Contact dermatitis, also called allergic contact dermatitis, is a common skin condition affecting adults and, to a lesser extent, children. It often occurs with other conditions such as eczema. One should suspect contact dermatitis when the skin condition does not respond adequately to therapy or occurs in a skin distribution not typical for eczema (e.g. a rash around the eyes). It may occur anywhere on the body. It occurs from an allergic reaction to something coming into contact with the skin on a chronic basis. Two common contact allergens are nickel, a substance in metals/jewelry, and neomycin, an antibiotic ointment. There are hundreds of other contact allergens that may be involved.
The symptoms are very similar to eczema and include red irritated itchy fixed skin lesions. A common example would be an earlobe rash or a rash under the pant buckle in an individual with contact dermatitis to nickel.
The main focus of management is to find the underlying contact allergen. Since the underlying mechanism of this allergy is different from the IgE-mediated allergy commonly seen with asthma, hay fever, and food allergy, patch testing, instead of skin testing, is performed. The contact allergens are placed on the back under devices called Finn chamber. There is a standard panel of common contact allergens called the TRUE test that may be used. Certain items may be brought from home. In patients with eosinophilic esophagtis, patch testing may be done with foods. The patient generally returns to the office two days and four days later for patch test reading/interpretation.
Your BVAAC board-certified allergist has the background and experience to pursue the detective work that is needed to solve this vexing problem. If you or someone in your family is troubled by contact dermatitis, we encourage you to give us a call today at 208-378-0080 or click here to make an appointment request online.