010 How to Predict Allergic Contact Dermatitis Accompanied in Patients with Atopic Dermatitis

In patients with atopic dermatitis (AD), the penetration of contact allergens is potentially increased through disrupted barrier, and hence the risk of sensitization is also increased. We performed this study to predict allergic contact dermatitis (ACD) accompanied in AD patients. 207 patients with AD who underwent patch test were included in the study. Subjects with any positive result were classified as “AD with ACD” (N=43, 20.8%), and negative result as “AD only” (N=164, 79.2%). Gender, age, past and family history, skin lesions, laboratory findings and gene variations including FLG 3321delA, FLG K4022X, KLK7, SPINK5, DEFB1, KDR, IL5RA, IL-5, IL-9 and IL12RB1,2 were compared between the two groups. “AD with ACD” was more common in female (p<0.001). Patients’ age and disease onset age were older in “AD with ACD” (p<0.001). “AD with ACD” patients had more personal and family histories about ACD (p<0.001). Nummular eczema was more common in “AD with ACD” (p=0.019). In multivariate logistic regression analysis, family history of ACD, female, older age had higher odds of ACD (9.82[3.38-30.26], 5.41[2.43-12.97], 1.07[1.05-1.10]). Receiver operating characteristics (ROC) curve analysis of age showed that optimal cutoff value was 7 years and the area under the ROC curve was 0.748 with the sensitivity of 95.3% and specificity of 43.9% (p<0.001). In multivariate logistic regression analysis with propensity score matching for age and gender, the heterozygous mutation in FLG 3321delA had higher odds of ACD (6.81 [1.09-131.79]). In conclusion, patients with AD who fall into one of the following cases, female over 7 years of aged, show nummular eczema, have heterozygous mutation in FLG 3321delA, should be suspected for accompanied ACD and patch test should be done.