White J M L, White I R, Kimber I, Basketter D A, Buckley D A, McFadden J P
Department of Cutaneous Allergy, St John's Institute of Dermatology, St Thomas' Hospital, London.
Allergy. 2009 Feb;64(2):312-6. doi: 10.1111/j.1398-9995.2008.01904.x.
Allergic contact dermatitis prevalence is reported as equal in atopic and nonatopic dermatitis. Atopic dermatitis is under-represented in those with allergic contact dermatitis to agents having cutaneous and dietary exposure. We compared rates of atopic dermatitis between patients with allergic contact dermatitis arising out of individual fragrance chemicals with known oral/cutaneous exposure against exclusively cutaneous exposure.
Between 1982 and 2007, 37 065 dermatitis patients were tested with Fragrance mix I. Those who were positive were tested for individual fragrance allergy. Chemicals were categorized according to whether their exposure pattern was solely cutaneous, oral or mixed. Current and past atopic dermatitis rates were compared between the whole population and groups allergic to individual fragrances. Age and gender were controlled.
Cinnamic alcohol and cinnamal allergy groups had reduced rates of both 'current' [24/266 (9.0%) P = 0.0008, 38/364 (10.4%) P = 0.0005] and 'past' atopic dermatitis [44/266 (16.5%) P = 0.009, 70/346 (19.2%) P = 0.037]. Atopic dermatitis rates in groups allergic to Evernia prunastri and hydroxycitronellal (cutaneous exposure only) were not reduced [120/597 (20.1%) and 41/153 (26.8%)]. Groups allergic to cinnamic alcohol (P < 0.0001, P < 0.0001) and cinnamal (P < 0.0001, P < 0.004) had reductions in 'current' and 'past' atopic dermatitis, compared with Evernia prunastri.
Patients allergic to individual fragrances with dietary exposure have reduced rates of atopic dermatitis. This suggests that patients with atopic dermatitis have heightened oral tolerance to dietary haptens, in contrast to the known close association of atopic dermatitis with food-protein allergy. Haptens may interfere with food protein tolerance by binding to soluble protein to alter its configuration and immunogenic profile.
据报道，过敏性接触性皮炎在特应性皮炎和非特应性皮炎中的患病率相当。在对具有皮肤和饮食接触的过敏原发生过敏性接触性皮炎的患者中，特应性皮炎的比例较低。我们比较了因已知经口/皮肤接触的单一香料化学品引起的过敏性接触性皮炎患者与仅经皮肤接触引起的过敏性接触性皮炎患者的特应性皮炎发病率。
1982年至2007年间，37065例皮炎患者接受了香料混合物I检测。阳性患者接受了单一香料过敏检测。根据化学品的接触模式是仅经皮肤、经口还是混合接触进行分类。比较了整个人群和对单一香料过敏的人群中当前和既往特应性皮炎的发病率。对年龄和性别进行了控制。
肉桂醇和肉桂醛过敏组的“当前”[24/266（9.0%）P = 0.0008，38/364（10.4%）P = 0.0005]和“既往”特应性皮炎发病率均降低[44/266（16.5%）P = 0.009，70/346（19.2%）P = 0.037]。对扁枝衣和羟基香茅醛（仅经皮肤接触）过敏的组中，特应性皮炎发病率未降低[120/597（20.1%）和41/153（26.8%）]。与扁枝衣相比，对肉桂醇（P < 0.0001，P < 0.0001）和肉桂醛（P < 0.0001，P < 0.004）过敏的组中，“当前”和“既往”特应性皮炎发病率降低。
对经饮食接触的单一香料过敏的患者特应性皮炎发病率降低。这表明，与特应性皮炎与食物蛋白过敏的已知密切关联相反，特应性皮炎患者对饮食性半抗原的口服耐受性增强。半抗原可能通过与可溶性蛋白结合改变其构型和免疫原性特征来干扰食物蛋白耐受性。
