Diagnostic approach in allergic and irritant contact dermatitis

Abstract

Contact dermatitis is a highly frequent disease with a significant impact on the quality of life of the affected patients and a relevant socioeconomic impact. According to the pathophysiological mechanisms involved, two major types of contact dermatitis may be recognized: irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD). The two types may, and often do, coexist. Differentiating between ICD and ACD is often difficult in the clinical setting. The basis for a diagnosis of either ICD or ACD is mainly established by a comprehensive clinical history and physical examination, as well as by performing appropriate diagnostic patch testing. The only useful and reliable method for the diagnosis of ACD remains the patch test. Positive patch test results, the current and/or past relevance of which has to be assessed, are confirmative of contact sensitization. Additional tests, such as the repeated open application test or the provocative use test, are sometimes necessary to confirm a causal relationship. This algorithmic diagnostic approach will allow the adoption of rational measures of allergen or irritant avoidance and the implementation of realistic patient information and education.

Insulin-like growth factor-1 induces regulatory T cell-mediated suppression of allergic contact dermatitis in mice

“…Clinical symptoms of ACD include itching with erythema, vesicles and blisters during acute phase, and cracks and fissures in the chronic phase (Usatine and Riojas, 2010). ACD can have a significant influence on the quality of life of affected individuals in addition to a considerable socio-economic impact (Kimber et al, 2002; Ale and Maibacht, 2010). Knowledge of the molecular mechanisms and the pathophysiology of ACD has mainly been derived from contact hypersensitivity (CHS) animal models in which skin inflammation is induced by painting the skin with haptens such as 2,4-dinitrofluorobenzene (DNFB) (Simonetta and Bourgeois, 2011).…”

Osteopontin and allergic disease: pathophysiology and implications for diagnostics and therapy

“…Immunol. 7(1), (2011) identified by the immune system as pathogenic, a delayed cellmediated response occurs that eventually leads to eczema at the contact site within 12-24 h (allergic contact dermatitis [ACD]); however, this may also spread to other skin locations and eventually become chronic [13].…”

Contact Dermatitis Following Use of Tropical Traditional Medicine

“…Factors affecting the severity of the lesions include the concentration of the product, extent of application, duration of exposure and host susceptibility. Personal or family history of atopy increases the risk of developing contact dermatitis due to the presence of abnormal skin barrier function (Ale & Maibacht 2010). In the present case, it was unknown whether the adverse reaction produced is due to the herbal, menthol or camphor component in the ointment as the patient refused further testing using patch test.…”