic contact dermatitis (ACD) was diagnosed in 30.9%, comprising non-occupational (84.7%) and occupational (15.3%) ACD. Nickel was the leading allergen in almost every age group. Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) was the clinically most relevant allergen, followed by p-phenylenediamine (PPD), ammonium persulfate, fragrance mix I, nickel sulfate, and mercury/mercury(II)amidochloride. Occupational ACD was most frequently seen in hairdresser apprentices (adolescents only) who were sensitized with PPD ± ammonium persulfate. ACD from MCI/MI increased to 5-fold, ammonium persulfate and mercurial compounds to 2-fold, and PPD to 1.7-fold after 2007. Almost one third of patients would be missed by testing only with the recommended allergens. CONCLUSIONS For patch testing in Turkish children and adolescents, we suggest additionally testing with ammonium persulfate, mercury/mercury(II)amidochloride, toluenesulfonamide formaldehyde resin, and polyethylene glycol, the latter as a marker for nitrofurazone allergy, in appropriate patients.
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Affiliation(s)
- Zeynep Yılmaz
- Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Clinic for Dermatology and Venereology, Boyabat 75th Year State Hospital, Sinop, Turkey
| | - Esen Özkaya
- Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Goossens A, Morren MA. Contact Allergy in Children. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kunkiel K, Sojewska M, Feleszko W. Contact haptens in emollients marketed in two European countries (Poland and Spain). Allergol Immunopathol (Madr) 2020; 48:814-818. [PMID: 32460993 DOI: 10.1016/j.aller.2020.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/07/2020] [Accepted: 04/15/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION AND OBJECTIVES Atopic dermatitis (AD) is the most common skin disease among pediatric patients, which affects up to 20% of children worldwide. Characterized by pruritus and eczema, it is also associated with improper skin barrier function and allergen sensitization. Here, we aimed to assess the presence of haptens in emollients marketed in two European countries: in Poland and Spain, as, firstly, these products are considered to be AD's basic therapy, and, secondly, frequent application of potent sensitizers on atopic skin may result in contact dermatitis. MATERIALS AND METHODS We systematically searched for moisturizers explicitly described as "Atopic skin care" products in the most frequently visited online pharmacies in Poland and Spain. Subsequently, we created a database of all products and compared their composition with 139 contact haptens listed in the European Baseline Series (EBS), Fragrance and Cosmetic Series. RESULTS As of December 2018, our list comprised 159 and 111 emollients available on the Polish and Spanish markets, respectively. There were no ingredients listed in 28 (17.5%) products in Poland and 24 (21.6%) in Spain. Only 23 (17.5%) and 13 (14.8%) products were hapten free. The pattern of most common haptens was similar in both countries, including phenoxyethanol, tocopherol and tocopheryl acetate, undefined parfum in Poland and tocopherol, phenoxyethanol, tocopheryl acetate and undefined parfum in Spain. CONCLUSIONS This study shows that a vast majority of products taken into consideration contain at least one potential contact hapten. These findings indicate a need for patient education about potentially allergenic ingredients and stronger cooperation between academia and cosmetic manufacturers.
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Affiliation(s)
- K Kunkiel
- Department of Pediatric Respiratory Diseases and Allergy, The Medical University of Warsaw, Żwirki i Wigury 63A, PL-02-091 Warsaw, Poland
| | - M Sojewska
- Department of Pediatric Respiratory Diseases and Allergy, The Medical University of Warsaw, Żwirki i Wigury 63A, PL-02-091 Warsaw, Poland
| | - W Feleszko
- Department of Pediatric Respiratory Diseases and Allergy, The Medical University of Warsaw, Żwirki i Wigury 63A, PL-02-091 Warsaw, Poland.
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Uldahl A, Engfeldt M, Svedman C. Clinical relevance of positive patch test reactions to lanolin: A ROAT study. Contact Dermatitis 2020; 84:41-49. [PMID: 32844454 PMCID: PMC7756495 DOI: 10.1111/cod.13689] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/20/2020] [Accepted: 08/23/2020] [Indexed: 11/30/2022]
Abstract
Background Lanolin is often included when patch testing for common contact allergens. The clinical relevance of a positive patch test reaction to lanolin markers is, however, still a subject for debate. Objectives To evaluate Amerchol L101 as a marker of lanolin allergy and investigate the clinical impact of lanolin‐containing moisturizers on healthy and damaged skin using the repeated open application test (ROAT). Methods Twelve test subjects and 14 controls were patch tested with Amerchol L 101 and additional lanolin markers. Subsequently, a blinded ROAT was performed on the arms of the study participants for 4 weeks. Each participant applied a lanolin‐free cream base and two different lanolin‐containing test creams twice daily on one arm with intact skin and on the other arm with irritant dermatitis, induced by sodium lauryl sulfate (SLS). Results Eleven test subjects (92%) had positive patch test reactions to Amerchol L 101 when retested and one test subject (8%) had a doubtful reaction. None of the study participants had any skin reactions to the ROAT on intact skin and all participants healed during the ROAT on damaged skin. Conclusions Lanolin‐containing emollients do not cause or worsen existing dermatitis when performing ROAT in volunteers patch test positive to Amerchol L101.
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Affiliation(s)
- Ada Uldahl
- Department of Dermatology and Venereology, Skåne University Hospital, Lund University, Malmö, Sweden.,Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Malin Engfeldt
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden.,Current Address: Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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18
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Pediatric contact allergens in the neonatal intensive care unit. J Perinatol 2020; 40:1554-1559. [PMID: 32807911 DOI: 10.1038/s41372-020-00769-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 07/15/2020] [Accepted: 08/03/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The degree of neonatal exposure to potentially sensitizing agents on neonatal intensive care units (NICUs) and the process by which personal care products are selected for use in the NICU are poorly documented. STUDY DESIGN We evaluated personal care products used in three NICUs for potentially sensitizing agents. We interviewed NICU staff to analyze how products are selected and approved for use. RESULTS Twenty-four personal care products were evaluated. 75% contained one or more potential contact allergen, with fragrances being most common. Staff preference, brand loyalty, cost, and small product size were often considered when approving NICU products. CONCLUSIONS The prevalence of potentially sensitizing agents in the products indicates a need for improvement in the evaluation and acquisition process of over-the-counter products used for neonatal skin care. The involvement of dermatology in this process may be beneficial.
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Tam I, Schalock PC, González E, Yu J. Comparison of Allergic Contact Sensitization Prevalence Between Children and Adults: A 10-Year Retrospective Study. Dermatitis 2020; 31:e55-e57. [PMID: 32947464 DOI: 10.1097/der.0000000000000619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Idy Tam
- Tufts University School of Medicine, Boston, MA Department of Dermatology, Massachusetts General Hospital, Boston Department of Surgery (Dermatology), Geisel School of Medicine at Dartmouth, Hanover, NH Department of Dermatology, Massachusetts General Hospital, Boston Harvard Medical School, Boston, MA
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20
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Paulsen E, Andersen KE. Compositae sensitization in Danish children and adolescents. Contact Dermatitis 2020; 83:296-300. [PMID: 32542786 DOI: 10.1111/cod.13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/10/2020] [Accepted: 06/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Compositae plant sensitization in children is relatively frequent. From 1995-2006, we found a prevalence of 1.8% sesquiterpene lactone (SL) mix/parthenolide patch test positives among consecutive eczema patients <18 years. OBJECTIVES To report the results of patch test screening for Compositae sensitization in patients <18 years in the last 13 years. METHODS Children and adolescents <18 years, diagnosed with Compositae sensitization between 2007 and 2019, were included. RESULTS Among 388 children tested, 12 (3%) were Compositae-sensitized, and 11 (2.8%) had positive reactions to SL mix. Compositae mix 5% pet. elicited positive reactions in six of seven patients tested, and dandelion extract 2.5% pet. in six of 10 patients tested. The mean age of the five girls and seven boys was 9.4 years and 11.7 years, respectively. Eleven children had a personal and one a family history of atopy, and 11 children had hand eczema. Only two were mono-sensitized to Compositae. CONCLUSIONS SL mix is a suitable screening agent among children and adolescents in our area, well supplemented with Compositae mix 5% and dandelion extract. The study emphasizes the importance of Compositae screening in children with a personal and/or family history of atopy, hand eczema or widespread airborne dermatitis, summer exacerbation, and plant exposure.
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Affiliation(s)
- Evy Paulsen
- Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Klaus E Andersen
- Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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21
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Abstract
PURPOSE OF REVIEW Allergic contact dermatitis (ACD) affects 20% of children. However, diagnosis of ACD may be underreported in children due to lack of recognition. Patch testing is the gold standard for evaluation of ACD in children but poses unique challenges in this population. RECENT FINDINGS Recent studies highlight the significance of ACD and the utility of patch testing in children. Evaluation of ACD in children is difficult and requires knowledge of a child's exposure history, careful selection of allergens, and knowledge of specialized patch testing considerations to minimize irritation and maximize cooperation. Until recently, there were no agreed upon patch test series for children. In 2018, a comprehensive pediatric baseline series was published enabling thorough evaluation of ACD in children (Yu J, Atwater AR, Brod B, Chen JK, Chisolm SS, Cohen DE, et al. Dermatitis. 2018;29(4):206-12). This review provides an overview of the current literature, an update on pediatric ACD, and patch testing methods in children to effectively evaluate and manage ACD.
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Affiliation(s)
- Idy Tam
- Tufts University School of Medicine, Boston, MA, USA
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford St, Suite 200, Boston, MA, 02114, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford St, Suite 200, Boston, MA, 02114, USA.
- Harvard Medical School, Boston, MA, USA.
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22
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van Amerongen CCA, Ofenloch R, Dittmar D, Schuttelaar MLA. New positive patch test reactions on day 7-The additional value of the day 7 patch test reading. Contact Dermatitis 2019; 81:280-287. [PMID: 31116435 PMCID: PMC6771944 DOI: 10.1111/cod.13322] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/15/2019] [Accepted: 05/21/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Not performing a day (D) 7 patch test reading might result in positive patch test reactions being missed. OBJECTIVES To investigate the added value of the D7 patch test reading for individual allergens, and to identify patient characteristics and allergen groups associated with new positive D7 reactions. METHODS Data from patients patch tested between 2008 and 2018 with the extended European baseline series were analysed. Patch test readings were performed on D3 and D7. Positive reactions were categorized into positive on D3 or new positive on D7. RESULTS A total of 3292 patients were consecutively patch tested with at least 43 allergens of the TRUE Test panels 1 and 2 supplemented with investigator-loaded allergens. In total, 447 (13.6%) patients showed new positive D7 reactions. In univariable regression analysis, age between 18 and 30 years showed a negative association with new positive D7 reactions. Significantly more D7 positive reactions were seen for topicals (odds ratio [OR] 2.60, 95% confidence interval [CI]: 1.92-3.51) and corticosteroids (OR 1.87, 95%CI: 1.09-3.21). No associations were found between sex, atopic dermatitis and occupational dermatitis and a new positive D7 reaction. CONCLUSION A D7 reading to identify new positive patch test reactions is of added value, especially for topicals and corticosteroids.
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Affiliation(s)
- Cynthia C. A. van Amerongen
- Department of DermatologyUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
| | - Robert Ofenloch
- Department of Social Medicine, Occupational and Environmental DermatologyUniversity of HeidelbergHeidelbergGermany
| | - Daan Dittmar
- Department of DermatologyUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
| | - Marie L. A. Schuttelaar
- Department of DermatologyUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
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Teo Y, McFadden JP, White IR, Lynch M, Banerjee P. Allergic contact dermatitis in atopic individuals: Results of a 30‐year retrospective study. Contact Dermatitis 2019; 81:409-416. [DOI: 10.1111/cod.13363] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/20/2019] [Accepted: 07/24/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Ying Teo
- Department of DermatologyUniversity Hospital Southampton NHS Foundation Trust Southampton UK
- Department of Cutaneous AllergySt John's Institute of Dermatology, Guy's Hospital London UK
| | - John P. McFadden
- Department of Cutaneous AllergySt John's Institute of Dermatology, Guy's Hospital London UK
| | - Ian R. White
- Department of Cutaneous AllergySt John's Institute of Dermatology, Guy's Hospital London UK
| | - Magnus Lynch
- Department of Cutaneous AllergySt John's Institute of Dermatology, Guy's Hospital London UK
| | - Piu Banerjee
- Department of Cutaneous AllergySt John's Institute of Dermatology, Guy's Hospital London UK
- Department of DermatologyLewisham Hospital London UK
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Stingeni L, Tramontana M, Bianchi L, Foti C, Romita P, Patruno C, Cristaudo A, Gallo R, Corazza M, Schena D, Pigatto PD, Milanesi N, Nettis E, Guarneri F, Hansel K. Patch test with sorbitan sesquioleate in Italian consecutive patients: A 1‐year multicenter SIDAPA study. Contact Dermatitis 2019; 81:454-456. [DOI: 10.1111/cod.13359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 07/19/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Luca Stingeni
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Marta Tramontana
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Leonardo Bianchi
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human OncologyUniversity of Bari Bari Italy
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Science and Human OncologyUniversity of Bari Bari Italy
| | - Cataldo Patruno
- Section of Dermatology, Health Sciences DepartmentMagna Graecia University Catanzaro Italy
| | - Antonio Cristaudo
- Department of DermatologySan Gallicano Dermatological Institute, IRCCS Rome Italy
| | - Rosella Gallo
- Section of Dermatology, Department of Health Sciences (DiSSAL)University of Genoa, Ospedale Policlinico San Martino Genoa Italy
| | - Monica Corazza
- Section of Dermatology, Department of Medical SciencesUniversity of Ferrara Ferrara Italy
| | - Donatella Schena
- Section of Dermatology and Venereology, Department of MedicineUniversity of Verona Verona Italy
| | - Paolo D. Pigatto
- Department of Biomedical, Surgical and Dental Sciences, Unit of DermatologyIRCCS Istituto Ortopedico Galeazzi, University of Milan Milan Italy
| | - Nicola Milanesi
- Allergological and Occupational Dermatology Unit, Department of Surgery and Translational MedicineUniversity of Florence Florence Italy
| | - Eustachio Nettis
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical ImmunologyUniversity of Bari Aldo Moro Bari Italy
| | - Fabrizio Guarneri
- Section of Dermatology, Department of Clinical and Experimental MedicineUniversity of Messina Messina Italy
| | - Katharina Hansel
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
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de Groot A, Gilissen L, Geier J, Orton D, Goossens A. Adding sorbitan sesquioleate to the European baseline series: Necessary, reasonable, or unavoidable? Contact Dermatitis 2019; 81:221-225. [PMID: 31177535 DOI: 10.1111/cod.13332] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/05/2019] [Accepted: 06/07/2019] [Indexed: 11/30/2022]
Abstract
Positive reactions to fragrance mix I (FM I) are frequent in consecutively patch tested patients suspected of having allergic contact dermatitis. However, the FM I test preparations contain 5% of the emulsifier sorbitan sesquioleate (SSO), and it is well known that SSO can cause contact allergic reactions in its own right. Indeed, the available data show that some patients with contact allergy to SSO react to FM I but are not allergic to fragrances. When SSO is not tested, this situation may go unnoticed, a wrong diagnosis of fragrance allergy may be given to the patient, and unjustified advice to avoid fragrances and fragranced products will be given in such cases. To avoid such suboptimal patient care, we postulate that testing with SSO in all patch tested individuals is mandatory. As it is well known that only a minority of FM I-reactive patients will undergo a breakdown test with the ingredients and SSO, testing with SSO in all patients can only be achieved by adding it to the European baseline series. Not testing with SSO may also result in misinterpretation of patch test reactions to Myroxylon pereirae resin and 2-hydroxyethyl methacrylate in the baseline series, as both (may) contain SSO, and, for the same reason, of reactions to several other hapten test materials.
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Affiliation(s)
| | - Liesbeth Gilissen
- Department of Dermatology, University Hospital KU Leuven, Leuven, Belgium
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | | | - An Goossens
- Department of Dermatology, University Hospital KU Leuven, Leuven, Belgium
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26
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Balato A, Raimondo A, Arenberger P, Bruze M, Czarnecka-Operacz M, Johanssen JD, Gonçalo M, Ranki A, Uter W, Wilkinson M, Ayala F, John SM, Giménez-Arnau A, Gollnick H. The role of the dermatologist in the immune-mediated/allergic diseases - position statement of the EADV task force on contact dermatitis, EADV task force on occupational skin diseases, UEMS-EBDV subcommission allergology and European Dermatology Forum. J Eur Acad Dermatol Venereol 2019; 33:1459-1464. [PMID: 31062452 DOI: 10.1111/jdv.15610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 02/28/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The members of the Task Force on Contact Dermatitis and the Task Force on Occupational Dermatoses of the European Academy of Dermatology and Venereology (EADV), of the European Dermatology Forum (EDF), and the members of the UEMS Section of Dermatology-Venereology (UEMS-EBDV) we want to vindicate the fundamental role that the specialist in Dermatology has in the diagnosis and management of Immuno-mediated /allergic Diseases. OBJECTIVE In disagreement with the blueprint paper of the UEMS section of Allergology (2013), in which dermatologists are excluded from one of their core activities it was decided to write this consensus paper. DISCUSSION The skin occupies a crucial place in the broad spectrum of allergic diseases; there is no other organ with such a multitude of different clinical conditions mediated by so many pathogenetic immune mechanisms. Subsequently, dermatologists play a fundamental role in the management of immune-mediated diseases including among others contact dermatitis, atopic dermatitis, urticaria and angioedema or cutaneous adverse drug, food and arthropod reactions. The essential role of dermatology in the diagnostic, therapeutic and preventive management of immune mediated /allergic diseases which is crucial for patient management is justified from both the academic and professional point of view. CONCLUSION Based on the best care of the patient with cutaneous immune allergic disease a multidisciplinary approach is desirable and the dermatologist has a pivotal role in patient management. Be so good and no one will not ignore you, dermatologist. Ideally Dermatology should be governed according the following Henry Ford statement: "Arriving together is the beginning; keeping together is progress; working together is success."
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Affiliation(s)
- A Balato
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - A Raimondo
- Department of Medicine, Surgery and Dentistry, 'Scuola Medica Salernitana', University of Salerno, Salerno, Italy
| | - P Arenberger
- Department of Dermatology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - M Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - M Czarnecka-Operacz
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - J D Johanssen
- Department of Dermatology and Allergy, National Allergy Research Centre, Herlev-Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - M Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - A Ranki
- Department of Dermatology, Allergology and Venereology, University of Helsinki and Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - W Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - M Wilkinson
- Dermatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - F Ayala
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - S M John
- Department of Dermatology, Environmental Medicine, University of Osnabrueck, Osnabrueck, Germany
| | - A Giménez-Arnau
- Department of Dermatology, Hospital del Mar. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - H Gollnick
- Department of Dermatology and Venereology, Otto-von-Guericke Universität, Magdeburg, Germany
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Silverberg JI. Comorbidities and the impact of atopic dermatitis. Ann Allergy Asthma Immunol 2019; 123:144-151. [PMID: 31034875 DOI: 10.1016/j.anai.2019.04.020] [Citation(s) in RCA: 206] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 04/22/2019] [Accepted: 04/22/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease with substantial patient and population burdens. A number of comorbid health problems occur in patients with AD, aside from the cutaneous signs and symptoms. This review summarizes recent developments in the burden and comorbidities of AD. DATA SOURCES Literature review. STUDY SELECTIONS Nonsystematic. RESULTS Different aspects of AD, such as chronic pruritus, psychosocial distress, and inflammation, can lead to anxiety, depression, or suicidality. Atopic dermatitis is associated with and may predispose to higher risk of other atopic disorders, including asthma, hay fever, food allergy, and eosinophilic esophagitis. Persons with AD appear to be at higher risk for infectious and cardiovascular risk. CONCLUSION Atopic dermatitis is associated with substantial burden and comorbidities. Identifying AD comorbidities is essential for proper disease management and improving overall patient outcomes.
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Affiliation(s)
- Jonathan I Silverberg
- Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University, Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois.
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Mortz CG, Brockow K, Bindslev‐Jensen C, Broesby‐Olsen S. It looks like childhood eczema but is it? Clin Exp Allergy 2019; 49:744-753. [DOI: 10.1111/cea.13381] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/28/2019] [Accepted: 03/03/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Charlotte G. Mortz
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital University of Southern Denmark Odense C Denmark
| | - Knut Brockow
- Division Environmental Dermatology and Allergology, Department of Dermatology und Allergology Biederstein, Helmholtz Zentrum München/TUM Technical University Munich Munich Germany
| | - Carsten Bindslev‐Jensen
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital University of Southern Denmark Odense C Denmark
| | - Sigurd Broesby‐Olsen
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital University of Southern Denmark Odense C Denmark
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Knijp J, Bruynzeel DP, Rustemeyer T. Diagnosing lanolin contact allergy with lanolin alcohol and Amerchol L101. Contact Dermatitis 2019; 80:298-303. [PMID: 30624788 PMCID: PMC6593808 DOI: 10.1111/cod.13210] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/31/2018] [Accepted: 01/04/2019] [Indexed: 02/06/2023]
Abstract
Background The prevalence of lanolin contact allergy in dermatitis patients varies from 1.2% to 6.9%. Different lanolin derivatives are used in patch testing. Objectives To determine which combination of lanolin derivatives is most effective in patch testing for the diagnosis of lanolin contact allergy. Methods A retrospective analysis of patients patch tested between 2016 and 2017 was performed. Patients were eligible if they had been tested with lanolin alcohol 30% pet., Amerchol L101 50% pet., and a supplementary series containing other lanolin derivatives. Lanolin alcohol and Amerchol L101 were tested in duplicate. Results Of 594 patients, 28.6% (95% confidence interval [CI]: 25.1%‐32.3%) had a positive patch test reaction to at least one lanolin derivative. Reactions to lanolin alcohol (14.7%, 95%CI: 11.3%‐18.2%) and Amerchol L101 (15.0%, 95%CI: 11.5%‐18.5%) were common in the routinely tested series. Reactions to other test preparations were significantly less frequent (P < 0.05). The addition of Amerchol L101 to lanolin alcohol significantly increased the number of positive cases (odds ratio 1.79, P < 0.001). Conclusions The combination of lanolin alcohol and Amerchol L101 is effective in patch testing for the diagnosis of lanolin contact allergy. Routinely testing with other lanolin derivatives may not be worthwhile, as it detects only a few additional patients.
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Affiliation(s)
- Jannet Knijp
- Department of Dermatology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Derk P Bruynzeel
- Department of Dermatology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
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Dumycz K, Kunkiel K, Feleszko W. Cosmetics for neonates and infants: haptens in products' composition. Clin Transl Allergy 2019; 9:15. [PMID: 30899450 PMCID: PMC6407239 DOI: 10.1186/s13601-019-0257-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 02/26/2019] [Indexed: 12/18/2022] Open
Abstract
Cosmetics and skin care products for neonates and infants are considered as ‘‘hypoallergenic’’, “tested” or ‘‘safe’’. Nevertheless, the prevalence of haptens in these products is a matter of concern, since allergic contact dermatitis in children is gaining an importance. We aimed to assess the prevalence of haptens in cosmetics designed for children younger than 1 year. To identify haptens, the components of the cosmetics listed on packaging were compared with substances from European baseline series, Cosmetics series and Fragrance series. Survey comprised 212 cosmetics among which 186 (87.7%) contained at least one hapten from reference lists. Altogether there were 41 different haptens found in cosmetics. Number of sensitizers per product ranged between 1–12 and, each product contained 2.51 haptens on average. The most abundant sensitizers were cocamidopropyl betaine, tocopherol, propylene glycol, fragrances, lanolin. Majority of products for children were labeled as hypoallergenic/dermatologically tested/safe for children etc. from which 85% contained haptens. This survey highlights the extent of presence of haptens in cosmetics for children under the first year of age.
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Affiliation(s)
- Karolina Dumycz
- Department of Pediatric Pneumology and Allergy, The Medical University of Warsaw, Żwirki i Wigury 63A, 02-091 Warsaw, Poland
| | - Katarzyna Kunkiel
- Department of Pediatric Pneumology and Allergy, The Medical University of Warsaw, Żwirki i Wigury 63A, 02-091 Warsaw, Poland
| | - Wojciech Feleszko
- Department of Pediatric Pneumology and Allergy, The Medical University of Warsaw, Żwirki i Wigury 63A, 02-091 Warsaw, Poland
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31
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Lagrelius M, Wahlgren C, Matura M, Bergström A, Kull I, Lidén C. Atopic dermatitis at preschool age and contact allergy in adolescence: a population‐based cohort study. Br J Dermatol 2019; 180:782-789. [DOI: 10.1111/bjd.17449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2018] [Indexed: 11/28/2022]
Affiliation(s)
- M. Lagrelius
- Institute of Environmental Medicine Karolinska Institutet SE‐171 77 Stockholm Sweden
- Centre for Occupational and Environmental Medicine Stockholm County Council SE‐113 65 Stockholm Sweden
| | - C.‐F. Wahlgren
- Dermatology Unit Department of Medicine Solna Karolinska Institutet, and Karolinska University Hospital SE‐171 76 Stockholm Sweden
| | - M. Matura
- Institute of Environmental Medicine Karolinska Institutet SE‐171 77 Stockholm Sweden
- Centre for Occupational and Environmental Medicine Stockholm County Council SE‐113 65 Stockholm Sweden
| | - A. Bergström
- Institute of Environmental Medicine Karolinska Institutet SE‐171 77 Stockholm Sweden
- Centre for Occupational and Environmental Medicine Stockholm County Council SE‐113 65 Stockholm Sweden
| | - I. Kull
- Department of Clinical Science and Education Stockholm South General Hospital Karolinska Institutet, and Sachs’ Children's Hospital SE‐118 83 Stockholm Sweden
| | - C. Lidén
- Institute of Environmental Medicine Karolinska Institutet SE‐171 77 Stockholm Sweden
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Milam EC, Jacob SE, Cohen DE. Contact Dermatitis in the Patient with Atopic Dermatitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:18-26. [DOI: 10.1016/j.jaip.2018.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/05/2018] [Accepted: 11/05/2018] [Indexed: 12/20/2022]
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Ozceker D, Haslak F, Dilek F, Sipahi S, Yucel E, Guler N, Tamay Z. Contact sensitization in children with atopic dermatitis. Allergol Immunopathol (Madr) 2019; 47:47-51. [PMID: 30193890 DOI: 10.1016/j.aller.2018.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 06/13/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Atopic dermatitis is a common illness in childhood. Children with atopic dermatitis are prone to develop cutaneous sensitization due to skin barrier dysfunction. AIM The aim of this study was to evaluate the frequency of cutaneous sensitizations in patients with atopic dermatitis and to identify the most frequent causative allergens. STUDY DESIGN The study group consisted of 112 children with atopic dermatitis, aged 1-18 years (median 88.5 months) and 39 healthy controls, aged 1-8 years (median 88.48 months). METHODS The diagnosis of atopic dermatitis was established by modified Hanifin and Rajka criteria; severity of the disease was assessed by scoring of atopic dermatitis. Serum blood eosinophil count, total IgE and skin prick tests for common aeroallergens and food allergens were performed. Patch tests with cosmetic series and European standard patch test series (Stallegenes© Ltd, Paris, France) were applied. RESULTS Of the children with atopic dermatitis, 17% (n=19) were sensitized to either cosmetic or standard series or both of them; no children in the control group had a positive patch test (p=0.001). Atopy and severity of atopic dermatitis was not a significant risk factor for cutaneous sensitization. The most common allergens were Nickel sulphate and Methychloroisothiazinolone (4.5% and 4.5%) in the European standard patch test and cocamidoproplybetaine (12.5%) in the cosmetic series patch test. CONCLUSION Cutaneous sensitization can develop in children with atopic dermatitis, therefore allergic contact dermatitis should be kept in mind.
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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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Simonsen AB, Foss-Skiftesvik MH, Thyssen JP, Deleuran M, Mortz CG, Zachariae C, Skov L, Osterballe M, Funding A, Avnstorp C, Andersen BL, Vissing S, Danielsen A, Dufour N, Nielsen NH, Thormann H, Sommerlund M, Johansen JD. Contact allergy in Danish children: Current trends. Contact Dermatitis 2018; 79:295-302. [DOI: 10.1111/cod.13079] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/15/2018] [Accepted: 06/17/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Anne B. Simonsen
- National Allergy Research Centre, Department of Dermatology and Allergy; University of Copenhagen, Herlev and Gentofte Hospital; Gentofte, Denmark
- Department of Dermatology and Allergy; University of Copenhagen; Herlev and Gentofte Hospital Gentofte, Denmark
| | - Majken H. Foss-Skiftesvik
- Department of Dermatology and Allergy; University of Copenhagen; Herlev and Gentofte Hospital Gentofte, Denmark
| | - Jacob P. Thyssen
- Department of Dermatology and Allergy; University of Copenhagen; Herlev and Gentofte Hospital Gentofte, Denmark
| | - Mette Deleuran
- Department of Dermatology and Venereology; Aarhus University Hospital; Aarhus Denmark
| | - Charlotte G. Mortz
- Department of Dermatology and Allergy Centre; Odense University Hospital; Odense Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy; University of Copenhagen; Herlev and Gentofte Hospital Gentofte, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy; University of Copenhagen; Herlev and Gentofte Hospital Gentofte, Denmark
| | | | | | | | | | | | | | | | | | | | - Mette Sommerlund
- Department of Dermatology and Venereology; Aarhus University Hospital; Aarhus Denmark
| | - Jeanne D. Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy; University of Copenhagen, Herlev and Gentofte Hospital; Gentofte, Denmark
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Owen JL, Vakharia PP, Silverberg JI. The Role and Diagnosis of Allergic Contact Dermatitis in Patients with Atopic Dermatitis. Am J Clin Dermatol 2018; 19:293-302. [PMID: 29305764 DOI: 10.1007/s40257-017-0340-7] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Patients with atopic dermatitis (AD) have increased penetration of allergens, immune dysregulation (including shared cytokine pathways), and frequent use of emollients and topical medications, all of which may predispose toward developing allergic contact dermatitis (ACD). Recent systematic reviews have suggested that ACD is a significant clinical problem in both children and adults with AD. While this remains controversial, ACD remains an important comorbidity and potential exacerbant of AD in clinical practice. Common relevant allergens, include lanolin, neomycin, formaldehyde, sesquiterpene lactone mix, compositae mix, and fragrances that are commonly found in AD patients' personal care products. We herein review the clinical scenarios where patch testing is indicated in AD. In addition, we review the contraindications, preferred patch-testing series, pitfalls, and challenges determining the relevance of positive patch-test reactions in AD patients.
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Affiliation(s)
- Joshua L Owen
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Paras P Vakharia
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Jonathan I Silverberg
- Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St, Suite 1600, Chicago, IL, 60611, USA.
- Northwestern Medicine Multidisciplinary Eczema Center, Chicago, USA.
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Uter W, Werfel T, White IR, Johansen JD. Contact Allergy: A Review of Current Problems from a Clinical Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061108. [PMID: 29844295 PMCID: PMC6025382 DOI: 10.3390/ijerph15061108] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/20/2018] [Accepted: 05/26/2018] [Indexed: 12/17/2022]
Abstract
Contact allergy is common, affecting 27% of the general population in Europe. Original publications, including case reports, published since 2016 (inclusive) were identified with the aim of collating a full review of current problems in the field. To this end, a literature search employing methods of systematic reviewing was performed in the Medline® and Web of Science™ databases on 28 January 2018, using the search terms (“contact sensitization” or “contact allergy”). Of 446 non-duplicate publications identified by above search, 147 were excluded based on scrutiny of title, abstract and key words. Of the remaining 299 examined in full text, 291 were deemed appropriate for inclusion, and main findings were summarised in topic sections. In conclusion, diverse sources of exposures to chemicals of widely-differing types and structures, continue to induce sensitisation in man and may result in allergic contact dermatitis. Many of the chemicals are “evergreen” but others are “newcomers”. Vigilance and proper investigation (patch testing) are required to detect and inform of the presence of these haptens to which our populations remain exposed.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, 91054 Erlangen, Germany.
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, 30625 Hannover, Germany.
| | - Ian R White
- St John's Institute of Dermatology, Guy's Hospital, London SE1 9RT, UK.
| | - Jeanne D Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Herlev and Gentofte, 2900 Hellerup, Denmark.
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Uter W, Schnuch A, Geier J. Contact sensitization to lanolin alcohols and Amerchol® L101 - analysis of IVDK data. Contact Dermatitis 2018; 78:367-369. [DOI: 10.1111/cod.12952] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/16/2017] [Accepted: 12/03/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen/Nürnberg; 91054 Erlangen Germany
| | - Axel Schnuch
- Information Network of Departments of Dermatology at the University of Göttingen; 37075 Göttingen Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology at the University of Göttingen; 37075 Göttingen Germany
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40
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Simonsen A, Johansen J, Deleuran M, Mortz C, Skov L, Sommerlund M. Children with atopic dermatitis may have unacknowledged contact allergies contributing to their skin symptoms. J Eur Acad Dermatol Venereol 2018; 32:428-436. [DOI: 10.1111/jdv.14737] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/20/2017] [Indexed: 12/30/2022]
Affiliation(s)
- A.B. Simonsen
- Department of Dermatology and Venereology; Aarhus University Hospital; Aarhus Denmark
- National Allergy Research Centre; Department of Dermatology and Allergy, Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - J.D. Johansen
- National Allergy Research Centre; Department of Dermatology and Allergy, Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - M. Deleuran
- Department of Dermatology and Venereology; Aarhus University Hospital; Aarhus Denmark
| | - C.G. Mortz
- Department of Dermatology and Allergy Centre; Odense University Hospital; Odense Denmark
| | - L. Skov
- Department of Dermatology and Allergy; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - M. Sommerlund
- Department of Dermatology and Venereology; Aarhus University Hospital; Aarhus Denmark
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Fransen M, Overgaard LEK, Johansen JD, Thyssen JP. Contact allergy to lanolin: temporal changes in prevalence and association with atopic dermatitis. Contact Dermatitis 2017; 78:70-75. [DOI: 10.1111/cod.12872] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/09/2017] [Accepted: 07/12/2017] [Indexed: 02/06/2023]
Affiliation(s)
- Marloes Fransen
- Department of Dermatology and Allergy, National Allergy Research Centre, Herlev and Gentofte Hospital; University of Copenhagen; 2900 Hellerup Denmark
- Department of Dermatology; Maastricht University Medical Centre; P.O. Box 5800, 6202 AZ Maastricht The Netherlands
| | - Line E. K. Overgaard
- Department of Dermatology and Allergy, National Allergy Research Centre, Herlev and Gentofte Hospital; University of Copenhagen; 2900 Hellerup Denmark
| | - Jeanne D. Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Herlev and Gentofte Hospital; University of Copenhagen; 2900 Hellerup Denmark
| | - Jacob P. Thyssen
- Department of Dermatology and Allergy, National Allergy Research Centre, Herlev and Gentofte Hospital; University of Copenhagen; 2900 Hellerup Denmark
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Uter W, Amario-Hita J, Balato A, Ballmer-Weber B, Bauer A, Belloni Fortina A, Bircher A, Chowdhury M, Cooper S, Czarnecka-Operacz M, Dugonik A, Gallo R, Giménez-Arnau A, Johansen J, John S, Kieć-Świerczyńska M, Kmecl T, Kręcisz B, Larese Filon F, Mahler V, Pesonen M, Rustemeyer T, Sadowska-Przytocka A, Sánchez-Pérez J, Schliemann S, Schuttelaar M, Simon D, Spiewak R, Valiukevičienė S, Weisshaar E, White I, Wilkinson S. European Surveillance System on Contact Allergies (ESSCA): results with the European baseline series, 2013/14. J Eur Acad Dermatol Venereol 2017. [DOI: 10.1111/jdv.14423] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- W. Uter
- Department of Medical Informatics; Biometry and Epidemiology; Friedrich-Alexander-University Erlangen/Nürnberg; Erlangen Germany
| | - J.C. Amario-Hita
- Department of Dermatology; University Hospital of Puerto Real; Cádiz Spain
| | - A. Balato
- Department of Advanced Biomedical Sciences; University of Naples Federico II; Napoli Italy
| | - B. Ballmer-Weber
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
- Centre for Dermatology and Allergology; Kantonsspital Luzern; Luzern Switzerland
| | - A. Bauer
- Department of Dermatology; University Hospital Carl Gustav Carus; Technical University of Dresden; Dresden Germany
| | - A. Belloni Fortina
- Pediatric Dermatology Unit; Department of Medicine DIMED; University of Padova; Padova Italy
| | - A. Bircher
- Allergology Unit; Department of Dermatology; University Hospital Basel; Basel Switzerland
| | - M.M.U. Chowdhury
- The Welsh Institute of Dermatology; University Hospital of Wales; Cardiff UK
| | | | | | - A. Dugonik
- Department of Dermatology; University Medical Center Maribor; Maribor Slovenia
| | - R. Gallo
- Clinica Dermatologica; IRCCS - AOU San Martino - IST and Department of Health Sciences; University of Genoa; Genoa Italy
| | - A. Giménez-Arnau
- Department of Dermatology; Hospital del Mar; Universitat Autónoma; Barcelona Spain
| | - J.D. Johansen
- National Allergy Centre/Department of Dermatology; Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - S.M. John
- Department of Dermatology; Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm); University of Osnabrück; Lower Saxony Institute for Occupational Dermatology (NIB); Osnabrück Germany
| | - M. Kieć-Świerczyńska
- Department of Dermatology; Nofer Institute of Occupational Medicine; Łodz Poland
| | - T. Kmecl
- Department of Dermatology; General Hospital Celje; Celje Slovenia
| | - B. Kręcisz
- Department of Dermatology; Nofer Institute of Occupational Medicine; Łodz Poland
- Faculty of Medicine and Health Science; Institute of Medical Science; Jan Kochanowski University; Kielce Poland
| | - F. Larese Filon
- Department of Public Health, Occupational Medicine; University of Trieste; Trieste Italy
| | - V. Mahler
- Department of Dermatology; University Hospital Erlangen; Friedrich-Alexander-University Erlangen-Nürnberg; Erlangen Germany
| | - M. Pesonen
- Occupational Medicine; Finnish Institute of Occupational Health (FIOH); Helsinki Finland
| | - T. Rustemeyer
- Department of Dermatology; Free University of Amsterdam; Amsterdam The Netherlands
| | | | - J. Sánchez-Pérez
- Department of Dermatology; Hospital Universitario la Princesa; Madrid Spain
| | - S. Schliemann
- Department of Dermatology and Allergology; University Hospital Jena; Jena Germany
| | - M.L. Schuttelaar
- Department of Dermatology; University Medical Centre Groningen; University of Groningen; Groningen The Netherlands
| | - D. Simon
- Department of Dermatology; Inselspital; Bern University Hospital; University of Bern; Bern Switzerland
| | - R. Spiewak
- Department of Experimental Dermatology and Cosmetology; Faculty of Pharmacy; Jagiellonian University Medical College; Krakow Poland
| | - S. Valiukevičienė
- Department of Skin and Venereal Diseases; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - E. Weisshaar
- Department of Clinical Social Medicine; University Hospital Heidelberg; Heidelberg Germany
| | - I.R. White
- St. John's Institute of Dermatology; Guy's Hospital; London UK
| | - S.M. Wilkinson
- Dermatology; Leeds Teaching Hospitals NHS Trust; Leeds UK
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Simonsen A, Johansen J, Deleuran M, Mortz C, Sommerlund M. Contact allergy in children with atopic dermatitis: a systematic review. Br J Dermatol 2017; 177:395-405. [DOI: 10.1111/bjd.15628] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2017] [Indexed: 12/30/2022]
Affiliation(s)
- A.B. Simonsen
- Department of Dermatology and Venereology; Aarhus University Hospital; Aarhus Denmark
- National Allergy Research Centre; Department of Dermatology and Allergy; Copenhagen University Hospital Gentofte - Herlev; Kildegaardsvej 28 2900 Hellerup Denmark
| | - J.D. Johansen
- National Allergy Research Centre; Department of Dermatology and Allergy; Copenhagen University Hospital Gentofte - Herlev; Kildegaardsvej 28 2900 Hellerup Denmark
| | - M. Deleuran
- Department of Dermatology and Venereology; Aarhus University Hospital; Aarhus Denmark
| | - C.G. Mortz
- Department of Dermatology and Allergy; Odense University Hospital; Odense Denmark
| | - M. Sommerlund
- Department of Dermatology and Venereology; Aarhus University Hospital; Aarhus Denmark
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