European Surveillance System on Contact Allergies (ESSCA): polysensitization, 2009-2014

Daan Dittmar, Wolfgang Uter, Andrea Bauer, Anna B. Fortina, Andreas J. Bircher, Magdalena Czarnecka-Operacz, Aleksandra Dugonik, Peter Elsner, Rosella Gallo, Sharizan A. Ghaffar, Anna Giménez-Arnau, Graham A. Johnston, Beata Kręcisz, Francesca L. Filon, Thomas Rustemeyer, Anna Sadowska-Przytocka, Javier Sánchez-Pérez, Axel Schnuch, Dagmar Simon, Radoslaw SpiewakPhilipp Spring, Maria T. Corradin, Skaidra Valiukevičienė, Marko Vok, Elke Weisshaar, Mark Wilkinson, Marie L. Schuttelaar (Lead / Corresponding author), for the ESSCA Network

    Research output: Contribution to journalArticlepeer-review

    17 Citations (Scopus)


    Background: Polysensitization, defined as being allergic to three or more haptens from the European baseline series, is considered to reflect increased susceptibility to developing a contact allergy, and is likely to be associated with an impaired quality of life.

    Objectives: To evaluate the prevalences of polysensitization across Europe and to analyse factors associated with polysensitization.

    Methods: Patch test data collected by the European Surveillance System on Contact Allergies (ESSCA; in consecutively patch tested patients from January 2009 to December 2014, comprising 11 countries and 57 departments, were retrospectively analysed.

    Results: A total of 86 416 patients were available for analysis, showing a standardized prevalence of polysensitization of 7.02%, ranging from 12.7% (Austria) to 4.6% (Italy). Allergen pairs with the strongest association are reported for the total population, for South Europe, and for North/Central Europe. Overall, polysensitized patients showed a higher percentage of extreme (+++) positive patch test reactions than oligosensitized patients. Female sex, occupational dermatitis and age > 40 years were risk factors for polysensitization.

    Conclusions: The varying prevalences of polysensitization across Europe most likely reflect differences in patient characteristics and referral patterns between departments. Known risk factors for polysensitization are confirmed in a European dermatitis population.

    Original languageEnglish
    Pages (from-to)373-385
    Number of pages13
    JournalContact Dermatitis
    Issue number6
    Early online date22 Feb 2018
    Publication statusPublished - Jun 2018


    • Journal article
    • Clinical epidemiology
    • Contact allergy
    • Patch test
    • Polysensitization
    • contact allergy
    • clinical epidemiology
    • patch test
    • polysensitization
    • Prevalence
    • Humans
    • Middle Aged
    • Patch Tests/statistics & numerical data
    • Dermatitis, Allergic Contact/epidemiology
    • Young Adult
    • Europe/epidemiology
    • Adult
    • Retrospective Studies
    • Allergens/immunology
    • Dermatitis, Atopic/epidemiology
    • Population Surveillance

    ASJC Scopus subject areas

    • Dermatology
    • Immunology and Allergy


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