Two-year follow-up survey of patients with allergic contact dermatitis from an occupational cohort: is the prognosis dependent on the omnipresence of the allergen?

TY - JOUR

T1 - Two-year follow-up survey of patients with allergic contact dermatitis from an occupational cohort

T2 - is the prognosis dependent on the omnipresence of the allergen?

AU - Clemmensen, Kim Katrine Bjerring

AU - Carøe, T K

AU - Thomsen, S F

AU - Ebbehøj, N E

AU - Agner, T

N1 - © 2013 British Association of Dermatologists.

PY - 2014/5

Y1 - 2014/5

N2 - Background Skin diseases are the most frequently recognized occupational diseases in Denmark. The prognosis for occupational contact dermatitis is often poor. Objectives To investigate the prognosis, assessed by eczema, job status and skin-related quality of life, among patients allergic to rubber chemicals and latex (ubiquitous allergens) and epoxy (nonubiquitous allergen), 2 years after recognition of occupational allergic contact dermatitis. Methods From a cohort of all patients recognized as having occupational dermatitis by the Danish National Board of Industrial Injuries in 2010, 199 patients with relevant rubber allergy (contact allergy to rubber chemicals or contact urticaria from latex) or epoxy allergy were identified. Follow-up consisted of a questionnaire covering current severity of eczema, employment, exposure and quality of life. Results The response rate was 75%. Clearance of eczema was reported by 11% of patients and 67% reported improvement. Overall 22% of patients with allergy to a nonubiquitous allergen had total clearance of eczema compared with 10% of cases allergic to ubiquitous allergens and 0% of those with contact urticaria (P = 0·116). Improvement was significantly more frequent in those who had changed jobs compared with those who had not (P = 0·01). Conclusions At follow-up, patients with contact urticaria had significantly poorer prognosis than those with contact allergy, and there was a trend towards a poorer prognosis for those with contact allergy to rubber chemicals than those with allergy to epoxy. A significant positive association between job change and improvement was found. What's already known about this topic? Skin conditions are the most frequently recognized occupational diseases in Denmark, and contact dermatitis constitutes more than 90% of these. The prognosis for occupational contact dermatitis is often poor. What does this study add? Quality of life (QoL) was less impaired in patients with relevant occupational contact allergy to a nonubiquitous allergen, and there was a trend that total clearance of eczema was more frequent for this group. Patients with contact urticaria had significantly less frequent clearance, less improvement in eczema and most impairment of QoL at follow-up. A significant positive association between job change and improvement was found.

AB - Background Skin diseases are the most frequently recognized occupational diseases in Denmark. The prognosis for occupational contact dermatitis is often poor. Objectives To investigate the prognosis, assessed by eczema, job status and skin-related quality of life, among patients allergic to rubber chemicals and latex (ubiquitous allergens) and epoxy (nonubiquitous allergen), 2 years after recognition of occupational allergic contact dermatitis. Methods From a cohort of all patients recognized as having occupational dermatitis by the Danish National Board of Industrial Injuries in 2010, 199 patients with relevant rubber allergy (contact allergy to rubber chemicals or contact urticaria from latex) or epoxy allergy were identified. Follow-up consisted of a questionnaire covering current severity of eczema, employment, exposure and quality of life. Results The response rate was 75%. Clearance of eczema was reported by 11% of patients and 67% reported improvement. Overall 22% of patients with allergy to a nonubiquitous allergen had total clearance of eczema compared with 10% of cases allergic to ubiquitous allergens and 0% of those with contact urticaria (P = 0·116). Improvement was significantly more frequent in those who had changed jobs compared with those who had not (P = 0·01). Conclusions At follow-up, patients with contact urticaria had significantly poorer prognosis than those with contact allergy, and there was a trend towards a poorer prognosis for those with contact allergy to rubber chemicals than those with allergy to epoxy. A significant positive association between job change and improvement was found. What's already known about this topic? Skin conditions are the most frequently recognized occupational diseases in Denmark, and contact dermatitis constitutes more than 90% of these. The prognosis for occupational contact dermatitis is often poor. What does this study add? Quality of life (QoL) was less impaired in patients with relevant occupational contact allergy to a nonubiquitous allergen, and there was a trend that total clearance of eczema was more frequent for this group. Patients with contact urticaria had significantly less frequent clearance, less improvement in eczema and most impairment of QoL at follow-up. A significant positive association between job change and improvement was found.

KW - Adolescent

KW - Adult

KW - Aged

KW - Allergens

KW - Denmark

KW - Dermatitis, Allergic Contact

KW - Dermatitis, Occupational

KW - Eczema

KW - Employment

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Latex Hypersensitivity

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Quality of Life

KW - Urticaria

KW - Young Adult

U2 - 10.1111/bjd.12795

DO - 10.1111/bjd.12795

M3 - Journal article

C2 - 24359102

SN - 0007-0963

VL - 170

SP - 1100

EP - 1105

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 5

ER -