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The association between contact sensitization and atopic disease by linkage of a clinical database and a nationwide patient registry

机译：通过临床数据库和全国患者注册系统的联系，接触性致敏与特应性疾病之间的关联

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Background Experimental studies have shown that individuals with atopic dermatitis are likely to have suppressed contact sensitivity secondary to their disease whereas some clinical and epidemiological studies have shown that individuals with atopic dermatitis might have a higher prevalence of contact sensitization than controls. The objective was to study the association between contact sensitization and, respectively, atopic dermatitis and asthma using clinical databases. Methods Record linkage of two different registers was performed: (i) a tertiary hospital register of dermatitis patient's patch tested for contact sensitivity and (ii) the Danish National Patient Register containing nationwide hospital discharge diagnoses and outpatient contacts. Results An inverse association was found between contact sensitization and, respectively, presumed severe atopic dermatitis (OR, 0.70; 95% CI, 0.61-0.81) and asthma (OR, 0.61; 95% CI, 0.42-0.90) when linkage was performed. Inverse associations were found for all groups of chemicals and metals except for sensitization to fragrances and topical drugs where positive associations were identified. A significant positive association between fragrance sensitization and presumed mild-moderate atopic dermatitis was also found when data from hospital register only were used, suggesting an overall higher prevalence of fragrance sensitization in patients with atopic dermatitis. Conclusions Our findings support that patients with severe atopic dermatitis and asthma have an overall lower prevalence of contact sensitization when compared with controls, whereas mild-to-moderate disease does not suppress contact sensitization. The prevalence of contact sensitization to fragrance chemicals was higher in patients with atopic dermatitis. Patients should be instructed to avoid scented moisturizers and products containing highly sensitizing substances.
机译：背景技术实验研究表明，特应性皮炎患者继发于疾病后可能会抑制接触敏感性，而一些临床和流行病学研究表明，特应性皮炎患者接触致敏的发生率可能高于对照组。目的是使用临床数据库研究接触敏化与特应性皮炎和哮喘之间的关联。方法进行两个不同注册簿的记录链接：（i）皮肤炎患者贴剂的三级医院注册簿进行接触敏感性测试，以及（ii）包含全国出院诊断和门诊患者联系的丹麦国民注册簿。结果进行联系时，接触致敏与假定的严重特应性皮炎（OR，0.70; 95％CI，0.61-0.81）和哮喘（OR，0.61; 95％CI，0.42-0.90）之间呈负相关。除对香料和局部药物的敏化作用已确定为正相关外，所有类别的化学物质和金属均具有相反的关系。当仅使用来自医院登记的数据时，还发现芳香剂致敏与假定的轻度中度特应性皮炎之间存在显着的正相关性，这表明异位性皮炎患者中芳香剂致敏的总体患病率较高。结论我们的发现支持重度特应性皮炎和哮喘患者与对照组相比，接触致敏的患病率总体较低，而轻度至中度疾病不会抑制接触致敏。特应性皮炎患者对香精化学品接触致敏的患病率较高。应指导患者避免使用香熏保湿剂和含有高敏物质的产品。

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