Skip to main content

Allergic Contact Dermatitis in Patients with Atopic Dermatitis

Abstract

Purpose of Review

It is still debated whether the risk of allergic contact dermatitis (ACD) is altered in patients with atopic dermatitis (AD). In this article, the recent literature on the risk of ACD in AD patients is reviewed and put into a clinical context.

Recent Findings

ACD is common in AD patients, but a literature review showed conflicting results on the exact risk compared to non-AD individuals. The development of ACD in AD patients is affected by the dysfunctional skin barrier in particular due to filaggrin deficiency, the Th2 inflammatory immune dysregulation, and microbial dysbiosis. While the increased exposure to topical allergens in AD patients increases the risk of ACD in AD, the Th2-skewed immune response observed in AD reduces the risk of ACD in a severity-dependent manner.

Summary

ACD should be considered in AD patients with eczema worsening, or atypical morphology and generalization despite relevant treatment. Special attention should be paid to the increased risk of ACD to allergens found in topical products.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

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

  1. 1.

    Sullivan M, Silverberg NB. Current and emerging concepts in atopic dermatitis pathogenesis. Clin Dermatol. 2017;35(4):349–53.

    PubMed  Article  PubMed Central  Google Scholar 

  2. 2.

    Lee HH, Patel KR, Singam V, Rastogi S, Silverberg JI. A systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis. J Am Acad Dermatol. 2019;80(6):1526–1532.e7.

    PubMed  Article  PubMed Central  Google Scholar 

  3. 3.

    Asher M, Montefort S, Bjorksten B, Lai C, Strachan D, Weiland S, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood. Lancet. 2006;368(9537):733–43.

    PubMed  Article  PubMed Central  Google Scholar 

  4. 4.

    Odhiambo JA, Williams HC, Clayton TO, Robertson CF, Asher MI. Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three. J Allergy Clin Immunol. 2009;124(6):1251–1258.e23.

    PubMed  Article  PubMed Central  Google Scholar 

  5. 5.

    Lloyd-Lavery A, Solman L, Grindlay DJC, Rogers NK, Thomas KS, Harman KE. What’s new in atopic eczema? An analysis of systematic reviews published in 2016. Part 2: epidemiology, aetiology and risk factors. Clin Exp Dermatol. 2019;44(4):370–5.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  6. 6.

    Clausen ML, Agner T, Lilje B, Edslev SM, Johannesen TB, Andersen PS. Association of disease severity with skin microbiome and filaggrin gene mutations in adult atopic dermatitis. JAMA Dermatology. 2018;154(3):293–300.

    PubMed  PubMed Central  Article  Google Scholar 

  7. 7.

    Clausen ML, Edslev SM, Andersen PS, Clemmensen K, Krogfelt KA, Agner T. Staphylococcus aureus colonization in atopic eczema and its association with filaggrin gene mutations. Br J Dermatol. 2017;177(5):1394–400.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  8. 8.

    Olesen CM, Clausen M-L, Andersen PS, Agner T. The skin microbiome in atopic dermatitis—a potential treatment target? Curr Dermatol Rep. 2018;7(4):199–208.

    Article  Google Scholar 

  9. 9.

    Narla S, Silverberg JI. The role of environmental exposures in atopic dermatitis. Curr Allergy Asthma Rep. 2020;20(12).

  10. 10.

    Thomsen SF, Elmose C, Szecsi PB, Stender S, Kyvik KO, Backer V, et al. Filaggrin gene loss-of-function mutations explain discordance of atopic dermatitis within dizygotic twin pairs. Int J Dermatol. 2016;55(12):1341–4.

    CAS  PubMed  Article  Google Scholar 

  11. 11.

    Esaki H, Brunner PM, Renert-Yuval Y, Czarnowicki T, Huynh T, Tran G, et al. Early-onset pediatric atopic dermatitis is TH2 but also TH17 polarized in skin. J Allergy Clin Immunol. 2016;138(6):1639–51.

    CAS  PubMed  Article  Google Scholar 

  12. 12.

    Calov M, Alinaghi F, Hamann CR, Silverberg J, Egeberg A, Thyssen JP. The association between season of birth and atopic dermatitis in the northern hemisphere: a systematic review and meta-analysis. J Allergy Clin Immunol Pract. 2020;8(2):674–680.e5.

    PubMed  Article  Google Scholar 

  13. 13.

    Bieber T. Atopic dermatitis. N Engl J Med. 2008;358:1483–94.

    CAS  PubMed  Article  Google Scholar 

  14. 14.

    Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020;396(10247):345–60.

    CAS  PubMed  Article  Google Scholar 

  15. 15.

    Dittmar D, Schuttelaar ML. Immunology and genetics of tumour necrosis factor in allergic contact dermatitis. Contact Dermatitis. 2017;76(5):257–71.

    CAS  PubMed  Article  Google Scholar 

  16. 16.

    Alinaghi F, Bennike NH, Egeberg A, Thyssen JP, Johansen JD. Prevalence of contact allergy in the general population: a systematic review and meta-analysis. Contact Dermatitis. 2019;80(2):77–85.

    CAS  PubMed  Article  Google Scholar 

  17. 17.

    Diepgen TL, Ofenloch RF, Bruze M, Bertuccio P, Cazzaniga S, Coenraads PJ, et al. Prevalence of contact allergy in the general population in different European regions. Br J Dermatol. 2016;174(2):319–29.

    CAS  PubMed  Article  Google Scholar 

  18. 18.

    Kim Y, Flamm A, ElSohly MA, Kaplan DH, Hage RJ, Hamann CP, et al. Poison ivy, oak, and sumac dermatitis: what is known and what is new? Dermatitis. 2019;30(3):183–90.

    PubMed  Article  Google Scholar 

  19. 19.

    Hereford B, Maczuga S, Flamm A. Allergic contact dermatitis and concomitant dermatologic diseases. Dermatitis. 2020;Publish Ah:1–5.

  20. 20.

    Nedorost ST. Allergic contact sensitization in healthy skin differs from sensitization in chronic dermatitis: atopic, occupational wet work, and stasis dermatitis. Dermatol Clin. 2020;38(3):301–8.

    CAS  PubMed  Article  Google Scholar 

  21. 21.

    •• Halling-Overgaard AS, Kezic S, Jakasa I, Engebretsen KA, Maibach H, Thyssen JP. Skin absorption through atopic dermatitis skin: a systematic review. Br J Dermatol. 2017;177(1):84–106 A systematic review finding a twofold increased absorption in AD skin compared to healthy individuals.

    PubMed  Article  Google Scholar 

  22. 22.

    Uehara M, Sawai T. A longitudinal study of contact sensitivity in patients with atopic dermatitis. Arch Dermatol. 1989;125(3):366–8.

    CAS  PubMed  Article  Google Scholar 

  23. 23.

    Spiewak R. Atopy and contact hypersensitivity: a reassessment of the relationship using objective measures. Ann Allergy Asthma Immunol. 2005;95(1):61–5.

    PubMed  Article  Google Scholar 

  24. 24.

    Schmidlin K, Sani S, Bernstein DI, Fonacier L. A hands-on approach to contact dermatitis and patch testing. J Allergy Clin Immunol Pract. 2020;8(6):1883–93.

    PubMed  Article  Google Scholar 

  25. 25.

    Kezic S, Jakasa I. Filaggrin and skin barrier function. Curr Probl dermatology. 2016;49.

  26. 26.

    Meisser SS, Altunbulakli C, Bandier J, Opstrup MS, Castro-Giner F, Akdis M, et al. Skin barrier damage after exposure to paraphenylenediamine. J Allergy Clin Immunol. 2020;145(2):619–631.e2.

    CAS  PubMed  Article  Google Scholar 

  27. 27.

    Yuki T, Hachiya A, Kusaka A, Sriwiriyanont P, Visscher MO, Morita K, et al. Characterization of tight junctions and their disruption by UVB in human epidermis and cultured keratinocytes. J Invest Dermatol. 2011;131(3):744–52.

    CAS  PubMed  Article  Google Scholar 

  28. 28.

    Berard F, Marty J-P, Nicolas J-F. Allergen penetration through the skin. EJD Eur J dermatology. 2003;13(4):324–30.

    CAS  Google Scholar 

  29. 29.

    Nielsen J, Benfeldt E, Holmgaard R. Penetration through the skin barrier. Curr Probl Dermatol. 2016;49:103–11.

    PubMed  Article  Google Scholar 

  30. 30.

    Kohli N, Nedorost S. Inflamed skin predisposes to sensitization to less potent allergens. J Am Acad Dermatol. 2016;75(2):312–317.e1.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  31. 31.

    Lee HY, Stieger M, Yawalkar N, Kakeda M. Cytokines and chemokines in irritant contact dermatitis. Mediat Inflamm. 2013;2013:1–7.

    Google Scholar 

  32. 32.

    Cumberbatch M, Kimber I. Tumour necrosis factor-alpha is required for accumulation of dendritic cells in draining lymph nodes and for optimal contact sensitization. Immunology. 1995;84(1):31–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Agner T, Johansen JD, Overgaard L, Vølund A, Basketter D, Menné T. Combined effects of irritants and allergens: synergistic effects of nickel and sodium lauryl sulfate in nickel-sensitized individuals. Contact Dermatitis. 2002;47(1):21–6.

    CAS  PubMed  Article  Google Scholar 

  34. 34.

    •• Ahlström MG, Thyssen JP, Menné T, Midander K, Julander A, Lidén C, et al. Short contact with nickel causes allergic contact dermatitis: an experimental study. Br J Dermatol. 2018;179(5):1127–34 An experimental study showing that the pre-irritated skin barrier may enhance the elicitation of nickel in sensitized individuals compared to skin sites without pre-irritation.

    PubMed  Article  CAS  Google Scholar 

  35. 35.

    De Rentiis AMA, Pink M, Verma N, Schmitz-Spanke S. Assessment of the different skin sensitization potentials of irritants and allergens as single substances and in combination using the KeratinoSens assay. Contact Dermatitis. December 2020;2020:1–9.

    Google Scholar 

  36. 36.

    Kaplan DH, Igyárto BZ, Anthony AG. Early events in the induction of allergic contact dermatitis. Nat Rev Immunol. 2013;12(2):114–24.

    Article  CAS  Google Scholar 

  37. 37.

    Martin SF. New concepts in cutaneous allergy. Contact Dermatitis. 2015;72(1):2–10.

    PubMed  Article  Google Scholar 

  38. 38.

    Dhingra N, Shemer A. Correa Da Rosa J, Rozenblit M, Fuentes-Duculan J, Gittler JK, et al. Molecular profiling of contact dermatitis skin identifies allergen-dependent differences in immune response. J Allergy Clin Immunol. 2014;134(2):362–72.

    CAS  PubMed  Article  Google Scholar 

  39. 39.

    Masjedi K, Ahlborg N, Gruvberger B, Bruze M, Karlberg AT. Methylisothiazolinones elicit increased production of both T helper (Th)1- and Th2-like cytokines by peripheral blood mononuclear cells from contact allergic individuals. Br J Dermatol. 2003;149(6):1172–82.

    CAS  PubMed  Article  Google Scholar 

  40. 40.

    Koppes SA, Engebretsen KA, Agner T, Angelova-Fischer I, Berents T, Brandner J, et al. Current knowledge on biomarkers for contact sensitization and allergic contact dermatitis. Contact Dermatitis. 2017;77(1):1–16.

    PubMed  Article  Google Scholar 

  41. 41.

    Martin SF. Immunological mechanisms in allergic contact dermatitis. Curr Opin Allergy Clin Immunol. 2015;15(2):124–30.

    CAS  PubMed  Article  Google Scholar 

  42. 42.

    González-Tarancón R, Sanmartín R, Lorente F, Salvador-Rupérez E, Hernández-Martín A, Rello L, et al. Prevalence of FLG loss-of-function mutations R501X, 2282del4, and R2447X in Spanish children with atopic dermatitis. Pediatr Dermatol. 2020;37(1):98–102.

    PubMed  Article  Google Scholar 

  43. 43.

    Smith FJD, Irvine AD, Terron-Kwiatkowski A, Sandilands A, Campbell LE, Zhao Y, et al. Loss-of-function mutations in the gene encoding filaggrin cause ichthyosis vulgaris. Nat Genet. 2006;38(3):337–42.

    CAS  PubMed  Article  Google Scholar 

  44. 44.

    Pellerin L, Henry J, Hsu CY, Balica S, Jean-Decoster C, Méchin MC, et al. Defects of filaggrin-like proteins in both lesional and nonlesional atopic skin. J Allergy Clin Immunol. 2013;131(4):1094–102.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  45. 45.

    Guttman-Yassky E, Bissonnette R, Ungar B, Suárez-Fariñas M, Ardeleanu M, Esaki H, et al. Dupilumab progressively improves systemic and cutaneous abnormalities in patients with atopic dermatitis. J Allergy Clin Immunol. 2019;143(1):155–72.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  46. 46.

    Jensen JM, Scherer A, Wanke C, Bräutigam M, Bongiovanni S, Letzkus M, et al. Gene expression is differently affected by pimecrolimus and betamethasone in lesional skin of atopic dermatitis. Allergy Eur J Allergy Clin Immunol. 2012;67(3):413–23.

    CAS  Article  Google Scholar 

  47. 47.

    Kim BE, Kim J, Goleva E, Berdyshev E, Lee J, Vang KA, et al. Particulate matter causes skin barrier dysfunction. JCI Insight. 2021;6(5):1–16.

    Article  Google Scholar 

  48. 48.

    Lee H, Shin JJ, Bae HC, Ryu W-I, Son SW. Toluene downregulates filaggrin expression via the extracellular signal-regulated kinase and signal transducer and activator of transcription-dependent pathways. J Allergy Clin Immunol. 2017;139(1):355–8.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  49. 49.

    Jungersted JM, Scheer H, Mempel M, Baurecht H, Cifuentes L, Høgh JK, et al. Stratum corneum lipids, skin barrier function and filaggrin mutations in patients with atopic eczema. Allergy Eur J Allergy Clin Immunol. 2010;65(7):911–8.

    CAS  Article  Google Scholar 

  50. 50.

    •• Liljedahl ER, Johanson G, de Paula HK, Faniband M, Assarsson E, Littorin M, et al. Filaggrin polymorphisms and the uptake of chemicals through the skin—a human experimental study. Environ Health Perspect. 2021;129(1):1–10 Experimental study finding an increased penetration of chemicals through the skin with FLG loss-of-function mutations.

    Google Scholar 

  51. 51.

    Wahlberg K, Liljedahl ER, Alhamdow A, Lindh C, Lidén C, Albin M, et al. Filaggrin variations are associated with PAH metabolites in urine and DNA alterations in blood. Environ Res. 2019;177(June):108600.

    CAS  PubMed  Article  Google Scholar 

  52. 52.

    Liljedahl ER, Wahlberg K, Lidén C, Albin M, Broberg K. Genetic variants of filaggrin are associated with occupational dermal exposure and blood DNA alterations in hairdressers. Sci Total Environ [Internet]. 2019;653(0):45–54. Available from. https://doi.org/10.1016/j.scitotenv.2018.10.328.

    CAS  Article  Google Scholar 

  53. 53.

    Joensen UN, Jørgensen N, Thyssen JP, Petersen JH, Szecsi PB, Stender S, et al. Exposure to phenols, parabens and UV filters: associations with loss-of-function mutations in the filaggrin gene in men from the general population. Environ Int. 2017;105(April):105–11.

    CAS  PubMed  Article  Google Scholar 

  54. 54.

    Mortz CG, Andersen KE, Dellgren C, Barington T, Bindslev-Jensen C. Atopic dermatitis from adolescence to adulthood in the TOACS cohort: prevalence, persistence and comorbidities. Allergy Eur J Allergy Clin Immunol. 2015;70(7):836–45.

    CAS  Article  Google Scholar 

  55. 55.

    Margolis DJ, Mitra N, Wubbenhorst B, D’Andrea K, Kraya AA, Hoffstad O, et al. Association of filaggrin loss-of-function variants with race in children with atopic dermatitis. JAMA Dermatology. 2019;155(11):1284–90.

    Article  Google Scholar 

  56. 56.

    Jurakic Toncic R, Kezic S, Jakasa I, Ljubojevic Hadzavdic S, Balic A, Petkovic M, et al. Filaggrin loss-of-function mutations and levels of filaggrin degradation products in adult patients with atopic dermatitis in Croatia. J Eur Acad Dermatology Venereol. 2020;34(8):1789–94.

    CAS  Article  Google Scholar 

  57. 57.

    Rupnik H, Rijavec M, Korošec P. Filaggrin loss-of-function mutations are not associated with atopic dermatitis that develops in late childhood or adulthood. Br J Dermatol. 2015;172(2):455–61.

    CAS  PubMed  Article  Google Scholar 

  58. 58.

    Holm JG, Agner T, Clausen ML, Thomsen SF. Determinants of disease severity among patients with atopic dermatitis: association with components of the atopic march. Arch Dermatol Res. 2019;311(3):173–82.

    PubMed  Article  Google Scholar 

  59. 59.

    •• LEK O, Main KM, Frederiksen H, Stender S, Szecsi PB, Williams HC, et al. Children with atopic dermatitis and frequent emollient use have increased urinary levels of low-molecular-weight phthalate metabolites and parabens. Allergy Eur J Allergy Clin Immunol. 2017;72(11):1768–77 A study documenting increased urinary metabolites from topical products in AD patients compared to individuals without AD, thereby suggesting enhanced absorption through the AD skin barrier.

    Article  CAS  Google Scholar 

  60. 60.

    Wang IJ, Karmaus WJJ. The effect of phthalate exposure and filaggrin gene variants on atopic dermatitis. Environ Res. 2015;136:213–8.

    CAS  PubMed  Article  Google Scholar 

  61. 61.

    Blakeway H, Van-de-Velde V, Allen VB, Kravvas G, Palla L, Page MJ, et al. What is the evidence for interactions between filaggrin null mutations and environmental exposures in the aetiology of atopic dermatitis? A systematic review. Br J Dermatol. 2020;183(3):443–51.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  62. 62.

    Thyssen JP, Linneberg A, Ross-Hansen K, Carlsen BC, Meldgaard M, Szecsi PB, et al. Filaggrin mutations are strongly associated with contact sensitization in individuals with dermatitis. Contact Dermatitis. 2013;68(5):273–6.

    CAS  PubMed  Article  Google Scholar 

  63. 63.

    • Elhaji Y, Sasseville D, Pratt M, Asai Y, Matheson K, WHI ML, et al. Filaggrin gene loss-of-function mutations constitute a factor in patients with multiple contact allergies. Contact Dermatitis. 2019;80(6):354–8 Comparative study showing that contact sensitization may be associated with FLG mutations.

    CAS  PubMed  Article  Google Scholar 

  64. 64.

    Thyssen JP, Johansen JD, Linneberg A, Menné T, Nielsen NH, Meldgaard M, et al. The association between null mutations in the filaggrin gene and contact sensitization to nickel and other chemicals in the general population. Br J Dermatol. 2010;162(6):1278–85.

    CAS  PubMed  Article  Google Scholar 

  65. 65.

    Ross-Hansen K, Østergaard O, Tanassi JT, Thyssen JP, Johansen JD, Menné T, et al. Filaggrin is a predominant member of the denaturation-resistant nickel-binding proteome of human epidermis. J Invest Dermatol. 2014;134(4):1164–6.

    CAS  PubMed  Article  Google Scholar 

  66. 66.

    • Petersen TH, Jee MH, ASØ G, Schmidt JD, Sloth JJ, Sonnenberg GF, et al. Mice with epidermal filaggrin deficiency show increased immune reactivity to nickel. Contact Dermatitis. 2019;80(3):139–48 Experimental study finding increased reactivity to nickel in mice with FLG deficiency.

    CAS  PubMed  Article  Google Scholar 

  67. 67.

    Lee S, Wang H. young, Kim E, Hwang HJ, Choi E, Lee H, et al. Clinical characteristics and genetic variation in atopic dermatitis patients with and without allergic contact dermatitis. Eur J Dermatology. 2018;28(5):637–43.

    CAS  Google Scholar 

  68. 68.

    Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopic dermatitis. Nat Rev Dis Prim. 2018;4(1).

  69. 69.

    Newell L, Polak ME, Perera J, Owen C, Boyd P, Pickard C, et al. Sensitization via healthy skin programs Th2 responses in individuals with atopic dermatitis. J Invest Dermatol. 2013;133(10):2372–80.

    CAS  PubMed  Article  Google Scholar 

  70. 70.

    Totté JEE, van der Feltz WT, Hennekam M, van Belkum A, van Zuuren EJ, Pasmans SGMA. Prevalence and odds of Staphylococcus aureus carriage in atopic dermatitis: a systematic review and meta-analysis. Br J Dermatol. 2016;175(4):687–95.

    PubMed  Article  PubMed Central  Google Scholar 

  71. 71.

    Geoghegan JA, Irvine AD, Foster TJ. Staphylococcus aureus and atopic dermatitis: a complex and evolving relationship. Trends Microbiol. 2018;26(6):484–97.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  72. 72.

    Adachi N, Takayama E, Adachi M, Mizuno-Kamiya M, Kawaki H, Takeuchi H, et al. Promotion of nickel (Ni) allergy by anamnestic sensitization with a bacterial component, lipopolysaccharide (LPS), in mice. Open Dent J. 2016;10(1):531–7.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  73. 73.

    Kinbara M, Sato N, Kuroishi T, Takano-Yamamoto T, Sugawara S, Endo Y. Allergy-inducing nickel concentration is lowered by lipopolysaccharide at both the sensitization and elicitation steps in a murine model. Br J Dermatol. 2011;164(2):356–62.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  74. 74.

    Brandt EB, Sivaprasad U. Th2 cytokines and atopic dermatitis. J Clin Cell Immunol. 2011;2(3).

  75. 75.

    Hamann CR, Bernard S, Hamann D, Hansen R, Thyssen JP. Is there a risk using hypoallergenic cosmetic pediatric products in the United States?: To the editor. J Allergy Clin Immunol. 2015;135(4):1070–1.

    PubMed  Article  PubMed Central  Google Scholar 

  76. 76.

    •• Xu S, Kwa M, Lohman ME, Evers-Meltzer R, Silverberg JI. Consumer preferences, product characteristics, and potentially allergenic ingredients in best-selling moisturizers. JAMA Dermatology. 2017;153(11):1099–105 A study inspecting the most common moisturizers for allergens; several hypoallergenic topical products were found to contain contact allergens.

    PubMed  PubMed Central  Article  Google Scholar 

  77. 77.

    Mailhol C, Lauwers-Cances V, Rancé 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 Eur J Allergy Clin Immunol. 2009;64(5):801–6.

    CAS  Article  Google Scholar 

  78. 78.

    Neale H, Garza-Mayers AC, Tam I, Yu J. De. Pediatric allergic contact dermatitis. Part I: clinical features and common contact allergens in children. J Am Acad Dermatol. 2021;84(2):235–44.

    PubMed  Article  Google Scholar 

  79. 79.

    •• Lubbes S, Rustemeyer T, Sillevis Smitt JH, Schuttelaar ML. Middelkamp-Hup MA. Contact sensitization in Dutch children and adolescents with and without atopic dermatitis – a retrospective analysis. Contact Dermatitis. 2017;76(3):151–9 A retrospective study identifying frequent allergens in patch-tested children with and without atopic dermatitis. Certain allergens were significantly more common in children with atopic dermatitis than without.

    PubMed  Article  Google Scholar 

  80. 80.

    Fransen M, Overgaard LEK, Johansen JD, Thyssen JP. Contact allergy to lanolin: temporal changes in prevalence and association with atopic dermatitis. Contact Dermatitis. 2018;78(1):70–5.

    CAS  PubMed  Article  Google Scholar 

  81. 81.

    •• Rastogi S, Patel KR, Singam V, Silverberg JI. Allergic contact dermatitis to personal care products and topical medications in adults with atopic dermatitis. J Am Acad Dermatol. 2018;79(6):1028–1033.e6 A retrospective study reporting that AD patients had significantly higher rates of positive reactions to ingredients in personal care products and topical medications.

    CAS  PubMed  Article  Google Scholar 

  82. 82.

    •• Hamann CR, Hamann D, Egeberg A, Johansen JD, Silverberg J, Thyssen JP. Association between atopic dermatitis and contact sensitization: a systematic review and meta-analysis. J Am Acad Dermatol. 2017;77(1):70–8 Systematic review and meta-analysis based on 74 studies evaluating the association between atopic dermatitis and contact sensitization. The study found no overall difference in the prevalence of contact sensitization and atopic dermatitis. Subanalyses showed that the association between atopic dermatitis and contact sensitization was increased in the general population and inverse in the referred population.

    PubMed  Article  Google Scholar 

  83. 83.

    Fishbein AB, Silverberg JI, Wilson EJ, Ong PY. Update on atopic dermatitis: diagnosis, severity assessment, and treatment selection. J Allergy Clin Immunol Pract. 2020;8(1):91–101.

    PubMed  Article  Google Scholar 

  84. 84.

    Nygaard U, Deleuran M, Vestergaard C. Emerging treatment options in atopic dermatitis: topical therapies. Dermatology. 2018;233(5):333–43.

    Article  Google Scholar 

  85. 85.

    Nardelli A, D’Hooghe E, Drieghe J, Dooms M, Goossens A. Allergic contact dermatitis from fragrance components in specific topical pharmaceutical products in Belgium. Contact Dermatitis. 2009;60(9):303–13.

    CAS  PubMed  Article  Google Scholar 

  86. 86.

    •• Simonsen AB, Foss-Skiftesvik MH, Thyssen JP, Deleuran M, Mortz CG, Zachariae C, et al. Contact allergy in Danish children: current trends. Contact Dermatitis. 2018;79(5):295–302 A retrospective study based on patch test data from 1573 children and adolescents found no overall difference in the number of positive patch test results in patients with and without atopic dermatitis.

    CAS  PubMed  Article  Google Scholar 

  87. 87.

    Thyssen JP, Andersen Y, Halling AS, Williams HC, Egeberg A. Strengths and limitations of the United Kingdom Working Party criteria for atopic dermatitis in adults. J Eur Acad Dermatology Venereol. 2020;34(8):1764–72.

    CAS  Article  Google Scholar 

  88. 88.

    Andersen YMF, Egeberg A, Hamann CR, Skov L, Gislason GH, Skaaby T, et al. Poor agreement in questionnaire-based diagnostic criteria for adult atopic dermatitis is a challenge when examining cardiovascular comorbidity. Allergy Eur J Allergy Clin Immunol. 2018;73(4):923–31.

    CAS  Article  Google Scholar 

  89. 89.

    Simonsen AB, Johansen JD, Deleuran M, Mortz CG, Sommerlund M. Contact allergy in children with atopic dermatitis: a systematic review. Br J Dermatol. 2017;177(2):395–405.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  90. 90.

    •• Teo Y, JP MF, White IR, Lynch M, Banerjee P. Allergic contact dermatitis in atopic individuals: results of a 30-year retrospective study. Contact Dermatitis. 2019;81(6):409–16 A large retrospective study evaluating a total of 46,250 patch-tested patients. Contact allergy to, for example, primin was less likely to arise in atopic dermatitis patients, while a positive association was found between substances found in topical products and atopic dermatitis.

    PubMed  Article  Google Scholar 

  91. 91.

    Napolitano M, Fabbrocini G, Patruno C. Allergic contact dermatitis in patients with atopic dermatitis: a retrospective study. J Allergy Clin Immunol Pract. 2019;7(7):2459–61.

    PubMed  Article  Google Scholar 

  92. 92.

    Thyssen JP, Linneberg A, Engkilde K, Menné T, Johansen JD. Contact sensitization to common haptens is associated with atopic dermatitis: new insight. Br J Dermatol. 2012;166(6):1255–61.

    CAS  PubMed  Article  Google Scholar 

  93. 93.

    •• Chen JK, Jacob SE, Nedorost ST, Hanifin JM, Simpson EL, Boguniewicz M, et al. A pragmatic approach to patch testing atopic dermatitis patients: clinical recommendations based on expert consensus opinion. Dermatitis. 2016;27(4):186–92 This paper is based on expert consensus opinions and provides general clinical recommendations on patch testing of patients with atopic dermatitis.

    CAS  PubMed  Article  Google Scholar 

  94. 94.

    Owen J, Vakharia PP, Silverberg JI. The role and diagnosis of allergic contact dermatitis in patients. Am J Clin Dermatol. 2018;19(3):293–302.

    PubMed  PubMed Central  Article  Google Scholar 

  95. 95.

    Johansen JD, Aalto-Korte K, Agner T, Andersen KE, Bircher A, Bruze M, et al. European Society of Contact Dermatitis guideline for diagnostic patch testing—recommendations on best practice. Contact Dermatitis. 2015;73(4):195–221.

    PubMed  PubMed Central  Article  Google Scholar 

  96. 96.

    Thyssen JP, McFadden JP, Kimber I. The multiple factors affecting the association between atopic dermatitis and contact sensitization. Allergy Eur J Allergy Clin Immunol. 2014;69(1):28–36.

    CAS  Article  Google Scholar 

  97. 97.

    Brasch J, Schnuch A, Uter W. Patch-test reaction patterns in patients with a predisposition to atopic dermatitis. Contact Dermatitis. 2003;49(4):197–201.

    CAS  PubMed  Article  Google Scholar 

  98. 98.

    Fowler JF, Maibach HI, Zirwas M, Taylor JS, DeKoven JG, Sasseville D, et al. Effects of immunomodulatory agents on patch testing: expert opinion 2012. Dermatitis. 2012;23(6):301–3.

    PubMed  Article  Google Scholar 

  99. 99.

    Raffi J, Suresh R, Botto N, Murase JE. The impact of dupilumab on patch testing and the prevalence of comorbid allergic contact dermatitis in recalcitrant atopic dermatitis: a retrospective chart review. J Am Acad Dermatol. 2020;82(1):132–8.

    CAS  PubMed  Article  Google Scholar 

  100. 100.

    Stout M, Silverberg JI. Variable impact of dupilumab on patch testing results and allergic contact dermatitis in adults with atopic dermatitis. J Am Acad Dermatol. 2019;81(1):157–62.

    CAS  PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Yasemin Topal Yüksel.

Ethics declarations

Human and Animal Rights

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.

This article is part of the Topical Collection on Contact Dermatitis

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Yüksel, Y.T., Nørreslet, L.B. & Thyssen, J.P. Allergic Contact Dermatitis in Patients with Atopic Dermatitis. Curr Derm Rep (2021). https://doi.org/10.1007/s13671-021-00335-4

Download citation

Keywords

  • Allergic contact dermatitis
  • Atopic dermatitis
  • Contact sensitization
  • Patch testing