Transcript Contact dermatitis - UCI Department of Emergency Medicine

William Pinette
30 July, 2010
Toxicodendron diversilobum, Poison-oak
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Contact Dermatitis:
“Contact dermatitis is an eczematous skin reaction caused
by direct and usually repeated exposure to harmful objects or
chemicals … It is typically characterized by itching papules ...
but may vary from slight hyperkeratosis ... and small fissures to
extensive redness, swelling and oozing. A histopathological
examination of a biopsy shows an acute inflammation in the
epidermis.”
– European Society for Contact Dermatitis
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Allergic Contact Dermatitis
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Irritant Contact Dermatitis
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Immune response
 Delayed Type Hypersensitivity
 T lymphocytes
Allergens
 Toxicodendron
 Urushiol
 Nickel and other metals
 Latex
 Chemicals
 Formaldehyde
 Perfume
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No direct immune response
Exposure to irritants that compromise
the epithelium in various ways
Industrial Solvents
 Oil products
 Hair products
 Dimethyl Fumarate
(DMF)
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ACD
Cannot “cure” the immune system.
 Avoid exposure to allergen
 Wash affected area with soap and cool water
 Corticosteroids and antihistamine for more severe
cases
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ICD
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Avoid prolonged exposure to irritants
Personal protective equipment
Barrier creams
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What is contact dermatitis? European Society of Contact
Dermatitis. http://www.escd.org/aims/contact_dermatitis
Kalish RS, Johnson KL. Enrichment and function of urushiol (poison-ivy)specific T Lymphocytes in lesions of allergic contact dermatitis to
urushiol. J Immunol.(1990) 145: 3706-3713
Niyama et. al. Th2 Immune Response Plays a Critical Role in the
Development of Nickel-Induced Allergic Contact Dermatitis. Int Arch
Allergy Immunol (2010). 153: 303–314
Gimenez-Arnaui et al. Shoe contact dermatitis from dimethyl fumarate:
clinical manifestations, patch test results, chemical analysis, and source of
exposure. Contact Dermatitis (2009) 61: 249–260
Chew IL, Maibach HI. Occupational issues of irritant contact dermatitis.
Int Arch Occup Environ Health (2003) 76: 339–346