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Kontaktallergie und Atopie

Allergic contact dermatitis and atopy

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Zusammenfassung

Größere retrospektive Studien zeigen, dass epikutane Sensibilisierungen bei atopischen und nichtatopischen Patienten ähnlich häufig vorkommen. Auch bei Kindern und Jugendlichen scheint die Wahrscheinlichkeit für eine epikutane Sensibilisierung unabhängig von der Diagnose einer atopischen Dermatitis (AD) zu sein. Hingegen sind Patienten mit einer AD nach einer neueren Untersuchung in der Gruppe der polysensibilisierten Patienten überrepräsentiert. Als mögliche Risikofaktoren für eine epikutane Sensibilisierung bei AD wurden das Vorliegen IgE-vermittelter Sensibilisierungen und die Krankheitsdauer bzw. ein früher Krankheitsbeginn bei AD identifiziert. Ferner fördert eine gestörte Hautbarriere bei AD die Penetration von Kontaktallergenen und Irritanzien in die Epidermis und stellt einen wichtigen Kofaktor für die Sensibilisierung dar. Es konnte eine Assoziation zwischen dem Vorliegen von Mutationen im Filaggrin-Gen bei AD und einer klinisch relevanten Sensibilisierung gegenüber Nickel, nicht jedoch gegenüber anderen Kontaktallergenen nachgewiesen werden. Weitere prospektive Studien an großen Patientenkohorten sind notwendig, um den Zusammenhang zwischen gestörter Hautbarriere bei AD und dem Risiko der Entstehung einer Kontaktallergie näher zu untersuchen.

Abstract

Retrospective studies demonstrate that the prevalence of skin sensitization does not significantly differ between atopic and non-atopic patients. In children and adolescents the risk for sensitization seems to occur independently from AD. According to the results of a recent study, AD patients are overrepresented in the group of polysensitized patients. IgE-mediated sensitization as well as an early onset of AD and duration of the disease have been identified as possible risk factors for skin sensitization to contact allergens. A defective permeability barrier with increased epidermal water loss is a hallmark of AD and contributes to sensitization against common allergens. A highly significant association between FLG mutations and the risk of early onset, severe, persistent AD and an increased risk for asthma has been shown in several studies. A more recent study revealed an association between FLG mutations and increased nickel sensitization, but not other contact allergens. However, further large prospective studies with well-characterized patients are necessary to clarify the correlation between impaired skin barrier, atopic dermatitis and allergic contact dermatitis.

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Authors and Affiliations

  1. Klinik für Dermatologie, Allergologie und Venerologie , Medizinische Hochschule Hannover, Ricklinger Str. 5, 30449, Hannover, Deutschland

    M. Niebuhr, A. Kapp, T. Werfel & A. Heratizadeh

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  1. M. Niebuhr
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  2. A. Kapp
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  3. T. Werfel
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  4. A. Heratizadeh
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Correspondence to M. Niebuhr.

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Niebuhr, M., Kapp, A., Werfel, T. et al. Kontaktallergie und Atopie. Hautarzt 62, 744–750 (2011). https://doi.org/10.1007/s00105-011-2182-1

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