Allergic contact dermatitis

Last Updated: 2021-04-27

Author(s): -

Contact eczema, contact allergic dermatitis, contact allergic eczema, contact allergy, contact dermatitis, allergic contact dermatitis.

Type IV allergy mediated by sensitized T lymphocytes in contact exposure to triggering allergens. In some cases, contact by very fine droplets in the ambient air (primroses, paints) may also be the cause.

  • Prevalence in the population between 5-30% (depending on source). It is well known how many % of the tested people are allergic to the different allergens - but what percentage of the population can actually be tested is less studied. 
  • Women > Men
  • Acute allergic contact dermatitis
  • Chronic allergic contact dermatitis
  • Medical history
  • Clinical features
  • Biopsy
  • Epicutaneous testing

In some cases the implementation of a ROAT (repeated open application test) can be useful.

Exposure prophylaxis

  • Topical therapy
  • For acute eczema, a watery ointment base is used (adheres better, less occlusion!), while for sub-acute or chronic eczema, a greasy ointment base is recommended.

 

Topical Therapy

  • Moisturizing local therapy
  • Clobetasone propionate cream/ ointment
  • Mometasone fluroate cream/solution/ointment
  • Clobetasol foam/skin spray/emulsion/shampoo

 

Systemic Therapy

  • Prednisolone p.o. 25-100 mg 1x a day 
  • Levocetirizine p.o. 5 mg 1x a day
  • Desloratadine p.o. 5 mg 1x a day
  • Fexofenadine p.o. 180 mg 1x a day

 

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  3. Gober MD, Gaspari AA. Allergic contact dermatitis. Curr Dir Autoimmun 2008;10:1-26.
  4. Molin S, Vollmer S, Weiss EH, Ruzicka T, Prinz JC. Filaggrin mutations may confer susceptibility to chronic hand eczema characterized by combined allergic and irritant contact dermatitis. British Journal of Dermatology 2009;161:801-7.
  5. Usatine RP, Riojas M. Diagnosis and management of contact dermatitis. Am Fam Physician 2010;82:249-55.