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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.
-
-