Objective:

To evaluate the prevalence of atopic dermatitis and patterns of allergen sensitization in patients with skin of color referred for patch testing.

Key Findings:

• Higher rates of atopic dermatitis were found in adults with skin of color (21%-38% in Black adults, 26% in Hispanic adults, 33% in Asian adults) compared to the general US population (10%).
• Among pediatric patients, 49%-67% had a diagnosis of atopic dermatitis.
• Black patients had a higher history of atopic dermatitis (13%) compared to White patients (9%).
• Certain allergens showed higher positive reactions in Black patients, such as p-phenylenediamine.
• Asian patients exhibited higher sensitization rates to cinnamic aldehyde, colophony, and nickel compared to White patients.
• Disparities in access to patch testing were noted, with Black patients representing 5% and Hispanic patients 2% of those tested despite their larger population percentages.

Interpretation:

The review suggests that allergic contact dermatitis may exacerbate atopic dermatitis severity in patients with skin of color, highlighting the need for increased awareness and testing.

Limitations:

• Most studies included were retrospective and heterogeneous.
• Causality between allergic contact dermatitis and atopic dermatitis severity could not be established.

Conclusion:

Physicians should consider contact allergy in patients with skin of color who have persistent or treatment-resistant atopic dermatitis and refer for patch testing when appropriate.