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Rudzikaitė-Fergizė G, Senulytė A, Guobytė N, Jurėnas A, Macejevska M, Grigaitienė J. Prevalence and trends of contact sensitization in patients with psoriasis in Lithuania. JAAD Int 2024; 16:59-65. [PMID: 38774342 PMCID: PMC11107226 DOI: 10.1016/j.jdin.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 05/24/2024] Open
Abstract
Background Psoriasis and allergic contact dermatitis are 2 very common dermatoses. The relationship between them has not yet been fully understood. Contact dermatitis can be an additional cause of epidermal disruption in psoriasis patients, resulting in poor management of the disease. Objective To analyze the tendencies of contact sensitization in a cohort of psoriasis patients with suspected allergic contact dermatitis. Methods Psoriasis patients (n = 85) with suspected contact dermatitis underwent patch testing with European Baseline allergen series S-1000 in Vilnius University Hospital Santaros Klinikos Centre of Dermatovenereology from August 2020 to August 2021. Their results are presented in this study. Results The patch test was positive in 43.5% (n = 37) of patients. Contact sensitization was more prevalent in patients with mild psoriasis, as characterized by Psoriasis Area Surface Index scores ≤10, compared to those with moderate-to-severe psoriasis (P < .05). Generalized psoriasis and nail involvement were more common among nonsensitized patients (P < .05). Most common contact allergens among sensitized patients were nickel (II) sulfate, formaldehyde, and potassium dichromate. Conclusion An inverse trend was observed between psoriasis severity and contact sensitization. Extended psoriatic involvement was uncommon in sensitized patients.
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Affiliation(s)
- Gabija Rudzikaitė-Fergizė
- Clinic of Infectious Diseases and Dermatovenereology, Vilnius University Faculty of Medicine, Vilnius, Lithuania
- Centre of Dermatovenereology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Augustė Senulytė
- Clinic of Infectious Diseases and Dermatovenereology, Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - Neringa Guobytė
- Centre of Dermatovenereology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Andrius Jurėnas
- Centre of Dermatovenereology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | | | - Jūratė Grigaitienė
- Clinic of Infectious Diseases and Dermatovenereology, Vilnius University Faculty of Medicine, Vilnius, Lithuania
- Centre of Dermatovenereology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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Roach K, Roberts J. A comprehensive summary of disease variants implicated in metal allergy. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2022; 25:279-341. [PMID: 35975293 PMCID: PMC9968405 DOI: 10.1080/10937404.2022.2104981] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Allergic disease represents one of the most prominent global public health crises of the 21st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.
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Affiliation(s)
- Ka Roach
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
| | - Jr Roberts
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
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Stănescu AMA, Cristea AMA, Bejan GC, Vieru M, Simionescu AA, Popescu FD. Allergic Contact Cell-Mediated Hypersensitivity in Psoriasis: A Narrative Minireview. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58070914. [PMID: 35888633 PMCID: PMC9324524 DOI: 10.3390/medicina58070914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
The dysfunctionality of the protective skin barrier in psoriasis allows easier cutaneous penetration of various contact haptens; thus, such patients can develop allergic contact hypersensitivity as a comorbidity. Both skin conditions involve T-cell-mediated mechanisms. Dermatologists and allergists should consider assessing allergic contact cell-mediated hypersensitivity in selected psoriasis patients, especially those with palmoplantar psoriasis and who are refractory to topical treatments, and in patients with psoriasis, with or without arthritis, treated with biologics that present skin lesions clinically suggestive of contact dermatitis.
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Affiliation(s)
| | - Ana-Maria-Antoaneta Cristea
- Department of Allergology and Clinical Immunology, Nicolae Malaxa Clinical Hospital, 022441 Bucharest, Romania; (A.-M.-A.C.); (F.-D.P.)
| | - Gabriel Cristian Bejan
- Department of Family Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Correspondence: (G.C.B.); (M.V.)
| | - Mariana Vieru
- Department of Allergology and Clinical Immunology, Nicolae Malaxa Clinical Hospital, 022441 Bucharest, Romania; (A.-M.-A.C.); (F.-D.P.)
- Department of Allergology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: (G.C.B.); (M.V.)
| | - Anca Angela Simionescu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | - Florin-Dan Popescu
- Department of Allergology and Clinical Immunology, Nicolae Malaxa Clinical Hospital, 022441 Bucharest, Romania; (A.-M.-A.C.); (F.-D.P.)
- Department of Allergology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Claßen A, Buhl T, Schubert S, Worm M, Bauer A, Geier J, Molin S. The frequency of specific contact allergies is reduced in patients with psoriasis. Br J Dermatol 2018; 180:315-320. [DOI: 10.1111/bjd.17080] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2018] [Indexed: 12/17/2022]
Affiliation(s)
- A. Claßen
- Department of Dermatology and Allergology University Medical Center Göttingen Göttingen Germany
| | - T. Buhl
- Department of Dermatology and Allergology University Medical Center Göttingen Göttingen Germany
| | - S. Schubert
- Information Network of Departments of Dermatology (IVDK) University of Göttingen Göttingen Germany
| | - M. Worm
- Department of Dermatology and Allergology Allergy‐Center‐Charité, Charité – Universitätsmedizin Berlin Berlin Germany
| | - A. Bauer
- Department of Dermatology University Hospital Carl Gustav Carus Technical University Dresden Dresden Germany
| | - J. Geier
- Information Network of Departments of Dermatology (IVDK) University of Göttingen Göttingen Germany
| | - S. Molin
- Department of Dermatology and Allergy Ludwig Maximilian University Munich Germany
- Division of Dermatology Queen's University 166 Brock Street C3‐027 Kingston ON K7L 5G2 Canada
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Žužul K, Kostović K, Čeović R, Ljubojević Hadžavdić S. Contact hypersensitivity in patients with psoriasis. Contact Dermatitis 2018. [PMID: 29527724 DOI: 10.1111/cod.12921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kristina Žužul
- Private Dermatovenereology Clinic, 47000 Karlovac, Croatia
| | - Krešimir Kostović
- Department of Dermatology and Venereology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Romana Čeović
- Department of Dermatology and Venereology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Suzana Ljubojević Hadžavdić
- Department of Dermatology and Venereology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Rasool F, Akhtar S, Hassan I, Zeerak S, Mubashir S, Sheikh G. Common Contact Allergens in Patients with Palmoplantar and Scalp Psoriasis and Impact of their Avoidance on Dermatology Life Quality Index: A Hospital-Based Study. Indian J Dermatol 2018; 63:160-164. [PMID: 29692459 PMCID: PMC5903047 DOI: 10.4103/ijd.ijd_760_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: Scalp psoriasis and psoriasis limited to palms and/or soles have been referred to as difficult to control psoriasis. Contact allergy has long been suspected to aggravate existing lesions and cause resistance to therapy in these psoriasis variants. Objectives: The objective of the study was to assess common contact allergens in patients with palmoplantar and scalp psoriasis and the impact of their avoidance on dermatology life quality index (DLQI). Materials and Methods: A total of 54 patients with palmoplantar and scalp psoriasis were patch tested with Indian Standard Series. The patch test results were read on day 2 and day 4. DLQI was calculated before patch testing and at 1 month and 3 month in patch test positive patients after instructing allergen avoidance. Results: Sixteen out of fifty-four patients (29.62%) showed positive patch test reactions. Metal antigens like nickel and cobalt were the most common sensitizers identified. Statistically significant improvement in DLQI was observed at 1 month and at 3 month of allergen avoidance. Conclusion: Patch testing is a useful test to determine the triggering or aggravating antigens in patients with palmoplantar and scalp psoriasis and subsequent allergen avoidance should be stressed on.
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Affiliation(s)
- Farhan Rasool
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College Srinagar, University of Kashmir, Jammu and Kashmir, India
| | - Saniya Akhtar
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College Srinagar, University of Kashmir, Jammu and Kashmir, India
| | - Iffat Hassan
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College Srinagar, University of Kashmir, Jammu and Kashmir, India
| | - Sumaya Zeerak
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College Srinagar, University of Kashmir, Jammu and Kashmir, India
| | - Syed Mubashir
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College Srinagar, University of Kashmir, Jammu and Kashmir, India
| | - Gousia Sheikh
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College Srinagar, University of Kashmir, Jammu and Kashmir, India
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Bai S, Zhang Z, Hou S, Liu X. Influence of different types of contact hypersensitivity on imiquimod-induced psoriasis-like inflammation in mice. Mol Med Rep 2016; 14:671-80. [PMID: 27221314 PMCID: PMC4918611 DOI: 10.3892/mmr.2016.5299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 05/03/2016] [Indexed: 02/07/2023] Open
Abstract
It is currently believed that psoriasis and allergic contact dermatitis (ACD) are different diseases; however, they share clinical similarities. The involvement of T helper 17 (Th17) cells in these disorders provides a novel opportunity to investigate the relationship between them. The present study aimed to determine whether the same or overlapping inflammatory pathways are involved in the two diseases, and the influence of different types of ACD on psoriasis. Compound mouse models of Th1 or Th2‑type contact hypersensitivity (CHS) combined with imiquimod (IMQ)‑induced psoriasis‑like inflammation were established, in order to mimic the characteristics of ACD and psoriasis. Histopathology, immunohistochemistry and cytokine detection in blood serum and tissues were used to compare the differences between the mice treated with IMQ alone or IMQ combined with Th1 and Th2‑type CHS. As compared with the IMQ‑treated mice or IMQ-treated Th1‑type CHS mice, the mice with Th2‑type CHS treated with IMQ exhibited more serious psoriasis‑like inflammation with increased epidermal thickness and infiltrating cells in the derma. High mRNA expression levels of interleukin (IL)‑17, IL‑22, IL‑23, TNF‑α and RORγt were detected in back skin lesions. Additionally, high levels of IL‑17 and IL‑22 in blood serum were detected in IMQ‑treated mice combined with Th2‑type CHS. The mice treated with IMQ alone, and IMQ treatment combined with Th1‑type CHS had a comparable psoriasis‑like inflammatory response in the back skin. In conclusion, these data demonstrate that Th2‑type CHS exacerbated the IMQ‑treated psoriatic inflammation of mice via the IL‑23/IL‑17 axis. Th17 cells and associated pathways may link ACD and psoriasis. Therefore, patients with psoriasis should avoid contact with specific sensitizers, such as fragrance and rubber products, which may induce Th2 polarization.
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Affiliation(s)
- Shuang Bai
- Department of Dermatology and Venereology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Zhenying Zhang
- Department of Dermatology and Venereology, The University of Hong Kong‑Shenzhen Hospital, Shenzhen, Guangdong 518053, P.R. China
| | - Suchun Hou
- Department of Dermatology and Venereology, The University of Hong Kong‑Shenzhen Hospital, Shenzhen, Guangdong 518053, P.R. China
| | - Xiaoming Liu
- Department of Dermatology and Venereology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
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