15731 Allergic contact dermatitis in patients with atopic dermatitis: A 10-year retrospective review

Abstract

Allergic contact dermatitis (ACD) is prevalent in 20% of patients with atopic dermatitis (AD). We performed a retrospective chart review of patients patch tested at the Massachusetts General Hospital from 2007 to 2016 to investigated the rate of ACD among patients with AD and those without AD. We further stratified by adult or pediatric (<18 years). Statistical analyses were carried out by contingency tables using χ2 and Fisher exact tests. A total of 2373 patients were patch tested: 695 (29.3%) in AD group and 1678 (70.7%) in non-AD group. One or more positive reactions were observed in 424 (61.0%) patients in AD group compared with 1003 (59.8%) patients in non-AD group. When stratified by age, there was no significant difference in ACD prevalence in the patients with AD and without AD. Nickel, Fragrance Mix 1, and Balsam of Peru were the top allergens in both groups. Six allergens were statistically different between AD and non-AD groups. Patients with AD had an increased sensitization to lanolin (amerchol-L101), quaternium-15, glyceryl monothioglycolate and dialkyl thiourea compared with non-AD patients. Patients with AD were noted to have decreased sensitization to neomycin and cinnamic aldehyde. Patients with AD were equally likely to develop contact sensitization as non-AD patients, regardless of age. Exposures to personal care products, such as lanolin containing moisturizers, in patients with AD may play a role in sensitization to specific allergens. Clinicians should consider patch testing patients with AD who report worsening of dermatitis or AD that does not respond to usual treatment.