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Dickel H, Kuhlmann L, Bauer A, Bircher AJ, Breuer K, Fuchs T, Grabbe J, Mahler V, Pföhler C, Przybilla B, Rieker-Schwienbacher J, Schröder-Kraft C, Simon D, Treudler R, Weisshaar E, Worm M, Trinder E, Geier J. Atopy patch testing with aeroallergens in a large clinical population of dermatitis patients in Germany and Switzerland, 2000-2015: a retrospective multicentre study. J Eur Acad Dermatol Venereol 2020; 34:2086-2095. [PMID: 32003071 DOI: 10.1111/jdv.16250] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 01/22/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The diagnostic significance of the atopy patch test for the management of dermatitis possibly triggered by aeroallergens is still controversial. However, sufficiently large studies with routinely tested standardized aeroallergen patch test preparations in dermatitis patients are lacking. OBJECTIVE To evaluate the reaction frequency and the reaction profiles of 10 until mid-2015 commercially available, standardized aeroallergen patch test preparations of the 'Stallerpatch' test series (Stallergenes, Antony Cedex, France) in a large multicentre patient cohort. METHODS A retrospective data analysis of patients with suspected aeroallergen-dependent eczematous skin lesions was performed, who were patch tested in 15 Information Network of Departments of Dermatology-associated clinics between 2000 and 2015. Patients were stratified according to their atopic dermatitis (AD) status. RESULTS The study group included 3676 patients (median age 41 years, 34.8% males, 54.5% AD). The most common aeroallergens causing positive patch test reactions were Dermatophagoides pteronyssinus (19.6%), Dermatophagoides farinae (16.9%), birch (6.2%), timothy grass (6.0%), cat dander (5.4%), mugwort (4.9%) and dog dander (4.6%). Reactions to other pollen allergen preparations, that is 5 grasses (3.2%), cocksfoot (2.1%) and plantain (1.6%), were less common. Positive patch test reactions to aeroallergens were consistently more frequent in patients with AD. These patients showed proportionally less dubious, follicular, irritant and weak positive reactions. Independent of AD status, a patient history of past or present allergic rhinitis was associated with an increased chance of a positive aeroallergen patch test reaction to pollen allergens. CONCLUSION The aeroallergen patch test is a useful add-on tool in clinical routine, especially in patients with AD and/or respiratory allergy. A patch test series comprising Dermatophagoides pteronyssinus, Dermatophagoides farinae, birch, timothy grass, cat dander and mugwort seems to be suitable. Controlled studies with specific provocation and elimination procedures are required to further evaluate the diagnostic significance of the proposed screening series.
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Affiliation(s)
- H Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - L Kuhlmann
- Department of Gynaecology and Obstetrics, St. Vincenz Hospital, Vestische Caritas Clinics GmbH, Datteln, Germany
| | - A Bauer
- Department of Dermatology, University Allergy Centre, University of Dresden, Dresden, Germany
| | - A J Bircher
- Allergy Unit, Dermatology Clinic, University Hospital Basel, University of Basel, Basel, Switzerland
| | - K Breuer
- Department of Allergology, Dermatologikum Hamburg, Hamburg, Germany
| | - T Fuchs
- Department of Dermatology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - J Grabbe
- Department of Dermatology and Allergology, Kantonsspital Aarau, Aarau, Switzerland
| | - V Mahler
- Department of Dermatology, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - C Pföhler
- Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany
| | - B Przybilla
- Department of Dermatology and Allergology, Ludwig Maximilians University of Munich, Munich, Germany
| | - J Rieker-Schwienbacher
- Centre for Dermatology, Phlebology and Allergology, Hospital Stuttgart, Stuttgart, Germany
| | - C Schröder-Kraft
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), BG Hospital Hamburg, Hamburg, Germany
| | - D Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - R Treudler
- Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany
| | - E Weisshaar
- Occupational Dermatology, Department of Dermatology, Ruprecht Karls University of Heidelberg, Heidelberg, Germany
| | - M Worm
- Division of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - E Trinder
- Department of Medicine I, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - J Geier
- Information Network of Departments of Dermatology (IVDK), University Medical Center Göttingen, Göttingen, Germany
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