Allergic contact dermatitis
Last Updated: 2021-04-27
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
- Epicutaneous testing
In some cases the implementation of a ROAT (repeated open application test) can be useful.
- 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.
- Moisturizing local therapy
- Clobetasone propionate cream/ ointment
- Mometasone fluroate cream/solution/ointment
- Clobetasol foam/skin spray/emulsion/shampoo
- 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
- Schnuch A, Uter W, Reich K. Allergic Contact Dermatitis and Atopic Eczema. Handbook of Atopic Eczema: Springer Science + Business Media:178-201.
- Saint-Mezard P, Rosieres A, Krasteva M, et al. Allergic contact dermatitis. Eur J Dermatol 2004;14:284-95.
- Gober MD, Gaspari AA. Allergic contact dermatitis. Curr Dir Autoimmun 2008;10:1-26.
- 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.
- Usatine RP, Riojas M. Diagnosis and management of contact dermatitis. Am Fam Physician 2010;82:249-55.