Uter W, Gefeller O, Mahler V, Geier J
Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany.
Paul Ehrlich Institut, Langen, Germany.
Br J Dermatol. 2020 Nov;183(5):857-865. doi: 10.1111/bjd.18946. Epub 2020 Mar 29.
Changing patterns of exposure lead to changes in the spectrum of contact allergy in the general population and in patients patch tested for suspected contact allergy. The main contact allergens (haptens) are assembled in the so-called 'baseline series'.
To present the current spectrum of contact allergy to baseline series allergens, and its temporal development over the last 12 years, based on data collected by the 56 active departments of the trinational Information Network of Departments of Dermatology (IVDK).
Patch-test data, along with core demographic and clinical information, subdivided into 4-year periods for all patients patch tested with the baseline series in the IVDK, were analysed descriptively. Moreover, log-binomial regression analysis addressed temporal trends of specific contact allergies, adjusted for potentially confounding factors.
Among the 125 436 patients tested with the German baseline series, the most common allergens were nickel (14·7%), fragrance mix I (8·1%), Myroxylon pereirae resin (7·5%) and cobalt (5·2%), with no conclusive trend. The rise and fall of contact allergy to methylchloroisothiazolinone/methylisothiazolinone (MI), following (self-) regulation in the European Union, reflected the MI contact allergy epidemic. Propolis showed a marked upward trend with a prevalence of 3·94% during the period 2015-2018.
Decreases in sensitization prevalence likely reflect reduced exposure, with some lag, as seen with hydroxyisohexyl 3-cyclohexene carboxaldehyde. If no (sufficient) decrease can be observed despite interventions, such as for nickel and chromium, affected subgroups should be identified and their causative exposures explored. Finally, increases such as that observed with propolis, certainly warrant targeted investigation of the exposures driving sensitization, and possibly intervention. What is already known about this topic? Contact allergy is prevalent in the general population. Surveillance based on clinical data offers timely information on trends concerning certain allergens or subgroups at risk. What does this study add? This analysis provides an update of the current contact allergy prevalence in Central Europe, including time trends. This study describes the demographic and clinical profile of patients tested from 2007 to 2018. This research identifies contact allergens that require (further) preventive efforts. Linked Comment: Schuttelaar. Br J Dermatol 2020; 183:800-801.
接触模式的改变导致普通人群以及因疑似接触性过敏而接受斑贴试验的患者中接触性过敏谱的变化。主要的接触性过敏原（半抗原）被纳入所谓的“基线系列”。
根据三国皮肤科部门信息网络（IVDK）56个活跃部门收集的数据，呈现目前对基线系列过敏原的接触性过敏谱及其在过去12年中的时间变化情况。
对IVDK中所有接受基线系列斑贴试验患者的斑贴试验数据以及核心人口统计学和临床信息进行描述性分析，这些数据按4年时间段细分。此外，采用对数二项回归分析特定接触性过敏的时间趋势，并对潜在的混杂因素进行校正。
在125436例接受德国基线系列试验的患者中，最常见的过敏原为镍（14.7%）、香料混合物I（8.1%）、秘鲁香脂树脂（7.5%）和钴（5.2%），无明确趋势。在欧盟（自我）监管后，对甲基氯异噻唑啉酮/甲基异噻唑啉酮（MI）的接触性过敏的上升和下降反映了MI接触性过敏的流行情况。蜂胶呈明显上升趋势，在2015 - 2018年期间患病率为3.94%。
致敏率的下降可能反映了接触减少，但存在一定滞后，如羟基异己基3 - 环己烯甲醛的情况。如果尽管采取了干预措施（如针对镍和铬）仍未观察到（足够的）下降，则应确定受影响的亚组并探索其致病接触因素。最后，如蜂胶的致敏率增加，肯定需要针对性地调查导致致敏的接触因素，并可能进行干预。关于该主题已知的信息有哪些？接触性过敏在普通人群中普遍存在。基于临床数据的监测可及时提供有关某些过敏原或高危亚组趋势的信息。本研究增加了什么内容？该分析提供了中欧目前接触性过敏患病率的最新情况，包括时间趋势。本研究描述了2007年至2018年接受检测患者的人口统计学和临床特征。本研究确定了需要（进一步）采取预防措施的接触性过敏原。相关评论：舒特拉尔。《英国皮肤病学杂志》2020年；183：800 - 801。
