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Atopy and Sensitization to Allergens Known to Cause Systemic Contact Dermatitis

Scott, Jeffrey F., MD*; Conic, Rosalynn R. Z., MD*; Kim, InYoung, MD, PhD*; Rowland, Douglas Y., PhD; Nedorost, Susan T., MD*

doi: 10.1097/DER.0000000000000436
STUDIES
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Background Atopic dermatitis (AD) associated with respiratory atopy may represent a form of systemic contact dermatitis (SCD), whereby AD flares after ingestion or inhalation of allergens.

Objective The aim of the study was to compare the prevalence of positive patch tests to allergens known to cause SCD in AD patients with and without respiratory atopy.

Methods This is a retrospective study of patients with AD patch tested to 23 allergens known to cause SCD. Positive patch tests were compared between AD patients with and without respiratory atopy, stratified by age and wet or dry work occupation.

Conclusions Children and adolescents, but not adults, with AD and respiratory atopy were more likely than age-matched AD patients without respiratory atopy to have positive patch tests to these allergens (odds ratio, 2.33; 95% confidence interval, 1.13–4.79). Moreover, AD patients with respiratory atopy and engaging in wet work, but not dry work, occupations were more likely than AD patients without respiratory atopy to have positive patch tests to allergens known to cause SCD (odds ratio, 1.47; 95% confidence interval, 1.05–2.06). Thus, respiratory atopy and wet work are associated with sensitization to allergens known to cause SCD in patients with AD, and patch testing may be valuable in identifying systemic triggers of dermatitis in these patients.

From the *Department of Dermatology, University Hospitals Cleveland Medical Center and Case Western Reserve University; and

Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH.

Address reprint requests to Jeffrey F. Scott, MD, Department of Dermatology, University Hospitals Cleveland Medical Center, Lakeside 3500, 11100 Euclid Ave, Cleveland OH 44106. E-mail: jeffrey.scott@uhhospitals.org.

Supported by an American Contact Dermatitis Society Clinical Research Award. In addition, R.R.Z.C. was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under award number 5T32 AR 7569-23.

Portions of this work were presented as a poster at the American Contact Dermatitis Society 2018 Annual Meeting, San Diego, CA; February 28, 2018.

The authors have no conflicts of interest to declare.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

This study was approved by the institutional review board of the University Hospitals Cleveland Medical Center.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.dermatitisjournal.com).

© 2019 American Contact Dermatitis Society
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