Atopic dermatitis in the European general population: The EDEN Fragrance study

M.L.A. Schuttelaar, R.F. Ofenloch, M. Bruze, P. Elsner, M. Gonçalo, L. Naldi, A. Svensson, T.L. Diepgen

Research output: Contribution to journalMeeting AbstractAcademic


OBJECTIVES: To determine the prevalence of atopic dermatitis (AD) in the general European population and to assess differences in contact allergy and avoidance of products between subjects with AD in lifetime and those who had not. MATERIALS AND METHODS: In five European countries (The Netherlands, Germany, Italy, Portugal and Sweden) a random sample of 12 377 participants, aged 18 to 74 years were interviewed using a standardized questionnaire. Questions were asked about previous atopic dermatitis and avoidance of products because of a skin reaction. A random sample of 3119 participants was patch tested. TRUE Test panel 1, 2 and 3 and investigator-loaded chamber systems were used, testing for a total of 47 allergens, including the individual fragrance allergens of fragrance mix (FM) I and FM II. Reading was performed at day 3. RESULTS: The physician-diagnosed lifetime prevalence of AD was 7.1% (95% CI 6.7-7.6). The age-standardized physician diagnosed life time prevalences of AD stratified per country were: Germany: 9.4% (95% CI 8.5-10.3); The Netherlands: 8.5% (95% CI 7.2-10.1); Sweden: 7.2% (95% CI 6.1-8.4); Italy 4.2% (95% CI 3.3-5.3); Portugal: 3.3% (95% CI 2.6-4.2). The prevalence of contact allergy to at least one allergen was not significantly different between those with AD in lifetime (31.1%) and those without AD (27.8%). Males with AD were significantly more sensitized to allergens of TRUE Test panel 2 (14.9%) than those without AD (6.9%) (P = .026). The prevalence of contact allergy to individual allergens was not significantly different for those with AD and those without, except for p-phenylenediamine in males: AD (4.0%), no AD (0.7%) (P = .023). The prevalence of a positive patch test reaction to the group of preservatives was slightly albeit not significant (P <.09) higher in subjects with AD in lifetime (8.9%) compared to those without (6.2%). Subjects with AD in lifetime reported significantly more avoidance of products because of any skin reaction compared to subjects without AD, regarding leave on products, rinse off products, household products, jewels/metals and topical medication (all differences significant P <.001). This avoidance behaviour was independent from having a contact allergy and could be replicated in AD patients with and without contact allergy. CONCLUSION: The lifetime prevalence of atopic dermatitis was higher in Germany, the Netherlands and Sweden compared with Italy and Portugal. Although patients with atopic dermatitis reported significantly more avoidance of products due to skin problems they were not more frequently sensitized.
Original languageEnglish
Pages (from-to)19
Number of pages1
Issue numberSuppl.1
Publication statusPublished - 1-Oct-2018
Event14th Congress of the European Society of Contact Dermatitis (ESCD), 18–20 October 2018, Milan, Italy - Milan, Italy
Duration: 17-Oct-201820-Oct-2018
Conference number: 14


  • allergen
  • domestic chemical
  • fragrance
  • phenylenediamine
  • adult
  • aged
  • allergy rapid test
  • atopic dermatitis
  • avoidance behavior
  • conference abstract
  • contact allergy
  • controlled study
  • diagnosis
  • Germany
  • human
  • human tissue
  • Italy
  • major clinical study
  • male
  • Netherlands
  • patch test
  • physician
  • population
  • Portugal
  • prevalence
  • questionnaire
  • random sample
  • skin manifestation
  • Sweden
  • topical drug administration

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