Dermatitis I Allergic contact dermatitis I Atopic dermatitis Opinion statement Allergic contact dermatitis (ACD) is a type IV (delayed) hypersensitivity reaction that has a wide spectrum of presentations that often imitate or overlap with other cutaneous eruptions. Differential diagnoses to consider include infections, skin lymphoma-malignancies, inflammatory dermatoses, nutritional deficiencies, and mechanical causes of tissue damage. We discuss clues to the diagnosis of ACD, such as pruritus, localization to the area of skin contact with the allergen, recurrence with repeat exposures, and supportive skin biopsy histology. Epicutaneous patch testing remains the gold standard for diagnosing ACD. Definitive treatment is contact allergen avoidance and, when indicated, dietary restriction. With these measures, most patients will improve clinically. In cases where avoidance measures and interim topical therapies fail, ultraviolet light therapy or systemic immunosuppression may be considered. Key points 1. Allergic contact dermatitis (ACD) is a type IV (delayed) hypersensitivity reaction with a range of clinical presentations. 2. Mimickers of ACD include infections, skin lymphoma-malignancies, inflammatory dermatoses, nutritional deficiencies, and mechanical causes of tissue damage. 3. Allergen avoidance, which might include dietary restriction, is the definitive treatment for ACD.
Background: Eccrine chromhidrosis, or colored eccrine sweating, may be caused by contamination of sweat by dyes, pigmentation from microorganisms, or more rarely, hyperbilirubinemia. Pigment usually affects the palms and soles, where abundant sweat glands are found.Purpose, Material and Methods: We report a unique case of eccrine chromhidrosis in the setting of hyperbilirubinemia and review the current literature available on PubMed of previously reported cases.Results: Six patients with chromhidrosis have been previously reported in the setting of significant hyperbilirubinemia, in association with fever and thickened stratum corneum.Conclusions: Eccrine chromhidrosis secondary to hyperbilirubinemia is very rare, but can be diagnosed on the basis of classic clinical findings, dermoscopic examination, and negative tissue cultures.
Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. In this modality, there is transfer of patient medical information electronically (including history and visual data) obtained in one location to a provider who is in another location (Roman & Jacob, 2015). The construct of the TeleDermViewPoint column is such that cases are presented in a standardized teledermatology reader format reflective of an actual teledermatology report. This is a case of pink plaques on the face.
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