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Immunology and Allergy Clinics of North... Feb 2017Allergic contact dermatitis (ACD) is a common skin disease caused by a T cell-mediated immune reaction to usually innocuous allergens. ACD can have grave medical and... (Review)
Review
Allergic contact dermatitis (ACD) is a common skin disease caused by a T cell-mediated immune reaction to usually innocuous allergens. ACD can have grave medical and socioeconomic consequences. ACD and irritant contact dermatitis often occur together. A detailed history and clinical examination are crucial and guide patch testing, which is the gold standard to diagnose ACD. T-cell clones persisting in the skin may explain the tendency of ACD to relapse even after years of allergen avoidance. Traditional treatments for ACD are topical steroids, calcineurin inhibitors, phototherapy, retinoids (including the recent alitretinoin), and immunosuppressants. Targeted therapies are lacking.
Topics: Allergens; Dermatitis, Allergic Contact; Dermatitis, Irritant; Diagnosis, Differential; Humans; Occupational Exposure; Patch Tests; Skin
PubMed: 27886903
DOI: 10.1016/j.iac.2016.08.014 -
The Journal of Allergy and Clinical... Apr 2022Contact dermatitis is a common disease that is caused by repeated skin contact with contact allergens or irritants, resulting in allergic contact dermatitis (ACD) and/or... (Review)
Review
Contact dermatitis is a common disease that is caused by repeated skin contact with contact allergens or irritants, resulting in allergic contact dermatitis (ACD) and/or irritant contact dermatitis. Attempts have been made to identify biomarkers to distinguish irritant and allergic patch test reactions, which could aid diagnosis. Some promising candidates have recently been identified, but verification and validation in clinical cases still need to be done. New causes of ACD are constantly being recognized. In this review, 10 new contact allergens from recent years, several relating to anti-aging products, have been identified. Frequent allergens causing considerable morbidity in the population, such as the preservative methylisothiazolinone, have been regulated in the European Union. A significant drop in the number of cases has been seen, whereas high rates are still occurring in other areas such as North America. Other frequent causes are fragrance allergens, especially the widely used terpenes and acrylates found in medical devices for control of diabetes. These represent unsolved problems. Recent advances in immunology have opened the way for a better understanding of the complexity of contact dermatitis, especially ACD-a disease that may be more heterogenous that previous understood, with several subtypes. With the rapidly evolving molecular understanding of ACD, the potential for development of new drugs for personalized treatment of contact dermatitis is considerable.
Topics: Allergens; Dermatitis, Allergic Contact; Dermatitis, Irritant; Humans; Irritants; Patch Tests
PubMed: 35183605
DOI: 10.1016/j.jaci.2022.02.002 -
Contact Dermatitis May 2022Hand eczema is a common inflammatory skin disorder. Health care providers need continuously updated information about the management of hand eczema to ensure best...
BACKGROUND
Hand eczema is a common inflammatory skin disorder. Health care providers need continuously updated information about the management of hand eczema to ensure best treatment for their patients.
OBJECTIVES
To update the European Society of Contact Dermatitis guideline on the diagnosis, prevention, and treatment on of hand eczema.
METHOD
The Guideline Development Group (GDG) was established on behalf of the ESCD. A call for interest was launched via the ESCD website and via the ESCD members' mailing list. Appraisal of the evidence for therapeutic and preventive interventions was applied and a structured method of developing consensus was used and moderated by an external methodologist. The final guideline was approved by the ESCD executive committee and was in external review on the ESCD webpage for 1 month.
RESULTS
Consensus was achieved for several statements and management strategies.
CONCLUSION
The updated guideline should improve management of hand eczema.
Topics: Dermatitis, Allergic Contact; Eczema; Hand Dermatoses; Humans; Patch Tests
PubMed: 34971008
DOI: 10.1111/cod.14035 -
Current Allergy and Asthma Reports Apr 2023Occupational hand dermatitis is a common work-related disorder of the skin. Prevention and management of this disease is critical to improving workers' quality of life... (Review)
Review
PURPOSE OF REVIEW
Occupational hand dermatitis is a common work-related disorder of the skin. Prevention and management of this disease is critical to improving workers' quality of life and for occupation-specific retention.
RECENT FINDINGS
This is a critical review of the current literature on occupational hand dermatitis. Occupational dermatitis continues to have a high prevalence among workers although the overall incidence may be slowly decreasing. Irritant contact dermatitis due to wet work exposure is the most common cause of occupational hand dermatitis. Healthcare workers, hairdressers, and metal workers are at particularly high risk for this disease. While some prevention programs have been ineffective in mitigating occupational hand dermatitis, other more resource-intensive initiatives may have benefit. Continued research is needed on ways to manage wet work exposures and on scalable, effective prevention programs for occupational hand dermatitis. The spectrum of culprit contact allergens continues to evolve, and vigilance for potential occupation-specific allergens remains important.
Topics: Humans; Dermatitis, Occupational; Dermatitis, Allergic Contact; Quality of Life; Allergens; Skin; Occupational Exposure; Patch Tests
PubMed: 36749448
DOI: 10.1007/s11882-023-01070-5 -
Indian Journal of Dermatology,... 2019
Topics: Dermatitis, Atopic; Humans; Immunoglobulin E; Patch Tests; Reagent Kits, Diagnostic
PubMed: 30058560
DOI: 10.4103/ijdvl.IJDVL_397_17 -
Cureus Oct 2021Reactions caused by photosensitivity, also called photodermatosis, are cutaneous reactions induced or exacerbated by exposure to electromagnetic radiation, including UV...
Reactions caused by photosensitivity, also called photodermatosis, are cutaneous reactions induced or exacerbated by exposure to electromagnetic radiation, including UV radiation, visible light, and infrared radiation. We present the case of a 41-year-old man with no personal history of allergy and who is referred to our Drug Allergy Unit for study. We performed a conventional patch test (non-irradiated) and photopatch (with the application of UVA) with reading at 48 and 96 hours and 24 hours after irradiation with an intensity of 5J/cm2. Drug-induced photosensitivity can manifest itself in two clinically indistinguishable forms: photoallergy and phototoxicity. Photoallergic reactions are due to an immunological response of type IV hypersensitivity (a cell-mediated mechanism). We present a case of photoallergy due to sensitization to naproxen, confirmed by photopatch tests.
PubMed: 34812328
DOI: 10.7759/cureus.18961 -
Actas Dermo-sifiliograficas Apr 2023Atopic dermatitis is a chronic inflammatory disease that is multifactorial in nature. Allergic contact dermatitis and protein contact dermatitis are allergic conditions... (Review)
Review
Atopic dermatitis is a chronic inflammatory disease that is multifactorial in nature. Allergic contact dermatitis and protein contact dermatitis are allergic conditions that may occur in the context of atopic dermatitis and be the cause of exacerbations. Although the prevalence of allergic contact dermatitis is similar in atopic patients and the general population, these 2 conditions are frequently associated because atopic inflammation disrupts the skin barrier. Skin tests are therefore recommended in atopic individuals. Dupilumab could be useful for treating allergic contact dermatitis if it is mediated by type 2 helper T cells but could exacerbate inflammation if mediated by T1 cells: further study is needed before conclusions can be drawn. Although the mechanism by which exposure to environmental proteins exacerbates atopic dermatitis remains under discussion, such exacerbations are routinely seen in clinical practice. Prick testing is recommended in symptomatic atopic dermatitis. When prick-test findings are positive, patients should be advised to avoid the culprit substances.
Topics: Humans; Dermatitis, Atopic; Haptens; Patch Tests; Dermatitis, Allergic Contact; Inflammation; Allergens
PubMed: 36529271
DOI: 10.1016/j.ad.2022.11.009 -
Actas Dermo-sifiliograficas Mar 2016Corticosteroids are widely used drugs in the clinical practice, especially by topic application in dermatology. These substances may act as allergens and produce... (Review)
Review
Corticosteroids are widely used drugs in the clinical practice, especially by topic application in dermatology. These substances may act as allergens and produce immediate and delayed hypersensitivity reactions. Allergic contact dermatitis is the most frequent presentation of corticosteroid allergy and it should be studied by patch testing in specific units. The corticosteroids included in the Spanish standard battery are good markers but not ideal. Therefore, if those makers are positive, it is useful to apply a specific battery of corticosteroids and the drugs provided by patients. Immediate reactions are relatively rare but potentially severe, and it is important to confirm the sensitization profile and to guide the use of alternative corticosteroids, because they are often necessary in several diseases. In this article we review the main concepts regarding these two types of hypersensitivity reactions in corticosteroid allergy, as well as their approach in the clinical practice.
Topics: Adrenal Cortex Hormones; Allergens; Dermatitis, Allergic Contact; Humans; Hypersensitivity, Delayed; Patch Tests
PubMed: 26621334
DOI: 10.1016/j.ad.2015.09.012 -
Giornale Italiano Di Dermatologia E... Jun 2018Contact allergies are common cause of eczema in all age groups and are one of the most common causes of occupational disability. Contact dermatitis (CD) can be divided... (Review)
Review
Contact allergies are common cause of eczema in all age groups and are one of the most common causes of occupational disability. Contact dermatitis (CD) can be divided into irritant and allergic contact dermatitis. Distinguishing between irritant and allergic triggers of CD by clinical and histologic examinations can be challenging. The approach to patients with CD should consist of a detailed (work and leisure) history, skin examination, patch tests with allergens based on history, physical examination, education on materials that contain the allergen and adequate therapy and prevention.
Topics: Allergens; Dermatitis, Allergic Contact; Dermatitis, Irritant; Dermatitis, Occupational; Eczema; Humans; Patch Tests
PubMed: 29199804
DOI: 10.23736/S0392-0488.17.05844-8 -
Actas Dermo-sifiliograficas Jun 2022Rosacea is a chronic acneiform skin disorder in which impaired skin barrier function can lead to sensitization to allergens. We aimed to analyze contact allergies in our...
BACKGROUND AND OBJECTIVE
Rosacea is a chronic acneiform skin disorder in which impaired skin barrier function can lead to sensitization to allergens. We aimed to analyze contact allergies in our patients with rosacea.
MATERIAL AND METHODS
Retrospective cohort study of all patients who underwent patch testing in our skin allergy clinic between May 1991 and May 2019.
RESULTS
A total of 200 patients with rosacea were referred to our clinic for patch testing during the study period; they represented 2.1% of all patch tested patients in the period. Eighty-one percent were women (mean age, 44.7years). At least 1positive patch test was recorded for 46.5%; 15% were of current relevance. The most frequent positive reaction was to nickel (26%), followed by cobalt chloride (6.5%), isothiazolinones (6%), p-phenylenediamine (5.5%), fragrance mixII (5%), and thimerosal (3.5%). The most common currently relevant patch test reactions were to isothiazolinones in 10 of the 200 patients (5%); to phenylenediamine, fragrance mixII, and toluensulfonamide formaldehyde resin in 4 patients (2%) each; and to tixocortol and fragrance mixI in 2 patients (1%) each. The allergen groups most often implicated were metals (of current relevance in 12.6%) and drugs (of current relevance in 25.8%). Preservatives and fragrances were the next most common allergen groups, and 70.8% and 43.7% of the positive reactions in these groups, respectively, were of current relevance. Cosmetics were the most frequent source of sensitization, followed by topical medications - notably corticosteroids and antifungal agents.
CONCLUSIONS
We emphasize the high prevalence of allergic contact dermatitis in patients with rosacea, a finding which supports patch testing, especially if eruptions worsen when these patients use cosmetics and topical medications.
Topics: Adult; Allergens; Cosmetics; Dermatitis, Allergic Contact; Female; Glucocorticoids; Humans; Male; Patch Tests; Retrospective Studies; Rosacea
PubMed: 35288101
DOI: 10.1016/j.ad.2022.02.026