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Getting sensitive: Repeated use of topical therapies for AD increases contact dermatitis risk


Repeated use of topical therapies for atopic dermatitis may lead to sensitization that results in allergic contact dermatitis. In a recent study, investigators identified several risk factors that are significantly linked with sensitization to local atopic dermatitis therapies.

Key Points

Montreal - The incidence of allergic contact dermatitis in patients using therapies for atopic dermatitis is low, but the possibility exists for sensitization with ongoing treatment, said Francoise Giordano-Labadie, M.D., department of dermatology, Purpan Hospital, Toulouse, France, at Contact Dermatitis 2008, the biennial meeting of the American Society of Contact Dermatitis.

"There are very few studies that have looked at the risk of allergic contact dermatitis associated with the management of atopic dermatitis," Dr. Giordano-Labadie says.

There are scant published data related to the risk of allergic contact dermatitis related to treatment of atopic dermatitis, he says.

Atopic dermatitis is chronic in nature, and frequent and long-term topical therapy often is used. Ongoing use of topical therapies, however, may lead to sensitization, resulting in allergic contact dermatitis.

Dr. Giordano-Labadie says that therapies for atopic dermatitis aim to decrease inflammation, relieve itching and xerosis and avoid future flare-ups of the condition. It's key that patients with atopic dermatitis avoid known allergens.

In a study published in Contact Dermatitis in 1999, Dr. Giordano-Labadie and colleagues found an incidence of contact sensitization of 43 percent when testing 137 children tested with atopic dermatitis.

Recent study

In a more recent study, Dr. Giordano-Labadie and colleagues evalutated 641 children with atopic dermatitis, all of whom were patch-tested with seven routinely administered topical therapies in a systematic fashion.

There were a total of 41 positive patch tests in 40 patients (6.2 percent). Allergens consisted of a variety of agents, including emollients (47.5 percent), chlorhexidine (42.5 percent), hexamidine (7.5 percent), tixocortol pivalate and bufexamac (2.5 percent each).

Researchers concluded that risk factors significantly associated with sensitization to local atopic dermatitis therapies included severity of atopic dermatitis, early onset of atopic dermatitis before the age of 6 months and IgE sensitization.

Results suggested that topical treatment of atopic dermatitis is associated with cutaneous sensitizers. Antiseptics and emollients are the main culprits in sensitization, according to Dr. Giordano-Labadie.

Disclosure: Dr. Giordano-Labadie reports no relevant financial disclosures.

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