The Clinical Phenotype of Patients with Contact Polysensitization, a Retrospective Cohort

Background: Polysensitization, defined as contact sensitization to three or more allergens, is an allergic phenotype with a common genetic background. Our study aims to characterize the clinical features of patients with polysensitization. Methods: We analyzed patch test results of 5,082 patients from a designated contact dermatitis clinic in Tel Aviv between 2012 and 2022 and compared the polysensitized group with nonsensitized and oligosensitized patients, hence patients reacting to 1 or 2 allergens. Results: About 8.5% of patients were polysensitized. In the nonsensitized group, there were significantly fewer female patients and more children (P < 0.05) than in the polysensitized group. Asthma prevalence was linearly associated with the number of positive reactions in patch test. Polysensitized patients were more commonly suffering from hand eczema and an occupational etiology (P < 0.05). Textile dye mix, lyral, fragrance mix II, formaldehyde, colophonium, and p-phenylendiamine were more common sensitizers among the polysensitized group, whereas nickel sulfate, 2-hydroxyethyl methacrylate, fragrance mix 1, p-tert-butylphenol formaldehyde resin, and sodium metabisulfite were more common among the oligosensitized group. Conclusions: The association between polysensitization, asthma prevalence, and sensitization to volatile allergens raises an intriguing clinical phenotype. Further mechanistic studies are needed in this regard.