Forum for Nordic Dermato-Venereology Nr 1, 2018 | Page 25
Dissertation
Contact Allergy to Aluminium
I ngrid S iemund , MD, P h D
Department of Occupational and Environmental Dermatology, Skåne University Hospital, SE-214 21 Malmö, Sweden. E-mail:
[email protected]
SIngrid Siemund, on September 8, 2017, defended her doctral thesis titled: “Contact allergy to aluminium”.
Available from: http://portal.research.lu.se/ws/files/29365156/Contact_allergy_to_aluminium.Ingrid_Sie-
mund.e_version.pdf.
Contact allergy and atopic dermatitis may be present in the
same patient. Known comorbidities of atopic dermatitis are
allergic asthma and allergic rhinoconjunctivitis, both of which
can be treated with allergen-specific immunotherapy (ASIT).
Persistent itching nodules and contact allergy to aluminium
are known adverse reactions after ASIT with aluminium-con-
taining allergen extracts as well as after immunisation with
aluminium-containing vaccines.
The aims of the thesis were: (i) to investigate the presence
of contact allergies in atopic individuals with and without
childhood eczema, before and after ASIT (Paper I); (ii) to
investigate wether ASIT with aluminium-containing allergen
extracts during one year induces persistent itching nodules
and contact allergy to aluminium (Paper II); (iii) to provide
increased knowledge about establishing contact allergy to alu-
minum (Paper III); and (iv) to study contact allergic reactions
to aluminium over time (Paper IV).
Papers I and II are based on a prospective study in atopic in-
dividuals suffering from allergic asthma and/or allergic rhino
cunjunctivitis. The study participants were treated with ASIT
with aluminium-containing allergen extracts during one year.
They were patch-tested with aluminium chloride hexahydrate
before and during ASIT. At the end of the study all participants
were patch-tested with aluminium and the baseline series.
Paper III reports on aluminium-allergic volunteers who were
patch-tested with 6 different aluminium compounds and an
empty Finn chamber ® , and also tested intradermally with
aluminium chloride hexahydrate. In paper IV the results of
repeated patch-testing with aluminium chloride hexahydrate
and aluminium lactate in aluminium-allergic volunteers are
presented.
The findings were as follows:
• a lower number of contact allergies was found in individuals
treated with ASIT,
a higher number of contact allergies was found in individ-
uals with a history of childhood eczema,
• contact allergy to aluminium was found in those treated
with ASIT but ASIT was not shown to be a risk factor,
Forum for Nord Derm Ven 2018, Vol. 23, No. 1
Ingrid Siemund with Professor Lennart Emtestam (Opponent) Depart-
ment of Dermatology, Karolinska Institut, Stockholm to the left and
Professor Magnus Bruze (Main Supervisor), Department of Occupational
and Environmental Dermatology, Lund University, Malmö to the right.
contact allergy to aluminium and itching nodules seemed
to be more common in children and in those with a history
of atopic dermatitis,
• patch testing with aluminium chloride hexahydrate 2.0%
and an empty Finn chamber ® , as well as the intradermal
test are insufficient to detect aluminium allergy,
most positive reactions were noted to aluminium chloride
hexahydrate 10 %, iv a) patch test reactivity to aluminium
varies over time, iv b) an aluminium-allergic individual may
have a false-negative reaction to aluminium.
List of publications
I.
Siemund I, Hindsén M, Netterlid E, Güner N, Bruze M. Contact
allergy in atopic individuals in relation to allergen-specific immu-
notherapy. Eur J Dermatol 2016; 26: 271–280.
II. Netterlid E, Hindsén M, Siemund I, Björk J, Werner S, Jacobsson
H, et al.. Does allergen-specific immunotherapy induce contact
allergy to aluminium? Acta Derm Venereol 2013; 93: 50–56.
III. Siemund I, Zimerson E, Hindsén M, Bruze M. Establishing alumin-
ium contact allergy. Contact Dermatitis 2012; 67: 162–170.
IV. Siemund I, Mowitz M, Zimerson E, Bruze M. Hindsén M. Individual
variation in aluminium patch test reactivity over time. Contact
Dermatitis 2017 Jul 11 [Epub] Doi: 10.1111/cod.12836.
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