Derm
Allergic Contact Dermatitis
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Allergic Contact Dermatitis
, Contact Urticaria
See Also
Irritant Contact Dermatitis
Contact Dermatitis
Rhus Dermatitis
(
Poison Ivy
)
Contact Dermatitis of the Eyelid
Pathophysiology
Only occurs in genetically predisposed person
Agent specific immunologic cell-mediated response
Requires sensitization
Reaction can be induced by over 3000 chemical agents
Course
Develops 24-48 hours after exposure (6 hours to 7 days)
Can develop after years of continued exposure
Resolves after 2-3 weeks
Causes
Common
Nickel (less expensive jewelry)
Reaction occurs in 6% of persons exposed
Consider
Patch Testing
for nickel allergy
Nickel allergic patients can test jewelry for nickel
Spot test is commercially available
Consider irritant dermatitis from jewelry
Remove Jewelry when washing hands
Jewelry traps soap and lotions
Black hair dye
Topical medications
Mycolog
Neomycin
Benzocaine
Ethylenediamine
Merthiolate (Thimerosal)
Latex Allergy
(10-17% of health care workers)
Rhus Dermatitis
(reaction in 70% of those exposed)
Cosmetics (Fragrances and preservatives)
Occupational exposures
Potassium
dichromate (cement, dyes, textiles)
Welders
Painters, dyers, leather tanners, lithographers
Battery workers
Epoxy resin (adhesives, electrical casings)
High-tech workers (e.g. computers)
Cable workers
Pipe workers
Rosin (adhesives)
Rubber
(thiuram, mercaptobenzothiazole,
Carbamate
)
Surgery and cosmetic (acrylates: methyl methacrylate)
Dentists and Dental Technicians
Orthopedic surgeons
Dyes
Glyceryl monothioglycolate
Para-phenylene diamine (in paint-on
Tattoo
s)
Sports participation
See
Sport-related Contact Dermatitis
Causes
Tattoo
related reactions
Topical antibiotic reaction (e.g. Neosporin)
Dye reaction
Mercuric Sulfide (Red): Irritant
Cadmium (Yellow): Photo-reaction to sunlight
Symptoms
Severe
Pruritus
(early symptom)
Mild Pain or Burning at dermatitis site
Signs
Marked erythema and edema
Sharply demarcated lesion
Distribution is single most important clue
Numerous
Vesicle
s
Contrast with
Pustule
s in
Irritant Contact Dermatitis
Resources
Haz-Map (Occupational Exposure Database)
http://www.haz-map.com
References
Habif (1996) Clinical Dermatology, p. 84-94
Lushniak (2000) Prim Care 27(4):895-916 [PubMed]
Peate (2002) Am Fam Physician 66(6):1025-40 [PubMed]
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