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Zhang Y, de Graaf NPJ, Roffel S, Spiekstra SW, Rustemeyer T, Kleverlaan CJ, Feilzer AJ, Bontkes H, Deng D, Gibbs S. Patch test-relevant concentrations of metal salts cause localized cytotoxicity, including apoptosis, in skin ex vivo. Contact Dermatitis 2021; 85:531-542. [PMID: 34268774 PMCID: PMC9291529 DOI: 10.1111/cod.13940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
Background Metal alloys containing contact sensitizers (nickel, palladium, titanium) are extensively used in medical devices, in particular dentistry and orthopaedic surgery. The skin patch test is used to test for metal allergy. Objective To determine whether metal salts, when applied to freshly excised skin at patch test–relevant concentrations and using a method which mimics skin patch testing, cause in changes in the epidermis and dermis. Methods Tissue histology, apoptosis, metabolic activity, and inflammatory cytokine release were determined for two nickel salts, two palladium salts, and four titanium salts. Results Patch test–relevant concentrations of all metal salts caused localized cytotoxicity. This was observed as epidermis separation at the basement membrane zone, formation of vacuoles, apoptotic nuclei, decreased metabolic activity, and (pro)inflammatory cytokine release. Nickel(II) sulfate hexahydrate, nickel(II) chloride hexahydrate, titanium(IV) bis(ammonium lactato)dihydroxide, and calcium titanate were highly cytotoxic. Palladium(II) chloride, sodium tetrachloropalladate(II), titanium(IV) isopropoxide, and titanium(IV) dioxide showed mild cytotoxicity. Conclusion The patch test in itself may be damaging to the skin of the patient being tested. These results need further verification with biopsies obtained during clinical patch testing. The future challenge is to remain above the elicitation threshold at noncytotoxic metal concentrations.
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Affiliation(s)
- Yan Zhang
- Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Niels P J de Graaf
- Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Sanne Roffel
- Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sander W Spiekstra
- Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, Amsterdam University Medical Centre location AMC, Amsterdam, The Netherlands
| | - Cees J Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Albert J Feilzer
- Department of Dental Materials Science, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hetty Bontkes
- Unit Medical Immunology, Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands
| | - Dongmei Deng
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Susan Gibbs
- Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
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Thyssen JP, Ahlström MG, Bruze M, Rustemeyer T, Lidén C. Metals. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_35-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ahlström MG, Thyssen JP, Wennervaldt M, Menné T, Johansen JD. Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment. Contact Dermatitis 2019; 81:227-241. [DOI: 10.1111/cod.13327] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/23/2019] [Accepted: 05/24/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Malin G. Ahlström
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte HospitalUniversity of Copenhagen Hellerup Denmark
| | - Jacob P. Thyssen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte HospitalUniversity of Copenhagen Hellerup Denmark
- Department of Dermatology and Allergy, Herlev and Gentofte HospitalUniversity of Copenhagen Hellerup Denmark
| | - Michael Wennervaldt
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte HospitalUniversity of Copenhagen Hellerup Denmark
| | - Torkil Menné
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte HospitalUniversity of Copenhagen Hellerup Denmark
| | - Jeanne D. Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte HospitalUniversity of Copenhagen Hellerup Denmark
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Halling-Overgaard AS, Kezic S, Jakasa I, Engebretsen K, Maibach H, Thyssen J. Skin absorption through atopic dermatitis skin: a systematic review. Br J Dermatol 2017; 177:84-106. [DOI: 10.1111/bjd.15065] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2016] [Indexed: 02/06/2023]
Affiliation(s)
- A.-S. Halling-Overgaard
- Department of Dermatology and Allergy; Herlev and Gentofte Hospital; University of Copenhagen; DK-2900 Hellerup Denmark
- National Allergy Research Centre; Herlev and Gentofte Hospital; University of Copenhagen; DK-2900 Hellerup Denmark
| | - S. Kezic
- Coronel Institute of Occupational Health; Academic Medical Centre; Amsterdam the Netherlands
| | - I. Jakasa
- Laboratory for Analytical Chemistry; Department of Chemistry and Biochemistry; Faculty of Food Technology and Biotechnology; University of Zagreb; Zagreb Croatia
| | - K.A. Engebretsen
- Department of Dermatology and Allergy; Herlev and Gentofte Hospital; University of Copenhagen; DK-2900 Hellerup Denmark
- National Allergy Research Centre; Herlev and Gentofte Hospital; University of Copenhagen; DK-2900 Hellerup Denmark
| | - H. Maibach
- Department of Dermatology; University of California San Francisco; San Francisco CA U.S.A
| | - J.P. Thyssen
- Department of Dermatology and Allergy; Herlev and Gentofte Hospital; University of Copenhagen; DK-2900 Hellerup Denmark
- National Allergy Research Centre; Herlev and Gentofte Hospital; University of Copenhagen; DK-2900 Hellerup Denmark
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Christiansen ES, Andersen KE, Bindslev-Jensen C, Halken S, Kjaer HF, Eller E, Høst A, Mortz CG. Low patch test reactivity to nickel in unselected adolescents tested repeatedly with nickel in infancy. Pediatr Allergy Immunol 2016; 27:636-9. [PMID: 27091397 DOI: 10.1111/pai.12578] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND It is questionable how repeated patch tests with nickel sulfate in infancy affect nickel patch test reactivity at a later age. METHODS The Danish Allergy Research Center (DARC) cohort encompasses 562 infants invited to a clinical examination including patch tests with nickel sulfate six times during the first 36 months of life. At the follow-up investigation at 14 years of age (2013-2014), participants were offered re-patch tests with nickel sulfate. The Odense Adolescence Cohort Study TOACS cohort encompasses 1501 schoolchildren evaluated for the first time at 14 years of age (1995-1996) including clinical examination and nickel sulfate patch tests. The prevalence of nickel sensitization in the DARC cohort was compared to the prevalence in the TOACS cohort at 14 years of age. RESULTS Nickel sulfate sensitization was found in 1.2% of the participants from the DARC cohort tested repeatedly with nickel sulfate in early childhood and retested at 14 years of age compared to 8.6% of the participants from the TOACS cohort patch-tested for the first time at 14 years of age using the same patch test system and test concentration. CONCLUSION The significant difference in nickel patch test reactivity comparing the two cohorts may reflect an immunologic effect or the effect of nickel regulation.
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Affiliation(s)
- Elisabeth Soegaard Christiansen
- Department of Dermatology and Allergy Center, Odense University Hospital, University of Southern Denmark, Odense C, Denmark.,Hans Christian Andersen Children's Hospital, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
| | - Klaus Ejner Andersen
- Department of Dermatology and Allergy Center, Odense University Hospital, University of Southern Denmark, Odense C, Denmark.,Centre for Innovative Medical Technology, Institute of Clinical Research, University of Southern Denmark, DK-5000, Odense C, Denmark
| | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Center, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
| | - Susanne Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
| | - Henrik Formsgaard Kjaer
- Hans Christian Andersen Children's Hospital, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
| | - Esben Eller
- Department of Dermatology and Allergy Center, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
| | - Arne Høst
- Hans Christian Andersen Children's Hospital, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
| | - Charlotte Gotthard Mortz
- Department of Dermatology and Allergy Center, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
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Belloni Fortina A, Fontana E, Peserico A. Contact Sensitization in Children: A Retrospective Study of 2,614 Children from a Single Center. Pediatr Dermatol 2016; 33:399-404. [PMID: 27241536 DOI: 10.1111/pde.12873] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Contact sensitization in children is more common than previously thought, but few studies have been performed on a large population assessed by the same team. The objective was to evaluate contact sensitization in children with suspected contact dermatitis, the relationship with atopic dermatitis (AD), and the most common allergens. METHODS The same team patch tested 2,614 children younger than 11 years old with a standard series of 30 allergens. RESULTS A total of 1220 children (46.7%) developed at least one positive reaction, 606 of which were clinically relevant (49.7%). The most frequent reactions were to nickel sulfate (22.7%), cobalt chloride (11.1%), potassium dichromate (9.9%), neomycin sulfate (5.2%), thimerosal (4.2%), cocamidopropyl betaine (3.4%), and methylchloroisothiazolinone/methylisothiazolinone (3.2%). The prevalence of contact sensitization was similar in children with (47.3%) and without (46.1%) AD. Children with AD had a higher prevalence of positive reactions to potassium dichromate (p < 0.001), Compositae mix (p = 0.01), and disperse blue (p = 0.03). CONCLUSIONS Contact sensitization is quite common in young children. This study adds some information on the most common contact allergens. A similar prevalence of positive patch test reactions was found in children with and without AD, but children with AD had a greater prevalence of positive patch test reactions to potassium dichromate, Compositae mix, and disperse blue.
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Affiliation(s)
- Anna Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Elena Fontana
- Pediatric Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Peserico
- Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
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de Waard-van der Spek FB, Darsow U, Mortz CG, Orton D, Worm M, Muraro A, Schmid-Grendelmeier P, Grimalt R, Spiewak R, Rudzeviciene O, Flohr C, Halken S, Fiocchi A, Borrego LM, Oranje AP. EAACI position paper for practical patch testing in allergic contact dermatitis in children. Pediatr Allergy Immunol 2015; 26:598-606. [PMID: 26287570 DOI: 10.1111/pai.12463] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Allergic contact dermatitis (ACD) in children appears to be on the increase, and contact sensitization may already begin in infancy. The diagnosis of contact dermatitis requires a careful evaluation of a patient's clinical history, physical examination, and skin testing. Patch testing is the gold standard diagnostic test. METHODS Based on consensus, the EAACI Task Force on Allergic Contact Dermatitis in Children produced this document to provide details on clinical aspects, the standardization of patch test methodology, and suggestions for future research in the field. RESULTS We provide a baseline list of test allergens to be tested in children with suspected ACD. Additional tests should be performed only on specific indications.
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Affiliation(s)
| | - Ulf Darsow
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, München, Germany
| | - Charlotte G Mortz
- Department of Dermatology & Allergy Center, Odense University Hospital, Odense, Denmark
| | - David Orton
- Department of Dermatology & Allergy, Hillingdon Hospitals NHS Foundation Trust, Uxbridge (London), UK
| | - Margitta Worm
- Department of Dermatology and Allergy, Allergy-Center Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Antonella Muraro
- Department of Pediatrics, Padua General University Hospital, Padua, Italy
| | | | - Ramon Grimalt
- Department of Dermatology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland
| | - Odilija Rudzeviciene
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Carsten Flohr
- Department of Paediatric Allergy & Dermatology, St John's Institute of Dermatology, St Thomas' Hospital & King's College London, London, UK
| | - Susanne Halken
- Department of Pediatrics, Odense University Hospital, Odense, Denmark
| | - Alessandro Fiocchi
- Department of Pediatrics - Chief Division of Allergy, Pediatric Hospital Bambino Gesu, Roma, Vatican City, Italy
| | - Luis Miguel Borrego
- Department of Allergology/Immunology, CUF Descobertas Hospital, Lisbon and NOVA Medical School, Lisbon, Portugal
| | - Arnold P Oranje
- Department of Dermatology, Dermicis Skin Hospital, Alkmaar, Foundation Pediatric Dermatology, Rotterdam, The Netherlands
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Pediatric Allergic Contact Dermatitis: Lessons for Better Care. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2015; 3:661-7; quiz 668. [DOI: 10.1016/j.jaip.2015.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 02/17/2015] [Accepted: 02/17/2015] [Indexed: 11/22/2022]
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Belloni Fortina A, Cooper SM, Spiewak R, Fontana E, Schnuch A, Uter W. Patch test results in children and adolescents across Europe. Analysis of the ESSCA Network 2002-2010. Pediatr Allergy Immunol 2015; 26:446-55. [PMID: 25939691 DOI: 10.1111/pai.12397] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Contact sensitization in children is more frequent than previously thought. METHODS The ESSCA collected patch test data from 11 European countries aggregated to 4 European regions. RESULTS Six thousand and eight patients aged 1-16 years old with suspected allergic contact dermatitis were analyzed during a period of 8 years (2002-2010). The overall prevalence of at least one positive reaction to a hapten was 36.9%. The 10 most frequent haptens were as follows: nickel sulfate, cobalt chloride and potassium dichromate, neomycin sulfate, Myroxylon pereirae resin (balsam of Peru), para-phenylenediamine, chloromethylisothiazolinone/methylisothiazolinone 3:1, fragrance mix, lanolin alcohols, and colophony. No difference was found in the prevalence of at least one positive reaction to at least one hapten between boys and girls and between children with atopic dermatitis and children without. Children without atopic dermatitis, when compared with those with, had a significantly higher prevalence of contact sensitization for nickel sulfate (20.91% vs 16.87%, respectively), 4-tert. butylphenol formaldehyde resin (1.61% vs. 0.7%), and para-phenylenediamine (2.49% vs. 1.3%). LIMITATIONS OF THE STUDY Chamber loading is not an exact science and variation may occur between staff and departments. Interinstitution variations in readings can occur. A possible geographic confounder is that the southern regions tested more children in the younger age group. Relevance was not addressed due to difficulties in the application of a set of uniform definitions. CONCLUSIONS Our study adds information on the most common contact allergens detected in children which could help to define a Standard European Pediatric Baseline Series.
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Affiliation(s)
- Anna Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Susan M Cooper
- Department of Dermatology, Churchill Hospital, Oxford, UK
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland
| | - Elena Fontana
- Pediatric Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Axel Schnuch
- Information Network of Departments of Dermatology (IVDK), University Medicine, Göttingen, Germany
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
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Nickel and Cobalt Release From Children’s Toys Purchased in Denmark and the United States. Dermatitis 2014; 25:356-65. [DOI: 10.1097/der.0000000000000084] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cipriani F, Dondi A, Ricci G. Recent advances in epidemiology and prevention of atopic eczema. Pediatr Allergy Immunol 2014; 25:630-8. [PMID: 25406640 DOI: 10.1111/pai.12309] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2014] [Indexed: 12/22/2022]
Abstract
Atopic dermatitis (AD), named also atopic eczema, is a chronic relapsing inflammatory skin disease with a considerable social and economic burden. The primum movens of AD is in most cases a genetic and/or immune-supported defect of the skin barrier, facilitating penetration and sensitization to food or airborne allergens, as well as infections by Staphylococcus aureus, herpes simplex virus, or other microbes. New pathogenetic concepts have generated new approaches to prevention and therapy of AD. In particular, the daily use of emollients in newborns at high risk of AD has shown interesting results, with a reduction in the cumulative incidence of AD ranging from 32% to 50% of the treated infants. On the other hand, the AD preventive efficacy of food and/or inhalant allergen avoidance has been questioned, and supplementation strategies (vitamin D, probiotics, or other compounds) need to be further investigated.
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Affiliation(s)
- Francesca Cipriani
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Abstract
Patch tests were introduced as a diagnostic tool in the late nineteenth century.
Since then, they have improved considerably becoming what they are today. Patch tests
are used in the diagnostic investigation of contact dermatitis worldwide. Batteries
or series previously studied and standardized should be used in patch testing. The
methodology is simple, but it requires adequate training for the results to be
correctly interpreted and used. Despite having been used for over a century, it needs
improvement like all other diagnostic techniques in the medical field.
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Affiliation(s)
- Rosana Lazzarini
- Dermatology Clinic, Irmandade da Santa Casa de Misericórdia de São Paulo, São PauloSP, Brazil, M.Sc. in Health Sciences - MD, Dermatology Clinic, Irmandade da Santa Casa de Misericórdia de São Paulo; Professor, School of Medical Sciences, Santa Casa de São Paulo (FCMSCSP) - São Paulo (SP), Brazil
| | - Ida Duarte
- Dermatology Clinic, Irmandade da Santa Casa de Misericórdia de São Paulo, São PauloSP, Brazil, PhD in Health Sciences - Attending physician, Dermatology Clinic, Irmandade da Santa Casa de Misericórdia de São Paulo; Professor, School of Medical Sciences, Santa Casa de São Paulo (FCMSCSP) - São Paulo (SP), Brazil
| | - Alessandra Lindmayer Ferreira
- Dermatology Clinic, Specialization Course in Dermatology, Irmandade da Santa Casa de Misericórdia de São Paulo, São PauloSP, Brazil, MD, Specialization Course in Dermatology, Dermatology Clinic, Irmandade da Santa Casa de Misericórdia de São Paulo - São Paulo (SP), Brazil
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Thyssen JP, McFadden JP, Kimber I. The multiple factors affecting the association between atopic dermatitis and contact sensitization. Allergy 2014; 69:28-36. [PMID: 24372195 DOI: 10.1111/all.12358] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2013] [Indexed: 02/06/2023]
Abstract
Atopic dermatitis and allergic contact dermatitis are both common skin diseases having an immune pathogenesis. There has been considerable interest about their inter-relationships with regard to altered susceptibility. Recent investigations have shed new light on this important question, and in this article, we explore whether there is evidence that atopic dermatitis affects the risk of contact sensitization and allergic contact dermatitis. The use of topical products to treat xerotic and inflamed skin in atopic dermatitis often results in a higher prevalence of sensitization to, for example, fragrances and other ingredients in emollients. Moreover, the prevalence of metal allergy seems to be increased, probably due to compromised chelation of the metals in the stratum corneum of patients with atopic dermatitis. However, conversely, the T-helper cell 2 bias that characterizes immune responses in atopic dermatitis appears to lower the risk of contact sensitization compared to healthy controls. Based on these observations, we conclude that multiple factors affect the association between atopic dermatitis and contact sensitization, and that these need to be appreciated in the clinical management of atopic dermatitis patients.
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Affiliation(s)
- J. P. Thyssen
- National Allergy Research Centre; Department of Dermato-Allergology; Gentofte University Hospital; Hellerup Denmark
| | - J. P. McFadden
- St John's Institute of Dermatology; King's College; St Thomas' Hospital; London UK
| | - I. Kimber
- Faculty of Life Sciences; University of Manchester; Manchester UK
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Nickelallergie – unsichere Diagnose bei Babys und Kleinkindern. ALLERGO JOURNAL 2013. [DOI: 10.1007/s15007-013-0218-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Toholka R, Nixon R. Allergic contact dermatitis to chlorhexidine. Australas J Dermatol 2013; 54:303-6. [DOI: 10.1111/ajd.12087] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 05/07/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Ryan Toholka
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation; Melbourne Victoria Australia
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre; Skin and Cancer Foundation; Melbourne Victoria Australia
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