{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:46:28Z","timestamp":1790520388887,"version":"4.1.0"},"reference-count":52,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,4,30]],"date-time":"2018-04-30T00:00:00Z","timestamp":1525046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Concomitant allergic contact dermatitis (<jats:styled-content style=\"fixed-case\">ACD<\/jats:styled-content>) has been described as a possible cause of atopic dermatitis (<jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>) becoming difficult\u2010to\u2010treat. However, contact sensitization in this patient group has barely been studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the occurrence of <jats:styled-content style=\"fixed-case\">ACD<\/jats:styled-content> in a population of difficult\u2010to\u2010treat <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> children and adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical and patch test information of 48 patients with difficult\u2010to\u2010treat <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> unresponsive to conventional outpatient treatments was gathered retrospectively. We studied prevalence and relevance of common allergens, performed dynamic patch test analysis and assessed occurrence of polysensitization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 48 patients with difficult\u2010to\u2010treat <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>, 75% (<jats:italic>n<\/jats:italic> = 36\/48) had a concomitant contact allergy, and 39% (<jats:italic>n<\/jats:italic> = 14\/36) of these patients were polysensitized. <jats:styled-content style=\"fixed-case\">ACD<\/jats:styled-content> and polysensitization prevalences were equal amongst children and adults. The most frequent and relevant reactions were seen against wool alcohols, surfactants cocamidopropyl betaine and dimethylaminopropylamine, bichromate and fragrance mix I. Dynamic pattern analysis showed these reactions to be mostly allergic and not irritative of nature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Difficult\u2010to\u2010treat <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> patients frequently suffer from concomitant (multiple) contact allergies, and this may be a reason why the <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> turns into a difficult\u2010to\u2010treat disease. Awareness of this phenomenon is necessary, as pragmatic implementation of allergen avoidance strategies may be helpful in getting disease control in this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.14973","type":"journal-article","created":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T14:20:54Z","timestamp":1522074054000},"page":"1554-1561","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Both children and adult patients with difficult\u2010to\u2010treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized"],"prefix":"10.1111","volume":"32","author":[{"given":"M.","family":"Boonstra","sequence":"first","affiliation":[{"name":"Department of Dermatology VU University Medical Center Amsterdam The Netherlands"},{"name":"Department of Dermatology Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Rustemeyer","sequence":"additional","affiliation":[{"name":"Department of Dermatology VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.A.","family":"Middelkamp\u2010Hup","sequence":"additional","affiliation":[{"name":"Department of Dermatology Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2006.02.031"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2006.01186.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2017.01.005"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.138.7.939"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200X.2010.03227.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00130832-200410000-00009"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3928\/00904481-20090201-05"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(99)70025-4"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1939-4551-6-6"},{"key":"e_1_2_7_11_1","first-page":"1","article-title":"Treatment of eczema: corticosteroids and beyond","volume":"51","author":"Chong M","year":"2015","journal-title":"Clin Rev Allergy Immunol"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2012.09.002"},{"key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1001\/archderm.1976.01630340009002","article-title":"Immunodeficiencies in severe atopic dermatitis. 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