Phototoxic and Photoallergic Contact Reactions

Gonçalo, Margarida

doi:10.1007/978-3-030-36335-2_18

Cited by 11 publications

(11 citation statements)

References 185 publications

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“…Photopatch testing is not usually indicated in the investigation of phytophotodermatitis or in dermatitis after exposure to a known phototoxic chemical, as a phototoxic test reaction will develop in most individuals. 1 However, when the patient refers to low sun exposure or short contact with the possible culprit, photopatch testing performed with low concentrations of the chemical and low UV doses may reveal photoallergy. Furthermore, damage caused by phototoxicity may facilitate sensitization, leading to overlapping conditions.…”

Section: Photopatch Test Resultsmentioning

confidence: 99%

Shedding a light on the importance of photopatch testing: A 12‐year experience in a dermatology unit

et al. 2023

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Background: Photopatch testing has been standardized for diagnosing photoallergic contact dermatitis but is still infrequently used.Objectives: To characterize photopatch test (PPT) results and their clinical relevance. Methods:We collected retrospective data from patients photopatch tested in our Dermatology Unit (2010-2021), using the European PPT 'baseline' series, other allergens, and patient's own products, when appropriate.Results: Out of 223 patients, 75 patients (33.6%) were reactive with 124 positive PPT reactions, considered relevant in 56/223 patients (25.1%) and in 72/124 reactions (58.1%). Most reactions were caused by topical drugs (n = 33; 45.8%), such as ketoprofen or promethazine, and 7 (9.8%) by systemic drugs, such as hydrochlorothiazide and fenofibrate. 'Classical' ultraviolet filters were responsible for six positive PPT reactions whereas there was only three relevant PPT to the 'newer' UV filters.Patients' sunscreens/cosmetics or plant extracts caused 10 positive PPT each.Additional patch test reactions were observed, mostly to Tinosorb ® M. Conclusion:Contrary to the trend in ACD, most positive PPT reactions were caused by topical drugs, outweighing ultraviolet filters and cosmetics. We stress the low reactivity to the 'newer' UV filters included in the PPT series. PPT was occasionally positive in systemic drug photosensitivity, but overall PPT reactivity was low.

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Section: Photopatch Test Resultsmentioning

confidence: 99%

Shedding a light on the importance of photopatch testing: A 12‐year experience in a dermatology unit

et al. 2023

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“…Depending on the disease course (and the school of dermatology), such dermatitis (ICD-10: L24.-) is referred to as acute irritant contact dermatitis, acute toxic contact dermatitis, chronic irritant contact dermatitis, cumulative-(sub)toxic contact dermatitis, or degenerative contact dermatitis. A special case is phototoxic contact dermatitis (L56.2), which is triggered by the combined exposure to a phototoxic substance and UV light [7].…”

Section: Definitionmentioning

confidence: 99%

German S1 guideline: Contact dermatitis

Bauer

Mahler

Neustädter

et al. 2022

J Deutsche Derma Gesell

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Summary Contact dermatitis is an inflammation of the epidermis and dermis at the site of exposure triggered by external agents. The two main forms are irritant and allergic contact dermatitis, which cause significant health and socioeconomic costs in addition to a marked reduction in quality of life. The anamnesis and the clinical picture are decisive for the necessary diagnostic measures. The most accurate possible diagnostic classification of contact dermatitis by means of allergological testing is important for disease management, since not only classical eczema therapy but also avoidance of the exogenous triggering factors are of great importance here. The choice of therapy should be based on the acuity, clinical severity, morphology of the lesions and localization of the contact dermatitis. A combination of basic therapy, topical, physical, and systemic therapy adapted to the patient’s needs is required, whereby not all forms of therapy must be carried out simultaneously but can be used in a varying manner. Primary, secondary, and tertiary prevention strategies aim at the recognition of the triggering noxae or allergens with subsequent contact avoidance or minimization. The present S1‐guideline on contact dermatitis is primarily intended to provide dermatologists, allergologists and physicians working in allergology and occupational dermatology with a decision‐making aid for the selection and implementation of suitable and sufficient diagnostics, therapy, and prevention.

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“…Je nach Verlaufsform (und dermato-logischer Schule) wird ein solches Ekzem (ICD-10: L24.-) als akutes irritatives Kontaktekzem, akute toxische Kontaktdermatitis, chronisches irritatives Kontaktekzem, kumulativ-(sub)toxisches Kontaktekzem oder degeneratives Kontaktekzem bezeichnet. Ein Spezialfall ist das phototoxische Kontaktekzem (L56.2), das durch die kombinierte Einwirkung von einer phototoxischen Substanz und UV-Licht ausgelöst wird [7].…”

Section: Definitionunclassified

S1‐Leitlinie Kontaktekzem

Bauer

Mahler

Neustädter

et al. 2022

J Deutsche Derma Gesell

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Zusammenfassung Das Kontaktekzem (syn. Kontaktdermatitis) ist eine durch äußere Einwirkungen ausgelöste Entzündung der Epidermis und der Dermis am Ort der Einwirkung. Die beiden Hauptformen sind das irritative und das allergische Kontaktekzem, die neben einer ausgeprägten Verminderung der Lebensqualität auch erhebliche gesundheits‐ und sozioökonomische Kosten verursachen. Wegweisend für die erforderlichen diagnostischen Maßnahmen sind die Anamnese und das klinische Bild. Eine möglichst genaue diagnostische Einordnung des Kontaktekzems mittels allergologischer Testung ist wichtig für das Krankheitsmanagement, da hier nicht nur die klassische Ekzemtherapie, sondern auch das Meiden der exogenen auslösenden Faktoren von großer Bedeutung sind. Die Wahl der Therapie sollte sich nach der Akuität, dem klinischen Schweregrad, der Morphologie der Läsionen und der Lokalisation des Kontaktekzems richten. Erforderlich ist eine bedarfsadaptierte Kombination aus Basistherapie, topischer, physikalischer und systemischer Therapie, wobei nicht alle Therapieformen gleichzeitig durchgeführt werden müssen, sondern variierend eingesetzt werden können. Primäre, sekundäre und tertiäre Präventionsstrategien zielen auf die Erkennung der auslösenden Noxen beziehungsweise der auslösenden Allergene mit nachfolgender Kontaktvermeidung oder ‐minimierung. Die vorliegende S1‐Leitlinie zum Kontaktekzem soll vor allem Dermatologen, Allergologen sowie allergologisch und berufsdermatologisch tätigen Ärzten eine Entscheidungshilfe für die Auswahl sowie die Durchführung einer geeigneten und suffizienten Diagnostik, Therapie und Prävention zur Verfügung zu stellen.

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Phototoxic and Photoallergic Contact Reactions

Cited by 11 publications

References 185 publications

Shedding a light on the importance of photopatch testing: A 12‐year experience in a dermatology unit

Shedding a light on the importance of photopatch testing: A 12‐year experience in a dermatology unit

German S1 guideline: Contact dermatitis

S1‐Leitlinie Kontaktekzem

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