Objective:
To evaluate the prevalence of atopic dermatitis and patterns of allergen sensitization in patients with skin of color referred for patch testing.
Approach:
- Higher rates of atopic dermatitis were found in adults with skin of color (21%-38% in Black adults, 26% in Hispanic adults, 33% in Asian adults) compared to the general US population (10%).
- Among pediatric patients, 49%-67% had a diagnosis of atopic dermatitis.
- Black patients had a higher history of atopic dermatitis (13%) compared to White patients (9%).
- Certain allergens showed higher positive reactions in Black patients, such as p-phenylenediamine.
- Asian patients exhibited higher sensitization rates to cinnamic aldehyde, colophony, and nickel compared to White patients.
- Disparities in access to patch testing were noted, with Black patients representing 5% and Hispanic patients 2% of those tested despite their larger population percentages.
- Most studies included were retrospective and heterogeneous.
- Causality between allergic contact dermatitis and atopic dermatitis severity could not be established.
Key Findings:
Interpretation:
The review suggests that allergic contact dermatitis may exacerbate atopic dermatitis severity in patients with skin of color, highlighting the need for increased awareness and testing.
Limitations:
Conclusion:
Physicians should consider contact allergy in patients with skin of color who have persistent or treatment-resistant atopic dermatitis and refer for patch testing when appropriate.
Sources:
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