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Purposeof Review <p>This review aims to provide an updated perpective on when to suspect allergic contact dermatitis (ACD) in patients with atopic dermatitis (AD), identify key contact allergens, and offer guidance on patch testing to avoid diagnostic pitfalls.</p> Recent Findings <p>ACD is a common comorbidity in AD, with contact sensitization rates up to 20–30%. Pathophysiologically, ACD is mostly a Th1-driven Type IV hypersensitivity, whereas AD involves mixed immune pathways. Clinically, ACD can mimic or coexist with AD, complicating diagnosis. Metals, fragrances, preservatives, topical products, and other skin sensitizers are increasingly recognized as significant contact allergens in AD patients. Patch testing is crucial for diagnosis, but presents challenges, particularly including irritant, false-positive and false-negative reactions, as well as the lack of standardized commercial test materials for atopy patch testing.</p> Summary <p>ACD should be suspected in AD patients with an unusual course, atypical distribution, poor treatment response, or late-onset disease. Future studies should focus on improving patch testing strategies to optimize diagnosis of ACD in AD, and better differentiation between these entities, thereby guiding personalised management.</p>

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Diagnostic Management of Allergic Contact Dermatitis in Patients with Atopic Dermatitis: A Comprehensive and Practical review

  • 期刊论文

  • 发表日期：

    2025年3月5日

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  • Esen Özkaya,
  • Olivier Aerts,
  • David Pesqué

摘要

Purposeof Review

This review aims to provide an updated perpective on when to suspect allergic contact dermatitis (ACD) in patients with atopic dermatitis (AD), identify key contact allergens, and offer guidance on patch testing to avoid diagnostic pitfalls.

Recent Findings

ACD is a common comorbidity in AD, with contact sensitization rates up to 20–30%. Pathophysiologically, ACD is mostly a Th1-driven Type IV hypersensitivity, whereas AD involves mixed immune pathways. Clinically, ACD can mimic or coexist with AD, complicating diagnosis. Metals, fragrances, preservatives, topical products, and other skin sensitizers are increasingly recognized as significant contact allergens in AD patients. Patch testing is crucial for diagnosis, but presents challenges, particularly including irritant, false-positive and false-negative reactions, as well as the lack of standardized commercial test materials for atopy patch testing.

Summary

ACD should be suspected in AD patients with an unusual course, atypical distribution, poor treatment response, or late-onset disease. Future studies should focus on improving patch testing strategies to optimize diagnosis of ACD in AD, and better differentiation between these entities, thereby guiding personalised management.