Department of Dermatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Department of Cutaneous Allergy, St John's Institute of Dermatology, Guy's Hospital, London, UK.
Contact Dermatitis. 2019 Dec;81(6):409-416. doi: 10.1111/cod.13363. Epub 2019 Aug 16.
The association between atopic dermatitis (AD) and contact allergy, remains unclear, with studies to date showing conflicting results.
To investigate the prevalence of contact allergy in AD individuals compared to those without AD.
Results of 46 250 patients patch tested in a single centre over a span of 30 years were reviewed, comparing those with AD with those without AD. Collected data were analysed with corrections for multiple confounding variables, including date of patch testing to account for changes in allergens tested over the period.
Nine allergens showed a statistically significant difference between the two groups. Contact allergy to nickel, cobalt and primin was less likely to arise in those with AD, whilst substances found in topical dermatological products were more likely to be associated with AD.
This is the largest single centre study of contact sensitization in atopy reported to date. The previously reported association between contact allergy to sesquiterpene lactone and AD is reinforced. The decreased incidence of metal allergy suggests distinct immunological effector mechanisms in sensitization to these allergens. In keeping with previous publications, exposure to topical treatments for AD can result in sensitisation and contact allergy and clinicians should consider patch testing in AD individuals who report worsening of their skin despite continued treatment with topical medicaments.
特应性皮炎（AD）与接触过敏之间的关联仍不清楚，迄今为止的研究结果相互矛盾。
与无特应性皮炎的患者相比，调查 AD 患者接触过敏的患病率。
回顾了在 30 年内对单个中心的 46250 名患者进行的斑贴试验结果，比较了有 AD 的患者和无 AD 的患者。对收集的数据进行了分析，对多种混杂变量进行了校正，包括斑贴试验的日期，以解释在此期间测试的变应原的变化。
有 9 种过敏原在两组之间存在统计学显著差异。与 AD 患者相比，镍、钴和普里明接触过敏的可能性较小，而局部皮肤科产品中发现的物质更可能与 AD 相关。
这是迄今为止报告的最大的特应性接触致敏单中心研究。先前报道的接触过敏到倍半萜内酯与 AD 之间的关联得到了加强。金属过敏的发生率降低表明对这些过敏原的致敏具有不同的免疫效应机制。与先前的出版物一致，AD 的局部治疗暴露会导致致敏和接触过敏，因此，对于尽管继续使用局部药物治疗但仍报告皮肤恶化的 AD 患者，临床医生应考虑进行斑贴试验。
