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J Am Acad Dermatol. 2018 Dec;79(6):1028-1033.e6. doi: 10.1016/j.jaad.2018.07.017. Epub 2018 Jul 25.

Allergic contact dermatitis to personal care products and topical medications in adults with atopic dermatitis.

Author information

1
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
2
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois. Electronic address: jonathanisilverberg@gmail.com.

Abstract

BACKGROUND:

Atopic dermatitis (AD) is associated with skin-barrier disruption, immune dysregulation, and application of emollients and topical medications that might predispose a person toward developing allergic contact dermatitis.

OBJECTIVE:

To determine the predictors of allergic contact dermatitis and relevant allergens in AD.

METHODS:

A retrospective chart review was performed for 502 adults (age ≥18 years) who were patch tested to an expanded allergen series during 2014-2017.

RESULTS:

Overall, 108 (21.5%) had current AD and 109 (21.7%) had past AD. Patients with and without current AD had similar proportions of any positive (+, ++, or +++ 80 [74.1%] vs 254 [64.5%], respectively, chi-squared P = .06); strong-positive (++ and +++ 34 [31.5%] vs 102 [25.9%], respectively, P = .25); and irritant (56 [51.9%] vs 188 [47.7%], respectively, P = .45) patch-test reactions. AD patients had significantly higher rates of positive reactions to ingredients in their personal care products and topical medications, including fragrance mix II (P = .04), lanolin (P = .03), bacitracin (P = .04), cinnamal (P = .02), budesonide (P = .01), tixocortol (P = .02), and chlorhexidine (P = .001); relevance was established in >90% of these reactions. Polysensitization occurred more commonly in patients with AD than without (35 [32.4%] vs 75 [19.0%]; P = .01).

LIMITATION:

Study was performed at a single center.

CONCLUSION:

AD patients had more positive patch-test reactions to ingredients in their personal care products, topical steroids, and antibiotics.

KEYWORDS:

allergic contact dermatitis; atopic dermatitis; eczema; polysensitization

PMID:
30053491
DOI:
10.1016/j.jaad.2018.07.017
[Indexed for MEDLINE]

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