Allergic Contact Dermatitis

Allergic contact dermatitis is an inflammatory skin condition caused by an allergic reaction to substances that come into contact with the skin. It results in redness, itching, and inflammation, sometimes accompanied by blistering. The condition occurs only in areas exposed to the allergen. Common triggers include certain metals, fragrances, preservatives, and plants.

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Key Points

What is allergic contact dermatitis?

Allergic contact dermatitis is a skin reaction triggered by an allergy to a specific substance that comes into contact with the skin. Unlike irritant contact dermatitis, it involves an immune response and typically affects only the area of contact.

Who gets allergic contact dermatitis?

Anyone can develop allergic contact dermatitis, but individuals with a history of allergies or atopic conditions such as asthma or hay fever may be more susceptible. It can develop at any age and affects people of all skin types.

Clinical features

Symptoms include red, itchy, and swollen skin at the contact site, which can sometimes progress to blistering and weeping lesions. The reaction typically appears 24-48 hours after exposure (rarely immediately) and can last several weeks.

Diagnosis and differential diagnosis

Diagnosis is often made based on the history of exposure to potential allergens and the clinical appearance. Patch testing is the standard method for identifying specific allergens. It’s important to differentiate allergic contact dermatitis from irritant contact dermatitis and other skin conditions like eczema or psoriasis.

Impact and complications

The condition can significantly impact quality of life, causing discomfort and affecting daily activities. Chronic exposure to allergens can lead to persistent dermatitis and skin damage.

Top 20 Common Contact Allergens

Based on information from the American Academy of Dermatology 2024, the top 20 most common contact allergens include;

  • Nickel (found in jewelry, clothing fasteners, and metal objects)
  • Fragrances (common in personal care products and cosmetics)
  • Balsam of Peru (used in fragrances and some medical and dental products)
  • Parabens (preservatives found in cosmetics and skin care products)
  • Cobalt (present in metal-plated objects and pigments)
  • Latex (used in rubber gloves and other products)
  • Chromium (used in leather and cement)
  • Formaldehyde (preservative in cosmetics, textiles, and construction materials)
  • Methylisothiazolinone (preservative in personal care products and paints)
  • Propylene glycol (used in cosmetics, topical medications, and food)
  • Quaternium-15 (preservative in cosmetics and industrial products)
  • Neomycin (topical antibiotic)
  • Bacitracin (topical antibiotic)
  • Ethylenediamine dihydrochloride (stabilizer in topical preparations)
  • Lanolin (moisturizer in cosmetics and skin care products)
  • Paraphenylenediamine (hair dye chemical)
  • Thiomersal (preservative in vaccines and cosmetics)
  • Epoxy resin (adhesive in industrial materials)
  • Rubber accelerators (used in rubber manufacturing)
  • Plants such as poison ivy, poison oak, and poison sumac

Treatment Options for allergic contact dermatitis

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