Skin allergies: Cause, Symptoms, Diagnostics and Treatment of dermatitis

Medically reviewed: 15, February 2024

Read Time:26 Minute

Skin rush: causes and symptoms of skin allergic reactions

Case history: for patients suffering from allergic contact dermatitis (ACD), the history of the disease before the skin allergic test and after it is extremely important. Test in this case follows all potential pathogens of allergic contact dermatitis, materials and substances with which the patient contacts frequently.

The doctor of a patient with allergic contact dermatitis will need a much more detailed history of the course of the disease than any patient with other dermatological diseases.

The history of the course of the disease after the skin allergic test is also extremely important. Only a medical history and a detailed description of the symptoms will help determine if contact dermatitis causes substances and materials on which the patient is allergic.

A positive result of an allergic test can only indicate the sensitivity of the human body to the substance, but not that the substance was the cause of dermatitis.

Preclinical stage of skin rush

Among patients with hemostatic dermatitis, the risk of allergic contact dermatitis due to reactions to materials and substances that are used to treat hemostatic dermatitis and leg ulcers is high. Sometimes the cause of allergic contact dermatitis is the drug Neomycin, which is used quite often, despite the lack of convincing documentation, indicating its effectiveness in the treatment of circulatory varicose ulcers.

Patients suffering from external otitis often develop an allergy to topical neomycin and topical corticosteroids.

People who suffer from anal itching and genital itching can develop sensitivity to benzocaine and other medications that are used to treat chronic pruritus.

In women suffering from sclerotic atrophic deprivation, allergic contact dermatitis often develops, which complicates acute chronic genital dermatosis.

Atopic dermatitis

Patients who have ever suffered from atopic dermatitis are at increased risk of developing nonspecific dermatitis of the hands and irritating contact dermatitis.

Patients suffering from atopic dermatitis are not at risk of allergic contact dermatitis, despite the use of many topical preparations and moisturizers in chronic atopic dermatitis.

Patients suffering from atopic dermatitis are at a lower risk of allergic contact dermatitis due to sumac.

Studies of american scientists have shown that patients suffering from atopic dermatitis are at a risk of allergic contact dermatitis caused by nickel.

Types of skin rush

Inflammation of the external ear

Often with inflammation of the external ear, topical preparations cause the appearance of allergic contact dermatitis.
Allergic contact dermatitis due to substances carried through the air: this type of dermatitis is manifested as much as possible on the eyelids; however, other areas susceptible to contact with a chemical substance, such as the head and neck, can be affected.

Ophthalmic dermatitis

An allergy to chemicals contained in ophthalmic preparations may cause dermatitis around the eyes.

Allergy to hair dye

May cause the appearance of an acute form of dermatitis in the face area, not the head.

Hemostatic dermatitis and ulcer

People suffering from these diseases are at increased risk of allergic contact dermatitis due to topical drugs that are used to treat inflamed or ulcerated skin. The chronic nature of the disease and the rapid absorption of drugs increase the risk of allergic contact dermatitis due to medications (eg, neomycin) in patients in this group.

The patient can develop extensive dermatitis due to the use of topical drugs that are used to treat ulcers, or cross-acting intravenous drugs of systemic action. For example, a patient suffering from an allergy to neomycin may develop systemic contact dermatitis in the case of treatment with intravenous gentamicin.

Multi-form erythema (ME)

It is an acute skin reaction, in which “target-like” lesions appear on the skin. The reaction manifests itself immediately after exposure to a particular drug, however, it can also be caused by an infection, in most cases by a simple herpes simplex virus (HSV). Erythema multiforme only rarely appears after allergic contact dermatitis, caused by contact with sumac root, tropical species of wood, nickel, hair dye.

Contact urticaria

Allergic reactions of immediate type, that is, the appearance of noticeable skin lesions within 30 minutes after contact, indicate contact urticaria (not allergic contact dermatitis), especially if the lesions are similar to a rash, and are accompanied by shortness of breath, conjunctival inflammation, rhinorrhea, anaphylaxis, and also, if a person previously had hives.

To date, rubber latex is the main cause of allergic contact urticaria. The “hypoallergenic” mark on gloves may indicate that no sensitizer was used in their manufacture, however, does not mean that the gloves do not contain rubber latex.

Sometimes people develop a late reaction to rubber latex, however, contact hives caused by rubber latex are more common than allergic contact dermatitis caused by latex. People with dermatitis, atopic dermatitis, hospital staff, children with spina bifida are at increased risk of contact urticaria caused by rubber latex.

A person can suffer from allergic contact dermatitis caused by chemicals that are part of rubber gloves, and, at the same time, contact urticaria on latex. People who regularly wear rubber gloves should be tested for both diseases.

Professional dermatitis

Professional dermatitis is one of the 10 major occupational diseases. This disease can interfere with the work of a person. Human hands are most prone to contact with allergens and irritants, both at home and at work. With the help of hands, a person does most of the tasks at work.

Symptoms of allergic contact dermatitis due to exposure to materials in the workplace may be less apparent on weekends and holidays, however, in people with chronic dermatitis, temporary improvement is not observed. The diagnosis of contact dermatitis can be confirmed by the fact of the disease of several employees in one workplace.

Contact dermatitis

In people suffering from allergic contact dermatitis, dermatitis appears (a few days after contact with the pathogen) in areas that are directly in contact with the allergen. Certain allergens (for example, neomycin) fall on a healthy area of ​​the skin in small quantities, and dermatitis can manifest only a week after contact.

At least 10 days is the process of developing the sensitivity of the body to a new contact allergen.

A person who has never suffered from an allergy may develop mild dermatitis 2 weeks after the first contact, however, as a rule, 1-2 days after the second and subsequent contacts, acute dermatitis develops. It should be remembered that it is quite difficult to remove allergen from the skin, and if a person does not wash the contact area within 30 minutes after contact, allergic contact dermatitis appears. A sign of the appearance of a reaction on pathogen are linear lesions on the skin.

If the skin lesions are linear or sufficiently clear, the external cause of dermatitis should be considered. The sudden appearance of dermatitis symptoms immediately after contact with the material – a potential allergen testifies to a cross-allergic reaction, about nonspecific irritant contact dermatitis to an unknown agent, or that a person forgot about contact with the substance.

Dermatitis of the eyelids: a person may have dermatitis on the eyelids and other skin areas that have come into contact with the allergen, after contact with allergens that are carried through the air.

Causes of a contact allergic dermatitis

Most allergens do not cause a reaction in many people at the same time.

  • Hobbies

can also cause allergic contact dermatitis, for example, work with exotic tropical wood or the manifestation of a film using color development agents that, when in direct contact with the skin, can cause the appearance of Wilson’s lichen.

  • Drugs

Drugs that a person decides to take himself, or prescribed by a doctor, sometimes become the cause of allergic contact dermatitis. A nurse can release an ineffective, or sensitivity-enhancing topical drug, such as Merthiolate, due to which the usual abrasion can turn into an acute allergic contact dermatitis. The patient may develop an allergy to the preservatives contained in the preparation and / or the active ingredients of topical preparations, especially neomycin and topical corticosteroids.

  • Iatrogenic side effects

The continued use of general corticosteroids for the treatment of allergic contact dermatitis can cause acute soreness. People suffering from allergic contact dermatitis should not constantly take general corticosteroids or immunosuppressants, unless the skin allergic test has determined which way to treat acute dermatitis.

The constant widespread use of potent corticosteroids can cause local cutaneous atrophy and regular side effects.

Manifestations on the skin: with acute allergic contact dermatitis, erythematous itching papules and vesicles appear on the skin. Lichen blood platelets may indicate the appearance of allergic contact dermatitis. In some cases, allergic contact dermatitis affects the entire skin (erythroderma, exfoliative dermatitis). The initial appearance of skin damage with dermatitis often gives an accurate clue about the cause of allergic contact dermatitis.

  • Brushes

Often become a place of occurrence of allergic contact dermatitis, especially in the workplace. Among the common causes of allergic dermatitis on the hands – chemicals that are part of rubber gloves.

  • Perianal zone

Allergic contact dermatitis often appears in the perianal area as a result of the use of sensitizing drugs (eg, topical benzocaine).

Scientists have about 25 types of chemicals that cause more than half the cases of allergic contact dermatitis.

Sumac rooting often causes the disease of acute allergic contact dermatitis among residents of North America. Allergic contact dermatitis due to sumac, characterized by the bands of acute dermatitis, which appear on the skin in places of direct contact with the plant.

Nickel is the main cause of the disease of allergic contact dermatitis in the world. In this case, skin lesions appear in places that come in contact with ornaments and other objects containing nickel. Nickel can be considered a kind of professional allergen. Nickel can be called a professional allergen hairdressers, retailers, suppliers, cleaners, locksmiths and mechanics. Nickel contained in foodstuffs, in some cases, can cause the appearance of vesicles on the fingers (dyshidrosis eczema of the hands or watermelon) in people who are allergic to nickel.

Chronic dermatitis of the hands in people who wear rubber gloves, usually indicates an allergy to 1 or more chemicals that are contained in gloves (unless, of course, the allergic test does not disprove the diagnosis).

Allergic contact dermatitis caused by chemicals contained in rubber gloves, as a rule, is maximally manifested on the back of the palm. As a rule, the dermatitis affects only the brush, that is, only the area of ​​the skin that is directly in contact with gloves. In people who are allergic to chemicals contained in rubber gloves, dermatitis can cause other chemicals (for example, an elastic band).

In people who are allergic to chemicals, with which the tissue is treated to make it irrepressible, dermatitis, as a rule, manifests itself on the lateral parts of the trunk except underarms. The first manifestations of dermatitis can be lesions in the form of small follicular papules or large blood plates.

People who are presumed to suffer from this type of allergic contact dermatitis should be tested for reactions to chemicals used in the manufacture of textiles, especially if the allergic test did not reveal allergies to formaldehyde. Most often the cause of the emergence of allergic contact dermatitis are new things, because, after multiple washing, the concentration of most allergens in old things decreases.

Allergic contact dermatitis can be caused by preservatives contained in cosmetics, moisturizers and topical preparations. Parabens are used most often, however, despite this, they do not cause allergic contact dermatitis. The most dangerous preservatives are quaternary-15 and isothiazolinones.

Often the cause of allergic contact dermatitis is formaldehyde. Certain chemical preservatives that are used in the production of shampoos, lotions and other moisturizers are called formaldehyde releasing substances (quaternium-15-Dovicil 200, imidazolidinyl urea-German 115).

Some people are allergic to perfume. Perfumes are a component of perfumes, colognes, after shaving lotions, deodorants and soaps, as well as many other products that hide an unpleasant odor. If the package of the product is indicated “without perfumes”, it may still contain perfume chemicals.

People who are allergic to perfume should avoid using products with odors. Unfortunately, not all chemical substances that form the smell of the product are indicated on the packaging by the manufacturer. A perfume product consists of four thousand different molecules. The manufacturer of perfumery products is not required to disclose the names of all the components that he uses for the production of a particular product, even given the fact that some people suffer from allergic contact dermatitis caused by odors contained in topical preparations. Deodorants are likely to cause allergic contact dermatitis, because they clog the skin. Among women, this type of allergic contact dermatitis is quite common.

Data from the last decade showed that many people with chronic dermatitis also suffer from allergies to topical corticosteroids. Most patients can be treated with some types of corticosteroids, however, a person may be allergic to all systemic and topical corticosteroids. Budesonide and pitual Tiksocortola are corticosteroids, which are used to conduct allergic tests to topical corticosteroids.

The risk of allergy to neomycin is directly related to the frequency of its use: it is significantly higher if neomycin is used to treat chronic hemostatic dermatitis. The risk is reduced when neomycin is used as an antibiotic for local action with cuts and abrasions. People who are allergic to neomycin often suffer from allergies and chemically similar aminoglycoside antibiotics (eg, gentamicin, tobramycin). Those who are allergic to neomycin should avoid using these medications.

Avoid the topical use of benzocaine. Benzocaine is part of most of the plates used for allergens. Xylocaine will not cause harm to people who are allergic to benzocaine, and will not enter into a cross-reaction with benzocaine.
Many people complain of acute reactions to sunscreen. In this case, it is an allergy to the preservatives contained in them, or the nonspecific skin irritation caused by these products.

In some cases, allergic contact dermatitis can be caused by the action of light, for example, is aggravated by ultraviolet rays (UV). An allergic reaction can occur if the chemical is exposed to the skin and simultaneously exposed to a significant amount of ultraviolet (UV-A, radiation with a range of 320-400 nanometers).

Differentiation of skin allergies

  • Eczema from degreasing
  • Atopic dermatitis
  • Key fob dermatitis
  • Contact Irritant Dermatitis
  • T-cell lymphoma of the skin
  • Dermatomyositis
  • Bullous disorder caused by the action of drugs
  • Photosensitivity caused by the action of drugs
  • Erythema multiforme
  • Folliculitis (inflammation of hair follicle)
  • Eczematization
  • Intertriginous dermatitis
  • Shingles shiny
  • Simple chronic lichen
  • Numullar dermatitis
  • Onycholysis (exfoliation of the nail plate from the nail bed)
  • Perioral dermatitis
  • Photophytodermatitis
  • Pigment Purple Dermatitis
  • Knotty scrapes of Gaida
  • Seborrheic dermatitis
  • Hemostatic dermatitis
  • Dermatophyte skin of the trunk
  • Skin dermatophyte in the groin
  • Foot dermatophyte
  • Transient acantholytic dermatosis
  • Hives, contact dermatitis syndrome
  • Mushroom mycosis.

Skin allergies: Research and procedures

Laboratory research:

  • Potassium hydroxide and / or fungal culture often cause dermatitis of the hands and feet.
  • Analyzes
  • Allergen test

Allergen test is used to determine chemicals in the environment that cause an allergic reaction in humans. The most accurate results of allergic test are given for patients suffering from recurrent or chronic allergic contact dermatitis. Allergic test is a cost-effective analysis, and significantly reduces the cost of treatment for patients suffering from acute allergic contact dermatitis.

Procedure for carrying out allergens

Solutions of potential allergens in small amounts are applied to the skin, they are closed from the effect of the external environment for a minimum of 2 days.

Solutions of potential allergens can remain on the skin up to 7 days after application.

The results of the analysis should be recorded two days after the application on the skin, and also repeatedly – in the interval between three days and a week after contact with the skin.

People who are presumed to suffer ACD, whose allergic test has not given an accurate result, as well as those who suffer from chronic or recurrent dermatitis, should conduct additional allergic tests (despite the fact that these patients should avoid allergens).

Conducting the analysis to detect the reaction to several allergens significantly increases the accuracy of the diagnosis of allergic contact dermatitis. Potential allergens can indicate the patient’s medical history, information about contact with certain substances in everyday life.

Reaction to certain chemicals (eg, neomycin) occurs only 4 days after application to the skin. Among older patients, the reaction appears later than among the young. Do not conduct an allergy test for patients taking more than 15 milligrams of prednisone daily.

If it is necessary to carry out allergens, these patients use antihistamines for oral administration.

Multiple positive results of allergic tests

Шf the patient’s allergen test produces positive results on many substances, a reanalysis for these allergens should be carried out in order to exclude false-positive reactions. Multiple positive results of allergic tests appear, as a rule, in people whose dermatitis is in a state of active development during the test, or in those patients in whom a positive reaction to an allergic test is manifested rather strongly. In both cases, there is hyperactivity of the skin at the point of contact with the allergen.

Substances to which additional allergic tests are carried out (when specifying the diagnosis):

  • Corticosteroids, especially thixocortol pivalate and budesonide
  • Chemicals used in dentistry that can cause dermatitis of the mouth and lips mucous membranes in patients, or chronic dermatitis of brushes in dentists and their assistants
  • Chemicals used in hairdressing, which can cause dermatitis of the face, ears and neck in clients and chronic dermatitis of brushes or eyelids in hairdressers
  • Fragrances contained in cosmetics and other products

Allergens that often cause allergic contact dermatitis:

  • Bacitracin
  • Acrylates, which are used in dentistry, printing, are contained in artificial nails
  • Chemicals used for baking
  • Pesticides (often dermatitis, allegedly caused by pesticides, is actually caused by completely different causes, often by plants, such as a baggy rooting)
  • Chemicals that are used in engineering, for example, lubricating and cooling liquids
  • Chemicals that are used in the development and printing of photographs
  • Plants, except sumac root
  • Chemicals that are part of the plastic and adhesives
  • Chemicals that are part of rubber products
  • Chemicals used in the manufacture of clothing and footwear
  • Components of sunscreens that protect against ultraviolet radiation and other similar chemicals
  • Other allergens.

The chemicals listed above are tested using Finn Chamber and IQ-Ultra systems. During the skin test for photosensitivity, two sets of chemicals are used. One kit is exposed to 10 J / 1 cm² (or 1 J / 1 cm² less than the minimum biological dose of UV-A) UV-A one day after the application of allergens.

Another set is protected from ultraviolet rays in order to distinguish AKD and AKD, sharpened by exposure to light, from AСD caused by exposure to light. Both sets are checked two days after the application, as well as the second time, as with a normal allergy test.

Repeated open application test (ROAT)

This test helps if the patient’s reaction to the chemical is unclear or weakly positive. ROAT is especially effective when the patient has a weakly positive reaction to a chemical contained in a cosmetic product that does not require flushing.

For example, a patient with an unclear reaction to a preservative contained in a moisturizer can apply it twice a day for a week around the neck or behind the ear. If clinical dermatitis does not arise with such an application, a weakly positive reaction is likely to be false. And, conversely, in the case of dermatitis after several days of using a cosmetic product, the reaction can be considered positive.

Dimethylglomax test

This test is a convenient method for determining metal objects containing a sufficient amount of nickel in order to cause allergic dermatitis in people who are allergic to nickel. Dermatologists can check metal products in the laboratory, the patient himself can also purchase a set for the test, and study subjects take at home or at work – jewelry, metal objects.

There are also other chemical tests to investigate potential allergens (eg, formaldehyde, chromate). In some cases, chemical analysis is used to determine new, previously unidentified, allergens.

Skin biopsy helps to exclude other diseases:

  • dermatophyte,
  • psoriasis,
  • skin lymphoma.

A biopsy of the damaged skin of the palms and the feet has certain disadvantages, namely:

  • The stratum corneum and the epidermis are particularly dense on the palms and feet. This complicates the diagnosis of psoriasis and increases the possibility that a skin sample for a biopsy will not contain enough skin to make a diagnosis.
  • If the skin biopsy is not properly performed, the physician can damage the motor nerve, which is a branch of the median nerve.
  • After a skin biopsy, a painful scar may remain on the foot.

Histological analysis

The histology of allergic contact dermatitis is similar to other forms of eczema. There are signs of acute or subacute dermatitis. Infiltrate in the focus of inflammation contains, mainly, lymphocytes and other mononuclear cells.

Epidermal edema (for example, spongiosis, the formation of a network of microvessels) is observed in some cases. However, with prolonged dermatitis accompanied by thickening of the epidermis (acanthosis), hyperkeratosis and parakeratosis of the stratum corneum of the epithelium, signs of edema may not be present. Allergic contact dermatitis leads to an atypical T cell antifiltrate, stimulating mushroom mycosis.

Skin allergies and rush: Treatment of dermatitis

Medical care: the cause of the disease with allergic contact dermatitis should be established, otherwise there is a threat that allergic contact dermatitis will develop into chronic or recurrent dermatitis.

Treatment of symptoms:

  • Cool compresses with saline solution or aluminum acetate solution help with acute vesicular dermatitis (for example, summoned by sumach rooting).
  • Some patients with extensive vesicular dermatitis are helped by a warm bath of oatmeal.
  • Sedative oral antihistamines help relieve itching.
  • Patients should avoid the use of topical antihistamines, including topical doxepin, because of the risk of developing iatrogenic allergic contact dermatitis in these medications.

Corticosteroids for skin rush

Topical corticosteroids are the main method of treatment of allergic contact dermatitis, their different types are suitable for treating different parts of the body affected by allergic contact dermatitis. In case of acute allergic contact dermatitis of brushes, a 3-week course of treatment with topical corticosteroids of the first class is required. Topical corticosteroids of grade 6 and 7 are generally used to treat intertriginous dermatitis.

Acute allergic contact dermatitis, for example, caused by sumach rooting, is often treated for 2 weeks with systemic corticosteroids. The initial dose of most adults is 40-60 mg. The dose is reduced after 2 weeks of use, however, this dose reduction is optional, based on a short period of drug intake.

Corticosteroids of systemic action should be taken 2 weeks, as a shorter course can lead to the reappearance of dermatitis. In this case, you can use 40-60 mg of triamcinolone acetonide, which has a prolonged effect, instead of oral prednisone.

Topical immunomodulators (TIM): used to treat atopic dermatitis and sometimes prescribed for allergic contact dermatitis instead of topical corticosteroids. When used near the eyes, topicheskom immunomodulators do not cause dermal atropy, glaucoma or cataract. Pimecrolim (cream Elidel) is a topical preparation that is used for allergic contact dermatitis of the face. Tacrolim (0.1% ointment Protopik) is the most effective drug for the treatment of allergic contact dermatitis of the hands.
Psolaren and UV-A: if topical corticosteroids do not help with chronic allergic contact dermatitis, a positive result can be treated with psolarene and UV-A (PUVA).


In rare cases, these drugs (azathioprine-Imuran, cyclosporine-neural) are used to treat acute chronic allergic contact dermatitis or acute dermatitis of the hands, diseases that are incredibly complicated for a person’s daily life.

Biologically active substances acting on T cells can also be used in the future to treat these diseases.


In some cases, with acute allergy to nickel and acute vesicular dermatitis of the hands, treatment with disulfiram (Antabouz) helps. The chelating effect of disulfiram helps to reduce the effect of nickel on the human body. People taking disulfiram should not drink alcoholic beverages – this can cause an acute reaction of the body.

Acute dermatitis, resumed after a short period of treatment, does not require further diagnosis. If the patient suffers from chronic dermatitis, especially if it is associated with work, the history of the disease and the standard allergy test, as well as testing for additional allergens that are potentially dangerous, based on the patient’s medical history, occupation, hobby, and results of the first allergy test.

Diet for contact dermatitis

Some chemicals are components of food. Patients suffering from acute dermatitis, especially in the case of vesicular dermatitis of the hands, a diet with a low content of minerals and chemicals on which a person is allergic is suitable. The most common is a diet low in nickel, however, there are also diets with a low content of chromate, cobalt, Peruvian balsam. These diets are rarely suitable for people suffering from acute chronic vesicular dermatitis.

Everyday life: some patients suffering from acute ACD sometimes have to temporarily stop working at all, for others, only a decrease in the number of duties performed is sufficient. This group of people should avoid contact with allergen chemicals, as well as chemicals that cross-react with allergens. P

atients should also minimize contact with any chemicals that cause irritation, especially if dermatitis is in the active stage or stage of resumption. They should also use soft skin cleansers, protective emollients (Lipocream, Cetaphyl) in order to prevent recurrence of AKD or the development of irritant contact dermatitis on the ceramic cream.

Categories of drugs used for dermatitis treatment

Medication is aimed at reducing painful symptoms and preventing complications. Topical glucocorticosteroids are the main group of drugs used in the treatment of allergic contact dermatitis. When choosing a topical glucocorticosteroid, one should compare the strength of its action and the area affected by dermatitis, the form of the preparation and the nature of skin lesions (ointment is used for dryness and flaking, lotion for ulcers).

In acute allergic contact dermatitis (for example, meadow dermatitis, erythroderma), sometimes systemic action of corticosteroids or other immunosuppressants is used.

Sometimes allergic contact dermatitis does not go away, even though there is no contact with the allergen. In such cases (for example, if the allergen is nickel), the reason may be the use of products containing small doses of an allergen, which is helped by the treatment of heavy metal poisoning with disulfiram.

In other cases, the cause of the persistence of dermatitis remains unclear; Many allergens come in contact with the skin through rubber gloves. In this case, treatment with psolarenom and UV-A.

Briefly about the main categories of drugs used:

  • Topical immunomodulators – these drugs weaken the processes of inflammation in the immune system.
  • Corticosteroids – have an anti-inflammatory effect, cause strong side effects associated with the metabolic process. These agents weaken the response of the immune system to various stimuli.
  • Antihistamines – actively suppress the action of histamine in receptors. Can remove itching by blocking the action of histamine. At treatment of an allergic contact dermatitis render only calming action, removing an itch.
  • Tricyclic antidepressants – have a calming effect, suppress the effect of histamine, are used in the treatment of contact dermatitis
  • Chelation – disulfiram is often used to treat alcoholism, however, chelates nickel, which is then excreted from the body with urine. A decrease in the level of nickel in the body helped patients suffering from dyshidrosis and hypersensitivity to the metal.

Such therapy can be used only in the case of acute dyshidrosis in patients suffering from nickel allergy, not consuming alcohol, provided that the other methods of treatment had no effect. With this therapy, the patient must regularly take a blood test to determine the level of toxic substances in the liver that appear due to the use of the drug.

Contact dermatitis: Follow-up medical supervision

Hospital treatment

With allergic contact dermatitis, inpatient treatment is necessary only in rare cases, when dermatitis does not allow a person to even take care of themselves. Examples of this condition can be acute allergic contact dermatitis, causing swelling of the eyelids and, thereby, deterioration of vision, acute allergic contact dermatitis of the penis, making it difficult to urinate.

If the patient’s acute dermatitis is caused by any of his home or work environment, he will need a temporary change in the situation to determine the cause of dermatitis.

Ambulatory treatment

The patient can develop a new kind of allergy. The patient, who will resume or worsen dermatitis, will need further observation of the doctor and, possibly, an allergic test.

Prevention of skin allergic reactions

To prevent the re-occurrence of allergic contact dermatitis, the patient should be aware of allergens and products that can contain them.

Patients who are allergic to perfumes, preservatives, certain media or medicines should definitely read the labels and leaflets of medications and cosmetics.

The dimethylglobox test helps to determine the presence of metal in the body of a patient who is allergic to nickel.
Many patients are allergic to chemicals that are not indicated on the product packaging (for example, rubber vulcanization accelerator). Such patients will be assisted by a doctor who will tell you which products should be avoided and which ones you can use (for example, what gloves are produced without the use of rubber vulcanization accelerator).

Often allergic contact dermatitis develops due to certain conditions in the workplace. Appropriate instruction of employees and an appropriate level of hygiene can prevent the occurrence of an allergic reaction. For example, glutaraldehyde, which is a sensitizer, is often used as a sterilizer in medicine and dentistry.

Many cases of allergic contact dermatitis could be avoided if health workers were properly informed about the use of gloves and other protective barriers preventing the contact of glutaraldehyde with the skin.

Patients should avoid contact with allergens in order to avoid recurrent ACD, chronic contact dermatitis, the occurrence of side effects from the continued use of nonspecific suppressive drugs (eg, topical and systemic corticosteroids, cyclosporine).

Skin Allergies Complications

In some cases, allergic contact dermatitis is complicated by a secondary bacterial infection, which is treated with appropriate antibiotics of systemic action.

In people with dark skin, allergic contact dermatitis can cause hypero- or hypopigmentation. In rare cases, skin depigmentation occurs in places affected by allergic contact dermatitis caused by certain chemicals.


People with allergic contact dermatitis may develop persistent or recurrent dermatitis, especially if allergens are not found, or if the person is not properly caring for the skin (that is, uses hard means to cleanse the skin, does not use emollients to protect the skin).

It is believed that the longer a person suffers from acute dermatitis, the longer recovery will take.
In some patients, persistent dermatitis develops after allergic contact dermatitis, especially in patients suffering from allergy to chromium.

A particular problem is neurodermatitis (simple chronic lichen), in which the patient constantly rubs or combs the skin, damaged by allergic contact dermatitis.

What the patient should know about skin rush

  1. The patient’s chances of recovery are increased if he makes every effort to avoid contact with allergens.
  2. The patient should receive maximum information about the chemical that causes it allergies, as well as all possible variations of the name of this chemical.
  3. People who are sensitive to many substances should read the makeup of cosmetic products before use, as chemicals are often used in the manufacture of consumer and medical products. The same chemical may have a different name depending on the purpose for which it is used.

Skin rush and the workplace

Allergic contact dermatitis is an occupational disease that can lead to temporary disability of the patient. Many people require changes in the workplace in order to be able to continue working. A detailed medical history and allergy test reduce the risk of iatrogenic complications after using systemic corticosteroids and other immunosuppressants.

The safety of allergic tests during pregnancy has not been proven in special studies, however, microscopic doses of allergens are unlikely to harm the fetus.

Despite this, in this case, as with any treatment for pregnant women, all possible threats and risks should be considered.

This article is written by

Cassandra Westwood - dermatologist
Cassandra Westwood - dermatologist
Dr. Cassandra Westwood is a board-certified dermatologist with a comprehensive background in dermatological care. She obtained her medical degree from Johns Hopkins University School of Medicine.

Throughout her career, Dr. Westwood has contributed to various healthcare institutions, including her tenure at Massachusetts General Hospital, where she specialized in the diagnosis and treatment of skin disorders. Her clinical proficiency extends to managing a diverse range of dermatological conditions, such as acne, psoriasis, and skin cancers.

Presently, Dr. Westwood serves as a dermatologist for NetdoctorWeb, a prominent online health platform. In her role, she distills her clinical experience and expertise into accessible articles, offering valuable insights on skin health and dermatological concerns. Through her work, she contributes to the dissemination of accurate and reliable health information to a wider audience.

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