Allergic Contact Dermatitis in Patients with Atopic Dermatitis

Purpose of Review
It is still debated whether the risk of allergic contact dermatitis (ACD) is altered in patients with atopic dermatitis (AD). In this article, the recent literature on the risk of ACD in AD patients is reviewed and put into a clinical context.

Recent Findings
ACD is common in AD patients, but a literature review showed conflicting results on the exact risk compared to non-AD individuals. The development of ACD in AD patients is affected by the dysfunctional skin barrier in particular due to filaggrin deficiency, the Th2 inflammatory immune dysregulation, and microbial dysbiosis. While the increased exposure to topical allergens in AD patients increases the risk of ACD in AD, the Th2-skewed immune response observed in AD reduces the risk of ACD in a severity-dependent manner.

Summary
ACD should be considered in AD patients with eczema worsening, or atypical morphology and generalization despite relevant treatment. Special attention should be paid to the increased risk of ACD to allergens found in topical products.