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Summary Background The association of atopic dermatitis (AD) and allergic contact dermatitis has been a matter of considerable uncertainty. Study results range from lack of any association to increased sensitization for multiple allergens, but fail to identify consistent allergen associations. Objective We studied a large patch test cohort of patients stratified by their atopic skin diathesis using the Erlangen Atopy Score (EAS), independent of active skin disease. Methods Retrospective multi‐center data analysis from five departments of dermatology in Germany with 4,509 patients. Patients were grouped as “no atopic skin diathesis” (n = 2,165) and “atopic skin diathesis” (n = 1,743), according to EAS. Results Significantly more individuals with atopic skin diathesis showed at least one positive patch test reaction to the baseline series compared to individuals without atopic skin diathesis (49.1 % vs. 38.3 %). In logistic regression analyses, atopic skin diathesis was associated with a significantly higher risk of sensitization to methylchloroisothiazolinone/methylisothiazolinone (OR 2.383) and methylisothiazolinone (OR 1.891), thiuram mix (OR 1.614), as well as nickel (OR 1.530), cobalt (OR 1.683), and chromium (OR 2.089). Conclusions Atopic skin diathesis proved to be the most important intrinsic risk factor for contact sensitization to few, specific allergens. Past or present AD was a less relevant variable.

Background Since the 1990s, gold has been recognized as an important contact allergen. Objectives Based on our results with gold sodium thiosulfate (GST) in the TRUE Test patch test system in the baseline series, the aims of the study were to evaluate baseline testing with gold salts worldwide and to discuss relevance. Methods Patients with positive patch test reactions to GST were questioned on exposure at day 7 reading. Results In a 1-year period, 89 (18.5%) of 480 patients tested positive to GST, making this the most frequent contact allergy. The 89 patients comprised 18 males and 71 females. The reaction was considered relevant in 21%; this is a minimum figure because 2 patients were withdrawn because of unknown relevance and because clinical features suggestive of gold contact allergy at distant sites, such as the face, were not taken into account. Altogether, 88% had been exposed. Worldwide, the prevalence of gold sensitization ranges between 0.78% and 30.7%, and relevance, in larger studies, has been between 15% and 20% of patients. The use of earrings and the presence of dental gold were important sources of exposure. Conclusions Because it may be difficult to diagnose gold allergy, screening may be recommended when history taken suggests gold exposure.

Contact allergies are common cause of eczema in all age groups and are one of the most common causes of occupational disability.Contact dermatitis can be divided into irritant and allergic contact dermatitis. Distinguishing between irritant and allergic triggers ofcontact dermatitis by clinical and histologic examinations can be challenging. The approach to patients with contact dermatitis should consist of a detailed (work and leisure) history, skin examination, patch tests with allergens based on history, physical examination, education on materials that contain the allergen and adequate therapy and prevention.