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Pesqué D, Aerts O, Bizjak M, Gonçalo M, Dugonik A, Simon D, Ljubojević-Hadzavdić S, Malinauskiene L, Wilkinson M, Czarnecka-Operacz M, Krecisz B, John SM, Balato A, Ayala F, Rustemeyer T, Giménez-Arnau AM. Differential diagnosis of contact dermatitis: A practical-approach review by the EADV Task Force on contact dermatitis. J Eur Acad Dermatol Venereol 2024; 38:1704-1722. [PMID: 38713001 DOI: 10.1111/jdv.20052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/15/2024] [Indexed: 05/08/2024]
Abstract
The diagnosis of eczema ('dermatitis') is mostly clinical and depends on the clinical history and exploratory objective findings (primary lesions, patterns). Contact dermatitis remains as an important condition in the group of eczematous disorders, with important socioeconomic and occupational relevance. Although irritant and allergic contact dermatitis have a different pathogenesis, both are characterized by a rather typical morphology, are triggered by external factors and tend to occur primarily in the area of contact with the exogenous agent. In addition, allergic and irritant dermatitis may also co-exist. The importance of diagnosing contact dermatitis, especially when allergic in nature, is both due to the possibility of avoiding the trigger, and due to its role in aggravating other skin conditions. Nevertheless, the heterogeneity of clinical presentations in daily practice may pose an important challenge for the suspicion and correct diagnosis of contact dermatitis. Furthermore, other conditions, with different pathogenesis and treatment, may clinically simulate contact dermatitis. The Task Force aims to conduct a review of the unifying clinical features of contact dermatitis and characterize its main clinical phenotypes, and its simulators, in order to contribute to an early suspicion or recognition of contact dermatitis and enable a correct differential diagnosis.
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Affiliation(s)
- David Pesqué
- Dermatology Department, Hospital del Mar Research Institute, Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA) and Research Group Immunology, University of Antwerp, Antwerp, Belgium
| | - Mojca Bizjak
- Division of Allergy, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - Margarida Gonçalo
- Department of Dermatology, Coimbra University Hospital, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Aleksandra Dugonik
- Department of Dermatology, University Medical Centre Maribor, Maribor, Slovenia
| | - Dagmar Simon
- Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Suzana Ljubojević-Hadzavdić
- Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Laura Malinauskiene
- Faculty of Medicine, Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology and Allergology, Vilnius University, Vilnius, Lithuania
| | - Mark Wilkinson
- Leeds Centre for Dermatology, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK
| | | | - Beata Krecisz
- Collegium Medicum, Jan Kochanowski University Kielce, Kielce, Poland
| | - Swen M John
- Department of Dermatology, Environmental Medicine, Osnabrueck University, Osnabrueck, Germany
| | - Anna Balato
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabio Ayala
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Thomas Rustemeyer
- Dermato-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Ana M Giménez-Arnau
- Dermatology Department, Hospital del Mar Research Institute, Universitat Pompeu Fabra (UPF), Barcelona, Spain
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Menanteau M, Bensefa-Colas L, Crepy MN. First case of occupational protein contact dermatitis to aromatic herbs with pustular allergic contact dermatitis to plants. Contact Dermatitis 2024; 90:93-95. [PMID: 37903514 DOI: 10.1111/cod.14433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 11/01/2023]
Affiliation(s)
- Marion Menanteau
- Department of Occupational and Environmental Diseases, Hotel-Dieu Hospital, APHP. Centre-Université Paris Cité, AP-HP, Paris, France
- HERA Team, Université Paris Cité, CRESS-INSERM UMR-1153, Paris, France
| | - Lynda Bensefa-Colas
- Department of Occupational and Environmental Diseases, Hotel-Dieu Hospital, APHP. Centre-Université Paris Cité, AP-HP, Paris, France
- HERA Team, Université Paris Cité, CRESS-INSERM UMR-1153, Paris, France
| | - Marie-Noëlle Crepy
- Department of Occupational and Environmental Diseases, Hotel-Dieu Hospital, APHP. Centre-Université Paris Cité, AP-HP, Paris, France
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Tramontana M, Hansel K, Bianchi L, Sensini C, Malatesta N, Stingeni L. Advancing the understanding of allergic contact dermatitis: from pathophysiology to novel therapeutic approaches. Front Med (Lausanne) 2023; 10:1184289. [PMID: 37283623 PMCID: PMC10239928 DOI: 10.3389/fmed.2023.1184289] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/18/2023] [Indexed: 06/08/2023] Open
Abstract
Allergic contact dermatitis (ACD) is a common inflammatory skin disease that, especially when the condition becomes chronic, has a high impact on the quality of life and represents a significant disease burden. ACD represents a type IV delayed-type hypersensitivity reaction that is triggered by contact with an allergen in previously sensitized individuals through the activation of allergen-specific T cells. In the acute phase, it is characterized by eczematous dermatitis, which presents with erythema, edema, vesicles, scaling, and intense itch. Non-eczematous clinical forms are also described (lichenoid, bullous, and lymphomatosis). Lichenification is the most common clinical picture in the chronic phase if the culprit allergen is not found or eliminated. ACD can be associated with both occupational and non-occupational exposure to allergens, representing approximately 90% of occupational skin disorders along with irritant contact dermatitis. Patch testing with suspected allergens is required for a diagnosis. Metals, especially nickel, fragrance mix, isothiazolinones, and para-phenylenediamine, are the most commonly positive allergens in patients patch tested for suspected ACD. The treatment goal is to avoid contact with the culprit agent and use topical and/or systemic corticosteroid therapy.
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Merhy R, Weill A, Ingen‐Housz‐Oro S, Assier H. Pustular allergic contact dermatitis of the dorsum of hands related to rubber gloves additives. Contact Dermatitis 2022; 87:199-201. [DOI: 10.1111/cod.14124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Reine Merhy
- Service de Dermatologie, AP‐HP Hôpital Henri Mondor Créteil France
- Faculty of Medicine Saint Joseph University Beirut Lebanon
| | - Amandine Weill
- Service de Dermatologie, AP‐HP Hôpital Henri Mondor Créteil France
| | - Saskia Ingen‐Housz‐Oro
- Service de Dermatologie, AP‐HP Hôpital Henri Mondor Créteil France
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Université Paris Est Créteil EpidermE Créteil France
| | - Haudrey Assier
- Service de Dermatologie, AP‐HP Hôpital Henri Mondor Créteil France
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
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