Impact of atopic dermatitis and loss-of-function mutations in the filaggrin gene on the development of occupational irritant contact dermatitis

Visser, Maaike; Landeck, Lilla; Campbell, Linda E.; McLean, W.H. Irwin; Weidinger, Stephan; Calkoen, Florentine; John, Swen Malte; Kežić, Sanja

doi:10.1111/bjd.12083

Cited by 136 publications

(93 citation statements)

References 53 publications

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“…The mechanisms for increased irritancy in AD are likely multifactorial. A German case-control study of patients with occupational irritant contact dermatitis (ICD) and healthy controls found that patients with either history of AD or common FLG null variants had significantly higher risk of ICD; however, those with both AD and FLG variants were at highest risk of ICD [62]. These results suggest that FLG variants may play an important role but are not the only mechanism.…”

Section: Irritants and Pruritogensmentioning

confidence: 99%

Environmental risk factors and their role in the management of atopic dermatitis

Kantor

Silverberg

2016

Expert Review of Clinical Immunology

263

225

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Introduction-The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.Areas covered-We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.Expert commentary-The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.

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Section: Irritants and Pruritogensmentioning

confidence: 99%

Environmental risk factors and their role in the management of atopic dermatitis

Kantor

Silverberg

2016

Expert Review of Clinical Immunology

263

225

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“…[5,7,11,12]. Other factors can also contribute to the onset of irritant CD -perspiration from glove occlusion or prolonged contact with an alkaline, skin sensitivity, prior skin damage, or an atopy such as atopic dermatitis (AD) [13]. In diagnostics of rubber glove allergies, the most common tests are skin prick tests (SPTs) and/or latex-specific IgE assay to determine immediate-type allergies to Hevea brasiliensis, and patch tests to determine delayed-type allergies to rubber additives [1,14,15].…”

mentioning

confidence: 99%

An Analysis of Skin Prick Tests to Latex and Patch Tests to Rubber Additives and other Causative Factors among Dental Professionals and Students with Contact Dermatoses

Japundžić¹,

Vodanović²,

Lugović-Mihić³

2018

Int Arch Allergy Immunol

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Background: Dental workers often experience unwanted allergic and nonallergic skin reactions resulting in different contact dermatoses (e.g., contact urticaria, irritant and allergic contact dermatitis) that are often attributed to rubber gloves. Objective: To examine allergic and nonallergic contact dermatoses by different methods amongst dental professionals and dental students, more specifically, reactions to natural rubber latex (NRL), rubber additives, and other causative factors. Methods: In this cross-sectional study we surveyed a total of 444 subjects (dentists, assistants, technicians, and students); 200 agreed to be tested to latex by the standard skin prick test (SPT) and prick-by-prick test, of whom 107 were patch tested to rubber additives (mercapto mix, thiuram mix, carba mix, and N-isopropyl-N-phenyl-4-phenylenediamine [IPPD]). Results: Skin lesions appeared significantly more frequently with longer work experience (p = 0.002; V = 0.181), frequent glove changes (p < 0.001; V = 0.310), and hand washing (p < 0.001; V = 0.263), and in subjects with a history of allergies (atopic dermatitis, allergic rhinitis, allergic conjunctivitis, and others) (p < 0.001; V = 0.183). Positive SPTs to latex occurred in 14/200 subjects (7%), of whom 5/14 subjects (35.7%) were also positive in prick-by-prick tests. Patch tests were positive in 5/104 subjects (4.8%) (mercapto mix 1%, thiuram mix 1.9%, and carba mix 1.9%). Conclusion: Only a small number of our subjects were allergic to latex (7%) or rubber additives (4.8%). Thus, self-reported contact dermatoses (during NRL product use) in dental professionals and students are not commonly caused by allergies to latex and rubber additives, as is often assumed, but by other factors.

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“…According to the literature, it could be suggested that sex (female), atopy, and wet work should be considered as markers of poor prognosis primarily for ICD. Wet work is known as a highly important occupational and non-occupational skin irritant and is performed mainly by female workers [3], while atopy in the form of childhood or adult atopic eczema or some other atopic disease is undoubtedly the most important independent risk factor in the development of ICD [4,10,30]. It could be stated that predictors of ACD prognosis have not yet been clearly defined, but there is agreement about the influence and interactions of genetic and environmental factors on the development and course of ACD [1,22], with a thus far more clearly presented influence of environmental factors [3,31].…”

Section: Discussionmentioning

confidence: 99%

“…While atopy and FLG null mutations are clearly defined as independent risk factors in the development of ICD [4,10,30], their role in the development of ACD is controversial. Up to now, 3 studies have suggested a risk of developing contact allergy to nickel in subjects with FLG null mutations, indicating that a damaged skin barrier in persons with FLG null mutations can facilitate the penetration and presentation of nickel to antigen-presenting cells in the skin resulting in the development of easier and earlier sensitization [7,8,36].…”

Section: Discussionmentioning

confidence: 99%

Occupational and Non-Occupational Allergic Contact Dermatitis: A Follow-Up Study

Macan

Rimac²,

Kežić

et al. 2013

Dermatology

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Background/Aims: The aim of this study was to obtain insight into the clinical course and prognosis of allergic contact dermatitis (ACD), including potential effects of genetic and environmental factors. Methods: Eighty-two patients with previously defined ACD acquired occupationally (OACD) or non-occupationally (NOACD) were patch retested and evaluated for the presence of persistent eczema, atopy and filaggrin mutations. Results: The crude risk for the persistence of a positive patch test (PT) reaction was 6.3 times higher (95% CI 3.63-11.0) for PT reactions assessed as ‘+++' compared to ‘++' reactions at the first PT. Among the categories of OACD, NOACD, age, gender, atopy, and the number of positive PT reactions at the first and second PT, only OACD (OR 10.0, 95% CI 1.95-51.2) and number of positive PT reactions at retesting (OR 3.85, 95% CI 1.57-9.44) were found to be predictors of persistent eczema. Conclusions: Occupationally acquired contact allergy was emphasized as the most important factor in predicting poor prognosis of ACD.

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Impact of atopic dermatitis and loss-of-function mutations in the filaggrin gene on the development of occupational irritant contact dermatitis

Abstract: Our results indicate that both FLG mutations and AD increase the risk of ICD. Individuals with concurrent FLG mutations and AD are at the highest risk of developing ICD.

Cited by 136 publications

References 53 publications

Environmental risk factors and their role in the management of atopic dermatitis

Environmental risk factors and their role in the management of atopic dermatitis

An Analysis of Skin Prick Tests to Latex and Patch Tests to Rubber Additives and other Causative Factors among Dental Professionals and Students with Contact Dermatoses

Occupational and Non-Occupational Allergic Contact Dermatitis: A Follow-Up Study

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