Forum for Nordic Dermato-Venereology Nr 4, 2019 | Page 17

Dissertation
Contact Allergy in Children
A nne B irgitte N ørremark S imonsen
Department of Dermatology and Venereology, Aarhus University Hospital, P.P. Ørumsgade 11, DK-8000 Aarhus C, Denmark.
E-mail: [e-mail]
Anne Birgitte Nørremark Simonsen defended her thesis “Allergic contact dermatitis in children” on April 5,
2018 in Aarhus University Hospital, Aarhus, Denmak. Main supervisor: Mette Sommerlund, Associate Professor,
MD, PhD, Aarhus University Hospital, Aarhus. Co-supervisors: Mette Deleuran, Associate Professor, MD, DMSc,
Aarhus University Hospital, Aarhus, Charlotte Gotthard Mørtz, Professor, MD, PhD, Odense University Hospital,
Odense, and Jeanne Duus Johansen, Professor, MD, DMSc, Copenhagen University Hospital, Herlev-Gentofte,
Denmark. Assessment Committee: An Goossens, Professor, MD, PhD, DMSc, University Hospital of Leuven,
Belgium, and Regina Fölster-Holst, Professor, MD, PhD, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
Contact allergy and allergic contact dermatitis was tradition-
ally considered uncommon among children due to the widely
held misconceptions that the immune system of children was
immature and that children’s exposure to contact allergens
was limited.
The impaired skin barrier in atopic dermatitis facilitates the
penetration of allergens. As children with atopic dermatitis are
exposed to emollients and topical agents from an early age and
for prolonged periods of time, this could theoretically increase
the risk of contact sensitization. Whether hidden contact al-
lergies can play a role in the skin symptoms in patients with
atopic eczema and to what extent is unclear.
Early identification of the caus-
ative allergen and subsequent
allergen avoidance is crucial in
order to reduce the duration
and durability of the disease
and its progression, but how
the positive or negative find-
ings influence the course of
skin symptoms in children
referred for patch testing had
never previously been explored.
The thesis consisted of 3 stud-
ies: An epidemiological study, a
follow-up study, and a clinical
study. The overall objectives
were i) to estimate the preva-
lence of contact allergy in Dan-
ish children and adolescents
referred for patch testing, ii) to
investigate the course of skin
symptoms and effect of contact
allergy and allergic contact der-
matitis on the children’s qual-
ity of life, and iii) to assess the
problem of contact allergy in
children with atopic dermatitis.
Based on the results of the 3 studies we found that allergic con-
tact dermatitis is a common diagnosis among Danish children
and adolescents with eczema. The results of our follow-up study
indicated that there is a significant risk of childhood eczema
becoming chronic, regardless of the nature of the eczema, and
that having persistent eczema is a strong and significant risk
factor for having severely impaired life quality.
Finally, we showed that children with atopic dermatitis have
unacknowledged contact allergies that may contribute to or
maintain the skin symptoms. The risk of contact allergy was
significantly correlated to the severity of atopic dermatitis. In
children with atopic dermatitis, metals and components of
topical skin care products were
the most frequent sensitizers.
L ist
of publications
I.
Regina Fölster-Holst
Mette Sommerlund An Goosens
Mette Deleuran Jeanne Duus Johansen
Forum for Nord Derm Ven 2019, Vol. 24, No. 4
Charlotte Gotthard Mørtz
Simonsen AB, Deleuran M,
Mortz CG, Johansen JD, Som-
merlund M. Allergic contact
dermatitis in Danish children
referred for patch testing – a
nationwide multi-centre study.
Contact Dermatitis 2014; 70:
104–111.
II. Simonsen AB, Sommerlund
M, Deleuran M, Mortz CG,
Johansen JD. Course of skin
symptoms and quality of life
in children referred for patch
testing – a long-term follow-up
study. Acta Derm Venereol
2015; 95: 206–210.
III. Simonsen AB, Johansen JD,
Deleuran M, Mortz CG, Skov
L, Sommerlund M. Children
with atopic dermatitis may
have unacknowledged contact
allergies contributing to their
skin symptoms. J Eur Acad
Dermatol Venereol 2018; 32:
428–436.
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