Contact sensitization to common haptens is associated with atopic dermatitis: new insight

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Abstract

Introduction:  It has been much debated whether atopic dermatitis is associated with contact sensitization since past findings have conflicted. A positive association might change our clinical practice. Objective:  To investigate the association between atopic dermatitis and contact sensitization taking the likely route of allergen exposure into account. Materials and Methods:  Questionnaire and clinical data from a cross-sectional study performed in a general population in Copenhagen. A total of 3202 (40.4%) 18-69 year olds were patch tested, filaggrin genotyped for 2282del4 and R501X and questioned about AD Results:  The variable "contact sensitization to common chemicals, but not nickel and thimerosal", was significantly associated with atopic dermatitis (OR=2.53; CI95%=1.59-4.04). The higher prevalence of contact sensitization was mainly driven by fragrance chemicals. In a sub-analysis in non-pierced women, a positive association was also found for nickel sensitization. Nickel and thimerosal sensitization may introduce bias in data analysis since these allergies often develop following skin piercing where the skin compartments are bypassed. Discussion:  We suspect that individuals with self-reported atopic dermatitis from this study mainly suffered from mild disease. However, clinicians should be aware of increased levels of contact sensitization in individuals with atopic dermatitis. Patch testing should therefore be considered at an early point in individuals with a history of atopic dermatitis and active disease. The fundamental relationship between atopic disease and environmental chemical exposure may be of a more complex and intimate nature than previously supposed.
OriginalsprogEngelsk
TidsskriftBritish Journal of Dermatology
Vol/bind166
Udgave nummer6
Sider (fra-til)1255-1261
ISSN0007-0963
DOI
StatusUdgivet - 2012

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