Sanja Kezic, Florentine de Boer, Nariman K A Metwally, Karen Ghauharali-van der Vlugt, Femke S Beers-Stet, Wouter Ouwerkerk, Ivone Jakasa, Thomas Rustemeyer, Henk F van der Molen
Background: Skin barrier impairment is central to irritant (ICD) and allergic contact dermatitis (ACD). Stratum corneum (SC) components cholesterol sulphate (CholSulph), glucosylcholesterol (CholGlc) and natural moisturising factor (NMF) are critical for barrier function, but their changes in ICD and ACD remain underexplored.
Objectives: To measure CholSulph, CholGlc, NMF and IL-1α in patch-induced ICD and ACD and in hand dermatitis (HD) diagnosed as ICD or ACD.
Methods: SC samples were collected from HD patients undergoing patch testing. Biomarkers were analysed in positive reactions to sodium lauryl sulphate (ICD, n = 44), allergens (ACD, n = 113; nickel, chromium, methylisothiazolinone [MI]), lesional HD skin (n = 45) and control (empty chamber, n = 121).
Results: CholGlc was significantly elevated in patch-induced ICD and ACD. CholSulph was increased in ICD and chromium- and MI-induced ACD. NMF decreased in ICD, while IL-1α decreased in ICD and chromium ACD. Chromium induced the strongest response, nickel the weakest. In HD, ICD and ACD showed elevated CholGlc, reduced NMF and IL-1α, with CholSulph increased only in ACD. No biomarker differences were detected between clinical ICD and ACD.
Conclusions: Both induced and clinical ICD and ACD show consistent SC biomarker changes reflecting barrier dysfunction, with no differences between clinical ICD and ACD.
背景：皮肤屏障损伤是刺激性（ICD）和过敏性接触性皮炎（ACD）的核心。角质层（SC）成分硫酸胆固醇（CholSulph）、葡萄糖胆固醇（CholGlc）和天然保湿因子（NMF）对屏障功能至关重要，但它们在ICD和ACD中的变化尚不清楚。目的：测定贴片性ICD、ACD及诊断为ICD、ACD的手性皮炎（HD）患者的胆硫、胆糖、NMF和IL-1α水平。方法：从HD患者中采集SC标本进行斑贴试验。对十二烷基硫酸钠（ICD, n = 44）、过敏原（ACD, n = 113；镍、铬、甲基异噻唑啉酮[MI]）、病变HD皮肤（n = 45）和对照组（空室，n = 121）的阳性反应进行生物标志物分析。结果：补片诱导的ICD和ACD中CholGlc明显升高。ICD、铬和mi诱导的ACD中CholSulph升高。ICD中NMF降低，ICD和铬ACD中IL-1α降低。铬的反应最强，镍的反应最弱。HD组ICD和ACD组CholGlc升高，NMF和IL-1α降低，仅ACD组cholsulh升高。临床ICD和ACD之间没有检测到生物标志物差异。结论：诱导性ICD和临床ACD均表现出一致的SC生物标志物变化，反映屏障功能障碍，临床ICD和ACD之间无差异。
{"title":"Skin Barrier Biomarkers in Patch-Induced and Clinical Allergic and Irritant Contact Dermatitis.","authors":"Sanja Kezic, Florentine de Boer, Nariman K A Metwally, Karen Ghauharali-van der Vlugt, Femke S Beers-Stet, Wouter Ouwerkerk, Ivone Jakasa, Thomas Rustemeyer, Henk F van der Molen","doi":"10.1111/cod.70070","DOIUrl":"https://doi.org/10.1111/cod.70070","url":null,"abstract":"<p><strong>Background: </strong>Skin barrier impairment is central to irritant (ICD) and allergic contact dermatitis (ACD). Stratum corneum (SC) components cholesterol sulphate (CholSulph), glucosylcholesterol (CholGlc) and natural moisturising factor (NMF) are critical for barrier function, but their changes in ICD and ACD remain underexplored.</p><p><strong>Objectives: </strong>To measure CholSulph, CholGlc, NMF and IL-1α in patch-induced ICD and ACD and in hand dermatitis (HD) diagnosed as ICD or ACD.</p><p><strong>Methods: </strong>SC samples were collected from HD patients undergoing patch testing. Biomarkers were analysed in positive reactions to sodium lauryl sulphate (ICD, n = 44), allergens (ACD, n = 113; nickel, chromium, methylisothiazolinone [MI]), lesional HD skin (n = 45) and control (empty chamber, n = 121).</p><p><strong>Results: </strong>CholGlc was significantly elevated in patch-induced ICD and ACD. CholSulph was increased in ICD and chromium- and MI-induced ACD. NMF decreased in ICD, while IL-1α decreased in ICD and chromium ACD. Chromium induced the strongest response, nickel the weakest. In HD, ICD and ACD showed elevated CholGlc, reduced NMF and IL-1α, with CholSulph increased only in ACD. No biomarker differences were detected between clinical ICD and ACD.</p><p><strong>Conclusions: </strong>Both induced and clinical ICD and ACD show consistent SC biomarker changes reflecting barrier dysfunction, with no differences between clinical ICD and ACD.</p>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mikkel Bak Jensen, Christoffer Kursawe Larsen, Carsten R. Hamann, Jeanne Duus Johansen, Anna Sophie Quaade
Whether atopic dermatitis (AD) is associated with an altered susceptibility to contact sensitization (CS) remains debated. The aim of this systematic review and meta-analysis was to provide updated estimates of the association between AD and CS overall, by population type (general or referred), various demographics and selected allergens. PubMed, Embase and Web of Science were systematically searched for studies published between 2016 and 2025 reporting CS prevalence in individuals with and without AD. Data were combined with a previous systematic review covering studies published between 1982 and 2016. Meta-analyses were performed to calculate pooled odds ratios (ORs). The pooled analyses showed no overall association between AD and CS (OR 1.08, 95% CI: 0.82–1.42), including in referred populations (OR 1.03, 95% CI: 0.76–1.38). In general population studies, CS prevalence was higher among individuals with AD. The association was statistically significant in children and adolescents (OR 1.34, 95% CI: 1.0–1.80) but not in adults. Positive associations were found between AD and CS to Compositae mix and sesquiterpene lactone mix, but not to nickel, cobalt, or chromium. In conclusion, our findings suggest no general association between AD and contact CS, but multiple factors may modify this relationship, underlining the value of patch testing in AD.
{"title":"Association Between Atopic Dermatitis and Contact Sensitization: An Updated Systematic Review and Meta-Analysis","authors":"Mikkel Bak Jensen, Christoffer Kursawe Larsen, Carsten R. Hamann, Jeanne Duus Johansen, Anna Sophie Quaade","doi":"10.1111/cod.70074","DOIUrl":"10.1111/cod.70074","url":null,"abstract":"<p>Whether atopic dermatitis (AD) is associated with an altered susceptibility to contact sensitization (CS) remains debated. The aim of this systematic review and meta-analysis was to provide updated estimates of the association between AD and CS overall, by population type (general or referred), various demographics and selected allergens. PubMed, Embase and Web of Science were systematically searched for studies published between 2016 and 2025 reporting CS prevalence in individuals with and without AD. Data were combined with a previous systematic review covering studies published between 1982 and 2016. Meta-analyses were performed to calculate pooled odds ratios (ORs). The pooled analyses showed no overall association between AD and CS (OR 1.08, 95% CI: 0.82–1.42), including in referred populations (OR 1.03, 95% CI: 0.76–1.38). In general population studies, CS prevalence was higher among individuals with AD. The association was statistically significant in children and adolescents (OR 1.34, 95% CI: 1.0–1.80) but not in adults. Positive associations were found between AD and CS to Compositae mix and sesquiterpene lactone mix, but not to nickel, cobalt, or chromium. In conclusion, our findings suggest no general association between AD and contact CS, but multiple factors may modify this relationship, underlining the value of patch testing in AD.</p>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 3","pages":"201-225"},"PeriodicalIF":4.6,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145803299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ying Xin Teo, Louise Cunningham, Hiva Fassihi, Robert Sarkany, Ian R White, Adam Fityan
Background: Chronic actinic dermatitis (CAD) is a photodermatosis associated with contact allergy. Changes in the contact allergen profile in patch-tested CAD patients from our department have been reported over several decades.
Objectives: To determine the frequency of positive patch tests and allergen profiles in recently investigated CAD patients and compare this to profiles in earlier decades.
Methods: A retrospective cohort study was undertaken at a tertiary Cutaneous Allergy department between 2011 and 2021. Demographics and 10 allergens with highest positivity in CAD and non-CAD patients were compared.
Results: Patch testing was performed in 309 (88.3%) of 349 CAD patients, with 186 (60.2%) testing positive to any allergen and 8 (2.6%) positive on photo-patch testing. Patients aged > 40 and with Fitzpatrick skin type V-VI were statistically more likely to be patch test positive (age > 40: p = 0.0082; Fitzpatrick skin type: p = 0.0361). Sesquiterpene lactones (SQL) (6.8%) and formaldehyde (4.8%) were amongst the top 10 most frequently positive allergens in CAD but not in non-CAD patients.
Conclusion: Allergic contact dermatitis remains prevalent amongst CAD patients, although sensitisation to allergens historically linked to CAD is decreasing. The cause of this is unclear but potentially due to changes in environmental exposures, particularly in younger CAD patients.
{"title":"Changes in Contact Dermatitis Allergen Profile in Chronic Actinic Dermatitis: Results From a Single Centre.","authors":"Ying Xin Teo, Louise Cunningham, Hiva Fassihi, Robert Sarkany, Ian R White, Adam Fityan","doi":"10.1111/cod.70073","DOIUrl":"https://doi.org/10.1111/cod.70073","url":null,"abstract":"<p><strong>Background: </strong>Chronic actinic dermatitis (CAD) is a photodermatosis associated with contact allergy. Changes in the contact allergen profile in patch-tested CAD patients from our department have been reported over several decades.</p><p><strong>Objectives: </strong>To determine the frequency of positive patch tests and allergen profiles in recently investigated CAD patients and compare this to profiles in earlier decades.</p><p><strong>Methods: </strong>A retrospective cohort study was undertaken at a tertiary Cutaneous Allergy department between 2011 and 2021. Demographics and 10 allergens with highest positivity in CAD and non-CAD patients were compared.</p><p><strong>Results: </strong>Patch testing was performed in 309 (88.3%) of 349 CAD patients, with 186 (60.2%) testing positive to any allergen and 8 (2.6%) positive on photo-patch testing. Patients aged > 40 and with Fitzpatrick skin type V-VI were statistically more likely to be patch test positive (age > 40: p = 0.0082; Fitzpatrick skin type: p = 0.0361). Sesquiterpene lactones (SQL) (6.8%) and formaldehyde (4.8%) were amongst the top 10 most frequently positive allergens in CAD but not in non-CAD patients.</p><p><strong>Conclusion: </strong>Allergic contact dermatitis remains prevalent amongst CAD patients, although sensitisation to allergens historically linked to CAD is decreasing. The cause of this is unclear but potentially due to changes in environmental exposures, particularly in younger CAD patients.</p>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145803331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zeineb Ben Lamine, Amen Moussa, Marwa Bouhoula, Razene Gerisha, Sarra Sabbagh, Imen Kacem, Asma Aloui, Souheil Chatti, Aicha Brahem, Ramzi Zemni, Foued Ben Hadj Slama
Background
Allergic contact dermatitis (ACD) is a multifactorial inflammatory skin disorder. Polysensitisation, defined as hypersensitivity to ≥ 3 unrelated allergens, reflects a more severe clinical form. The LCE3C_LCE3B deletion, implicated in skin barrier dysfunction, has a yet unclear role in the susceptibility to ACD and polysensitisation.
Objective
This study aims to evaluate the association between LCE3C_LCE3B deletion and susceptibility to ACD and polysensitisation in the Tunisian population.
Methods
A case–control study included 94 confirmed ACD patients and 125 age- and sex-matched controls without immune-related diseases. Patch testing followed the European Baseline Series. LCE3C_LCE3B genotyping was performed using conventional three-primer PCR after DNA extraction by the salting-out method.
Results
Polysensitisation was observed in 33% of ACD cases. Genotyping of the LCE3C_LCE3B deletion did not reveal statistically significant differences in allelic or genotypic frequencies between ACD cases and controls. Furthermore, no statistically significant association was found between the LCE3C_LCE3B del and polysensitisation. Similarly, no significant associations were observed between the LCE3C_LCE3B deletion and sensitisation to metals, including nickel, cobalt and chromium.
Conclusion
No significant association was found between the LCE3C_LCE3B deletion and either ACD or polysensitisation. Larger studies are needed to clarify the genetic contribution to these conditions.
{"title":"Genetic Insights Into Allergic Contact Dermatitis: Reassessing the Role of LCE3C_LCE3B Deletion","authors":"Zeineb Ben Lamine, Amen Moussa, Marwa Bouhoula, Razene Gerisha, Sarra Sabbagh, Imen Kacem, Asma Aloui, Souheil Chatti, Aicha Brahem, Ramzi Zemni, Foued Ben Hadj Slama","doi":"10.1111/cod.70058","DOIUrl":"10.1111/cod.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Allergic contact dermatitis (ACD) is a multifactorial inflammatory skin disorder. Polysensitisation, defined as hypersensitivity to ≥ 3 unrelated allergens, reflects a more severe clinical form. The LCE3C_LCE3B deletion, implicated in skin barrier dysfunction, has a yet unclear role in the susceptibility to ACD and polysensitisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to evaluate the association between LCE3C_LCE3B deletion and susceptibility to ACD and polysensitisation in the Tunisian population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A case–control study included 94 confirmed ACD patients and 125 age- and sex-matched controls without immune-related diseases. Patch testing followed the European Baseline Series. LCE3C_LCE3B genotyping was performed using conventional three-primer PCR after DNA extraction by the salting-out method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Polysensitisation was observed in 33% of ACD cases. Genotyping of the LCE3C_LCE3B deletion did not reveal statistically significant differences in allelic or genotypic frequencies between ACD cases and controls. Furthermore, no statistically significant association was found between the LCE3C_LCE3B del and polysensitisation. Similarly, no significant associations were observed between the LCE3C_LCE3B deletion and sensitisation to metals, including nickel, cobalt and chromium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No significant association was found between the LCE3C_LCE3B deletion and either ACD or polysensitisation. Larger studies are needed to clarify the genetic contribution to these conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 3","pages":"226-233"},"PeriodicalIF":4.6,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>The first cases of allergic contact dermatitis (ACD) to (meth)acrylates and cyanoacrylates in polymerised resins for artificial nails were described decades ago. However, such cases are now increasingly reported, driven by the wide use of permanent and semi-permanent acrylic nail polishes, either UV-cured or self-curing, applied in beauty salons or at home using manicure kits often purchased online. We herein report two atypical clinical presentations of ACD to acrylates.</p><p>In ACD to (meth)acrylates from artificial nails, ACD predominantly affects the hands in approximately 80% of cases [<span>2</span>]. Nail lesions are frequent, usually associated with periungual skin involvement, and may occasionally be accompanied by eczema at distant sites, possibly through self-transfer [<span>3</span>]. In some instances, ACD may only present as isolated digital pain, without visible skin lesions [<span>3</span>].</p><p>Atypical clinical forms may lead to diagnostic uncertainties or even diagnostic and therapeutic errors, which occurred in our second patient over a 2-year period. ACD presenting as pseudo-psoriatic nail changes has been rarely described in the literature in this setting, mainly presenting as onycholysis and subungual hyperkeratosis [<span>4-6</span>]. The presence of more typical nail psoriasis signs, such as salmon patches, has only been rarely reported [<span>7</span>]. Similarly, subungual haemorrhages that might initially be suggestive of autoimmune acral disorders are rarely described in this context [<span>8</span>]. These two cases highlight that any nail changes in users of artificial nails or nail polish should raise suspicion of ACD, even in the absence of pulpitis and paronychia.</p><p>Differential diagnoses include nail psoriasis, lichen planus, onychomycosis, and trauma. ACD should be considered when nail involvement occurs without psoriatic or lichenoid skin or mucosal lesions, without arthralgia, or when mycological cultures are negative. Persistence of nail lesions despite appropriate treatment should lead clinicians to consider acrylate allergy and perform patch testing.</p><p>The use of at-home kits and non-professional UV-curing nail polishes is associated with a higher risk of acrylate sensitisation [<span>3</span>]. Accordingly, European Union (EU) regulation introduced in 2021 restricted the use of 2-hydroxyethyl methacrylate (HEMA) and di-HEMA in nail cosmetics to professional use only [<span>9</span>]. However, Wilkinson et al. reported that this legislation did not significantly reduce the incidence of acrylate-induced ACD from nail products [<span>10</span>]: HEMA is not completely banned and continues to be used by professionals; additionally, many (meth)acrylates exhibit immunological cross-reactivity, and most nail products contain several different (meth)acrylates, which results in the label “HEMA-free” not being a guarantee of safety; finally, online sales of nail products make compliance with EU regula
{"title":"Two Cases of Less Common Clinical Presentations of Allergic Contact Dermatitis to Acrylates in UV-Cured Nail Polish","authors":"Léopoldine Vernhet, Nadia Raison-Peyron, Olivier Dereure, Aude Muslin, Quentin Samaran","doi":"10.1111/cod.70072","DOIUrl":"10.1111/cod.70072","url":null,"abstract":"<p>The first cases of allergic contact dermatitis (ACD) to (meth)acrylates and cyanoacrylates in polymerised resins for artificial nails were described decades ago. However, such cases are now increasingly reported, driven by the wide use of permanent and semi-permanent acrylic nail polishes, either UV-cured or self-curing, applied in beauty salons or at home using manicure kits often purchased online. We herein report two atypical clinical presentations of ACD to acrylates.</p><p>In ACD to (meth)acrylates from artificial nails, ACD predominantly affects the hands in approximately 80% of cases [<span>2</span>]. Nail lesions are frequent, usually associated with periungual skin involvement, and may occasionally be accompanied by eczema at distant sites, possibly through self-transfer [<span>3</span>]. In some instances, ACD may only present as isolated digital pain, without visible skin lesions [<span>3</span>].</p><p>Atypical clinical forms may lead to diagnostic uncertainties or even diagnostic and therapeutic errors, which occurred in our second patient over a 2-year period. ACD presenting as pseudo-psoriatic nail changes has been rarely described in the literature in this setting, mainly presenting as onycholysis and subungual hyperkeratosis [<span>4-6</span>]. The presence of more typical nail psoriasis signs, such as salmon patches, has only been rarely reported [<span>7</span>]. Similarly, subungual haemorrhages that might initially be suggestive of autoimmune acral disorders are rarely described in this context [<span>8</span>]. These two cases highlight that any nail changes in users of artificial nails or nail polish should raise suspicion of ACD, even in the absence of pulpitis and paronychia.</p><p>Differential diagnoses include nail psoriasis, lichen planus, onychomycosis, and trauma. ACD should be considered when nail involvement occurs without psoriatic or lichenoid skin or mucosal lesions, without arthralgia, or when mycological cultures are negative. Persistence of nail lesions despite appropriate treatment should lead clinicians to consider acrylate allergy and perform patch testing.</p><p>The use of at-home kits and non-professional UV-curing nail polishes is associated with a higher risk of acrylate sensitisation [<span>3</span>]. Accordingly, European Union (EU) regulation introduced in 2021 restricted the use of 2-hydroxyethyl methacrylate (HEMA) and di-HEMA in nail cosmetics to professional use only [<span>9</span>]. However, Wilkinson et al. reported that this legislation did not significantly reduce the incidence of acrylate-induced ACD from nail products [<span>10</span>]: HEMA is not completely banned and continues to be used by professionals; additionally, many (meth)acrylates exhibit immunological cross-reactivity, and most nail products contain several different (meth)acrylates, which results in the label “HEMA-free” not being a guarantee of safety; finally, online sales of nail products make compliance with EU regula","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 3","pages":"302-305"},"PeriodicalIF":4.6,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alessandra Chiei-Gallo, Francesca Barei, Angelo V. Marzano, Silvia M. Ferrucci
<p>Allergic contact dermatitis (ACD) is a T cell–mediated (type IV delayed-type) hypersensitivity reaction induced by the immunogenic properties of a subset of chemicals and requires the activation of both innate and acquired immunity. Biologic therapies targeting cytokines such as tumour necrosis factor (TNF)-α, IL-12/23 and IL-17 are widely used in treating various chronic inflammatory conditions. Their immunomodulatory effects have raised concerns about potential suppression of patch test (PT) responses, possibly leading to false-negative results [<span>1-3</span>]. Nonetheless, clinical evidence, including case series and expert opinions, suggests that positive PT reactions can still occur during biologic treatment [<span>1, 4-6</span>]. Patch testing during treatment with anti-TNFα agents and guselkumab has been reported; however, to our knowledge, no studies have been published on PT outcomes in patients receiving bimekizumab or risankizumab.</p><p>We herein present our experience with patch testing in six patients affected by psoriasis, hidradenitis suppurativa (HS) or Crohn's disease, treated with bimekizumab (<i>n</i> = 1) for psoriasis and HS, risankizumab (<i>n</i> = 1) for psoriasis, guselkumab (<i>n</i> = 2) for psoriasis and Adalimumab (<i>n</i> = 2) for Crohn's disease. These patients were referred to our tertiary centre for suspected ACD. Patch testing was performed without discontinuing biologic therapy, using the T.R.U.E. TEST system (Smart Practice, Phoenix, AZ, USA), which includes Panels 1.3, 2.3 and 3.3, comprising 35 common allergens and a negative control.</p><p>The clinical and epidemiological characteristics are detailed in Table 1. Five of six patients demonstrated at least one positive reaction, most commonly to nickel sulphate, with additional sensitisations to cobalt, chromium, and gold sodium thiosulfate. All reactions were clinically relevant.</p><p>These findings align with previous studies reporting preserved PT reactivity despite systemic immunomodulation [<span>1-3</span>]. Although biologics target Th1/Th17 pathways involved in ACD pathogenesis, our results support previous reports showing that patch test reactivity may persist during biologic treatment. While positive reactions to metals were detected, weaker or doubtful responses (particularly to allergens such as fragrances or preservatives) could have been suppressed by biologic therapy. This suggests that negative results should be interpreted with caution. Our experience supports the feasibility and clinical usefulness of performing patch testing during biologic therapy, although it remains uncertain whether biologics may attenuate certain elicitation reactions or reduce the intensity of weak responses. The use of the TRUE Test panel alone (without additional series) and the absence of a control group limit our ability to fully assess test sensitivity and generalise the findings. This highlights the need for future prospective studies, ideally including
过敏性接触性皮炎（ACD）是一种T细胞介导的（IV型延迟型）超敏反应，由一类化学物质的免疫原性引起，需要激活先天免疫和获得性免疫。针对肿瘤坏死因子(TNF)-α、IL-12/23和IL-17等细胞因子的生物疗法被广泛用于治疗各种慢性炎症。它们的免疫调节作用引起了人们对斑贴试验（PT）反应的潜在抑制的担忧，可能导致假阴性结果[1-3]。然而，包括病例系列和专家意见在内的临床证据表明，在生物治疗期间仍可能发生PT阳性反应[1,4 -6]。在使用抗tnf α药物和guselkumab治疗期间进行斑贴试验已有报道；然而，据我们所知，没有关于接受比美珠单抗或瑞尚珠单抗的患者PT结果的研究发表。在此，我们介绍了我们在6例银屑病、化脓性汗腺炎（HS）或克罗恩病患者中进行贴片试验的经验，治疗银屑病和HS的患者使用比美珠单抗（n = 1），治疗银屑病的患者使用瑞桑单抗（n = 1），治疗银屑病的患者使用guselkumab (n = 2)，治疗克罗恩病的患者使用阿达木单抗（n = 2）。这些患者被转介到我们的三级中心疑似ACD。在不停止生物治疗的情况下，使用T.R.U.E. TEST系统（Smart Practice, Phoenix， AZ， USA）进行斑贴试验，包括组1.3、2.3和3.3，包括35种常见过敏原和阴性对照。临床和流行病学特征详见表1。6例患者中有5例表现出至少一种阳性反应，最常见的是对硫酸镍，对钴、铬和硫代硫酸钠金有额外的过敏反应。所有反应均具有临床相关性。这些发现与先前报道的尽管有全身免疫调节，PT反应性仍保持不变的研究结果一致[1-3]。虽然生物制剂靶向参与ACD发病机制的Th1/Th17通路，但我们的研究结果支持先前的报道，即在生物治疗期间，斑贴试验的反应性可能持续存在。虽然检测到对金属的积极反应，但较弱或可疑的反应（特别是对香水或防腐剂等过敏原的反应）可以通过生物疗法加以抑制。这表明应该谨慎地解释负面结果。我们的经验支持在生物治疗期间进行贴片试验的可行性和临床实用性，尽管尚不确定生物制剂是否可以减轻某些诱发反应或降低弱反应的强度。单独使用TRUE测试组（没有额外的系列）和缺乏对照组限制了我们充分评估测试敏感性和概括结果的能力。这突出了未来前瞻性研究的必要性，理想情况下包括在开始生物治疗前和治疗几个月后进行补丁测试。然而，鉴于样本小且异质性，这些发现应被视为初步的，需要进一步的对照研究来更好地定义生物制剂如何影响斑贴试验的反应性。弗朗西斯卡·巴雷：写作-评论和编辑。Alessandra Chiei-Gallo：概念化，调查，写作-审查和编辑，写作-原始草案。马扎诺：写作-审查和编辑，写作-原稿。这项工作得到了IRCCS Ca' Granda Ospedale Maggiore Policlinico和Ministero della Salute基金会的支持。这是一个小样本的回顾性研究；不需要伦理批准。本文中的患者已书面知情同意其病例细节的发表。Silvia M. Ferrucci是安进（Amgen）、赛诺菲（Sanofi）、诺华（Novartis）、礼来（Lilly）、利奥制药（Leo Pharma）和艾伯维（Abbvie）临床试验的首席研究员，也是诺华（Novartis）、美纳里尼（Menarini）、赛诺菲（Sanofi）、艾伯维（Abbvie）和利奥制药（Leo Pharma）的顾问委员会成员或发言人。弗朗西斯卡·巴雷与利奥制药和阿尔米尔有利益冲突。其他作者宣称没有利益冲突。数据共享不适用于本文，因为在当前研究期间没有生成或分析数据集。
{"title":"Patch Testing Under Biologics: Six Cases From a Tertiary Centre","authors":"Alessandra Chiei-Gallo, Francesca Barei, Angelo V. Marzano, Silvia M. Ferrucci","doi":"10.1111/cod.70065","DOIUrl":"10.1111/cod.70065","url":null,"abstract":"<p>Allergic contact dermatitis (ACD) is a T cell–mediated (type IV delayed-type) hypersensitivity reaction induced by the immunogenic properties of a subset of chemicals and requires the activation of both innate and acquired immunity. Biologic therapies targeting cytokines such as tumour necrosis factor (TNF)-α, IL-12/23 and IL-17 are widely used in treating various chronic inflammatory conditions. Their immunomodulatory effects have raised concerns about potential suppression of patch test (PT) responses, possibly leading to false-negative results [<span>1-3</span>]. Nonetheless, clinical evidence, including case series and expert opinions, suggests that positive PT reactions can still occur during biologic treatment [<span>1, 4-6</span>]. Patch testing during treatment with anti-TNFα agents and guselkumab has been reported; however, to our knowledge, no studies have been published on PT outcomes in patients receiving bimekizumab or risankizumab.</p><p>We herein present our experience with patch testing in six patients affected by psoriasis, hidradenitis suppurativa (HS) or Crohn's disease, treated with bimekizumab (<i>n</i> = 1) for psoriasis and HS, risankizumab (<i>n</i> = 1) for psoriasis, guselkumab (<i>n</i> = 2) for psoriasis and Adalimumab (<i>n</i> = 2) for Crohn's disease. These patients were referred to our tertiary centre for suspected ACD. Patch testing was performed without discontinuing biologic therapy, using the T.R.U.E. TEST system (Smart Practice, Phoenix, AZ, USA), which includes Panels 1.3, 2.3 and 3.3, comprising 35 common allergens and a negative control.</p><p>The clinical and epidemiological characteristics are detailed in Table 1. Five of six patients demonstrated at least one positive reaction, most commonly to nickel sulphate, with additional sensitisations to cobalt, chromium, and gold sodium thiosulfate. All reactions were clinically relevant.</p><p>These findings align with previous studies reporting preserved PT reactivity despite systemic immunomodulation [<span>1-3</span>]. Although biologics target Th1/Th17 pathways involved in ACD pathogenesis, our results support previous reports showing that patch test reactivity may persist during biologic treatment. While positive reactions to metals were detected, weaker or doubtful responses (particularly to allergens such as fragrances or preservatives) could have been suppressed by biologic therapy. This suggests that negative results should be interpreted with caution. Our experience supports the feasibility and clinical usefulness of performing patch testing during biologic therapy, although it remains uncertain whether biologics may attenuate certain elicitation reactions or reduce the intensity of weak responses. The use of the TRUE Test panel alone (without additional series) and the absence of a control group limit our ability to fully assess test sensitivity and generalise the findings. This highlights the need for future prospective studies, ideally including ","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 3","pages":"299-301"},"PeriodicalIF":4.6,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mikkel Bak Jensen, Jose Hernán Alfonso, Alexandra Teresa Seibel, Steen Mollerup, Martin F. Wilks, Gianluca Selvestrel, Christina Rudén, Mayes Alswady-Hoff, Jakob Ferløv Baselius Schwensen, Charlotte Menne Bonefeld, Jeanne Duus Johansen
Consumers and workers are generally exposed to multiple allergens and irritants simultaneously in products. This systematic review of 13 studies: 4 clinical, 6 animal, and 3 in vitro studies, suggests that co-exposure often enhances both sensitisation and elicitation reactions. When an irritant is combined with an allergen, the threshold for sensitisation and elicitation is lowered, and the severity of reactions is increased. Animal models suggest that weak allergens, when combined, can elicit responses at individual subthreshold doses, supporting their role as immune-enhancing adjuvants. Current regulations generally assess allergens or irritants in isolation, potentially overlooking the combined effects of low-level exposures from everyday products. There is a need to refine safety standards and ensure that risk assessment tools reflect real-world interactions between multiple allergens and irritants. Contact allergy is frequent and increasing in the population. A clearer understanding of mixture effects in sensitisation and elicitation responses is essential to protect the general population from developing contact allergy.
{"title":"Chemical Mixture Exposures and Their Effects on Sensitisation and Elicitation Responses: A Systematic Review","authors":"Mikkel Bak Jensen, Jose Hernán Alfonso, Alexandra Teresa Seibel, Steen Mollerup, Martin F. Wilks, Gianluca Selvestrel, Christina Rudén, Mayes Alswady-Hoff, Jakob Ferløv Baselius Schwensen, Charlotte Menne Bonefeld, Jeanne Duus Johansen","doi":"10.1111/cod.70069","DOIUrl":"10.1111/cod.70069","url":null,"abstract":"<p>Consumers and workers are generally exposed to multiple allergens and irritants simultaneously in products. This systematic review of 13 studies: 4 clinical, 6 animal, and 3 in vitro studies, suggests that co-exposure often enhances both sensitisation and elicitation reactions. When an irritant is combined with an allergen, the threshold for sensitisation and elicitation is lowered, and the severity of reactions is increased. Animal models suggest that weak allergens, when combined, can elicit responses at individual subthreshold doses, supporting their role as immune-enhancing adjuvants. Current regulations generally assess allergens or irritants in isolation, potentially overlooking the combined effects of low-level exposures from everyday products. There is a need to refine safety standards and ensure that risk assessment tools reflect real-world interactions between multiple allergens and irritants. Contact allergy is frequent and increasing in the population. A clearer understanding of mixture effects in sensitisation and elicitation responses is essential to protect the general population from developing contact allergy.</p>","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 2","pages":"105-119"},"PeriodicalIF":4.6,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Prevalence of nickel sensitization is heterogeneous worldwide, and in Europe, it is higher in Southern compared to Northern European countries, a likely reflection of delayed and less stringent application of the EU directive 94/27/CE. This multicentre study aimed at investigating prevalence and factors associated with positive patch test reactions to nickel in North-eastern Italy during 1997–2023.</p> </section> <section> <h3> Methods</h3> <p>A cross-sectional study design was employed to estimate the yearly prevalence of positive patch test reactions to nickel sulphate 5% among 31 948 consecutive outpatients patch tested with the Triveneto series for suspected allergic contact dermatitis during 1997–2023 in four centres of Triveneto (North-Eastern Italy). Reading was performed at 48 h and 72 h/96 h. Multiple logistic regression separated by sex of patients was employed to investigate factors (birth year, atopic dermatitis, occupational dermatitis, body area affected and occupation) potentially associated with nickel sensitization, expressing the results as adjusted odds ratio (aOR) with 95% confidence intervals (95% CI).</p> </section> <section> <h3> Results</h3> <p>Prevalence of nickel sensitization was 26.05% during 1997–2004 and 26.40% across 1997–2023 (excluding Trento-Bolzano-Rovigo), reducing over time in all centers combined. Prevalence of positive reactions significantly increased over the years during 1997–2004 among males yet reduced across the entire study period (1997–2023) among females. Regardless of the study period, nickel sensitization was significantly lower in males and followed an inverse U-shape with respect to birth year among females, increasing from 35.70% in those born during 1955–1964 to 46.24% in females born during 1965–1974, reducing to 41.36% in those born during 1975–1984. With regard to occupation, a significantly higher prevalence of positive patch test reactions to nickel was observed among sellers, whereas it was lower in retirees and housewives.</p> </section> <section> <h3> Conclusions</h3> <p>Although decreasing over time, the prevalence of positive patch test reactions in this study is confirmed to be higher than that in Northern European countries. The latter pattern probably reflects delayed and less stringent application of the European directive. The U-trend of positive patch test reactions by birth year in female patients points to nickel exposure and sensitization in females aged 20–50 years before the enforcement of the European directive. Higher prevalence of positive patch test reactions in sellers could reflect prolonged exposure in coin han
{"title":"Sensitization to Nickel (Sulphate 5%) in North-Eastern Italy, 1997–2023: Prevalence, Trend Over Time and an Evaluation of the Occupational Risk","authors":"Luca Cegolon, Francesca Larese Filon","doi":"10.1111/cod.70051","DOIUrl":"10.1111/cod.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prevalence of nickel sensitization is heterogeneous worldwide, and in Europe, it is higher in Southern compared to Northern European countries, a likely reflection of delayed and less stringent application of the EU directive 94/27/CE. This multicentre study aimed at investigating prevalence and factors associated with positive patch test reactions to nickel in North-eastern Italy during 1997–2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study design was employed to estimate the yearly prevalence of positive patch test reactions to nickel sulphate 5% among 31 948 consecutive outpatients patch tested with the Triveneto series for suspected allergic contact dermatitis during 1997–2023 in four centres of Triveneto (North-Eastern Italy). Reading was performed at 48 h and 72 h/96 h. Multiple logistic regression separated by sex of patients was employed to investigate factors (birth year, atopic dermatitis, occupational dermatitis, body area affected and occupation) potentially associated with nickel sensitization, expressing the results as adjusted odds ratio (aOR) with 95% confidence intervals (95% CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prevalence of nickel sensitization was 26.05% during 1997–2004 and 26.40% across 1997–2023 (excluding Trento-Bolzano-Rovigo), reducing over time in all centers combined. Prevalence of positive reactions significantly increased over the years during 1997–2004 among males yet reduced across the entire study period (1997–2023) among females. Regardless of the study period, nickel sensitization was significantly lower in males and followed an inverse U-shape with respect to birth year among females, increasing from 35.70% in those born during 1955–1964 to 46.24% in females born during 1965–1974, reducing to 41.36% in those born during 1975–1984. With regard to occupation, a significantly higher prevalence of positive patch test reactions to nickel was observed among sellers, whereas it was lower in retirees and housewives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although decreasing over time, the prevalence of positive patch test reactions in this study is confirmed to be higher than that in Northern European countries. The latter pattern probably reflects delayed and less stringent application of the European directive. The U-trend of positive patch test reactions by birth year in female patients points to nickel exposure and sensitization in females aged 20–50 years before the enforcement of the European directive. Higher prevalence of positive patch test reactions in sellers could reflect prolonged exposure in coin han","PeriodicalId":10527,"journal":{"name":"Contact Dermatitis","volume":"94 3","pages":"259-271"},"PeriodicalIF":4.6,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号