Contact Dermatitis: Irritant

Wilkinson, S. M.; Beck, M. H.

doi:10.1002/9780470750520.ch19

Cited by 10 publications

(12 citation statements)

References 258 publications

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“…Typically, ICD remains localized to the area of skin contact. This is unlike ACD, which can spread to distant parts of the body as a result of an intradermal reaction or via contact with contaminated areas of skin such as the hands (10). Therefore, the diagnosis of AE precipitated by OCD is perhaps more straightforward when precipitated by irritants than by allergens, and for this reason, we have selected more cases of ICD to exemplify this clinical scenario.…”

Section: Discussionmentioning

confidence: 99%

Occupational autoeczematization or atopic eczema precipitated by occupational contact dermatitis?

2006

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Autoeczematization is characterized by the sudden dissemination of a previously localised form of eczema. While widely described, most cases reported have followed chronic, localized stasis dermatitis. In this study, we describe the clinical scenario of occupational contact dermatitis (OCD) triggering endogenous-like eczema in atopic individuals, who often have not had eczema since childhood, if at all. These cases appear similar to previously described cases of autoeczematization. To show this clinical scenario, a series of 6 patients is presented from the Occupational Dermatology Clinic in Melbourne, Australia. These workers initially developed OCD, usually affecting the hands, which then precipitated a flare of more generalized eczema. This appeared clinically consistent with atopic eczema (AE), and often became recurrent, and sometimes persistent. OCD can precipitate a flare of more generalized eczema, in a pattern consistent with AE, which may then persist. The clinical scenario is similar to that described for autoeczematization. It is possible that the pathophysiology, when clarified, will prove to be similar. Workers' compensation issues may become complicated for these patients, as the relationship between their generalized eczema and their occupational exposures may not be readily apparent. As a result, the work relatedness of their condition may not be recognized.

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Section: Discussionmentioning

confidence: 99%

Occupational autoeczematization or atopic eczema precipitated by occupational contact dermatitis?

2006

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“…In acute irritant contact dermatitis (AICD), histological features show much greater pleomorphism (2) and chemical irritants produce specific pathological changes, which may reflect differences in cytokine production and proliferative response (3, 4). However, it is not clear whether various chemical irritants may produce specific pathological changes in CICD or not.…”

mentioning

confidence: 99%

Pathological findings in cumulative irritation induced by SLS and croton oil in hairless mice

Moon

Seo²,

Han³

et al. 2001

Contact Dermatitis

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It is known that the pathological features of acute irritant contact dermatitis are specific according to the irritant. However, in chronic irritant contact dermatitis, it is not clear whether specific patterns exist. To investigate whether the specific pathology of acute irritant contact dermatitis is sustained in chronic irritant contact dermatitis, sodium lauryl sulfate (SLS) and croton oil were applied 3x a week for 2 weeks on the dorsal skin of hairless mice using Finn Chambers. The pathologic changes induced by irritants at various concentrations were evaluated using H&E and Luna's staining, as well as immunohistochemistry for 5-bromo-2-deoxyuridine (BrdU), keratin 6 and loricrin. Our results showed that epidermal hyperplasia and inflammatory infiltration were relatively marked in the groups treated with higher concentrations of irritants. These features were more prominent in the 1% croton oil treated group than in the 0.25% SLS treated group. However, lower concentrations of irritants resulted in very similar histological changes, characterized by epidermal hyperplasia with minimal inflammatory infiltration, irrespective of the chemical. Our results suggest that the histological responses to irritants vary with concentration in cumulative irritation, as in acute irritation, but repetitive mild irritation may evoke common histological changes, characterized by epidermal hyperplasia with minimal inflammatory infiltration, irrespective of the chemical used.

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“…However, since its introduction, this system has been subject to criticism 6,7 for allowing confusion between the morphology of the reaction elicited-that is, whether or not there is erythema, induration, vesiculation-with interpretation of whether this reaction pattern represents an allergic or an irritant aetiology.…”

Section: The Rating and Interpretation Of Patch Test Resultsmentioning

confidence: 99%

“…8 Marginal reactions often occur when testing substances such as carba mix or fragrance mix and are often incorrectly labelled as positive. 6 Follicular or diffuse scaling reactions commonly occur when testing the metal salts, especially in patients with atopic dermatitis. These are invariably irritant but are commonly misread and misinterpreted.…”

Section: The Rating and Interpretation Of Patch Test Resultsmentioning

confidence: 99%

Standardization of patch tests and the doctors who read them

Johnston¹

2009

British Journal of Dermatology

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Contact Dermatitis: Irritant

Cited by 10 publications

References 258 publications

Occupational autoeczematization or atopic eczema precipitated by occupational contact dermatitis?

Occupational autoeczematization or atopic eczema precipitated by occupational contact dermatitis?

Pathological findings in cumulative irritation induced by SLS and croton oil in hairless mice

Standardization of patch tests and the doctors who read them

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