An epidemiological study of allergic contact dermatitis in Greece: prevalence of sensitization to an adapted European baseline series’ allergens

Anna Tagka, Alexandros Stratigos, Panagiotis Stavropoulos, Dimitrios Rigopoulos, Argiro Chatziioannou


Background: Contact dermatitis is a common skin disorder related to environmental exposures affecting, all age groups, and both genders. The pattern of contact sensitization to a series of allergens included in the European baseline series has already been studied for a number of EU countries by the ESSCA Network. The current study aims to explore the patterns of contact dermatitis in Greece through a patch test against a large number of allergens provoking contact dermatitis.

Methods: Retrospective analyses of routine data of 668 patients were collected during 2014 in the Laboratory of Patch Testing, National Referral Centre of Occupational Dermatoses. Sensitization in all cases was tested with a battery of 28 allergens of the European baseline series and additional ones aiming to identify new sensitizations to inform the National baseline of allergens; information for an extended MOAHLFA index was also collected.

Results: One at least positive result was found in 61.5% of the patients while 19.1% of those found to be sensitized in two or more allergens. Nickel sulphate, fragrance mix and balsam of Peru were the most prevalent allergens in the total population, as well as with respect to gender. Nickel is the most frequent allergen of baseline series, a result which is in agreement with other reports.

Conclusions: Allergic contact dermatitis surveillance is of great importance towards the clinical and systematic understanding of the disease. Further studies should be directed towards that end, in order to facilitate more effective health policies.


Contact dermatitis, Sensitization, Allergen, Prevalence, Greece

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Mowad CM, Anderson B, Scheinman P, Pootongkam S, Nedorost S, Brod B. Allergic contact dermatitis: Patient management and education. J Am Acad Dermatol. 2016;74:1043-54.

Johansen JD, Aalto-Korte K, Agner T, Andersen KE, Bircher A, Bruze M, et al. European Society of Contact Dermatitis guideline for diagnostic patch testing - recommendations on best practice. Contact Dermatitis. 2015;73:195-221.

Peiser M, Tralau T, Heidler J, Api AM, Arts JH, Basketter DA, et al. Allergic contact dermatitis: epidemiology, molecular mechanisms, in vitro methods and regulatory aspects. Current knowledge assembled at an international workshop at BfR, Germany. Cell Mol Life Sci. 2012;69:763-81.

Uter W, Schnuch A, Wilkinson M, Dugonik A, Dugonik B, Ganslandt T. Registries in Clinical Epidemiology: the European Surveillance System on Contact Allergies (ESSCA). Methods Inf Med. 2016;55:193-9.

Uter W, Gefeller O, Gimenez-Arnau A, Frosch P, Duus Johansen J, Schuttelaar ML, et al. Characteristics of patients patch tested in the European Surveillance System on Contact Allergies (ESSCA) network, 2009-2012. Contact Dermatitis. 2015;73:82-90.

Uter W, Amario-Hita JC, Balato A, Ballmer-Weber B, Bauer A, Belloni Fortina A, et al. European Surveillance System on Contact Allergies (ESSCA): results with the European baseline series, 2013/14. J Eur Acad Dermatol Venereol. 2017;31:1516-25.

Uter W, Rustemeyer T, Wilkinson M,Duus Johansen J. Quality in epidemiological surveillance of contact allergy. Contact Dermatitis. 2016;74:175-80.

Hanifin JM,Rajka G. Diagnostic features of atopic dermatitis. Acta Derm. Venereol. 1980;60:44-7.

Schnuch A. PAFS: population-adjusted frequency of sensitization. (I) Influence of sex and age. Contact Dermatitis. 1996;34:377-82.

Uter W, Schnuch A, Gefeller O. Allergies EwgESSoC. Guidelines for the descriptive presentation and statistical analysis of contact allergy data. Contact Dermatitis. 2004;51:47-56.

Ahmad OB, Boschi Pinto C,Lopez AD, Age Standardization of Rates: A New WHO Standard. 2001: 10-12.

Uter W, Hegewald J, Aberer W, Ayala F, Bircher AJ, Brasch J, et al. The European standard series in 9 European countries, 2002/2003 -- first results of the European Surveillance System on Contact Allergies. Contact Dermatitis. 2005;53:136-45.

Heisterberg MV, Menne T,Johansen JD. Fragrance allergy and quality of life - a case-control study. Contact Dermatitis. 2014;70:81-9.

Kadyk DL, McCarter K, Achen F,Belsito DV. Quality of life in patients with allergic contact dermatitis. J Am Acad Dermatol. 2003;49:1037-48.

Dittmar D, Uter W, Bauer A, Fortina AB, Bircher AJ, Czarnecka-Operacz M, et al. European Surveillance System on Contact Allergies (ESSCA): polysensitization, 2009-2014. Contact Dermatitis. 2018;78:373-85.

Uter W, Gefeller O, Geier J,Schnuch A. Contact sensitization to cobalt--multifactorial analysis of risk factors based on long-term data of the Information Network of Departments of Dermatology. Contact Dermatitis. 2014;71:326-37.

Thyssen JP, Johansen JD, Menne T, Nielsen NH,Linneberg A. Nickel allergy in Danish women before and after nickel regulation. N Engl J Med. 2009;360:2259-60.

Thyssen JP, Menne T, Johansen JD. Nickel release from inexpensive jewelry and hair clasps purchased in an EU country - Are consumers sufficiently protected from nickel exposure? Sci Total Environ. 2009;407:5315-8.

Thyssen JP, Menne T, Linneberg A, Johansen JD. Contact sensitization to fragrances in the general population: a Koch's approach may reveal the burden of disease. Br J Dermatol. 2009;160:729-35.

Thyssen JP, Menne T, Schnuch A, Uter W, White I, White JM, et al. Acceptable risk of contact allergy in the general population assessed by CE-DUR--a method to detect and categorize contact allergy epidemics based on patient data. Regul Toxicol Pharmacol. 2009;54:183-7.