Patch Testing and Atopic Eczema

  • Thomas L. DiepgenEmail author


In contrast to type I allergy, there is an ongoing debate about the relationship between delayed-type allergy (type IV allergy) and atopic eczema (AE) and on the issue of whether patients with AE are more or less prone to (occupational) delayed-type contact allergy. Whenever patch testing is done, a reliable diagnosis of AE has to be settled, and all patients have to be assessed by a combination of detailed clinical examination and anamnestic questions. According to recent publications, contact allergy to occupational and nonoccupational allergens is at least as common in AE patients as in non-AE patients. Therefore, patients with AE should be patch tested because they also develop contact allergy to a significant degree. Patch testing often adds valuable information about contact allergy in AE patients.


Atopic Eczema Patch Test Allergic Contact Dermatitis Attributable Risk Atopic Eczema Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Diepgen TL. Occupational skin disease data in Europe. Int Arch Occup Environ Health. 2003;76:331–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Leung DY, Boguniewicz M, Howell MD, Nomura I, Hamid QA. New insights into atopic dermatitis. J Clin Invest. 2004;113:651–7.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Smith HR, Wakelin SH, McFadden JP, Rycroft RJ, White IR. A 15-year review of our MOAHLFA index. Contact Dermatitis. 1999;40:227–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Hanifin J, Rajka G. Diagnostic features of atopic eczema. Acta Derm Venereol. 1980;92:44–7.Google Scholar
  5. 5.
    Diepgen TL, Fartasch M, Hornstein OP. Evaluation and relevance of atopic basic and minor features in patients with atopic dermatitis and in the general population. Acta Derm Venereol Suppl (Stockh). 1989;144:50–4.Google Scholar
  6. 6.
    Diepgen TL, Sauerbrei W, Fartasch M. Development and validation of diagnostic scores for atopic dermatitis incorporating criteria of data quality and practical usefulness. J Clin Epidemiol. 1996;49:1031–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Williams HC, Burney PG, Hay RJ, Archer CB, Shipley MJ, Hunter JJ, et al. The U.K. working party’s diagnostic criteria for atopic dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis. Br J Dermatol. 1994;131:383–96.PubMedCrossRefGoogle Scholar
  8. 8.
    Garmhausen D, Hagemann T, Bieber T, Dimitriou I, Fimmers R, Diepgen T, Novak N. Characterization of different courses of atopic dermatitis in adolescent and adult patients. Allergy. 2013;68:498–506.PubMedCrossRefGoogle Scholar
  9. 9.
    Bieber T. Atopic dermatitis. N Engl J Med. 2008;358:1483–94.PubMedCrossRefGoogle Scholar
  10. 10.
    Wuthrich B. Atopic neurodermatitis. Wien Med Wochenschr. 1989;139:156–65.PubMedGoogle Scholar
  11. 11.
    Lammintausta K. Risk factors for hand dermatitis in wet work. Academic dissertation, Turku; 1982.Google Scholar
  12. 12.
    Kezic S, O’Regan GM, Yau N, Sandilands A, Chen H, Campbell LE, et al. Levels of filaggrin degradation products are influenced by both filaggrin genotype and atopic dermatitis severity. Allergy. 2011;66:934–40.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Thyssen JP, Linneberg A, Johansen JD, Carlsen BC, Zachariae C, Meldgaard M, et al. Atopic diseases by filaggrin mutations and birth year. Allergy. 2012;67:705–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Rystedt I. Hand eczema in patients with history of atopic manifestations in childhood. Acta Derm Venereol (Stockh). 1985;65:305–12.Google Scholar
  15. 15.
    Meding B, Swanbeck G. Predictive factors for hand eczema. Contact Dermatitis. 1990;23:154–61.PubMedCrossRefGoogle Scholar
  16. 16.
    Majoie IML, von Blomberg BME, Bruynzeel DP. Development of hand eczema in junior hairdressers: an 8-year follow-up study. Contact Dermatitis. 1996;34:243–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Rycroft RJG. Occupational contact dermatitis. In: Rycroft RJG, Menné T, Frosch PJ, Benezra C, editors. Textbook of contact dermatitis. 2nd ed. Berlin: Springer; 1995. p. 343–400.CrossRefGoogle Scholar
  18. 18.
    Lahti A. Immediate contact reactions. In: Rycroft RJG, Menné T, Frosch PJ, Benezra C, editors. Textbook of contact dermatitis. 2nd ed. Berlin: Springer; 1995. p. 62–74.CrossRefGoogle Scholar
  19. 19.
    Malajian D, Belsito DV. Cutaneous delayed-type hypersensitivity in patients with atopic dermatitis. J Am Acad Dermatol. 2013;69:232–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Nedorost ST, Cooper KD. The role of patch testing for chemical and protein allergens in atopic dermatitis. Curr Allergy Asthma Rep. 2001;1:323–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Sutthipisal N, McFadden JP, Cronin E. Sensitization in atopic and non-atopic hairdressers with hand eczema. Contact Dermatitis. 1993;29:206–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Rossi M, Coenraads PJ, Diepgen T, Svensson Å, Elsner P, Gonçalo M, et al. Design and feasibility of an international study assessing the prevalence of contact allergy to fragrances in the general population: the European Dermato-Epidemiology Network Fragrance Study. Dermatology. 2010;221:267–75.PubMedCrossRefGoogle Scholar
  23. 23.
    Dickel H, Bruckner TM, Schmidt A, Diepgen TL. Impact of atopic skin diathesis on occupational skin disease incidence in a working population. J Invest Dermatol. 2003;121:37–40.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Social MedicineUniversity Hospital HeidelbergHeidelbergGermany

Personalised recommendations