Trends and current spectrum of contact allergy in Central Europe: results of the Information Network of Departments of Dermatology (IVDK) 2007–2018

• Published in: British journal of dermatology (1951) Vol. 183; no. 5; pp. 857 - 865
• Main Authors: Uter, W., Gefeller, O., Mahler, V., Geier, J.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-11-2020
• Subjects: Allergens; Allergies; Chromium; Cobalt; Dermatitis, Allergic Contact - diagnosis; Dermatitis, Allergic Contact - epidemiology; Dermatitis, Allergic Contact - etiology; Dermatology; Europe - epidemiology; Haptens; Humans; Information Services; Nickel; Patch Tests; Propolis; Trends; Europe; Central Europe
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1111/bjd.18946

Summary
Background
Changing patterns of exposure lead to changes in the spectrum of contact allergy in the general population and in patients patch tested for suspected contact allergy. The main contact allergens (haptens) are assembled in the so‐called ‘baseline series’.
Objectives
To present the current spectrum of contact allergy to baseline series allergens, and its temporal development over the last 12 years, based on data collected by the 56 active departments of the trinational Information Network of Departments of Dermatology (IVDK).
Methods
Patch‐test data, along with core demographic and clinical information, subdivided into 4‐year periods for all patients patch tested with the baseline series in the IVDK, were analysed descriptively. Moreover, log‐binomial regression analysis addressed temporal trends of specific contact allergies, adjusted for potentially confounding factors.
Results
Among the 125 436 patients tested with the German baseline series, the most common allergens were nickel (14·7%), fragrance mix I (8·1%), Myroxylon pereirae resin (7·5%) and cobalt (5·2%), with no conclusive trend. The rise and fall of contact allergy to methylchloroisothiazolinone/methylisothiazolinone (MI), following (self‐) regulation in the European Union, reflected the MI contact allergy epidemic. Propolis showed a marked upward trend with a prevalence of 3·94% during the period 2015–2018.
Conclusions
Decreases in sensitization prevalence likely reflect reduced exposure, with some lag, as seen with hydroxyisohexyl 3‐cyclohexene carboxaldehyde. If no (sufficient) decrease can be observed despite interventions, such as for nickel and chromium, affected subgroups should be identified and their causative exposures explored. Finally, increases such as that observed with propolis, certainly warrant targeted investigation of the exposures driving sensitization, and possibly intervention.
What is already known about this topic?
Contact allergy is prevalent in the general population.
Surveillance based on clinical data offers timely information on trends concerning certain allergens or subgroups at risk.
What does this study add?
This analysis provides an update of the current contact allergy prevalence in Central Europe, including time trends.
This study describes the demographic and clinical profile of patients tested from 2007 to 2018.
This research identifies contact allergens that require (further) preventive efforts.
Linked Comment: Schuttelaar. Br J Dermatol 2020; 183:800–801.
What is already known about this topic?
Contact allergy is prevalent in the general population.
Surveillance based on clinical data offers timely information on trends concerning certain allergens or subgroups at risk.
What does this study add?
This analysis provides an update of the current contact allergy prevalence in Central Europe, including time trends.
This study describes the demographic and clinical profile of patients tested from 2007 to 2018.
This research identifies contact allergens that require (further) preventive efforts.
Linked Comment: Schuttelaar. Br J Dermatol 2020; 183:800–801.
Plain language summary available online
Respond to this article