Susann Forkel1, Naciye Cevik1, Tillmann Schill1, Margitta Worm2, Vera Mahler3,4, Elke Weisshaar5, Dieter Vieluf6, Wolfgang Pfützner7, Harald Löffler8, Michael P Schön1,9, Johannes Geier9,10, Timo Buhl1,9. 1. Department of Dermatology, Venereology and Allergology, University Medical Centre Göttingen, Germany. 2. Department of Dermatology, Venereology and Allergology, Charité University Medicine Berlin, Germany. 3. Paul-Ehrlich-Institut, Langen, Germany. 4. Department of Dermatology, University Hospital Erlangen, Germany. 5. Occupational Dermatology, Department of Dermatology, University of Heidelberg, Germany. 6. BG Clinic Falkenstein, Occupational Dermatology, Falkenstein, Germany. 7. Department of Dermatology and Allergology, Allergy Center Hessen, University Medical Center Marburg, Germany. 8. Department of Dermatology, Allergology and Phlebology, SLK Clinics Heilbronn, Germany. 9. Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Germany. 10. Information Network of Departments of Dermatology (IVDK), University Medical Center Göttingen, Germany.
Abstract
BACKGROUND: The association of atopic dermatitis (AD) and allergic contact dermatitis has been a matter of considerable uncertainty. Study results range from lack of any association to increased sensitization for multiple allergens, but fail to identify consistent allergen associations. OBJECTIVE: We studied a large patch test cohort of patients stratified by their atopic skin diathesis using the Erlangen Atopy Score (EAS), independent of active skin disease. METHODS: Retrospective multi-center data analysis from five departments of dermatology in Germany with 4,509 patients. Patients were grouped as "no atopic skin diathesis" (n = 2,165) and "atopic skin diathesis" (n = 1,743), according to EAS. RESULTS: Significantly more individuals with atopic skin diathesis showed at least one positive patch test reaction to the baseline series compared to individuals without atopic skin diathesis (49.1 % vs. 38.3 %). In logistic regression analyses, atopic skin diathesis was associated with a significantly higher risk of sensitization to methylchloroisothiazolinone/methylisothiazolinone (OR 2.383) and methylisothiazolinone (OR 1.891), thiuram mix (OR 1.614), as well as nickel (OR 1.530), cobalt (OR 1.683), and chromium (OR 2.089). CONCLUSIONS: Atopic skin diathesis proved to be the most important intrinsic risk factor for contact sensitization to few, specific allergens. Past or present AD was a less relevant variable.
BACKGROUND: The association of atopic dermatitis (AD) and allergic contact dermatitis has been a matter of considerable uncertainty. Study results range from lack of any association to increased sensitization for multiple allergens, but fail to identify consistent allergen associations. OBJECTIVE: We studied a large patch test cohort of patients stratified by their atopic skin diathesis using the Erlangen Atopy Score (EAS), independent of active skin disease. METHODS: Retrospective multi-center data analysis from five departments of dermatology in Germany with 4,509 patients. Patients were grouped as "no atopic skin diathesis" (n = 2,165) and "atopic skin diathesis" (n = 1,743), according to EAS. RESULTS: Significantly more individuals with atopic skin diathesis showed at least one positive patch test reaction to the baseline series compared to individuals without atopic skin diathesis (49.1 % vs. 38.3 %). In logistic regression analyses, atopic skin diathesis was associated with a significantly higher risk of sensitization to methylchloroisothiazolinone/methylisothiazolinone (OR 2.383) and methylisothiazolinone (OR 1.891), thiuram mix (OR 1.614), as well as nickel (OR 1.530), cobalt (OR 1.683), and chromium (OR 2.089). CONCLUSIONS: Atopic skin diathesis proved to be the most important intrinsic risk factor for contact sensitization to few, specific allergens. Past or present AD was a less relevant variable.