title: Contact allergy in atopic individuals in relation to allergen-specific immunotherapy.
abstract: Type I sensitizations and atopic dermatitis (AD) often appear in the same patient. Beneficial effects of allergen-specific immunotherapy (ASIT) in patients with both AD and type I allergies have been reported. The predisposing role of AD to the development of type IV sensitization is discussed. Whether ASIT for type I allergy also influences type IV allergies is unknown. To compare the number of contact allergies between patients with and without AD, before and after one year's treatment with ASIT. A controlled, single-blind multicentre study of children/adults with allergic asthma and/or rhinoconjunctivitis, treated or untreated with ASIT, was performed. The history of AD was collected using questionnaires. The number of contact allergies was assessed by patch testing with a baseline series. 205 individuals completed the study; 133 treated with ASIT (exposed) and 72 before starting ASIT (unexposed). For participants with AD, significantly more contact allergies were found in the groups of all children (p = 0.002), all exposed children (p<0.001), and all exposed study persons (p = 0.013). Independent of AD, significantly more contact allergies were noted in the groups of all unexposed adults (p = 0.004) and all unexposed study persons (p = 0.004). The higher number of contact allergies in patients with AD indicates that AD may be a risk factor for type IV sensitization in those with allergic asthma and/or rhinoconjunctivitis. The lower number of contact allergies in patients exposed to ASIT suggests an immunomodulatory effect on type IV sensitization.
authors.affiliation: Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, S-205 02 Malmö, Department of Dermatology and Venereology, Skåne University Hospital, Lund University, S-221 85 Lund.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Siemund
authors.affiliation: Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, S-205 02 Malmö
authors.forename: Monica
authors.initials: M
authors.lastname: Hindsén
authors.affiliation: Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, S-205 02 Malmö, Swedish Institute for Communicable Infectious Disease Control, S-171 65 Solna.
authors.forename: Eva
authors.initials: E
authors.lastname: Netterlid
authors.affiliation: Region Skånes Competence Centre for Clinical Research, Skåne University Hospital, S-221 85 Lund, Sweden.
authors.forename: Nuray
authors.initials: N
authors.lastname: Güner
authors.affiliation: Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, S-205 02 Malmö
authors.forename: Magnus
authors.initials: M
authors.lastname: Bruze
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D017449:Dermatitis, Allergic Contact / Q000150:complications* / Q000276:immunology / Q000628:therapy*; D003876:Dermatitis, Atopic / Q000150:complications* / Q000276:immunology; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D008297:Male; D010328:Patch Tests; D012307:Risk Factors; D016037:Single-Blind Method; D055815:Young Adult
chemical_list: D000485:Allergens
keywords: allergen-specific immunotherapy; allergic contact dermatitis; atopic eczema; cutaneous delayed-type hypersensitivity; patch testing; type I sensitization