Department of Dermatology and Allergology, University Medical Center Göttingen, Göttingen, Germany.
Information Network of Departments of Dermatology (IVDK), University of Göttingen, Göttingen, Germany.
Br J Dermatol. 2019 Feb;180(2):315-320. doi: 10.1111/bjd.17080. Epub 2018 Sep 30.
Earlier studies suggested an inverse association between contact allergy and psoriasis, although the results of clinical studies have been inconsistent. Gene expression studies in human contact allergy focusing on immune responses revealed nickel being an inducer of T helper (Th)1/Th17 and some Th22 immune polarization, whereas fragrances were found to promote a Th2-dominated immune activation.
To investigate the epidemiological association between contact allergy and psoriasis in a large multicentre cohort and to analyse the sensitization profile to specific allergens in these patients.
Retrospective analysis of patch-tested patients from 56 departments of dermatology (1996-2015), including 2387 patients with psoriasis and 161 989 control patients. All patients with atopic dermatitis were excluded from both groups.
The odds ratio (OR) for contact allergy was calculated to be 0·55 in patients with psoriasis (95% confidence interval 0·50-0·59). Logistic regression analyses with several independent variables indicated a 'protective effect' of having psoriasis for most allergens, independently of age, sex, affected body site and patch test indication. Fragrance mix II (OR 0·36) and lanolin alcohols (OR 0·38) were found to be among the least common allergens in patients with psoriasis. In contrast, the frequency of contact dermatitis to nickel was only marginally affected in patients with psoriasis compared with controls (OR 0·75).
The inverse association between psoriasis and allergic contact sensitization is likely to be not exclusively mediated by psoriasis itself. The polarization of the activated immune response by specific allergens may influence the occurrence and significance of contact allergies in underlying immune-mediated diseases, eventually even beyond the skin.
早期研究表明接触过敏与银屑病之间存在负相关，尽管临床研究结果并不一致。针对人类接触过敏的基因表达研究集中于免疫反应，结果表明镍可诱导 Th1/Th17 和某些 Th22 免疫极化，而香料则被发现可促进以 Th2 为主的免疫激活。
在一个大型多中心队列中调查接触过敏与银屑病之间的流行病学关联，并分析这些患者对特定变应原的致敏情况。
回顾性分析了 56 个皮肤科部门（1996-2015 年）的斑贴试验患者，包括 2387 例银屑病患者和 161989 例对照患者。两组均排除特应性皮炎患者。
银屑病患者接触过敏的比值比（OR）计算为 0.55（95%置信区间 0.50-0.59）。对多个自变量进行逻辑回归分析表明，银屑病对大多数变应原具有“保护作用”，与年龄、性别、受累部位和斑贴试验指征无关。香薰混合物 II（OR 0.36）和羊毛脂醇（OR 0.38）被认为是银屑病患者中最不常见的变应原之一。相比之下，与对照组相比，银屑病患者的镍接触性皮炎频率仅略有降低（OR 0.75）。
银屑病与过敏性接触致敏之间的负相关可能不仅仅是由银屑病本身介导的。特定变应原对激活免疫反应的极化可能会影响潜在免疫介导性疾病中接触过敏的发生和意义，甚至可能超越皮肤。
