New aspects of allergic dermatoses

This review reports new elements published this year in three different areas concerning allergic dermatoses. In patients with atopic dermatitis, systematic allergological surveys have demonstrated the frequency of contact sensitisation reactions. The allergens usually responsible are metals, perfumes, Peru balsam, para bens and lanolin. The role of airborne allergens in atopic dermatitis remains controversial. The relevance of skin tests to respiratory allergens must be established on the basis of clinical and chronological arguments. The responsibility of airborne allergens is suspected when the lesions predominantly affect air-exposed zones and are triggered by contact with certain airborne allergens. Recent studies suggest the reole of autoimmune phenomena in atopic dermatitis. An IgE immune response could be induced by enviromental allergens then maintained by autoantigens structurally related to exogenous allergens. Several recent studies emphasize the severity of some allergies to non-steroidal anti-inflammatory drugs and the possibility of cross-allergy : contact photo-allergy to ketoprofen with crossed photoallergy to fenofibrate, photoallergy to piroxicam in patients with contact allergy to thiomersal, sensitisations to bufexamac, systemic and local reactions to diclofenac. Several recent publications have reported cases of sensitisation to antifungal agents : imidazoles, tioconazole, ciclopiroxolamine or amorolfine. All local and/or systemic allergy reactions induced by topical drugs must be declared to pharmacovigilance centres.