Skip to main content
SpringerLink
Log in

The role of the environment in allergic skin disease

  • Review
  • Published:
Current Allergy and Asthma Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This paper explores how environmental factors influence allergic skin diseases, including atopic dermatitis (AD), contact dermatitis (CD), urticaria, angioedema, and reactions to drugs and insect bites.

Recent Findings

Research indicates a significant impact of environmental elements on allergic skin diseases. High air pollution levels exacerbate symptoms, while climate change contributes to increased skin barrier dysfunction, particularly affecting AD. Allergen prevalence is influenced by climate and pollution. Irritants, like those in detergents and cosmetics, play a major role in CD. Plants also contribute, causing various skin reactions.

Summary

Understanding the interplay between environmental factors and allergic skin diseases is crucial for effective management. Physicians must address these factors to support patient well-being and promote skin health amidst environmental changes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data Availability

No data was collected or analytical code used as part of this study. All data and information discussed in this article can be found in the articles included on our reference list.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. George S, Yu J. Patch Testing in atopic children: Is there a difference? Curr Dermatol Reports. 2023;12(4):1–6. https://doi.org/10.1007/s13671-023-00409-5.

    Article  Google Scholar 

  2. Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023):1109–22.

    Article  PubMed  Google Scholar 

  3. Williams H, Flohr C. How epidemiology has challenged 3 prevailing concepts about atopic dermatitis. J Allergy Clin Immunol. 2006;118(1):209–13.

    Article  PubMed  Google Scholar 

  4. Bosma AL, et al. Classifying atopic dermatitis: a systematic review of phenotypes and associated characteristics. J Eur Acad Dermatol Venereol. 2022;36(6):807–19.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Elias PM, Steinhoff M. “Outside-to-inside” (and now back to “outside”) pathogenic mechanisms in atopic dermatitis. J Invest Dermatol. 2008;128(5):1067–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Cork M, et al. Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol. 2003;149(3):582–9.

    Article  CAS  PubMed  Google Scholar 

  7. • Paller AS, et al. Dupilumab in children aged 6 months to younger than 6 years with uncontrolled atopic dermatitis: a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2022;400(10356):908–19.

    Article  CAS  PubMed  Google Scholar 

  8. • Blauvelt A, et al. Efficacy and Safety of Upadacitinib vs Dupilumab in Adults With Moderate-to-Severe Atopic Dermatitis: A Randomized Clinical Trial. JAMA Dermatol. 2021;157(9):1047–55.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Mikhaylov D, et al. Oral Janus kinase inhibitors for atopic dermatitis. Ann Allergy Asthma Immunol. 2023;130(5):577–92.

    Article  CAS  PubMed  Google Scholar 

  10. Scheinman PL, et al. Contact dermatitis Nat Rev Dis Primers. 2021;7(1):38.

    Article  PubMed  Google Scholar 

  11. Diepgen TL, et al. Prevalence of contact allergy in the general population in different European regions. Br J Dermatol. 2016;174(2):319–29.

    Article  CAS  PubMed  Google Scholar 

  12. Alinaghi F, et al. Prevalence of contact allergy in the general population: A systematic review and meta-analysis. Contact Dermatitis. 2019;80(2):77–85.

    Article  CAS  PubMed  Google Scholar 

  13. Li Y, Li L. Contact Dermatitis: Classifications and Management. Clin Rev Allergy Immunol. 2021;61(3):245–81.

    Article  PubMed  Google Scholar 

  14. Coffin SL, Turrentine JE, Cruz PD Jr. Photodermatitis for the Allergist. Curr Allergy Asthma Rep. 2017;17(6):36.

    Article  PubMed  Google Scholar 

  15. Kolkhir P, et al. Urticaria Nat Rev Dis Primers. 2022;8(1):61.

    Article  PubMed  Google Scholar 

  16. Zuberbier T, et al. Epidemiology of urticaria: a representative cross-sectional population survey. Clin Exp Dermatol. 2010;35(8):869–73.

    Article  CAS  PubMed  Google Scholar 

  17. Lee SJ, et al. Prevalence and Risk Factors of Urticaria With a Focus on Chronic Urticaria in Children. Allergy Asthma Immunol Res. 2017;9(3):212–9.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Church MK, et al. The role and relevance of mast cells in urticaria. Immunol Rev. 2018;282(1):232–47.

    Article  CAS  PubMed  Google Scholar 

  19. Zuberbier T, et al. The international EAACI/GA2LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77(3):734–66.

    Article  PubMed  Google Scholar 

  20. Weller K, et al. Epidemiology, comorbidities, and healthcare utilization of patients with chronic urticaria in Germany. J Eur Acad Dermatol Venereol. 2022;36(1):91–9.

    Article  CAS  PubMed  Google Scholar 

  21. Gonçalo M, et al. The global burden of chronic urticaria for the patient and society. Br J Dermatol. 2021;184(2):226–36.

    Article  PubMed  Google Scholar 

  22. Türk M, et al. How to Treat Patients with Chronic Spontaneous Urticaria with Omalizumab: Questions and Answers. J Allergy Clin Immunol Pract. 2020;8(1):113–24.

    Article  PubMed  Google Scholar 

  23. Kazandjieva J, Christoff G. Angioedema as a systemic disease. Clin Dermatol. 2019;37(6):636–43.

    Article  PubMed  Google Scholar 

  24. Zalewska-Janowska A, Spiewak R, Kowalski ML. Cutaneous Manifestation of Drug Allergy and Hypersensitivity. Immunol Allergy Clin North Am. 2017;37(1):165–81.

    Article  PubMed  Google Scholar 

  25. Naldi L, Crotti S. Epidemiology of cutaneous drug-induced reactions. G Ital Dermatol Venereol. 2014;149(2):207–18.

    CAS  PubMed  Google Scholar 

  26. Ardern-Jones MR, Friedmann PS. Skin manifestations of drug allergy. Br J Clin Pharmacol. 2011;71(5):672–83.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Blumenthal KG, Ziegler JB. Hypersensitivity Reactions, Dietary Supplements, and the Importance of the Case Report. J Allergy Clin Immunol Pract. 2016;4(1):177–8.

    Article  PubMed  Google Scholar 

  28. Cohen PA. Assessing supplement safety—the FDA’s controversial proposal. N Engl J Med. 2012;366(5):389–91.

    Article  CAS  PubMed  Google Scholar 

  29. Teresa Ventura M, et al. Hypersensitivity reactions to complementary and alternative medicine products. Curr Pharm Des. 2006;12(26):3393–9.

    Article  Google Scholar 

  30. Abrams EM, Golden DBK. Approach to Patients with Stinging Insect Allergy. Med Clin North Am. 2020;104(1):129–43.

    Article  PubMed  Google Scholar 

  31. Golden DB, et al. Stinging insect hypersensitivity: A practice parameter update 2016. Ann Allergy Asthma Immunol. 2017;118(1):28–54.

    Article  PubMed  Google Scholar 

  32. Golden DB. Insect sting anaphylaxis. Immunol Allergy Clin North Am. 2007;27(2):261–72.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Simons FER. Anaphylaxis. J Aller Clin Immunol. 2010;125(Supplement 2):S161–81.

    Article  Google Scholar 

  34. Singh S, Mann BK. Insect bite reactions. Indian J Dermatol Venereol Leprol. 2013;79(2):151–64.

    Article  PubMed  Google Scholar 

  35. Jadoo AS, Treat JR. Caterpillar dermatitis: A brief report. Pediatr Dermatol. 2020;37(3):570–1.

    Article  PubMed  Google Scholar 

  36. Elston DM. Bites and stings. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. Elsevier; 2018. p. 1516–35.

    Google Scholar 

  37. World Health Organization. WHO global air quality guidelines: particulate matter (PM(2.5) and PM(10)), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. Geneva: World Health Organization; 2021. https://apps.who.int/iris/bitstream/handle/10665/345329/9789240034228-eng.pdf.

  38. • Li A, et al. Associations between air pollution, climate factors and outpatient visits for eczema in West China Hospital, Chengdu, south-western China: a time series analysis. J Eur Acad Dermatol Venereol. 2018;32(3):486–94.

    Article  CAS  PubMed  Google Scholar 

  39. Pesce G, et al. Adult eczema in Italy: prevalence and associations with environmental factors. J Eur Acad Dermatol Venereol. 2015;29(6):1180–7.

    Article  CAS  PubMed  Google Scholar 

  40. Belugina IN, et al. Outdoor environment, ozone, radionuclide-associated aerosols and incidences of infantile eczema in Minsk. Belarus J Eur Acad Dermatol Venereol. 2018;32(11):1977–85.

    Article  CAS  PubMed  Google Scholar 

  41. Kim YM, et al. Short-term effects of weather and air pollution on atopic dermatitis symptoms in children: A panel study in Korea. PLoS ONE. 2017;12(4): e0175229.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Kim YM, et al. The effects of particulate matter on atopic dermatitis symptoms are influenced by weather type: Application of spatial synoptic classification (SSC). Int J Hyg Environ Health. 2018;221(5):823–9.

    Article  CAS  PubMed  Google Scholar 

  43. Cecchi L, D’Amato G, Annesi-Maesano I. External exposome and allergic respiratory and skin diseases. J Allergy Clin Immunol. 2018;141(3):846–57.

    Article  PubMed  Google Scholar 

  44. Belzer A, Parker ER. Climate Change, Skin Health, and Dermatologic Disease: A Guide for the Dermatologist. Am J Clin Dermatol. 2023;24(4):577–93.

    Article  PubMed  Google Scholar 

  45. Andersen LK, et al. Climate change and skin disease: a review of the English-language literature. Int J Dermatol. 2012;51(6):656–61.

    Article  PubMed  Google Scholar 

  46. St Leger RJ. Insects and their pathogens in a changing climate. J Invertebr Pathol. 2021;184: 107644.

    Article  PubMed  Google Scholar 

  47. Kuo IH, et al. The cutaneous innate immune response in patients with atopic dermatitis. J Allergy Clin Immunol. 2013;131(2):266–78.

    Article  CAS  PubMed  Google Scholar 

  48. Celebi Sözener Z, et al. Environmental factors in epithelial barrier dysfunction. J Allergy Clin Immunol. 2020;145(6):1517–28.

    Article  PubMed  Google Scholar 

  49. Román-Carrasco P, et al. The α-Gal Syndrome and Potential Mechanisms. Front Allergy. 2021;2: 783279.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Bains SN, Nash P, Fonacier L. Irritant Contact Dermatitis. Clin Rev Allergy Immunol. 2019;56(1):99–109.

    Article  CAS  PubMed  Google Scholar 

  51. Seyfarth F, et al. Dry skin, barrier function, and irritant contact dermatitis in the elderly. Clin Dermatol. 2011;29(1):31–6.

    Article  PubMed  Google Scholar 

  52. Zhai H, Maibach HI. Skin occlusion and irritant and allergic contact dermatitis: an overview. Contact Dermatitis: Review Article. 2001;44(4):201–6.

    Article  CAS  Google Scholar 

  53. Uter W, Gefeller O, Schwanitz HJ. An epidemiological study of the influence of season (cold and dry air) on the occurrence of irritant skin changes of the hands. Br J Dermatol. 1998;138(2):266–72.

    Article  CAS  PubMed  Google Scholar 

  54. Fluhr J, et al. Additive impairment of the barrier function by mechanical irritation, occlusion and sodium lauryl sulphate in vivo. Br J Dermatol. 2005;153(1):125–31.

    Article  CAS  PubMed  Google Scholar 

  55. McGovern TW. Dermatoses due to plants. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. Elsevier; 2018. p. 286–303.

    Google Scholar 

  56. Williford PM, Sheretz EF. Poison ivy dermatitis. Nuances in treatment Arch Fam Med. 1994;3(2):184–8.

    Article  CAS  PubMed  Google Scholar 

  57. Bousquet J, et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67(1):18–24.

    Article  CAS  PubMed  Google Scholar 

  58. Nixon RL, et al. Allergic contact dermatitis. In: Bolognia JL, Schaffer JV, Cerroni L, editors., et al., Dermatology. 4th ed. Elsevier; 2018. p. 242–61.

    Google Scholar 

  59. DeKoven JG, et al. North american contact dermatitis group patch test results 2013–2014. Dermatitis. 2017;28(1):33–46.

    Article  PubMed  Google Scholar 

  60. Zug KA, et al. Patch testing in children from 2005 to 2012: results from the North American contact dermatitis group. Dermatitis. 2014;25(6):345–55.

    Article  PubMed  Google Scholar 

  61. Jacob SE, Admani S. iPad–increasing nickel exposure in children. Pediatrics. 2014;134(2):e580–2.

    Article  PubMed  Google Scholar 

  62. Boyapati A, et al. Allergic contact dermatitis to methylisothiazolinone: exposure from baby wipes causing hand dermatitis. Australas J Dermatol. 2013;54(4):264–7.

    Article  PubMed  Google Scholar 

  63. Scheinman PL. The foul side of fragrance-free products: what every clinician should know about managing patients with fragrance allergy. J Am Acad Dermatol. 1999;41(6):1020–4.

    Article  CAS  PubMed  Google Scholar 

  64. Scheman A, et al. Balsam of Peru: past and future. Dermatitis. 2013;24(4):153–60.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Duke University School of Medicine, 1000 Trent Dr, Durham, NC, 27710, USA

    Khushnood Faraz & Mason Seely

  2. Department of Dermatology, Duke University Medical Center, 1000 Trent Dr, Durham, NC, 27710, USA

    Anne L. Marano

Authors
  1. Khushnood Faraz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mason Seely
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anne L. Marano
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

K.F. wrote the main manuscript text, M.S. revised the manuscript and created informational tables, A.M. provided significant writing guidance/direction and edits. All authors reviewed the manuscript.

Corresponding author

Correspondence to Anne L. Marano.

Ethics declarations

Conflict of Interest

Author A declares that she has no conflict of interest. Author B is an Immunovant scientific advisory board consultant, biogen principal investigator for clinical trials, and a Bristol myers squibb principal investigator for clinical trials.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Faraz, K., Seely, M. & Marano, A.L. The role of the environment in allergic skin disease. Curr Allergy Asthma Rep (2024). https://doi.org/10.1007/s11882-024-01147-9

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11882-024-01147-9

Keywords

Search

Navigation