Diagnostic Management of Allergic Contact Dermatitis in Patients with Atopic Dermatitis: A Comprehensive and Practical review


Özkaya E., Aerts O., Pesqué D.

Current Treatment Options in Allergy, cilt.12, sa.1, 2025 (ESCI) identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 12 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s40521-025-00384-1
  • Dergi Adı: Current Treatment Options in Allergy
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
  • Anahtar Kelimeler: Allergens, Allergic contact dermatitis, Atopic dermatitis, Contact dermatitis, Diagnosis, Diagnostic management, Patch test
  • İstanbul Üniversitesi Adresli: Evet

Özet

Purposeof Review: This review aims to provide an updated perpective on when to suspect allergic contact dermatitis (ACD) in patients with atopic dermatitis (AD), identify key contact allergens, and offer guidance on patch testing to avoid diagnostic pitfalls. Recent Findings: ACD is a common comorbidity in AD, with contact sensitization rates up to 20–30%. Pathophysiologically, ACD is mostly a Th1-driven Type IV hypersensitivity, whereas AD involves mixed immune pathways. Clinically, ACD can mimic or coexist with AD, complicating diagnosis. Metals, fragrances, preservatives, topical products, and other skin sensitizers are increasingly recognized as significant contact allergens in AD patients. Patch testing is crucial for diagnosis, but presents challenges, particularly including irritant, false-positive and false-negative reactions, as well as the lack of standardized commercial test materials for atopy patch testing. Summary: ACD should be suspected in AD patients with an unusual course, atypical distribution, poor treatment response, or late-onset disease. Future studies should focus on improving patch testing strategies to optimize diagnosis of ACD in AD, and better differentiation between these entities, thereby guiding personalised management.