Contact Allergy in Atopic Patients

Atopic dermatitis (AD) is a chronic inflammatory disease based on genetic and immune alterations and is part of the atopic symptom complex, including allergic rhinitis, allergic conjunctivitis, and bronchial asthma. A disturbed barrier function facilitates antigen penetration through the skin, with the subsequent development of allergic contact dermatitis (ACD). The gold standard for diagnosing ACD is epicutaneous (patch) testing, also applied to objectify contact sensitization in AD. This study aimed to determine the frequency of contact allergy (CA) among individuals with atopic history and the allergens that caused ACD in those cases. We studied 453 individuals tested in the period 2009-2022. Of these, a subpopulation of 189 individuals with atopic diathesis was identified. A retrospective analysis was used. Using clinical and allergological methods, we divided the tested patients according to sex, age, professional occupation, and areas of the body affected by dermatitis and identified the most common contact allergens that cause positive reactions and ACD. In conclusion, our results highlight the possibility of developing ACD in people with atopic diathesis. As far as we know, our study is the first one in Bulgaria to examine the frequency of contact sensitization in AD patients.