Systemic Contact Dermatitis

Systemic allergic dermatitis (systemic contact dermatitis) from pharmaceutical drugs: A review

“…Systemic allergic dermatitis from systemic drugs results from oral, parenteral (injections) or rectal (suppositories, enemas) administration of a chemical to which the patient has previously become sensitized from topical administration to the skin or mucosae. Sensitization may also be the result of cross‐reactivity to a related chemical that has previously induced contact allergy 1‐12,99 . In most cases, the sensitization is caused by topical therapeutical administration of the drug, but has in some cases resulted from occupational contact with bacampicillin, deflazacort, heroin, piperazine, nitrofurazone, propacetamol, pyridoxine, ranitidine, and thiamine (Table 4).…”

“…The main groups of allergens involved in SAD are metals (notably mercury and nickel), plant products, for example, in herbal teas and in foods including Myroxylon pereirae resin (balsam of Peru) and its constituents used as spices and flavorings, and pharmaceutical drugs. The pathophysiology of SAD, apart from (although highly likely to) being mediated by delayed‐type hypersensitivity, is incompletely understood and an explanation for the diverse clinical manifestations is lacking 1,2,5‐15 …”

Allergic Contact Dermatitis From Topical Drugs: An Overview

“…Systemic exposure to allergens can include transcutaneous, transmucosal, oral, intravenous, intramuscular, and inhalational routes, as well as implants. 67,68,[74][75][76][77][78][79][80] Possible manifestations are shown in Table 8 and include reactivation of previous eczema and positive patch test reactions, acrovesicular dermatitis, systemic symptoms, and various drug exanthemas including maculopapular . Allergic contact dermatitis from Hirudoid cream applied to superficial leg ulcers; in this case, there was only some spreading of the dermatitis to the skin proximal of the application site.…”

“…Systemic contact dermatitis (also termed systemic allergic contact dermatitis, systemic allergic dermatitis) is a condition that occurs when an individual sensitized to a contact allergen is exposed to that same allergen or a cross-reacting molecule through a systemic route. Systemic exposure to allergens can include transcutaneous, transmucosal, oral, intravenous, intramuscular, and inhalational routes, as well as implants 67,68,74–80 . Possible manifestations are shown in Table 8 and include reactivation of previous eczema and positive patch test reactions, acrovesicular dermatitis, systemic symptoms, and various drug exanthemas including maculopapular rashes, urticaria, erythema multiforme, and vasculitis.…”

Contact dermatitis and patch testing for the allergist

“…Thirty percent of the cases of contact allergy to corticosteroids would have been missed had late readings not been performed. 36,37 Drugs that have been reported to cause SCD from topical absorption include corticosteroids, nonsteroidal anti-inflammatory drugs (bufexamac, diclofenac), acetylsalicylic acid, anesthetics (cinchocaine), antibiotics (ampicillin, neomycin), and ethylenediamines 37 (Table 1).…”