Department of Cutaneous Allergy, St. John's Institute of Dermatology, St. Thomas' Hospital, London, SE1 7EH, UK.
Contact Dermatitis. 2013 Apr;68(4):208-13. doi: 10.1111/cod.12029.
Although atopic disease is associated with protein allergy, its relationship with chemicals (haptens/contact allergens and irritants) is less clearly defined. The 'hapten-atopy' hypothesis, whereby significant hapten and irritant exposure during times of natural T helper (Th)2 bias (pregnancy and first year of life) promotes the development of atopy and atopic disease in the resulting child, has been previously proposed. Supporting evidence includes the practice of repeated cutaneous application of haptens in generating animal models of atopic dermatitis, and the observation of a significant increase in atopic disease in children born to mothers with occupations associated with high chemical exposure during pregnancy.
To observe the relationship between personal chemical exposure and atopic disease in a particular case series.
We report a case series of exacerbation of atopic dermatitis after repeated cutaneous chemical exposure.
Most of the patients had atopic dermatitis in young childhood that had resolved. However, after repeated chemical exposure, either occupationally as an adult or after starting to use cosmetics as a teenager, there was clear exacerbation of atopic dermatitis. Patch tests gave negative results in most cases.
We propose that repeated exposure to chemicals in patients with an atopic background can occasionally lead to reactivation of atopic dermatitis.
尽管特应性疾病与蛋白质过敏有关，但它与化学物质（半抗原/接触过敏原和刺激性物质）的关系还不太明确。此前曾提出“半抗原-特应性”假说，即在特应性 2 型辅助性 T 细胞（Th2）自然偏向（妊娠和生命的第一年）期间，大量接触半抗原和刺激性物质，会促进特应性和特应性疾病在随后的孩子中发展。支持这一假说的证据包括：通过反复皮肤应用半抗原在动物模型中生成特应性皮炎，以及观察到在妊娠期间从事与高化学暴露相关职业的母亲所生的儿童中特应性疾病显著增加。
在特定病例系列中观察个人化学暴露与特应性疾病之间的关系。
我们报告了一系列因反复皮肤化学暴露而特应性皮炎恶化的病例。
大多数患者在儿童期都患有特应性皮炎，且已经缓解。然而，在成年后因职业原因或在青少年时开始使用化妆品后，特应性皮炎明显恶化。大多数情况下斑贴试验结果为阴性。
我们提出，在特应性背景下的患者中，反复接触化学物质偶尔会导致特应性皮炎的再次发作。
