Inhalant allergens provide a source of environmental factors that contribute to the development of clinical symptoms in patients with atopic dermatitis (AD).
Objective
To review the relationship between inhalant allergens and AD.
Methods
A literature review was conducted using three databases: PubMed/MEDLINE, ClinicalKey, and Web of Science. Search terms, including “atopic dermatitis,” “atopic eczema,” and “eczema,” were used in combination with “inhalant allergen,” “inhaled allergen,” and “aeroallergen” to identify relevant published manuscripts that highlight the relationship between AD and exposures to inhalant allergens.
Results
Fifteen articles were suitable for review. The studies included in the review investigated the effect of inhalant allergens on the clinical manifestations of AD through bronchial provocation, direct skin contact, and allergen sensitization.
Conclusion
There is a significant relationship between exposures to inhalant allergens and AD. Inhalant allergens may aggravate AD symptoms by either bronchial provocation or direct skin contact. Sensitization of inhalant allergens, mainly house dust mites, follows a specific age-related pattern.
David BootheWTarboxJATarboxMB. Atopic dermatitis: Pathophysiology. Adv Exp Med Biol. 2017;1027:21–37.
2.
Avena-WoodsC. Overview of atopic dermatitis. Am J Manag Care. 2017;23(8 Suppl):S115–SS23.
3.
NuttenS. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66(Suppl 1):8–16.
4.
DrislaneCIrvineAD. The role of filaggrin in atopic dermatitis and allergic disease. Ann Allergy Asthma Immunol. 2020;124(1):36–43.
5.
ScheurerSTodaMViethsS. What makes an allergen?Clin Exp Allergy. 2015;45(7):1150–1161.
6.
Tamagawa-MineokaRKatohN. Atopic dermatitis: identification and management of complicating factors. Int J Mol Sci. 2020;21(8):2671.
7.
TuftL. Atopic dermatitis-etiology and clinical management. Calif Med. 1950;73(3):233–239.
8.
SpergelJMPallerAS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol. 2003;112(6 Suppl):S118–S127.
9.
TupkerRADe MonchyJGCoenraadsPJHomanAvan der MeerJB. Induction of atopic dermatitis by inhalation of house dust mite. J Allergy Clin Immunol. 1996;97(5):1064–1070.
10.
BrinkmanLAslanderMMRaaijmakersJALammersJWKoendermanLBruijnzeel-KoomenCA. Bronchial and cutaneous responses in atopic dermatitis patients after allergen inhalation challenge. Clin Exp Allergy. 1997;27(9):1043–1051.
11.
SchuttelaarMLCoenraadsPJHuizingaJDe MonchyJGVermeulenKM. Increase in vesicular hand eczema after house dust mite inhalation provocation: a double-blind, placebo-controlled, cross-over study. Contact Dermatitis. 2013;68(2):76–85.
12.
LambrechtBNHammadHFahyJV. The cytokines of asthma. Immunity. 2019;50(4):975–991.
13.
KutluAKarabacakEAydinE, et al.Relationship between skin prick and atopic patch test reactivity to aeroallergens and disease severity in children with atopic dermatitis. Allergol Immunopathol (Madr). 2013;41(6):369–373.
14.
DarsowUVielufDRingJ. Evaluating the relevance of aeroallergen sensitization in atopic eczema with the atopy patch test: a randomized, double-blind multicenter study. Atopy Patch Test Study Group. J Am Acad Dermatol. 1999;40(2 Pt 1):187–193.
15.
ChongACChwaWJOngPY. Aeroallergens in atopic dermatitis and chronic urticaria. Curr Allergy Asthma Rep. 2022;22(7):67–75.
16.
Folster-HolstRGaleckaJWeissmantelS, et al.Birch pollen influence the severity of atopic eczema - prospective clinical cohort pilot study and ex vivo penetration study. Clin Cosmet Investig Dermatol. 2015;8:539–548.
17.
WerfelTHeratizadehANiebuhrM, et al.Exacerbation of atopic dermatitis on grass pollen exposure in an environmental challenge chamber. J Allergy Clin Immunol. 2015;136(1):96–103 e9.
18.
KramerUWeidingerSDarsowUMohrenschlagerMRingJBehrendtH. Seasonality in symptom severity influenced by temperature or grass pollen: results of a panel study in children with eczema. J Invest Dermatol. 2005;124(3):514–523.
19.
WahnUWarnerJSimonsFE, et al.IgE antibody responses in young children with atopic dermatitis. Pediatr Allergy Immunol. 2008;19(4):332–336.
20.
CelakovskaJBukacJ. The severity of atopic dermatitis evaluated with the SCORAD index and the occurrence of bronchial asthma and rhinitis, and the duration of atopic dermatitis. Allergy Rhinol (Providence). 2016;7(1):8–13.
21.
WisniewskiJAAgrawalRMinnicozziS, et al.Sensitization to food and inhalant allergens in relation to age and wheeze among children with atopic dermatitis. Clin Exp Allergy. 2013;43(10):1160–1170.
22.
OzdogruEEGonulalM. Atopic dermatitis, inhalant allergy and food allergy: a paediatric approach. Dermatol Ther. 2021;34(1):e14542.
23.
Shokouhi ShoormastiRFazlollahiMRKazemnejadA, et al.IgE sensitization to inhalant allergens and its association with allergic diseases in adults. Iran J Allergy Asthma Immunol. 2018;17(2):123–133.
24.
WangIJTungTHTangCSZhaoZH. Allergens, air pollutants, and childhood allergic diseases. Int J Hyg Environ Health. 2016;219(1):66–71.
25.
SchoeferYSchaferTMeisingerCWichmannHEHeinrichJgroupKS. Predictivity of allergic sensitization (RAST) for the onset of allergic diseases in adults. Allergy. 2008;63(1):81–86.
26.
CzarnowickiTEsakiHGonzalezJ, et al.Alterations in B-cell subsets in pediatric patients with early atopic dermatitis. J Allergy Clin Immunol. 2017;140(1):134–44 e9.
27.
van ZuurenEJFedorowiczZChristensenRLavrijsenAArentsBWM. Emollients and moisturisers for eczema. Cochrane Database Syst Rev. 2017;2(2):CD012119.
28.
FrazierWBhardwajN. Atopic dermatitis: diagnosis and treatment. Am Fam Physician. 2020;101(10):590–598.
29.
TanBBWealdDStricklandIFriedmannPS. Double-blind controlled trial of effect of housedust-mite allergen avoidance on atopic dermatitis. Lancet. 1996;347(8993):15–18.
30.
OostingAJde Bruin-WellerMSTerreehorstI, et al.Effect of mattress encasings on atopic dermatitis outcome measures in a double-blind, placebo-controlled study: the Dutch mite avoidance study. J Allergy Clin Immunol. 2002;110(3):500–506.
31.
KimJLeeSWooSY, et al.The indoor level of house dust mite allergen is associated with severity of atopic dermatitis in children. J Korean Med Sci. 2013;28(1):74–79.
32.
PatelGSaltounC. Skin testing in allergy. Allergy Asthma Proc. 2019;40(6):366–368.
