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$Unique_ID{BRK03658}
$Pretitle{}
$Title{Dermatitis, Contact}
$Subject{Dermatitis, Contact Dermatitis Medicamentosa Dermatitis Venenata
Delayed Hypersensitivity Drug Hypersensitivity Irritant Contact Dermatitis
Allergic Contact Dermatitis Photoallergic and Phototoxic Contact Dermatitis
Atopic Dermatitis Dyshidrosis Psoriasis}
$Volume{}
$Log{}
Copyright (C) 1988, 1989, 1991, 1993 National Organization for Rare
Disorders, Inc.
571:
Dermatitis, Contact
** IMPORTANT **
It is possible that the main title of this article (Contact Dermatitis)
is not the name you expected. Please check the SYNONYM list to find the
alternate names and disorder subdivisions covered by this article.
Synonyms
Dermatitis Medicamentosa
Dermatitis Venenata
Delayed Hypersensitivity
Drug Hypersensitivity
DISORDER SUBDIVISIONS
Irritant Contact Dermatitis
Allergic Contact Dermatitis
Photoallergic and Phototoxic Contact Dermatitis
Information on the following disorders can be found in the Related
Disorders section of this report:
Atopic Dermatitis
Dyshidrosis
Psoriasis
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your physician and/or the agencies listed in the "Resources" section
of this report.
Contact Dermatitis is an acute or chronic skin inflammation triggered by
substances that come in contact with the skin. Allergic Contact Dermatitis
may be due to delayed hypersensitivity.
Symptoms
Contact Dermatitis is a common disorder characterized by skin inflammation
(dermatitis) and possibly blisters when the disorder is acute. Redness,
swelling (edema), oozing, crusting, scaling, burning pain and usually itching
may also occur. Scratching or rubbing may lead to thickening of the skin
with changed markings (lichenification).
Irritant Contact Dermatitis, when it is due to strong chemical irritants,
usually appears immediately after contact with the skin. When it is caused
by a milder irritant, the skin inflammation may take longer to become
apparent.
Allergic Contact Dermatitis represents a delayed allergic reaction; e.g.,
to poison ivy or certain medications such as aspirin or antibiotics. The
period between the time of exposure and appearance of symptoms may range from
a few hours to days or weeks. Patients may unexpectedly become
hypersensitive (allergic) to some of the dermatologic medications or
cosmetics that they may have used for years.
Photoallergic and Phototoxic Contact Dermatitis require exposure to light
following the application of certain chemicals. Reactions appear to be an
exaggerated response to sunlight. Chemicals that are commonly responsible
for Photoallergic Contact Dermatitis include aftershave lotions, perfumes,
and locally applied sulfonamides. Certain substances used in perfumes or
drugs (psoralens), coal tar, and cutting oils may also cause Photoallergic
Contact Dermatitis. Hypersensitivity to sunlight caused by certain types of
drugs are NOT a form of Photoallergic Contact Dermatitis. Rather, abnormal
reactions to sunlight are a side effect of these drugs (usually antibiotics.)
Causes
The list of agents that can cause Contact Dermatitis is endless since new
chemicals are manufactured constantly, and each person may be sensitive or
allergic to different substances. The disorder may be caused either by
irritants or by allergic sensitizers (allergens). Some of the more common
causative agents are:
1. Chemical irritants:
Rhus oleoresin (found in poison ivy and poison oak)
Acids
Alkalis
Free Formaldehyde used in permanent press clothing
Tanning agents used in the manufacture of shoes
Solvents
Oils
Plastics
Resins
Phenol
Acrylates
Chrome compounds (Chromates)
Mercury compounds
Nickel compounds
Cosmetics such as hair removers (depilatories), nail polish and nail
polish remover (acetone), or deodorants
Dyes such as Phenyldiamine and others
Rubber chemicals and antioxidants in gloves, shoes, elastic underwear,
and other wearing apparel
Petroleum products not used as solvents
Glass dust and fiberglass
2. Dermatologic Medications:
Local Anesthetics such as benzocaine
Antibiotics such as neomycin, penicillin, sulfonamides
Antihistamines such as diphenhydramine, promethazine
Antiseptics such as thimerosal, hexachlorophene
Preservatives such as parabens
Stabilizers such as ethylene diamine and substances derived from ethylene
diamine
3. Plant and wood substances:
Burning nettle
Citrus fruit
Poison ivy, oak, or sumac
Pink rot celery
Primrose
Ragweed
4. Physical agents:
Ionizing and nonionizing radiation
Wind
Sunlight
Temperature extremes
Humidity
5. Biological agents:
Bacteria
Viruses
Fungi
Ectoparasites such as mites, ticks, fleas, etc.
Sweat or saliva (particularly the saliva of house pets)
6. Mechanical factors:
Pressure
Friction
Vibration
Affected Population
Contact Dermatitis affects males and females of all ages in equal numbers.
Hypersensitivity usually increases with each subsequent exposure. Of all
occupational skin disorders in the United States, 90 percent are forms of
Contact Dermatitis. Persons who have allergies, asthma and hay fever should
stay away from jobs that put them in touch with water, dirt or chemicals.
Thirty percent of Contact Dermatitis are caused by irritants, 70% by
allergies.
In July 1991, the Centers for Disease Control (CDC) in Atlanta, GA,
reported cases of extreme life-threatening allergic reactions (anaphylactic
shock) to latex occuring in children with Spina Bifida who have undergone
surgery for Spina Bifida. Latex is commonly used in many medical products
such as gloves, endotracheal tubes, and urinary catheters. It has been
suggested that any elective surgery be postponed until the reason for the
increased risk of anaphalaxis in children with Spina Bifida can be
determined. If a surgical procedure cannot be postponed, then caution should
be taken to avoid or minimize any contact with latex.
Related Disorders
Symptoms of the following disorders may be similar to those of Contact
Dermatitis. Comparisons can be useful for a differential diagnosis:
Atopic Dermatitis (Besnier Prurigo; Atopic Eczema; Constitutional Eczema;
Disseminated Neurodermatitis) is a chronic, inherited form of eczema. The
disorder is characterized by red, oozing and weeping skin inflammation with
itching. Atopic Dermatitis can occur in three forms: infantile, childhood,
and adult eczema. Usually, the first two forms clear up during childhood.
The adult form may become either widespread over the body surface, or may be
limited to a small area; e.g. on the hands or scalp only.
Dyshidrosis (Difficult Sweating; Hand Eczema; Cheiropompholyx; Pompholyx)
is a disorder of unknown cause, characterized initially by deep-seated itchy
blisters or elevated spots usually on the sides of the fingers. Later, the
skin of the hands may become dry, scaly, hardened, and fissured. The feet
may also be affected.
Psoriasis is a common chronic and recurrent skin disorder characterized
by dry, well-circumscribed silvery gray scaling spots (papules) or plaques
which usually appear on the scalp, elbows, knees, back, or buttocks. In a
few cases, the entire body may be affected. (For more information, choose
"Psoriasis" as your search term in the Rare Disease Database.)
Therapies: Standard
Contact Dermatitis can almost always be prevented by a combination of
environmental, personal, and medical measures. Diagnosis of the disorder can
be made by blood tests for the immunoglobulin levels in the blood and skin
tests for delayed-hypersensitivity against specific agents causing the
reaction.
Treatment for Contact Dermatitis consists in removing the agent that
causes the skin inflammation whenever possible. For treatment of mild
Contact Dermatitis, over-the-counter hydrocortisone creams may b applied to
the affected areas. For acute severe cases, prednisone may be prescribed.
Antihistamines can be used to decrease itching, and antibiotics to treat
possible secondary bacterial infections. Local cortisone preparations can be
prescribed for chronic forms of Contact Dermatitis. Local treatment for
acute weeping Dermatitis includes the use of wet compresses (water or
aluminum subacetate) and cortisone lotions.
Therapies: Investigational
This disease entry is based upon medical information available through
February 1993. Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate. Please check with the agencies listed in the Resources section for
the most current information about this disorder.
Resources
For more information on Contact Dermatitis, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
Asthma and Allergy Foundation of America
1835 K Street, N.W., Suite P-900
Washington, DC 20007
(202) 293-2950
Allergy Information Association
25 Poynter Drive, Suite 7
Weston, Ontario, MR9 1K8
Canada
The National Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
Box AMS
Bethesda, MD 20892
(301) 495-4484
Eczema Association for Science and Education
1221 South West Yamhill, #303
Portland, OR 97205
(503) 228-4430
References
ALLERGIC CONTACT DERMATITIS IN CHILDREN: W.L. Weston, et al.; Am Journal
Dis Child (October 1984: issue 138(10)). Pp. 932-936.
HOUSEHOLD TREATMENT FOR "CHILE BURNS" OF THE HANDS: L.A. Jones, et al.;
Journal Toxicol Clin Toxicol (1987: issue 25(6)). Pp. 483-491.
LOCAL AND SYSTEMIC DESENSITIZATION INDUCED BY REPEATED EPICUTANEOUS
HAPTEN APPLICATION: G.H. Boerrigter, et al.; Journal Invest Dermatol
(January 1987: issue 88(1)). Pp. 3-7.
INTERNAL MEDICINE, 2nd ed.: Jay H. Stein, et al., eds; Little, Brown,
1987. Pp. 1377-1378, 2268-2269.