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Page 9 of 9
Follow-Up continued... Patient Education:
- Patients have the best prognosis when they are able to remember the materials to which they are allergic and how to avoid further exposures.
- Provide patients with as much information as possible concerning the chemical to which they are allergic, including all known names of the chemical.
- Web sites, standard textbooks, and the TRUE test kit contain basic information about the chemicals.
- Susceptible individuals need to read the list of ingredients before applying American cosmetic products to their skin, since preservative chemicals are used widely in consumer, medical, and workplace products. The same chemical may have different names when used for consumer or industrial purposes.
- Provide pamphlets with color pictures of poison ivy to individuals allergic to the plant. The American Academy of Dermatology also has pamphlets on ACD and hand eczema.
- For excellent patient education resources, visit eMedicine's Skin, Hair, and Nails Center. Also, see eMedicine's patient education article Contact Dermatitis.
Miscalleneous Medical/Legal Pitfalls:
- ACD is a major occupational disease, and individuals may be temporarily unable to work. Many require modification of the workplace to continue working. Hopefully, a thorough history and patch testing minimize the risk of iatrogenic complications from systemic corticosteroids and other immunosuppressives.
Special Concerns:
- The safety of patch testing in pregnancy has not been studied; however, the minute amounts of allergens applied appear unlikely to be absorbed in sufficient amounts to harm the fetus. Nonetheless, as with all treatments in pregnant women, the benefits of testing should be weighed against any potential, albeit undocumented, risk.
Pictures Caption: Picture 1. Chronic stasis dermatitis with allergic contact dermatitis to quaternium-15, a preservative in moisturizer. Allergic contact dermatitis produces areas of erythema in areas of atrophie blanche and varicose veins.  | Caption: Picture 2. Erythema multiformelike reaction that developed acutely following hair dying |  | Caption: Picture 3. Allergic contact dermatitis to nickel in a necklace |  Caption: Picture 4. Severe allergic contact dermatitis resulting from preservatives in sunscreen. Patch testing was negative to the active ingredients in the sunscreen.
Picture Type: Photo
Caption: Picture 5. Onycholysis developing from allergic contact dermatitis to formaldehyde used to harden nails
Picture Type: Photo
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VitaDocs Medical Reference from eMedicineHealth Authors & Editors | Author: Daniel Hogan, MD, Chief of Dermatology, Professor, Departments of Internal Medicine and Pediatrics, Louisiana State University Medical Center | | Daniel Hogan, MD, is a member of the following medical societies: American Academy of Dermatology | | Editor(s): Donald Belsito, MD, Program Director, Professor, Department of Internal Medicine, Division of Dermatology, University of Kansas; Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA; Jeffrey P Callen, MD, Chief, Division of Dermatology, Professor of Medicine (Dermatology), Department of Internal Medicine, University of Louisville School of Medicine; Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania; and William D James, MD, Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System |
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