Buchvald D. Contact dermatitis and atopic dermatitis – rare comorbidity?

Authors: Dušan Buchvald
Authors‘ workplace: Univerzita Komenského v Bratislave, Lekárska fakulta, Detská dermatovenerologická klinika DFNsP, Slovenská republika
Published in: Čas. Lék. čes. 2010; 149: 217-220
Category: Review Article


Allergic contact dermatitis and atopic dermatitis represent two clinical entities resulting from the activation of two mutually exclusive subsets of T lymphocytes. Therefore, one might expect that the ability of atopic patients to evolve allergic contact dermatitis would be diminished. However, results of recent studies indicate, that similar cytokines’ spectra play role in the pathogenesis of both diseases. Similarly, the clinical epidemiological studies reveal comparable prevalence rates of contact hypersensitivity in atopic dermatitis patients and in non-atopics patients. Patch testing with contact allergens is substantiated in patients suffering from atopic dermatitis.

Key words:
allergic contact dermatitis, atopic dermatitis, cytokines, pathogenesis, comorbidity, epidemiology.


1. Wolf R, Orion E, Matz H, et al. Still elusive relationship between atopic dermatitis and allergic contact dermatitis. Acta Dermatovenerol Croat 2003; 11: 247–250.

2. Kapsenberg ML, Wierenga EA, Stiekema FE, et al. Th1 lymphokine production profiles of nickel-specific CD4+T-lymphocyte clones from nickel contact allergic and non-allergic individuals. J Invest Dermatol 1992; 98: 59–63.

3. Probst P, Kuntzlin D, Fleischer B. TH2-type infiltrating T cells in nickel-induced contact dermatitis. Cell Immunol 1995; 165: 134–140.

4. Werfel T, Hentschel M, Kapp A, et al. Dichotomy of blood- and skin-derived IL-4-producing allergen-specific T cells and restricted V beta repertoire in nickel-mediated contact dermatitis. J Immunol 1997; 158: 2500–2505.

5. Werfel T, Hentschel M, Renz H, et al. Analysis of the phenotype and cytokine pattern of blood- and skin-derived nickel specific T cells in allergic contact dermatitis. Int Arch Allergy Immunol 1997; 113: 384–386.

6. Daser A, Meissner N, Herz U, et al. Role and modulation of T‑cell cytokines in allergy. Curr Opin Immunol 1995; 7: 762–770.

7. Szepietowski JC, McKenzie RC, Keohane SG, et al. Atopic and non-atopic individuals react to nickel challenge in a similar way. A study of the cytokine profile in nickel-induced contact dermatitis. Br J Dermatol 1997; 137: 195–200.

8. Ryan CA, Gerberick GF. Cytokine mRNA expression in human epidermis after patch treatment with rhus and sodium lauryl sulfate. Am J Contact Dermat 1999; 10: 127–135.

9. Ohmen JD, Hanifin JM, Nickoloff BJ, et al. Overexpression of IL-10 in atopic dermatitis. Contrasting cytokine patterns with delayed-type hypersensitivity reactions. J Immunol 1995; 154: 1956–1963.

10. Neis MM, Peters B, Dreuw A, et al. Enhanced expression levels of IL-31 correlate with IL-4 and IL-13 in atopic and allergic contact dermatitis. J Allergy Clin Immunol 2006; 118: 930–937.

11. Rowe A, Bunker CB. Interleukin-4 and the interleukin-4 receptor in allergic contact dermatitis. Contact Dermatitis 1998; 38: 36–39.

12. Sebastiani S, Albanesi C, Nasorri F, et al. Nickel-specific CD4(+) and CD8(+) T cells display distinct migratory responses to chemokines produced during allergic contact dermatitis. J Invest Dermatol 2002; 118: 1052–1058.

13. Werfel T, Morita A, Grewe M, et al. Allergen specificity of skin-infiltrating T cells is not restricted to a type-2 cytokine pattern in chronic skin lesions of atopic dermatitis. J Invest Dermatol 1996; 107: 871–876.

14. Salerno A, Dieli F, Sireci G, et al. Interleukin-4 is a critical cytokine in contact sensitivity. Immunology 1995; 84: 404–409.

15. Asada H, Linton J, Katz SI. Cytokine gene expression during the elicitation phase of contact sensitivity: regulation by endogenous IL-4. J Invest Dermatol 1997; 108: 406–411.

16. Gautam SC, Chikkala NF, Hamilton TA. Anti-inflammatory action of IL-4. Negative regulation of contact sensitivity to trinitrochlorobenzene. J Immunol 1992; 148: 1411–1415.

17. Borish LC, Steinke JW. Cytokines and chemokines. J Allergy Clin Immunol 2003; 111: S460–S475.

18. Paludan SR. Interleukin-4 and interferon-gamma: the quintessence of a mutual antagonistic relationship. Scand J Immunol 1998; 48: 459–468.

19. Rustemeyer T, von Blomberg BME, van Hoogstraten IMW, et al. Analysis of effector and regulatory immune reactivity to nickel. Clin Exp Allergy 2004; 34: 1458–1466.

20. Wahlkvist H, Masjedi K, Gruvberger B, et al. The lipophilic hapten parthenolide induces interferon-gamma and interleukin-13 production by peripheral blood-derived CD8+ T cells from contact allergic subjects in vitro. Br J Dermatol 2008; 158: 70–77.

21. Borg L, Christensen JM, Kristiansen J, et al. Nickel-induced cytokine production from mononuclear cells in nickel-sensitive individuals and controls. Cytokine profiles in nickel-sensitive individuals with nickel allergy-related hand eczema before and after nickel challenge. Arch Dermatol Res 2000; 292: 285–291.

22. Masjedi K, Ahlborg N, Gruvberger B, et al. Methylisothiazolinones elicit increased production of both T helper (Th)1- and Th2-like cytokines by peripheral blood mononuclear cells from contact allergic individuals. Br J Dermatol 2003; 149: 1172–1182.

23. Wildemore JK, Junkins-Hopkins JM, James WD. Evaluation of the histologic characteristics of patch test confirmed allergic contact dermatitis. J Am Acad Dermatol 2003; 49: 243–248.

24. Satoh T, Yokozeki H, Nishioka K. Pathogenic roles of eosinophils in guinea-pig contact sensitivity: regulation of dermal eosinophilia with remotely administered IL-5. Clin Exp Immunol 2000; 122: 300–307.

25. Minang JT, Arestrom I, Zuber B, et al. Nickel-induced IL-10 down-regulates Th1- but not Th2-type cytokine responses to the contact allergen nickel. Clin Exp Immunol 2006; 143: 494–502.

26. Baker BS. The role of microorganisms in atopic dermatitis. Clin Exp Immunol 2006; 144: 1–9.

27. Nomura I, Goleva E, Howell MD, et al. Cytokine milieu of atopic dermatitis, as compared to psoriasis, skin prevents induction of innate immune response genes. J Immunol 2003; 171: 3262–3269.

28. McGirt LY, Beck LA. Innate immune defects in atopic dermatitis. J Allergy Clin Immunol 2006; 118: 202–208.

29. Howell MD, Wollenberg A, Gallo RL, et al. Cathelicidin deficiency predisposes to eczema herpeticum. J Allergy Clin Immunol 2006; 117: 836–841.

30. Belhadjali H, Mohamed M, Youssef M, et al. Contact sensitization in atopic dermatitis: results of a prospective study of 89 cases in Tunisia. Contact Dermatitis 2008; 58: 188–189.

31. Lammintausta K, Kalimo K, Fagerlund VL. Patch test reactions in atopic patients. Contact Dermatitis 1992; 26: 234–240.

32. Mailhol C, Lauwers-Cances V, Rance F, et al. Prevalence and risk factors for allergic contact dermatitis to topical treatment in atopic dermatitis: a study in 641 children. Allergy 2009; 64: 801–806.

33. De Groot AC. The frequency of contact allergy in atopic patients with dermatitis. Contact Dermatitis 1990; 22: 273–277.

34. Cronin E, McFadden JP. Patients with atopic eczema do become sensitized to contact allergens. Contact Dermatitis 1993; 28: 225–228.

35. Ruff CA, Belsito DV. The impact of various patient factors on contact allergy to nickel, cobalt, and chromate. J Am Acad Dermatol 2006; 55: 32–39.

36. Belloni Fortina A, Romano I, Peserico A. Contact sensitization to Compositae mix in children. J Am Acad Dermatol 2005; 53: 877–880.

37. Sutthipisal N, McFadden JP, Cronin E. Sensitization in atopic and non-atopic hairdressers with hand eczema. Contact Dermatitis 1993; 29: 206–209.

38. Seidenari S, Giusti F, Pepe P, et al. Contact sensitization in 1094 children undergoing patch testing over a 7-year period. Pediatr Dermatol 2005; 22: 1–5.

39. Roul S, Ducombs G, Taieb A. Usefulness of the European standard series for patch testing in children. A 3-year single-centre study of 337 patients. Contact Dermatitis 1999; 40: 232–235.

40. Ingordo V, D’Andria G, D’Andria C, et al. Clinical relevance of contact sensitization in atopic dermatitis. Contact Dermatitis 2001; 45: 239–240.

41. Giordano-Labadie F, Rance F, Pellegrin F, et al. Frequency of contact allergy in children with atopic dermatitis: results of a prospective study of 137 cases. Contact Dermatitis 1999; 40: 192–195.

42. Kuljanac I, Knezevic E, Cvitanovic H. Epicutaneous patch test reactions in atopic dermatitis patients. Acta Dermatovenerol Croat 2005; 13: 225–227.

43. Lever R, Forsyth A. Allergic contact dermatitis in atopic dermatitis. Acta Derm Venereol (Stockh) 1992; 176(Suppl): 95–98.

44. Dotterud LK, Smith-Sivertsen T. Allergic contact sensitization in the general adult population: a population-based study from Northern Norway. Contact Dermatitis 2007; 56: 10–15.

45. Nielsen NH, Linneberg A, Menne T, et al. Allergic contact sensitization in an adult Danish population: two cross-sectional surveys eight years apart (the Copenhagen Allergy Study). Acta Derm Venereol 2001; 81: 31–34.

46. Schafer T, Bohler E, Ruhdorfer S, et al. Epidemiology of contact allergy in adults. Allergy 2001; 56: 1192–1196.

47. Rees J, Friedmann PS, Matthews JN. Contact sensitivity to dinitrochlorobenzene is impaired in atopic subjects. Controversy revisited. Arch Dermatol 1990; 126: 1173–1175.

48. McFadden JP, White JML, Basketter DA, et al. Reduced allergy rates in atopic eczema to contact allergens used in both skin products and foods: atopy and the ‘hapten-atopy hypothesis’. Contact Dermatitis 2008; 58: 156–158.

49. McFadden JP, White JML. Reduced frequency of atopic dermatitis in quinoline-allergic patients: the ‘hapten-atopy hypothesis’. Contact Dermatitis 2008; 58: 291–295.

50. Rietschel RL, Fowler JF. Fisher’s Contact dermatitis. Fifth edition. Philadelphia: Lippincott Williams & Wilkins 2001.

51. Uter W, Pfahlberg A, Gefeller O, et al. Risk factors for contact allergy to nickel – results of a multifactorial analysis. Contact Dermatitis 2003; 48: 33–38.

52. Smith-Sivertsen T, Dotterud LK, Lund E. Nickel allergy and its relationship with local nickel pollution, ear piercing, and atopic dermatitis: a population-based study from Norway. J Am Acad Dermatol 1999; 40: 726–735.

53. Jappe U, Schnuch A, Uter W. Frequency of sensitization to antimicrobials in patients with atopic eczema compared with nonatopic individuals: analysis of multicentre surveillance data, 1995-1999. Br J Dermatol 2003; 149: 87–93.

54. el Samahy MH, el-Kerdani T. Value of patch testing in atopic dermatitis. Am J Contact Dermat 1997; 8: 154–157.

55. McFadden J. Contact allergic reactions in patients with atopic eczema. Acta Derm Venereol (Stockh) 2005; 215(Suppl.): 28–32.

56. Foti C, Bonifazi E, Casulli C, et al. Contact allergy to topical corticosteroids in children with atopic dermatitis. Contact Dermatitis 2005; 52: 162–163.

57. Menezes de Padua CA, Schnuch A, Lessmann H, et al. Contact allergy to neomycin sulfate: results of a multifactorial analysis. Pharmacoepidemiol Drug Saf 2005; 14: 725–733.

58. Brasch J, Schnuch A, Uter W. Patch-test reaction patterns in patients with a predisposition to atopic dermatitis. Contact Dermatitis 2003; 49: 197–201.

59. Makela L, Lammintausta K, Kalimo K. Contact sensitivity and atopic dermatitis: association with prognosis, a follow-up study in 801 atopic patients. Contact Dermatitis 2007; 56: 76–80.

Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account