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The role of patch testing for chemical and protein allergens in atopic dermatitis

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Abstract

Many patients who present for evaluation of allergic contact dermatitis have an atopic diathesis. Although the immunologic basis of atopic dermatitis differs from that of allergic contact dermatitis—and patients with atopic dermatitis are less easily sensitized under experimental conditions—atopic patients do develop allergic contact dermatitis, and patch testing is a valuable part of their medical care. Delayed (7-day) patch test readings are especially important in atopic patients to distinguish allergy from irritancy and to evaluate for steroid allergy. The utility of atopy patch tests to aeroallergens such as dust mite is increasingly recognized; aeroallergens may be the cause of a type of protein contact dermatitis.

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References and Recommended Reading

  1. Sutthipisal N, McFadden JP, Cronin E: Sensitization in atopic and non-atopic hairdressers with hand eczema. Contact Dermatitis 1993, 29:206–209.

    Article  PubMed  CAS  Google Scholar 

  2. Nassif A, Chan S, Storrs FJ, Hanifin JM: Abnormal skin irritancy in atopic dermatitis. Arch Dermatol 1994, 130:1402–1407.

    Article  PubMed  CAS  Google Scholar 

  3. Malten KE: The occurrence of hybrids between contact allergic eczema and atopic dermatitis (and vice versa) and their significance. Dermatologica 1968, 136:404–406.

    Article  PubMed  CAS  Google Scholar 

  4. Lugovic L, Lipozencic J: Contact hypersensitivity in atopic dermatitis. Arh Hig Rada Toksikol 1997, 48:287–296.

    PubMed  CAS  Google Scholar 

  5. Klas PA, Corey G, Storrs FJ, et al.: Allergic and irritant patch test reactions and atopic disease. Contact Dermatitis 1996, 34:121–124.

    Article  PubMed  CAS  Google Scholar 

  6. Valenta R, Seiberler S, Natter S, et al.: Autoallergy: a pathogenetic factor in atopic dermatitis? J Allergy Clin Immunol 2000, 105:432–437.

    Article  PubMed  CAS  Google Scholar 

  7. Fehr BS, Takashima A, Bergstresser PR, Cruz PD: T cells reactive to keratinocyte antigens are generated during induction of contact hypersensitivity in mice: a model for autoeczematization in humans? Am J Contact Dermatitis 2000, 3:145–154.

    Article  Google Scholar 

  8. Kang K, Stevens SR, Cooper KD: Cellular Mechanisms of Allergic Skin Responses. In Allergic Skin Disease. Edited by Leung DY, Greaves MW. New York: Marcel Dekker; 2000:53–86.

    Google Scholar 

  9. Jones HE, Lewis CW, McMarlin SL: Allergic contact sensitivity in atopic dermatitis. Arch Dermatol 1973, 107:217–222.

    Article  PubMed  CAS  Google Scholar 

  10. Palacios J, Fuller EW, Blaylock WK: Immunological capabilities of patients with atopic dermatitis. J Invest Dermatol 1966, 47:484–490.

    Article  PubMed  CAS  Google Scholar 

  11. Rees J, Friedmann PS, Matthews JNS: Contact sensitivity to dinitrochlorobenzene is impaired in atopic subjects. Arch Dermatol 1990, 126:1173–1175.

    Article  PubMed  CAS  Google Scholar 

  12. Forsbeck M, Hovmark A, Skog E: Patch testing, tuberculin testing and sensitization with dinitrochlorobenzene and nitrosodimethylanilini of patients with atopic dermatitis. Acta Derm Venereol 1976, 56:135–138.

    PubMed  CAS  Google Scholar 

  13. Uehara M, Sawai T: A longitudinal study of contact sensitivity in patients with atopic dermatitis. Arch Dermatol 1989, 125:366–368.

    Article  PubMed  CAS  Google Scholar 

  14. Rystedt I: Hand eczema in patients with history of atopic manifestations in childhood. Acta Derm Venereol 1985, 65:305–312.

    PubMed  CAS  Google Scholar 

  15. Goh CL: Eczema of the face, scalp, and neck: an epidemiological comparison by site. J Dermatol 1989, 16:223–226.

    PubMed  CAS  Google Scholar 

  16. Goh CL: An epidemiological comparison between occupational and non-occupational hand eczema. Br J Dermatol 1989, 120:77–82.

    Article  PubMed  CAS  Google Scholar 

  17. Cronin E, McFadden JP: Patients with atopic eczema do become sensitized to contact allergens. Contact Dermatitis 1993, 28:225–228.

    Article  PubMed  CAS  Google Scholar 

  18. Lever R, Forsyth A: Allergic contact dermatitis in atopic dermatitis. Acta Derm Venereol Suppl (Stockh) 1992, 176:95–98.

    CAS  Google Scholar 

  19. Marks JG, Belsito DV, DeLeo VA, et al.: North American Contact Dermatitis Group patch-test results, 1996–1998. Arch Dermatol 2000, 136:272–273.

    Article  PubMed  Google Scholar 

  20. Fedler R, Stromer K: Nickel sensitivity in atopics, psoriatics and healthy subjects. Contact Dermatitis 1993, 29:65–69.

    Article  PubMed  CAS  Google Scholar 

  21. Becker W, O’Brien MP: Value of patch tests in dermatologya special study of follicular reactions. Arch Dermatol 1958, 117:569–577.

    Google Scholar 

  22. Uehara M, Takahashi C, Ofuji S: Pustular patch test reactions in atopic dermatitis. Arch Dermatol 1975, 111:1154–1157.

    Article  PubMed  CAS  Google Scholar 

  23. Fischer T, Rystedt I: False-positive, follicular and irritant patch test reactions to metal salts. Contact Dermatitis 1985, 12:93–98.

    Article  PubMed  CAS  Google Scholar 

  24. Storrs FJ, White CR: False-positive "poral" cobalt patch test reactions reside in the eccrine acrosyringium. Cutis 2000, 65:49–53.

    PubMed  CAS  Google Scholar 

  25. Moller H, Larsson A, Bjorkner B, Bruze M: The histological and immunohistochemical pattern of positive patch test reactions to gold sodium thiosulfate. Acta Derm Venereol 1994, 74:417–423.

    PubMed  CAS  Google Scholar 

  26. Fleming C, Lucke T, Forsyth A, et al.: A controlled study of gold contact hypersensitivity. Contact Dermatitis 1998, 38:137–139. article delineates the problems with frequent irrelevant positive gold patch test reactions and shows that these reactions occur in the general population without dermatitis

    Article  PubMed  CAS  Google Scholar 

  27. Fisher A:Metallic gold: the cause of a persistent allergic "dermal" contact dermatitis. Cutis 1974, 14:177–180.

    Google Scholar 

  28. Fisher A: Allergic dermal contact dermatitis due to gold earrings. Cutis 1987, 39:473–475.

    PubMed  CAS  Google Scholar 

  29. Fox JM, Kennedy R, Rostenberg A: Eczematous contactsensitivity to gold. Arch Dermatol 1961, 83:110–113.

    Google Scholar 

  30. Estlander T, Kari O, Jolanki R, Kanerva L: Occupational allergic contact dermatitis and blepharoconjunctivitis caused by gold. Contact Dermatitis 1998, 38:40–59.

    Article  PubMed  CAS  Google Scholar 

  31. Laeijendecker R, van Joost T: Oral manifestations of gold allergy. J Am Acad Dermatol 1994, 30:205–209.

    Article  PubMed  CAS  Google Scholar 

  32. Ehrlich A, Belsito DV: Allergic contact dermatitis to gold. Cutis 2000, 65:323–326.

    PubMed  CAS  Google Scholar 

  33. Sinigaglia F: The molecular basis of metal recognition by T cells. J Invest Dermatol 1994, 102:398–401.

    Article  PubMed  CAS  Google Scholar 

  34. Kubicka-Muranyi M, Goebel C, Griem P, et al.: Adverse immune reactions to drugs (gold, procainamide) and environmental chemicals (mercury, platinum): the role of phagocytic cells in generating immunogenic metabolites. In Symposium in Immunology I: Symposium in Immunology II. Edited by Eibl MM, Huber C, Decker H, Wahn U. Berlin: Sprin; 1993:190–210.

    Google Scholar 

  35. deShazo RD, Kemp S: Allergic reactions to drugs and biologic agents. JAMA 1997, 278:1895–1906.

    Article  PubMed  CAS  Google Scholar 

  36. Kligman A: The identification of contact allergens by human assay III: the maximization test: a procedure for screening and rating contact sensitizers. J Invest Dermatol 1966, 47:393–409.

    Article  PubMed  CAS  Google Scholar 

  37. Liden C, Nordenadler M, Skare L: Metal release from gold-containing jewelry materials: no gold release detected. Contact Dermatitis 1998, 39:281–285.

    Article  PubMed  CAS  Google Scholar 

  38. Suzuki H: Nickel and gold in skin lesions of pierced earlobes with contact dermatitis: a study using scanning electron microscopy and x-ray microanalysis. Arch Dermatol Res 1998, 290:523–527.

    Article  PubMed  CAS  Google Scholar 

  39. Thomson KF, Wilkinson SM, Powell S, Beck MH: The prevalence of corticosteroid allergy in two U.K. centres: prescribing implications. Br J Dermatol 1999, 141:863–866. This article contains helpful information from an epidemiologic study.

    Article  PubMed  CAS  Google Scholar 

  40. Isaksson M, Bruze M, Bjorkner B, et al.: The benefit of patch testing with a corticosteroid at a low concentration. Am J Contact Dermatitis 1999, 10:31–33. This article contains important technical information on patch testing to corticosteroids.

    Article  PubMed  CAS  Google Scholar 

  41. Darsow U, Ring J: The atopy patch test: its role in the evaluation and management of atopic eczema. In Allergic Skin Disease. Edited by Leung DY, Greaves MW. New York: Marcel Dekker; 2000:435–447.

    Google Scholar 

  42. Darsow U, Vieluf D, Ring J: The atopy patch test: an increased rate of reactivity in patients who have an air-exposed pattern of atopic eczema. Br J Dermatol 1996, 135:182–186.

    Article  PubMed  CAS  Google Scholar 

  43. Meglio P, Milita O, Businco L: Patch test response to house dust mites is positive in children with atopic dermatitis and in their parents. J Investig Allergol Clin Immunol 1996, 6:190–195.

    PubMed  CAS  Google Scholar 

  44. Darsow U, Vieluf D, Ring J: Evaluating the relevance of aeroallergen sensitization in atopic eczema with the atopy patch test: a randomized, double-blind multicenter study. J Am Acad Dermatol 1999, 40:187–193. ospective questionnaire’s correlation to atopy patch test results lends credibility to the real impact of dust mites on atopic dermatitis.

    Article  PubMed  CAS  Google Scholar 

  45. Hjorth N, Roed-Petersen J: Occupational protein contact dermatitis in food handlers. Contact Dermatitis 1976, 2:28–42.

    Article  PubMed  CAS  Google Scholar 

  46. Janssens V, Morren M, Dooms-Goossens A, DeGreef H: Protein contact dermatitis: myth or reality? Br J Dermatol 1995, 132:1–6.

    Article  PubMed  CAS  Google Scholar 

  47. Turjanmaa K: Update on occupational natural rubber latex allergy. Dermatol Clin 1994, 12:561–567.

    PubMed  CAS  Google Scholar 

  48. Guin J, Styles A: Protein-contact eczematous reaction to cornstarch in clothing. J Am Acad Dermatol 1999, 40:991–994. This article contains innovative sleuthing.

    Article  PubMed  CAS  Google Scholar 

  49. Tan BB, Weald D, Stickland I, Friedmann PS: Double-blind controlled trial of effect of house dust-mite allergen avoidance on atopic dermatitis. Lancet 1996, 347:15–18.

    Article  PubMed  CAS  Google Scholar 

  50. Tupker RA, DeMonchy JGR, Coenraads PJ, et al.: Induction of atopic dermatitis by inhalation of house dust mite. J Allergy Clin Immunol 1996, 97:1064–1070.

    Article  PubMed  CAS  Google Scholar 

  51. Hanifin JM, Klas PA: The spectrum of cutaneous patch-test reactions in patients with atopic dermatitis. Clin Rev Allergy Immunol 1996, 14:225–240.

    PubMed  CAS  Google Scholar 

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  1. Department of Dermatology, University Hospitals of Cleveland and Case Western Reserve University, 11100 Euclid Avenue, 44106, Cleveland, OH, USA

    Susan T. Nedorost MD & Kevin D. Cooper MD

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  1. Susan T. Nedorost MD
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  2. Kevin D. Cooper MD
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Nedorost, S.T., Cooper, K.D. The role of patch testing for chemical and protein allergens in atopic dermatitis. Curr Allergy Asthma Rep 1, 323–328 (2001). https://doi.org/10.1007/s11882-001-0043-1

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