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Erschienen in: Current Allergy and Asthma Reports 6/2024

11.05.2024 | Review

The role of the environment in allergic skin disease

verfasst von: Khushnood Faraz, Mason Seely, Anne L. Marano

Erschienen in: Current Allergy and Asthma Reports | Ausgabe 6/2024

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Abstract

Purpose of Review

This paper explores how environmental factors influence allergic skin diseases, including atopic dermatitis (AD), contact dermatitis (CD), urticaria, angioedema, and reactions to drugs and insect bites.

Recent Findings

Research indicates a significant impact of environmental elements on allergic skin diseases. High air pollution levels exacerbate symptoms, while climate change contributes to increased skin barrier dysfunction, particularly affecting AD. Allergen prevalence is influenced by climate and pollution. Irritants, like those in detergents and cosmetics, play a major role in CD. Plants also contribute, causing various skin reactions.

Summary

Understanding the interplay between environmental factors and allergic skin diseases is crucial for effective management. Physicians must address these factors to support patient well-being and promote skin health amidst environmental changes.
Literatur
3.
Zurück zum Zitat Williams H, Flohr C. How epidemiology has challenged 3 prevailing concepts about atopic dermatitis. J Allergy Clin Immunol. 2006;118(1):209–13.PubMedCrossRef Williams H, Flohr C. How epidemiology has challenged 3 prevailing concepts about atopic dermatitis. J Allergy Clin Immunol. 2006;118(1):209–13.PubMedCrossRef
4.
Zurück zum Zitat Bosma AL, et al. Classifying atopic dermatitis: a systematic review of phenotypes and associated characteristics. J Eur Acad Dermatol Venereol. 2022;36(6):807–19.PubMedPubMedCentralCrossRef Bosma AL, et al. Classifying atopic dermatitis: a systematic review of phenotypes and associated characteristics. J Eur Acad Dermatol Venereol. 2022;36(6):807–19.PubMedPubMedCentralCrossRef
5.
Zurück zum Zitat Elias PM, Steinhoff M. “Outside-to-inside” (and now back to “outside”) pathogenic mechanisms in atopic dermatitis. J Invest Dermatol. 2008;128(5):1067–70.PubMedPubMedCentralCrossRef Elias PM, Steinhoff M. “Outside-to-inside” (and now back to “outside”) pathogenic mechanisms in atopic dermatitis. J Invest Dermatol. 2008;128(5):1067–70.PubMedPubMedCentralCrossRef
6.
Zurück zum Zitat Cork M, et al. Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol. 2003;149(3):582–9.PubMedCrossRef Cork M, et al. Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol. 2003;149(3):582–9.PubMedCrossRef
7.
Zurück zum Zitat • Paller AS, et al. Dupilumab in children aged 6 months to younger than 6 years with uncontrolled atopic dermatitis: a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2022;400(10356):908–19.PubMedCrossRef • Paller AS, et al. Dupilumab in children aged 6 months to younger than 6 years with uncontrolled atopic dermatitis: a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2022;400(10356):908–19.PubMedCrossRef
8.
Zurück zum Zitat • Blauvelt A, et al. Efficacy and Safety of Upadacitinib vs Dupilumab in Adults With Moderate-to-Severe Atopic Dermatitis: A Randomized Clinical Trial. JAMA Dermatol. 2021;157(9):1047–55.PubMedPubMedCentralCrossRef • Blauvelt A, et al. Efficacy and Safety of Upadacitinib vs Dupilumab in Adults With Moderate-to-Severe Atopic Dermatitis: A Randomized Clinical Trial. JAMA Dermatol. 2021;157(9):1047–55.PubMedPubMedCentralCrossRef
9.
Zurück zum Zitat Mikhaylov D, et al. Oral Janus kinase inhibitors for atopic dermatitis. Ann Allergy Asthma Immunol. 2023;130(5):577–92.PubMedCrossRef Mikhaylov D, et al. Oral Janus kinase inhibitors for atopic dermatitis. Ann Allergy Asthma Immunol. 2023;130(5):577–92.PubMedCrossRef
11.
Zurück zum Zitat Diepgen TL, et al. Prevalence of contact allergy in the general population in different European regions. Br J Dermatol. 2016;174(2):319–29.PubMedCrossRef Diepgen TL, et al. Prevalence of contact allergy in the general population in different European regions. Br J Dermatol. 2016;174(2):319–29.PubMedCrossRef
12.
Zurück zum Zitat Alinaghi F, et al. Prevalence of contact allergy in the general population: A systematic review and meta-analysis. Contact Dermatitis. 2019;80(2):77–85.PubMedCrossRef Alinaghi F, et al. Prevalence of contact allergy in the general population: A systematic review and meta-analysis. Contact Dermatitis. 2019;80(2):77–85.PubMedCrossRef
13.
Zurück zum Zitat Li Y, Li L. Contact Dermatitis: Classifications and Management. Clin Rev Allergy Immunol. 2021;61(3):245–81.PubMedCrossRef Li Y, Li L. Contact Dermatitis: Classifications and Management. Clin Rev Allergy Immunol. 2021;61(3):245–81.PubMedCrossRef
14.
Zurück zum Zitat Coffin SL, Turrentine JE, Cruz PD Jr. Photodermatitis for the Allergist. Curr Allergy Asthma Rep. 2017;17(6):36.PubMedCrossRef Coffin SL, Turrentine JE, Cruz PD Jr. Photodermatitis for the Allergist. Curr Allergy Asthma Rep. 2017;17(6):36.PubMedCrossRef
16.
Zurück zum Zitat Zuberbier T, et al. Epidemiology of urticaria: a representative cross-sectional population survey. Clin Exp Dermatol. 2010;35(8):869–73.PubMedCrossRef Zuberbier T, et al. Epidemiology of urticaria: a representative cross-sectional population survey. Clin Exp Dermatol. 2010;35(8):869–73.PubMedCrossRef
17.
Zurück zum Zitat Lee SJ, et al. Prevalence and Risk Factors of Urticaria With a Focus on Chronic Urticaria in Children. Allergy Asthma Immunol Res. 2017;9(3):212–9.PubMedPubMedCentralCrossRef Lee SJ, et al. Prevalence and Risk Factors of Urticaria With a Focus on Chronic Urticaria in Children. Allergy Asthma Immunol Res. 2017;9(3):212–9.PubMedPubMedCentralCrossRef
18.
Zurück zum Zitat Church MK, et al. The role and relevance of mast cells in urticaria. Immunol Rev. 2018;282(1):232–47.PubMedCrossRef Church MK, et al. The role and relevance of mast cells in urticaria. Immunol Rev. 2018;282(1):232–47.PubMedCrossRef
19.
Zurück zum Zitat Zuberbier T, et al. The international EAACI/GA2LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77(3):734–66.PubMedCrossRef Zuberbier T, et al. The international EAACI/GA2LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77(3):734–66.PubMedCrossRef
20.
Zurück zum Zitat Weller K, et al. Epidemiology, comorbidities, and healthcare utilization of patients with chronic urticaria in Germany. J Eur Acad Dermatol Venereol. 2022;36(1):91–9.PubMedCrossRef Weller K, et al. Epidemiology, comorbidities, and healthcare utilization of patients with chronic urticaria in Germany. J Eur Acad Dermatol Venereol. 2022;36(1):91–9.PubMedCrossRef
21.
Zurück zum Zitat Gonçalo M, et al. The global burden of chronic urticaria for the patient and society. Br J Dermatol. 2021;184(2):226–36.PubMedCrossRef Gonçalo M, et al. The global burden of chronic urticaria for the patient and society. Br J Dermatol. 2021;184(2):226–36.PubMedCrossRef
22.
Zurück zum Zitat Türk M, et al. How to Treat Patients with Chronic Spontaneous Urticaria with Omalizumab: Questions and Answers. J Allergy Clin Immunol Pract. 2020;8(1):113–24.PubMedCrossRef Türk M, et al. How to Treat Patients with Chronic Spontaneous Urticaria with Omalizumab: Questions and Answers. J Allergy Clin Immunol Pract. 2020;8(1):113–24.PubMedCrossRef
23.
Zurück zum Zitat Kazandjieva J, Christoff G. Angioedema as a systemic disease. Clin Dermatol. 2019;37(6):636–43.PubMedCrossRef Kazandjieva J, Christoff G. Angioedema as a systemic disease. Clin Dermatol. 2019;37(6):636–43.PubMedCrossRef
24.
Zurück zum Zitat Zalewska-Janowska A, Spiewak R, Kowalski ML. Cutaneous Manifestation of Drug Allergy and Hypersensitivity. Immunol Allergy Clin North Am. 2017;37(1):165–81.PubMedCrossRef Zalewska-Janowska A, Spiewak R, Kowalski ML. Cutaneous Manifestation of Drug Allergy and Hypersensitivity. Immunol Allergy Clin North Am. 2017;37(1):165–81.PubMedCrossRef
25.
Zurück zum Zitat Naldi L, Crotti S. Epidemiology of cutaneous drug-induced reactions. G Ital Dermatol Venereol. 2014;149(2):207–18.PubMed Naldi L, Crotti S. Epidemiology of cutaneous drug-induced reactions. G Ital Dermatol Venereol. 2014;149(2):207–18.PubMed
27.
Zurück zum Zitat Blumenthal KG, Ziegler JB. Hypersensitivity Reactions, Dietary Supplements, and the Importance of the Case Report. J Allergy Clin Immunol Pract. 2016;4(1):177–8.PubMedCrossRef Blumenthal KG, Ziegler JB. Hypersensitivity Reactions, Dietary Supplements, and the Importance of the Case Report. J Allergy Clin Immunol Pract. 2016;4(1):177–8.PubMedCrossRef
28.
Zurück zum Zitat Cohen PA. Assessing supplement safety—the FDA’s controversial proposal. N Engl J Med. 2012;366(5):389–91.PubMedCrossRef Cohen PA. Assessing supplement safety—the FDA’s controversial proposal. N Engl J Med. 2012;366(5):389–91.PubMedCrossRef
29.
Zurück zum Zitat Teresa Ventura M, et al. Hypersensitivity reactions to complementary and alternative medicine products. Curr Pharm Des. 2006;12(26):3393–9.CrossRef Teresa Ventura M, et al. Hypersensitivity reactions to complementary and alternative medicine products. Curr Pharm Des. 2006;12(26):3393–9.CrossRef
30.
Zurück zum Zitat Abrams EM, Golden DBK. Approach to Patients with Stinging Insect Allergy. Med Clin North Am. 2020;104(1):129–43.PubMedCrossRef Abrams EM, Golden DBK. Approach to Patients with Stinging Insect Allergy. Med Clin North Am. 2020;104(1):129–43.PubMedCrossRef
31.
Zurück zum Zitat Golden DB, et al. Stinging insect hypersensitivity: A practice parameter update 2016. Ann Allergy Asthma Immunol. 2017;118(1):28–54.PubMedCrossRef Golden DB, et al. Stinging insect hypersensitivity: A practice parameter update 2016. Ann Allergy Asthma Immunol. 2017;118(1):28–54.PubMedCrossRef
33.
Zurück zum Zitat Simons FER. Anaphylaxis. J Aller Clin Immunol. 2010;125(Supplement 2):S161–81.CrossRef Simons FER. Anaphylaxis. J Aller Clin Immunol. 2010;125(Supplement 2):S161–81.CrossRef
34.
Zurück zum Zitat Singh S, Mann BK. Insect bite reactions. Indian J Dermatol Venereol Leprol. 2013;79(2):151–64.PubMedCrossRef Singh S, Mann BK. Insect bite reactions. Indian J Dermatol Venereol Leprol. 2013;79(2):151–64.PubMedCrossRef
35.
Zurück zum Zitat Jadoo AS, Treat JR. Caterpillar dermatitis: A brief report. Pediatr Dermatol. 2020;37(3):570–1.PubMedCrossRef Jadoo AS, Treat JR. Caterpillar dermatitis: A brief report. Pediatr Dermatol. 2020;37(3):570–1.PubMedCrossRef
36.
Zurück zum Zitat Elston DM. Bites and stings. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. Elsevier; 2018. p. 1516–35. Elston DM. Bites and stings. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. Elsevier; 2018. p. 1516–35.
38.
Zurück zum Zitat • Li A, et al. Associations between air pollution, climate factors and outpatient visits for eczema in West China Hospital, Chengdu, south-western China: a time series analysis. J Eur Acad Dermatol Venereol. 2018;32(3):486–94.PubMedCrossRef • Li A, et al. Associations between air pollution, climate factors and outpatient visits for eczema in West China Hospital, Chengdu, south-western China: a time series analysis. J Eur Acad Dermatol Venereol. 2018;32(3):486–94.PubMedCrossRef
39.
Zurück zum Zitat Pesce G, et al. Adult eczema in Italy: prevalence and associations with environmental factors. J Eur Acad Dermatol Venereol. 2015;29(6):1180–7.PubMedCrossRef Pesce G, et al. Adult eczema in Italy: prevalence and associations with environmental factors. J Eur Acad Dermatol Venereol. 2015;29(6):1180–7.PubMedCrossRef
40.
Zurück zum Zitat Belugina IN, et al. Outdoor environment, ozone, radionuclide-associated aerosols and incidences of infantile eczema in Minsk. Belarus J Eur Acad Dermatol Venereol. 2018;32(11):1977–85.PubMedCrossRef Belugina IN, et al. Outdoor environment, ozone, radionuclide-associated aerosols and incidences of infantile eczema in Minsk. Belarus J Eur Acad Dermatol Venereol. 2018;32(11):1977–85.PubMedCrossRef
41.
Zurück zum Zitat Kim YM, et al. Short-term effects of weather and air pollution on atopic dermatitis symptoms in children: A panel study in Korea. PLoS ONE. 2017;12(4): e0175229.PubMedPubMedCentralCrossRef Kim YM, et al. Short-term effects of weather and air pollution on atopic dermatitis symptoms in children: A panel study in Korea. PLoS ONE. 2017;12(4): e0175229.PubMedPubMedCentralCrossRef
42.
Zurück zum Zitat Kim YM, et al. The effects of particulate matter on atopic dermatitis symptoms are influenced by weather type: Application of spatial synoptic classification (SSC). Int J Hyg Environ Health. 2018;221(5):823–9.PubMedCrossRef Kim YM, et al. The effects of particulate matter on atopic dermatitis symptoms are influenced by weather type: Application of spatial synoptic classification (SSC). Int J Hyg Environ Health. 2018;221(5):823–9.PubMedCrossRef
43.
Zurück zum Zitat Cecchi L, D’Amato G, Annesi-Maesano I. External exposome and allergic respiratory and skin diseases. J Allergy Clin Immunol. 2018;141(3):846–57.PubMedCrossRef Cecchi L, D’Amato G, Annesi-Maesano I. External exposome and allergic respiratory and skin diseases. J Allergy Clin Immunol. 2018;141(3):846–57.PubMedCrossRef
44.
Zurück zum Zitat Belzer A, Parker ER. Climate Change, Skin Health, and Dermatologic Disease: A Guide for the Dermatologist. Am J Clin Dermatol. 2023;24(4):577–93.PubMedCrossRef Belzer A, Parker ER. Climate Change, Skin Health, and Dermatologic Disease: A Guide for the Dermatologist. Am J Clin Dermatol. 2023;24(4):577–93.PubMedCrossRef
45.
Zurück zum Zitat Andersen LK, et al. Climate change and skin disease: a review of the English-language literature. Int J Dermatol. 2012;51(6):656–61.PubMedCrossRef Andersen LK, et al. Climate change and skin disease: a review of the English-language literature. Int J Dermatol. 2012;51(6):656–61.PubMedCrossRef
46.
Zurück zum Zitat St Leger RJ. Insects and their pathogens in a changing climate. J Invertebr Pathol. 2021;184: 107644.PubMedCrossRef St Leger RJ. Insects and their pathogens in a changing climate. J Invertebr Pathol. 2021;184: 107644.PubMedCrossRef
47.
Zurück zum Zitat Kuo IH, et al. The cutaneous innate immune response in patients with atopic dermatitis. J Allergy Clin Immunol. 2013;131(2):266–78.PubMedCrossRef Kuo IH, et al. The cutaneous innate immune response in patients with atopic dermatitis. J Allergy Clin Immunol. 2013;131(2):266–78.PubMedCrossRef
48.
Zurück zum Zitat Celebi Sözener Z, et al. Environmental factors in epithelial barrier dysfunction. J Allergy Clin Immunol. 2020;145(6):1517–28.PubMedCrossRef Celebi Sözener Z, et al. Environmental factors in epithelial barrier dysfunction. J Allergy Clin Immunol. 2020;145(6):1517–28.PubMedCrossRef
50.
Zurück zum Zitat Bains SN, Nash P, Fonacier L. Irritant Contact Dermatitis. Clin Rev Allergy Immunol. 2019;56(1):99–109.PubMedCrossRef Bains SN, Nash P, Fonacier L. Irritant Contact Dermatitis. Clin Rev Allergy Immunol. 2019;56(1):99–109.PubMedCrossRef
51.
Zurück zum Zitat Seyfarth F, et al. Dry skin, barrier function, and irritant contact dermatitis in the elderly. Clin Dermatol. 2011;29(1):31–6.PubMedCrossRef Seyfarth F, et al. Dry skin, barrier function, and irritant contact dermatitis in the elderly. Clin Dermatol. 2011;29(1):31–6.PubMedCrossRef
52.
Zurück zum Zitat Zhai H, Maibach HI. Skin occlusion and irritant and allergic contact dermatitis: an overview. Contact Dermatitis: Review Article. 2001;44(4):201–6.CrossRef Zhai H, Maibach HI. Skin occlusion and irritant and allergic contact dermatitis: an overview. Contact Dermatitis: Review Article. 2001;44(4):201–6.CrossRef
53.
Zurück zum Zitat Uter W, Gefeller O, Schwanitz HJ. An epidemiological study of the influence of season (cold and dry air) on the occurrence of irritant skin changes of the hands. Br J Dermatol. 1998;138(2):266–72.PubMedCrossRef Uter W, Gefeller O, Schwanitz HJ. An epidemiological study of the influence of season (cold and dry air) on the occurrence of irritant skin changes of the hands. Br J Dermatol. 1998;138(2):266–72.PubMedCrossRef
54.
Zurück zum Zitat Fluhr J, et al. Additive impairment of the barrier function by mechanical irritation, occlusion and sodium lauryl sulphate in vivo. Br J Dermatol. 2005;153(1):125–31.PubMedCrossRef Fluhr J, et al. Additive impairment of the barrier function by mechanical irritation, occlusion and sodium lauryl sulphate in vivo. Br J Dermatol. 2005;153(1):125–31.PubMedCrossRef
55.
Zurück zum Zitat McGovern TW. Dermatoses due to plants. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. Elsevier; 2018. p. 286–303. McGovern TW. Dermatoses due to plants. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. Elsevier; 2018. p. 286–303.
56.
Zurück zum Zitat Williford PM, Sheretz EF. Poison ivy dermatitis. Nuances in treatment Arch Fam Med. 1994;3(2):184–8.PubMedCrossRef Williford PM, Sheretz EF. Poison ivy dermatitis. Nuances in treatment Arch Fam Med. 1994;3(2):184–8.PubMedCrossRef
57.
Zurück zum Zitat Bousquet J, et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67(1):18–24.PubMedCrossRef Bousquet J, et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67(1):18–24.PubMedCrossRef
58.
Zurück zum Zitat Nixon RL, et al. Allergic contact dermatitis. In: Bolognia JL, Schaffer JV, Cerroni L, editors., et al., Dermatology. 4th ed. Elsevier; 2018. p. 242–61. Nixon RL, et al. Allergic contact dermatitis. In: Bolognia JL, Schaffer JV, Cerroni L, editors., et al., Dermatology. 4th ed. Elsevier; 2018. p. 242–61.
59.
Zurück zum Zitat DeKoven JG, et al. North american contact dermatitis group patch test results 2013–2014. Dermatitis. 2017;28(1):33–46.PubMedCrossRef DeKoven JG, et al. North american contact dermatitis group patch test results 2013–2014. Dermatitis. 2017;28(1):33–46.PubMedCrossRef
60.
Zurück zum Zitat Zug KA, et al. Patch testing in children from 2005 to 2012: results from the North American contact dermatitis group. Dermatitis. 2014;25(6):345–55.PubMedCrossRef Zug KA, et al. Patch testing in children from 2005 to 2012: results from the North American contact dermatitis group. Dermatitis. 2014;25(6):345–55.PubMedCrossRef
61.
Zurück zum Zitat Jacob SE, Admani S. iPad–increasing nickel exposure in children. Pediatrics. 2014;134(2):e580–2.PubMedCrossRef Jacob SE, Admani S. iPad–increasing nickel exposure in children. Pediatrics. 2014;134(2):e580–2.PubMedCrossRef
62.
Zurück zum Zitat Boyapati A, et al. Allergic contact dermatitis to methylisothiazolinone: exposure from baby wipes causing hand dermatitis. Australas J Dermatol. 2013;54(4):264–7.PubMedCrossRef Boyapati A, et al. Allergic contact dermatitis to methylisothiazolinone: exposure from baby wipes causing hand dermatitis. Australas J Dermatol. 2013;54(4):264–7.PubMedCrossRef
63.
Zurück zum Zitat Scheinman PL. The foul side of fragrance-free products: what every clinician should know about managing patients with fragrance allergy. J Am Acad Dermatol. 1999;41(6):1020–4.PubMedCrossRef Scheinman PL. The foul side of fragrance-free products: what every clinician should know about managing patients with fragrance allergy. J Am Acad Dermatol. 1999;41(6):1020–4.PubMedCrossRef
64.
Metadaten
Titel
The role of the environment in allergic skin disease
verfasst von
Khushnood Faraz
Mason Seely
Anne L. Marano
Publikationsdatum
11.05.2024
Verlag
Springer US
Erschienen in
Current Allergy and Asthma Reports / Ausgabe 6/2024
Print ISSN: 1529-7322
Elektronische ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-024-01147-9

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