National Allergy Research Centre, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark.
Br J Dermatol. 2012 Jun;166(6):1255-61. doi: 10.1111/j.1365-2133.2012.10852.x. Epub 2012 May 8.
It has been much debated whether atopic dermatitis (AD) is associated with contact sensitization as past findings have been conflicting. A positive association might change our clinical practice.
To investigate the association between AD and contact sensitization taking the likely route of allergen exposure into account.
Questionnaire and clinical data from a cross-sectional study performed in a general population in Copenhagen. In total, 3202 adults aged 18-69 years were patch tested, filaggrin genotyped for 2282del4 and R501X and questioned about AD.
The variable 'contact sensitization to at least one allergen, but not nickel and thimerosal' was significantly associated with AD (odds ratio 2·53, 95% confidence interval 1·59-4·04). The higher prevalence of contact sensitization was driven mainly by fragrance chemicals. In a subanalysis in nonpierced women, a positive association was also found for nickel sensitization. Nickel and thimerosal sensitization may introduce bias in data analysis as these allergies often develop following skin piercing where the skin compartments are bypassed.
We suspect that individuals with self-reported AD from this study mainly had mild disease. However, clinicians should be aware of increased levels of contact sensitization in individuals with AD. Patch testing should therefore be considered at an early point in individuals with a history of AD and active disease. The fundamental relationship between atopic disease and environmental chemical exposure may be of a more complex and intimate nature than previously supposed.
特应性皮炎（AD）是否与接触致敏有关一直存在争议，因为过去的研究结果存在矛盾。如果两者之间存在正相关，可能会改变我们的临床实践。
考虑到过敏原暴露的可能途径，研究 AD 与接触致敏之间的关联。
在哥本哈根进行的一项横断面研究中，通过问卷调查和临床数据对 3202 名 18-69 岁的成年人进行斑贴试验、2282del4 和 R501X 型丝聚蛋白基因检测，并询问他们是否患有 AD。
“至少对一种过敏原，但不是对镍和硫柳汞过敏”这一变量与 AD 显著相关（比值比 2.53，95%置信区间 1.59-4.04）。接触致敏的更高患病率主要是由香料化学品驱动的。在非穿孔女性的亚分析中，也发现镍致敏呈阳性关联。镍和硫柳汞致敏可能会导致数据分析出现偏差，因为这些过敏通常是在皮肤穿孔后发生的，此时皮肤屏障被绕过。
我们怀疑本研究中报告有特应性皮炎的个体主要患有轻度疾病。然而，临床医生应该意识到 AD 患者接触致敏水平升高。因此，对于有 AD 病史和活动性疾病的个体，应在早期考虑进行斑贴试验。特应性疾病与环境化学暴露之间的基本关系可能比之前假设的更为复杂和密切。
