Differential diagnoses of psoriasis
M. Alan Menter, Caitriona Ryan in Psoriasis, 2017
Allergic contact dermatitis is an inflammatory disorder that is initiated by contact with an allergen to which the person has previously been sensitized. The prevalence of allergic contact dermatitis is about 7% of the general population.22 It is uncommon in children. Clinically, there may be erythematous papules, small vesicles, or weeping plaques, which are usually pruritic (Figure 12.41 and 12.42). The lesions usually develop 12–48 hours following exposure to the allergen.22 Lesions may extend beyond the zone of contact.23,24 Causative agents may include cosmetics, fragrance, foods, plants, topical medicaments, and industrial chemicals (Figures 12.43 through 12.46).23 Allergic contact dermatitis is characterized in the very early stages by spongiosis, which is most marked in the lower epidermis.24 This is followed by the formation of spongiotic vesicles at different levels. The upper dermis contains a mild to moderately heavy infiltrate of lymphocytes, macrophages, and Langerhans cells, with accentuation around the superficial plexus.24 There is exocytosis of lymphocytes and sometimes eosinophils.24 Chronic lesions may show little spongiosis but prominent epidermal hyperplasia of psoriasiform type.24 Mild fibrosis may develop in the papillary dermis.
Trunk
Robin Lewallen, Adele Clark, Steven R. Feldman in Clinical Handbook of Contact Dermatitis, 2014
In cases of allergic contact dermatitis to a known allergen, avoidance of the culprit is recommended. One trick that patients with nickel allergies can try is to cover exposed metal with clear nail polish to prevent exposure to the nickel-containing surface. Jeans with nickel buttons treated with a clear coat of nail polish tested negative with dimethylglyoxime after two washes.13 There are commercially available nickel-detecting kits that can be used by patients to determine whether nickel is present in a particular item. When contact dermatitis is suspected from an unknown allergen, patients should be advised to avoid common allergens such as fragrances, preservatives, and dyes, and if the allergy persists, patch testing should be recommended.
Test Methods for Allergic Contact Dermatitis in Animals
Francis N. Marzulli, Howard I. Maibach in Dermatotoxicology Methods: The Laboratory Worker’s Vade Mecum, 2019
The most promising preventive measure for reducing the incidence of allergic contact dermatitis in a population is to limit the contamination of our environment with potential contact allergens U.S. Department of Health, Education, and Welfare, 1975). A skilled, selected, and properly performed animal assay on guinea pigs offers a useful tool to assess the sensitizing potential of individual chemicals as well as “end use” products (Andersen and Maibach, 1985a, 1985b). This becomes increasingly important as more predictive animal data become available for which a good correlation exists with epidemiological findings. It is of paramount importance in safety assessment that the difference between animal skin sensitizing risk and human health hazard is clearly stated. Thus, for the purpose of hazard evaluation, a positive result originating from animal sensitization assay does not necessarily mean that a hazard for humans exists, taking assumed exposure conditions to environmental contactants into consideration.
Comparison between patch test results of natural dyes and standard allergens in batik workers with occupational contact dermatitis
Published in Cutaneous and Ocular Toxicology, 2022
Eka Devinta Novi Diana, Suci Widhiati, Moerbono Mochtar, Muhammad Eko Irawanto
Occupational contact dermatitis (OCD) is a skin disease caused by contact with certain substances in the workplace. Occupational contact dermatitis is the second most common occupational disease, accounting for 15% of occupational diseases. Most cases of OCD are irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD), which is 80% of cases that affect the hands1. OCD is divided into ICD and ACD, both acute and chronic. ICD is a non-immunologic reaction that causes inflammation of the skin. Allergic contact dermatitis is a delayed-type hypersensitivity reaction due to exposure to allergens in sensitised individuals2. OCD remains a global burden whose highly related to repeated allergen and irritant exposure in the long term, with textile dyes substance as one of many risk factors of contact dermatitis3.
Comorbidity identification and referral in atopic dermatitis: a consensus document
Published in Journal of Dermatological Treatment, 2022
Javier Ortíz de Frutos, Gregorio Carretero, Raul de Lucas, Susana Puig, Esther Serra, Susana Gómez Castro, Francisco Rebollo Laserna, Estíbaliz Loza, Juan Francisco Silvestre-Salvador
Concerning allergic contact dermatitis: In AD, at the first visit/s and periodically during follow-up, allergic contact dermatitis should be actively ruled out, in both children and adults (LE 5; GR D; LA 83%)The impact of allergic contact dermatitis on AD patients should be carefully assessed, as it could significantly differ depending on the age at diagnosis; therefore, the clinical attitude should differ, as well (LE 5; GR D; LA 83%)Allergic contact dermatitis should be suspected if any of the following is present: AD with a poor or torpid clinical course, asymmetric locations, extensive flares, or 'atypical’ clinical forms (LE 5; GR D; LA 100%)
Allergic contact dermatitis of adjacent normal skin from 5-fluorouracil for the treatment of flat facial warts
Published in Baylor University Medical Center Proceedings, 2020
Usman Asad, Jeannie Nguyen, Ashley Sturgeon
5-FU has proven to be a safe and effective treatment for flat warts, both as monotherapy and combination therapy.3–5 Cases of irritant contact dermatitis localized to the site of 5-FU application have been reported; adverse effects have included hyperpigmentation, dryness, and erythema.6 However, allergic contact dermatitis on the adjacent normal skin from 5-FU is generally uncommon. In the few reported cases of allergic contact dermatitis, symptoms have included erythema, ulcerations, severe pruritus, and eczematous eruptions. We favored the diagnosis of allergic contact dermatitis over irritant contact dermatitis because our patient’s rash was widespread and present beyond the sites of 5-FU application. In addition, her rash was more severe and extensive than the irritant reaction seen from 5-FU, which generally does not consist of severe erythema, ulcerations, or erosions.
Related Knowledge Centers
- Allergen
- Blister
- Epidermis
- Inflammation
- Rash
- Allergic Contact Dermatitis
- Irritation
- Irritant Contact Dermatitis
- Immune Response
- Phototoxicity