Skip to main content
SpringerLink
Log in

Contact allergy in atopic individuals in relation to allergen-specific immunotherapy

  • Clinical report
  • Published:
European Journal of Dermatology

Abstract

Background

Type I sensitizations and atopic dermatitis (AD) often appear in the same patient. Beneficial effects of allergen-specific immunotherapy (ASIT) in patients with bothADand type I allergies have been reported. The predisposing role of AD to the development of type IV sensitization is discussed. Whether ASIT for type I allergy also influences type IV allergies is unknown.

Objectives

To compare the number of contact allergies between patients with and without AD, before and after one year’s treatment with ASIT.

Materials and methods

A controlled, single-blind multicentre study of children/adults with allergic asthma and/or rhinoconjunctivitis, treated or untreated with ASIT, was performed. The history of AD was collected using questionnaires. The number of contact allergies was assessed by patch testing with a baseline series.

Results

205 individuals completed the study; 133 treated with ASIT (exposed) and 72 before starting ASIT (unexposed). For participants with AD, significantly more contact allergies were found in the groups of all children (p = 0.002), all exposed children (p<0.001), and all exposed study persons (p = 0.013). Independent of AD, significantly more contact allergies were noted in the groups of all unexposed adults (p = 0.004) and all unexposed study persons (p = 0.004).

Conclusion

The higher number of contact allergies in patients with AD indicates that AD may be a risk factor for type IV sensitization in those with allergic asthma and/or rhinoconjunctivitis. The lower number of contact allergies in patients exposed to ASIT suggests an immunomodulatory effect on type IV sensitization.

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

References

  1. Noon L CB, Eng F. Prophylactic inoculation against hay fever. Lancet 1911; 177: 1572–3.

    Article  Google Scholar 

  2. Weller K, Soost S, Worm M, Maurer M, Zuberbier T. Atopic dermatitis and allergic rhinitis–do co-effects in therapy exist? J Dtsch Dermatol Ges 2012; 10: 221–36, quiz: 38-9.

    PubMed  Google Scholar 

  3. Bae JM, Choi YY, Park CO, Chung KY, Lee KH. Efficacy of allergenspecific immunotherapy for atopic dermatitis: a systematic review and meta-analysis of randomized controlled trials. J Allergy Clin Immunol 2013; 132: 110–7.

    Article  PubMed  Google Scholar 

  4. Spiewak R. Immunotherapy of allergic contact dermatitis. Immunotherapy 2011; 3: 979–96.

    Article  CAS  PubMed  Google Scholar 

  5. Johansson SG, Bieber T, Dahl R, et al. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol 2004; 113: 832–6.

    Article  CAS  PubMed  Google Scholar 

  6. Spergel JM. Epidemiology of atopic dermatitis and atopic march in children. Immunol Allergy Clin North Am 2010; 30: 269–80.

    Article  PubMed  Google Scholar 

  7. Netterlid E, Hindsen M, Bjork J, et al. There is an association between contact allergy to aluminium and persistent subcutaneous nodules in children undergoing hyposensitization therapy. Contact Dermatitis 2009; 60: 41–9.

    Article  PubMed  Google Scholar 

  8. Netterlid E, Hindsen M, Ekqvist S, Henricson KA, Bruze M. Young individuals with atopic disease and asthma or rhinoconjunctivitis may have clinically relevant contact allergies. Dermatitis 2014; 25: 115–9.

    Article  CAS  PubMed  Google Scholar 

  9. Clemmensen O, Knudsen HE. Contact sensitivity to aluminium in a patient hyposensitized with aluminium precipitated grass pollen. Contact Dermatitis 1980; 6: 305–8.

    Article  CAS  PubMed  Google Scholar 

  10. Frost L, Johansen P, Pedersen S, Veien N, Ostergaard PA, Nielsen MH. Persistent subcutaneous nodules in children hyposensitized with aluminium-containing allergen extracts. Allergy 1985; 40: 368–72.

    Article  CAS  PubMed  Google Scholar 

  11. Bergfors E, Trollfors B, Inerot A. Unexpectedly high incidence of persistent itching nodules and delayed hypersensitivity to aluminium in children after the use of adsorbed vaccines from a single manufacturer. Vaccine 2003; 22: 64–9.

    Article  PubMed  Google Scholar 

  12. Netterlid E, Hindsen M, Siemund I, et al. Does allergen-specific immunotherapy induce contact allergy to aluminium? Acta Derm Venereol 2013; 93: 50–6.

    CAS  PubMed  Google Scholar 

  13. Stenberg B, Lindberg M, Meding B, Svensson A. Is the question’ Have you had childhood eczema?’ useful for assessing childhood atopic eczema in adult population surveys? Contact Dermatitis 2006; 54: 334–7.

    Article  PubMed  Google Scholar 

  14. Bruze M, Andersen KE, Goossens A, & ESCD; EECDRG. Recommendation to include fragrance mix 2 and hydroxyisohexyl 3-cyclohexene carboxaldehyde (Lyral) in the European baseline patch test series. Contact Dermatitis 2008; 58: 129–33.

    Article  CAS  PubMed  Google Scholar 

  15. Wilkinson DS, Fregert S, Magnusson B, et al. Terminology of contact dermatitis. Acta Derm Venereol 1970; 50: 287–92.

    CAS  PubMed  Google Scholar 

  16. Simonsen AB, Deleuran M, Johansen JD, Sommerlund M. Contact allergy and allergic contact dermatitis in children -a review of current data. Contact Dermatitis 2011; 65: 254–65.

    Article  PubMed  Google Scholar 

  17. Mortz CG, Lauritsen JM, Bindslev-Jensen C, Andersen KE. Prevalence of atopic dermatitis, asthma, allergic rhinitis, and hand and contact dermatitis in adolescents. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis. Br J Dermatol 2001; 144: 523–32.

    CAS  PubMed  Google Scholar 

  18. Ponyai G, Hidvegi B, Nemeth I, Sas A, Temesvari E, Karpati S. Contact and aeroallergens in adulthood atopic dermatitis. J Eur Acad Dermatol Venereol 2008; 22: 1346–55.

    Article  CAS  PubMed  Google Scholar 

  19. Landeck L, Schalock P, Baden L, Gonzalez E. Contact sensitization pattern in 172 atopic subjects. Int J Dermatol 2011; 50: 806–10.

    Article  PubMed  Google Scholar 

  20. Dotterud LK, Smith-Sivertsen T. Allergic contact sensitization in the general adult population: a population-based study from Northern Norway. Contact Dermatitis 2007; 56: 10–5.

    Article  CAS  PubMed  Google Scholar 

  21. Thyssen JP, Linneberg A, Menne T, Johansen JD. The epidemiology of contact allergy in the general population–prevalence and main findings. Contact Dermatitis 2007; 57: 287–99.

    Article  PubMed  Google Scholar 

  22. Shaughnessy CN, Malajian D, Belsito DV. Cutaneous delayedtype hypersensitivity in patients with atopic dermatitis: reactivity to topical preservatives. J Am Acad Dermatol 2014; 70: 102–7.

    Article  CAS  PubMed  Google Scholar 

  23. Diepgen TL, Ofenloch RF, Bruze M, et al. Prevalence of contact allergy in the general population in different European regions. Br J Dermatol 2016; 174: 319–29.

    Article  CAS  PubMed  Google Scholar 

  24. Bingefors K, Svensson A, Isacson D, Lindberg M. Self-reported lifetime prevalence of atopic dermatitis and co-morbidity with asthma and eczema in adulthood: a population-based cross-sectional survey. Acta Derm Venereol 2013; 93: 438–41.

    Article  PubMed  Google Scholar 

  25. Ballardini N, Kull I, Lind T, et al. Development and comorbidity of eczema, asthma and rhinitis to age 12: data from the BAMSE birth cohort. Allergy 2012; 67: 537–44.

    Article  CAS  PubMed  Google Scholar 

  26. Niebuhr M, Kapp A, Werfel T. Specific immunotherapy in the treatment of atopic dermatitis. Hautarzt 2007; 58: 232–6.

    Article  CAS  PubMed  Google Scholar 

  27. Heine G, Schnuch A, Uter W, Worm M, & Information Network of Departments of D, German Contact Dermatitis Research G. Type-IV sensitization profile of individuals with atopic eczema: results from the Information Network of Departments of Dermatology (IVDK) and the German Contact Dermatitis Research Group (DKG). Allergy 2006; 61: 611–6.

    Article  CAS  PubMed  Google Scholar 

  28. Czarnobilska E, Obtulowicz K, Dyga W, Spiewak R. A half of schoolchildren with’ ISAAC eczema’ are ill with allergic contact dermatitis. J Eur Acad Dermatol Venereol 2011; 25: 1104–7.

    Article  CAS  PubMed  Google Scholar 

  29. Lammintausta K, Kalimo K, Fagerlund VL. Patch test reactions in atopic patients. Contact Dermatitis 1992; 26: 234–40.

    Article  CAS  PubMed  Google Scholar 

  30. Mortz CG, Andersen KE. Allergic contact dermatitis in children and adolescents. Contact Dermatitis 1999; 41: 121–30.

    Article  CAS  PubMed  Google Scholar 

  31. Giordano-Labadie F, Rance F, Pellegrin F, Bazex J, Dutau G, Schwarze HP. Frequency of contact allergy in children with atopic dermatitis: results of a prospective study of 137 cases. Contact Dermatitis 1999; 40: 192–5.

    Article  CAS  PubMed  Google Scholar 

  32. Thyssen JP, Linneberg A, Engkilde K, Menne T, Johansen JD. Contact sensitization to common haptens is associated with atopic dermatitis: new insight. Br J Dermatol 2012; 166: 1255–61.

    Article  CAS  PubMed  Google Scholar 

  33. Herro EM, Matiz C, Sullivan K, Hamann C, Jacob SE. Frequency of contact allergens in pediatric patients with atopic dermatitis. J Clin Aesthet Dermatol 2011; 4: 39–41.

    PubMed  PubMed Central  Google Scholar 

  34. Mailhol C, Lauwers-Cances V, Rance F, Paul C, Giordano-Labadie F. Prevalence and risk factors for allergic contact dermatitis to topical treatment in atopic dermatitis: a study in 641 children. Allergy 2009; 64: 801–6.

    Article  CAS  PubMed  Google Scholar 

  35. Cronin E, McFadden JP. Patients with atopic eczema do become sensitized to contact allergens. Contact Dermatitis 1993; 28: 225–8.

    Article  CAS  PubMed  Google Scholar 

  36. Isaksson M, Olhardt S, Rådehed J, Svensson J. Å. Children with atopic dermatitis should always be patch-tested if they have hand or foot dermatitis. Acta Derm Venereol 2015; 95: 583–6.

    Article  PubMed  Google Scholar 

  37. Rees J, Friedmann PS, Matthews JN. Contact sensitivity to dinitrochlorobenzene is impaired in atopic subjects. Controversy revisited. Arch Dermatol 1990; 126: 1173–5.

    Article  CAS  PubMed  Google Scholar 

  38. de Groot AC. The frequency of contact allergy in atopic patients with dermatitis. Contact Dermatitis 1990; 22: 273–7.

    Article  PubMed  Google Scholar 

  39. Jappe U, Schnuch A, Uter W. Frequency of sensitization to antimicrobials in patients with atopic eczema compared with nonatopic individuals: analysis of multicentre surveillance data, 1995-1999. Br J Dermatol 2003; 149: 87–93.

    Article  CAS  PubMed  Google Scholar 

  40. de Waard-van der Spek FB, Andersen KE, Darsow U, et al. Allergic contact dermatitis in children: which factors are relevant? (review of the literature). Pediatr Allergy Immunol 2013; 24: 321–9.

    Article  PubMed  Google Scholar 

  41. Thyssen JP, McFadden JP, Kimber I. The multiple factors affecting the association between atopic dermatitis and contact sensitization. Allergy 2014; 69: 28–36.

    Article  CAS  PubMed  Google Scholar 

  42. Warshaw EM, Nelsen DD, Maibach HI, et al. Positive patch test reactions to lanolin: cross-sectional data from the north american contact dermatitis group, 1994 to 2006. Dermatitis 2009; 20: 79–88.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, S-205 02, Malmö, Sweden

    Ingrid Siemund, Monica Hindsén, Eva Netterlid & Magnus Bruze

  2. Department of Dermatology and Venereology, Skåne University Hospital, Lund University, S-221, 85 Lund, Sweden

    Ingrid Siemund

  3. Swedish Institute for Communicable Infectious Disease Control, S-171 65, Solna, Sweden

    Eva Netterlid

  4. Region Skånes Competence Centre for Clinical Research, Skåne University Hospital, S-221, 85 Lund, Sweden

    Nuray Güner

Authors
  1. Ingrid Siemund
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Monica Hindsén
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eva Netterlid
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nuray Güner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Magnus Bruze
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ingrid Siemund.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Siemund, I., Hindsén, M., Netterlid, E. et al. Contact allergy in atopic individuals in relation to allergen-specific immunotherapy. Eur J Dermatol 26, 271–280 (2016). https://doi.org/10.1684/ejd.2016.2765

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1684/ejd.2016.2765

Keywords

Search

Navigation