{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:49:05Z","timestamp":1783950545261,"version":"3.55.0"},"reference-count":55,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,2,22]],"date-time":"2018-02-22T00:00:00Z","timestamp":1519257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"EU","award":["QLK4-CT-2001-00343 and QLK4-CT-2001-2812"],"award-info":[{"award-number":["QLK4-CT-2001-00343 and QLK4-CT-2001-2812"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Contact Dermatitis"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Polysensitization, defined as being allergic to three or more haptens from the European baseline series, is considered to reflect increased susceptibility to developing a contact allergy, and is likely to be associated with an impaired quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the prevalences of polysensitization across Europe and to analyse factors associated with polysensitization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patch test data collected by the European Surveillance System on Contact Allergies (ESSCA; \n<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.essca-dc.org\">www.essca\u2010dc.org<\/jats:ext-link>) in consecutively patch tested patients from January 2009 to December 2014, comprising 11 countries and 57 departments, were retrospectively analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 86\u2009416 patients were available for analysis, showing a standardized prevalence of polysensitization of 7.02%, ranging from 12.7% (Austria) to 4.6% (Italy). Allergen pairs with the strongest association are reported for the total population, for South Europe, and for North\/Central Europe. Overall, polysensitized patients showed a higher percentage of extreme (+++) positive patch test reactions than oligosensitized patients. Female sex, occupational dermatitis and age &gt;\u200940\u2009years were risk factors for polysensitization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The varying prevalences of polysensitization across Europe most likely reflect differences in patient characteristics and referral patterns between departments. Known risk factors for polysensitization are confirmed in a European dermatitis population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cod.12966","type":"journal-article","created":{"date-parts":[[2018,2,22]],"date-time":"2018-02-22T09:22:39Z","timestamp":1519291359000},"page":"373-385","source":"Crossref","is-referenced-by-count":25,"title":["European Surveillance System on Contact Allergies (ESSCA): polysensitization, 2009\u20132014"],"prefix":"10.1111","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2233-7424","authenticated-orcid":false,"given":"Daan","family":"Dittmar","sequence":"first","affiliation":[{"name":"University of Groningen, University Medical Centre Groningen Department of Dermatology  9700 RB Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4498-3710","authenticated-orcid":false,"given":"Wolfgang","family":"Uter","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Biometry and Epidemiology University of Erlangen\/N\u00fcrnberg  91054 Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Allergy Centre, University Hospital Carl Gustav Carus, Technical University of Dresden  01307 Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana B.","family":"Fortina","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Paediatrics University of Padova  35137 Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6683-3975","authenticated-orcid":false,"given":"Andreas J.","family":"Bircher","sequence":"additional","affiliation":[{"name":"Allergy Unit, Department of Dermatology University Hospital  4031 Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Czarnecka\u2010Operacz","sequence":"additional","affiliation":[{"name":"Dermatology Department University of Medical Sciences  60\u2010355 Poznan Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Dugonik","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Medical Centre Maribor  2000 Maribor Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7696-3274","authenticated-orcid":false,"given":"Peter","family":"Elsner","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital Jena  07743 Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosella","family":"Gallo","sequence":"additional","affiliation":[{"name":"Section of Dermatology, DISSAL\u00a0\u2013\u00a0Department of Health Sciences University of Genoa  16132 Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharizan A.","family":"Ghaffar","sequence":"additional","affiliation":[{"name":"Department of Dermatology Ninewells Hospital and Medical School  Dundee DD1 9SY UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gim\u00e9nez\u2010Arnau","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital del Mar. Universitat Aut\u00f2noma and Pompeu Fabra  08003 Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham A.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Department of Dermatology Leicester Royal Infirmary  Leicester, LE1 5WW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beata","family":"Kr\u0119cisz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Science The Jan Kochanowski University  25\u2010317 Kielce Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca L.","family":"Filon","sequence":"additional","affiliation":[{"name":"Unit of Occupational Medicine University of Trieste  34129 Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Rustemeyer","sequence":"additional","affiliation":[{"name":"Department of Dermatology Free University of Amsterdam  1081 HV Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Sadowska\u2010Przytocka","sequence":"additional","affiliation":[{"name":"Dermatology Department University of Medical Sciences  60\u2010355 Poznan Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"S\u00e1nchez\u2010P\u00e9rez","sequence":"additional","affiliation":[{"name":"Dermatology Department Hospital Universitario de la Princesa, Instituto de Investigaci\u00f3n Sanitaria la Princesa (IIS\u2010IP)  28006 Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Schnuch","sequence":"additional","affiliation":[{"name":"Information Network of Departments of Dermatology at the University of G\u00f6ttingen  37075 G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8965-9407","authenticated-orcid":false,"given":"Dagmar","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Dermatology Inselspital, Bern University Hospital, University of Bern  3010 Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radoslaw","family":"Spiewak","sequence":"additional","affiliation":[{"name":"Department of Experimental Dermatology and Cosmetology Jagiellonian University Medical College  30\u2010688 Krakow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Spring","sequence":"additional","affiliation":[{"name":"Department of Dermatology Centre Hospitalier Universitaire Vaudois  1011 Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria T.","family":"Corradin","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital of Pordenone  33170 Pordenone Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Skaidra","family":"Valiukevi\u010dien\u0117","sequence":"additional","affiliation":[{"name":"Department of Skin and Venereal Diseases Lithuanian University of Health Sciences  44307 Kaunas Lithuania"},{"name":"Lithuanian University of Health Sciences Hospital  50009 Kaunas Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Vok","sequence":"additional","affiliation":[{"name":"Dermatovenerolo\u0161ka ambulanta  6310 Izola Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"Weisshaar","sequence":"additional","affiliation":[{"name":"Department of Clinical Social Medicine, Occupational and Environmental Dermatology University Hospital Heidelberg  69117 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7253-3461","authenticated-orcid":false,"given":"Mark","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Dermatology, Leeds Teaching Hospitals NHS Trust  Leeds LS7 4SA UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0766-4382","authenticated-orcid":false,"given":"Marie L.","family":"Schuttelaar","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Centre Groningen Department of Dermatology  9700 RB Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the ESSCA Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2007.01155.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12769"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2010.01800.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12623"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12362"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.03.009"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2007.01232.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01590.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2004.05917.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2010.01735.x"},{"key":"e_1_2_7_12_1","first-page":"232","article-title":"Susceptibility and amplification of sensitivity in contact dermatitis","volume":"61","author":"Moss C","year":"1985","journal-title":"Clin Exp Immunol"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12128"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(03)02112-1"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/DER.0000000000000111"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12423"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajcd.2001.26669"},{"key":"e_1_2_7_18_1","doi-asserted-by":"crossref","first-page":"456","DOI":"10.2340\/0001555572456460","article-title":"Allergic contact sensitization in an unselected Danish population","volume":"72","author":"Nielsen N H","year":"1992","journal-title":"Acta Derm Venereol"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2005.00693.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2012.02070.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0105-1873.2003.0225n.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12432"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.3414\/ME15-01-0099"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0105-1873.2004.00406.x"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12112"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12150"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12409"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12168"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2011.01964.x"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1997.tb02435.x"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12706"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12583"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0536.2000.042006315.x"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14423"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14063"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4064"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12582"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12420"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12454"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2009.01572.x"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2009.01573.x"},{"key":"e_1_2_7_42_1","first-page":"324","article-title":"Occupational skin diseases","volume":"16","author":"Diepgen T","year":"2006","journal-title":"Eur J Dermatol"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2006.01029.x"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12358"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2009.09287.x"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12763"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62720-2"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12255"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2010.01712.x"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2007.01122.x"},{"key":"e_1_2_7_51_1","first-page":"45","article-title":"Primin\u2010free Primula obconica plants available","volume":"43","author":"Christensen L P","year":"2000","journal-title":"Contact Dermatitis"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1999.tb06154.x"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2006.00998.x"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1996.d01-1096.x"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0536.2000.043005280.x"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0536.2000.042001027.x"}],"container-title":["Contact Dermatitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcod.12966","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cod.12966","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cod.12966","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cod.12966","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T13:22:59Z","timestamp":1694179379000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cod.12966"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,22]]},"references-count":55,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1111\/cod.12966"],"URL":"https:\/\/doi.org\/10.1111\/cod.12966","archive":["Portico"],"relation":{},"ISSN":["0105-1873","1600-0536"],"issn-type":[{"value":"0105-1873","type":"print"},{"value":"1600-0536","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,22]]}}}