Contact dermatitis is significantly associated with atopic dermatitis, and rates of contact hypersensitivity are comparable in patients with atopic dermatitis and patients with psoriasis, researchers reported in the Australasian Journal of Dermatology.
For this descriptive, retrospective study, researchers recruited patients with chronic contact dermatitis with a duration of 6 months or more and concomitant atopic dermatitis or psoriasis from 2000 to 2011 from a tertiary care hospital in Spain. A total of 206 adults (mean age 42.1±14.6 years; 58.3% women) were included; 76 patients had atopic dermatitis and 130 had psoriasis. No significant differences were observed in the groups regarding age and gender.
The researchers found a statistically significant association between facial contact dermatitis and atopic dermatitis (adjusted odds ratio [aOR] 0.2; 95% CI: 0.05-0.8; P =.022). Patch test results (aOR 0.6; 95% CI: 0.3-1.3; P =.194) revealed no differences in the groups.
Contact dermatitis most frequently affected the hands in both groups: 43.4% in the atopic dermatitis group and 77.7% in the psoriasis group (OR 4.5; 95% CI: 2.4-8.4; P <.001). In addition, 23.7% of patients with atopic dermatitis had facial involvement compared with 5.4% of patients with psoriasis (OR 0.2; 95% CI: 0.1-0.5; P <.001); 21.1% of patients with atopic dermatitis and 7.7% of patients with psoriasis had generalized involvement (OR 0.3; 95% CI: 0.1-0.7; P =.005).
The most common occupation of participants with atopic dermatitis was office worker (n=34, 44.7%); of those with psoriasis, the most common occupation was cleaning worker (n=44, 33.8%). A significant association was found between wet-work occupations and patients with psoriasis (OR 2.2; 95% CI: 1.2-3.9; P =007). Nickel sulphate was the most common clinically relevant allergen in both groups.
Study limitations include the retrospective design, the collection of data from all patients at a single hospital, and distinguishing among contact dermatitis, atopic dermatitis, and psoriasis was difficult in some cases.
“Participants in this study, who worked in a humid (wet) environment, had a significantly higher risk of having psoriasis than atopic dermatitis,” the researchers concluded. “New policies and specific preventive measures aimed at wet-work professions are needed, particularly for workers with diseases that can alter the skin barrier, such as psoriasis.”
García-Souto F, Lorente-Lavirgen AI, Bernabéu-Wittel J, Rojas C, Lorente R. Long-lasting contact dermatitis in patients with atopic dermatitis or psoriasis [published online July 13, 2020]. Australas J Dermatol. doi: 10.1111/ajd.13367