Published Online: July 14, 2014
Atopic Dermatitis (AD), also known as eczema, is a common skin disease in children and adults, and is often characterized by itchy red skin lesions on the face, neck, trunk and extremities. Contact Dermatitis (CD) is another skin disease that can cause itchy rashes in children and adults. The most commonly known example of contact dermatitis is poison ivy, oak or sumac. However, CD can occur in patients with atopic dermatitis and can occur in similar locations. If the diagnosis of allergic contact dermatitis is missed, improvement of the rash in atopic dermatitis patients may be delayed.
In an article recently published in The Journal of Allergy and Clinical Immunology: In Practice, Aquino and colleagues review the medical literature focusing on the issue of contact dermatitis in patients who have eczema.
Although the exact occurrence of contact dermatitis in patients with atopic dermatitis is currently unknown, the most recent U.S and European data suggests that CD can be just as common if not more common in patients with atopic dermatitis. Clues that a patient with atopic dermatitis may also have contact dermatitis include worsening of skin lesions with medical topical therapy, hard to control skin lesions even in patients who are using their medications consistently and appropriately, and lesions that have moved to previously unaffected areas.
Contact dermatitis is a skin disease common to both adults and children. Patients with AD can become allergic to any number of allergens, including topical moisturizers, lotions, medications, and other personal products, as well as metals (for example nickel, cobalt, chromium). The diagnosis of allergic contact dermatitis is made via a skin test, called patch testing. In this process allergens are placed on the back and remain in contact with the skin to reproduce in small scale the process of contact allergy.
If your doctor suspects contact allergy, he or she will perform patch testing or refer you to a center where patch testing is performed. Based on these positive results, a list of products that do not contain the substance you are allergic to can be generated. Identification and avoidance of allergens is the mainstay treatment of contact dermatitis.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.