Allergic Contact Dermatitis To Personal Care Products And Topical Medications In Adults With Atopic Dermatitis

Publication date: Available online 25 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Supriya Rastogi, Kevin R. Patel, Vivek Singam, Jonathan I. Silverberg

ABSTRACT

Background

Atopic dermatitis (AD) is associated with skin-barrier disruption, immune dysregulation, and application of emollients and topical medications, which may predispose towards developing allergic contact dermatitis (ACD).

Objective(s)

To determine the predictors of ACD and relevant allergens in AD.

Methods

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

Results

Overall, 108 (21.5%) had current AD and 109 (21.7%) had past AD. Patients with vs. without current AD had similar proportions of any positive (+/++/+++: 80 [74.1%] vs. 254 [64.5%]; Chi-square, P=0.06), stronger (++/+++: 34 [31.5%] vs. 102 [25.9%], P=0.25) and irritant (56 [51.9%] vs. 188 [47.7%], P=0.45) patch test reactions. AD patients had significantly higher rates of positive reactions to ingredients in personal care products and topical medications, including fragrance mix II (P=0.04), lanolin (P=0.03), bacitracin (P=0.04), cinnamal (P=0.02), budesonide (P=0.01), tixocortol (P=0.02), and chlorhexidine (P=0.001); relevance was established in >90% of these reactions. Polysensitization occurred more commonly in patients with vs. without AD (35 [32.4%] vs. 75 [19.0%], P=0.01).

Limitations

Study performed at a single center.

Conclusion

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