The frequency of specific contact allergies is reduced in patients with psoriasis

Summary Background Earlier studies suggested an inverse association between contact allergy and psoriasis, although the results of clinical studies have been inconsistent. Gene expression studies in human contact allergy focusing on immune responses revealed nickel being an inducer of T helper (Th)1...

Full description

Saved in:
Bibliographic Details
Published in:British journal of dermatology (1951) 2019-02, Vol.180 (2), p.315-320
Main Authors: Claßen, A., Buhl, T., Schubert, S., Worm, M., Bauer, A., Geier, J., Molin, S.
Format: Article
Language:English
Subjects:
Adult
Age Factors
Alcohols
Allergens
Allergens - immunology
Allergies
Atopic dermatitis
Austria - epidemiology
Case-Control Studies
Contact dermatitis
Dermatitis
Dermatitis, Allergic Contact - diagnosis
Dermatitis, Allergic Contact - epidemiology
Dermatitis, Allergic Contact - immunology
Eczema
Female
Gene expression
Germany - epidemiology
Helper cells
Humans
Immune response
Lymphocytes T
Male
Nickel
Patch Tests
Polarization
Prevalence
Psoriasis
Psoriasis - epidemiology
Psoriasis - immunology
Retrospective Studies
Sex Factors
Skin - immunology
Switzerland - epidemiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary Background Earlier studies suggested an inverse association between contact allergy and psoriasis, although the results of clinical studies have been inconsistent. Gene expression studies in human contact allergy focusing on immune responses revealed nickel being an inducer of T helper (Th)1/Th17 and some Th22 immune polarization, whereas fragrances were found to promote a Th2‐dominated immune activation. Objectives To investigate the epidemiological association between contact allergy and psoriasis in a large multicentre cohort and to analyse the sensitization profile to specific allergens in these patients. Methods Retrospective analysis of patch‐tested patients from 56 departments of dermatology (1996–2015), including 2387 patients with psoriasis and 161 989 control patients. All patients with atopic dermatitis were excluded from both groups. Results The odds ratio (OR) for contact allergy was calculated to be 0·55 in patients with psoriasis (95% confidence interval 0·50–0·59). Logistic regression analyses with several independent variables indicated a ‘protective effect’ of having psoriasis for most allergens, independently of age, sex, affected body site and patch test indication. Fragrance mix II (OR 0·36) and lanolin alcohols (OR 0·38) were found to be among the least common allergens in patients with psoriasis. In contrast, the frequency of contact dermatitis to nickel was only marginally affected in patients with psoriasis compared with controls (OR 0·75). Conclusions The inverse association between psoriasis and allergic contact sensitization is likely to be not exclusively mediated by psoriasis itself. The polarization of the activated immune response by specific allergens may influence the occurrence and significance of contact allergies in underlying immune‐mediated diseases, eventually even beyond the skin. What's already known about this topic? Earlier studies suggested an inverse association between contact allergy and psoriasis, although the results have been inconsistent. What does this study add? Our findings revealed a significantly lower overall risk for contact sensitization in individuals with psoriasis. These results lend further support to the potential role of allergen‐specific immune polarization in contact dermatitis. Linked Comment:  Erfurt–Berge. Br J Dermatol 2019; 180:256–257. Plain language summary available online Respond to this article
ISSN:0007-0963
1365-2133
DOI:10.1111/bjd.17080