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Treatment of Irritant and Allergic Contact Dermatitis

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Handbook of Occupational Dermatology

Abstract

It is not always practical for persons, whose occupation or activities mandate the use of irritants or allergens, to avoid their use. In order to reduce the risk of developing irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD) in industry, prophylactic measures are indicated. Application of moisturizers as well as barrier creams (BCs) before or during work and wearing appropriate gloves and clothing may be protective. Oral and, to a lesser extent, topical corticoids have demonstrated significant efficacy in the treatment of ACD. Additional therapies include UVB/UVA treatment, other immunosuppressives, and Grenz ray.

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References

  1. Aalto-Korte K, Turpeinen M (1995) Pharmacokinetics of topical hydrocortisone at plasma level after applications once or twice daily in patients with widespread dermatitis. Br J Dermatol 133:259–263

    Article  PubMed  CAS  Google Scholar 

  2. Altura BM (1966) Role of glucocorticoids in local regulation of blood flow. Am J Physiol 211:1393–1397

    PubMed  CAS  Google Scholar 

  3. Amin S, Maibach HI (1997) Immunologic contact urticaria definition. In: Contact urticaria syndrome. Amin S, Lahti A, Maibach HI (eds), CRC Press, Boca Raton, pp 11–26

    Google Scholar 

  4. Ballard PL, Baxter JD, Higgins SJ, Rousseau GC, Tomkins GM (1974) General presence of glucocorticoid receptors in mammalian tissues. Endocrin 94:998–1002

    Article  CAS  Google Scholar 

  5. Barry BW, Woodford R (1977) Vasoconstrictor activities and bioavailabilities of seven proprietary corticosteroid creams assessed using a non-occluded multiple dosage regimen: clinical considerations. Br J Dermatol 97:555–560

    Article  PubMed  CAS  Google Scholar 

  6. Birmingham D (1969) Prevention of occupational skin disease. Cutis 5:153–156

    Google Scholar 

  7. Blackwell GJ, Carnuccio R, DiRosa M, Flower RJ, Parente L, Pérsico P (1980) Macrocortin: a polypeptide causing the anti-phospholipase effect of glucocorticoids. Nature 287:147–149

    Article  PubMed  CAS  Google Scholar 

  8. Blichmann CW, Serup J, Winther A (1989) Effects of single application of a moisturizer: evaporation of emulsion water, skin surface temperature, electrical conductance, electrical capacitance, and skin surface (emulsion) lipids. Acta Derm Venereol 69:327–330

    PubMed  CAS  Google Scholar 

  9. Bode HH (1980) Dwarfism following long-term topical corticosteroid therapy. J Am Med Assoc 244:813–814

    Article  CAS  Google Scholar 

  10. Boman A, Wahlberg JE, Johansson G (1982) A method for the study of the effect of barrier creams and protective gloves on the percutaneous absorption of solvents. Dermatológica 164:157–160

    Article  PubMed  CAS  Google Scholar 

  11. Carr RD, Tarnowski WM (1968) Percutaneous absorption of corticosteroids: adrenocortical suppression with total body inunction. Acta Derm Venereol 48:417–428

    PubMed  CAS  Google Scholar 

  12. Christensen OB (1994) UV-light treatment of hand eczema. In: Menné T, Maibach HI (eds) Hand eczema. CRC Press, Boca Raton, pp 293–301

    Google Scholar 

  13. Cronin E, Stoughton RB (1962) Percutaneous absorption: regional variations and the effect of hydration and epidermal stripping. Br J Dermatol 74:265–272

    Article  PubMed  CAS  Google Scholar 

  14. Davidson CL (1994) Occupational contact dermatitis of the upper extremity. Occup Med 9:59–74

    PubMed  CAS  Google Scholar 

  15. Du Vivier A, Stoughton RB (1976) Acute tolerance to effects of topical glucocorticoids. Br J Dermatol 94[Suppl 121:25–32

    Article  Google Scholar 

  16. Du Vivier A, Phillips H, Hehir M (1982) Applications of glucocorticosteroids: the effects of twice-daily vs once-every-other-day applications on mouse epidermal cell DNA synthesis. Arch Dermatol 118:305–308

    Article  PubMed  Google Scholar 

  17. Epstein EH, Bonifas JM (1982) Glucocorticoid receptors of the human epidermis. J Invest Dermatol 78:144–146

    Article  PubMed  CAS  Google Scholar 

  18. Estlander T, Jolanki R, Kanerva L (1994) Protective gloves. In: Menné T, Maibach HI (eds) Hand eczema. CRC Press, Boca Raton, pp 311–321

    Google Scholar 

  19. Estlander T, Jolanki R, Kanerva L (1996) Rubber glove dermatitis: a significant occupational hazard-prevention. In: Eisner P, Lachapelle JM, Wahlberg JE, Maibach HI (eds) Prevention of contact dermatitis. (Curr Probl Dermatol) Karger, Basel, pp 170–176

    Google Scholar 

  20. Feldmann RJ, Maibach HI (1965) Penetration of 14C-hydrocortisone through normal human skin: the effect of stripping and occlusion. Arch Dermatol 91:661–666

    Article  PubMed  CAS  Google Scholar 

  21. Feldmann RJ, Maibach HI (1966) Percutaneous penetration of hydrocortisone in man. II. Effect of certain bases and pretreatments. Arch Dermatol 94:649–651

    Article  PubMed  CAS  Google Scholar 

  22. Feldmann RJ, Maibach HI (1967) Regional variation in percutaneous penetration of 14C Cortisol in man. J Invest Dermatol 48:181–183

    PubMed  CAS  Google Scholar 

  23. Feldmann RJ, Maibach HI (1968) Percutaneous penetration of steroids in man. J Invest Dermatol 52:89–94

    Google Scholar 

  24. Feldmann RJ, Maibach HI (1974) Percutaneous penetration of hydrocortisone with urea. Arch Dermatol 109:58–59

    Article  PubMed  CAS  Google Scholar 

  25. Fredrickson T, Lassus A, Bleeker J (1980) Treatment of psoriasis and atopic dermatitis with halcinonide cream applied once, two-three times daily. Br J Dermatol 102: 575–577

    Article  Google Scholar 

  26. Frosch PJ, Kurte A (1994) Efficacy of skin barrier creams. (IV). The repetitive irritation test (RIT) with a set of 4 standard irritants. Contact Dermatitis 31:161–168

    Article  PubMed  CAS  Google Scholar 

  27. Frosch PJ, Kurte A, Pilz B (1993) Biophysical techniques for the evaluation of skin protective creams. In: Frosch PJ, Kligman AM (eds) Noninvasive methods for the quantification of skin functions. Springer, Berlin Heidelberg New York, pp 214–222

    Chapter  Google Scholar 

  28. Frosch PJ, Kurte A, Pilz B (1993) Efficacy of skin barrier creams. (III). The repetitive irritation test (RIT) in humans. Contact Dermatitis 29:113–118

    Article  PubMed  CAS  Google Scholar 

  29. Frosch PJ, Schulze-Dirks A, Hoffmann M, Axthelm I (1993) Efficacy of skin barrier creams. (II). Ineffectiveness of a popular “skin protector” against various irritants in the repetitive irritation test in the guinea pig. Contact Dermatitis 2974–77

    Google Scholar 

  30. Frosch PJ, Schulze-Dirks A, Hoffmann M, Axthelm I, Kurte A (1993) Efficacy of skin barrier creams. (I). The repetitive irritation test (RIT) in the guinea pig. Contact Dermatitis 28:94–100

    Article  PubMed  CAS  Google Scholar 

  31. Fullerton A, Menne T (1995) In vitro and in vivo evaluation of the effect of barrier gels in nickel contact allergy. Contact Dermatitis 32:100–106

    Article  PubMed  CAS  Google Scholar 

  32. Funk JO, Maibach HI (1994) Horizons in pharmacologic intervention in allergic contact dermatitis. J Am Acad Dermatol 31:999–1014

    Article  PubMed  CAS  Google Scholar 

  33. Gammal CE, Pagnoni A, Kligman AM, Gammal SE (1996) A model to assess the efficacy of moisturizers — the quantification of soap-induced xerosis by image analysis of adhesive-coated discs (D-Squames). Clin Exp Dermatol 21:338–343

    Article  PubMed  Google Scholar 

  34. Ginsburg J, Duff RS (1958) Influence of intra-arterial hydrocortisone on adrenergic responses in the hand. BMJ 2:424–428

    Article  PubMed  CAS  Google Scholar 

  35. Goh CL (1991) Cutting oil dermatitis on guinea pig skin. (I). Cutting oil dermatitis and barrier cream. Contact Dermatitis 24:16–21

    Article  PubMed  CAS  Google Scholar 

  36. Goh CL (1991) Cutting oil dermatitis on guinea pig skin. (II). Emollient creams and cutting oil dermatitis. Contact Dermatitis 24:81–85

    Article  PubMed  CAS  Google Scholar 

  37. Goh CL, Gan SL (1994) Efficacies of a barrier cream and an afterwork emollient cream against cutting fluid dermatitis in metalworkers: a prospective study. Contact Dermatitis 31:176–180

    Article  PubMed  CAS  Google Scholar 

  38. Grevelink SA, Murrell DF, Olsen EA (1992) Effectiveness of various barrier preparations in preventing and/or ameliorating experimentally produced Toxicodendron dermatitis. J Am Acad Dermatol 27:182–188

    Article  PubMed  CAS  Google Scholar 

  39. Grunewald AM, Lorenz J, Gloor M, Gehring W, Kleesz P (1996) Lipophilic irritants: protective value of urea- and of glycerol-containing oil in water emulsions. Dermatosen 44:81–86

    Google Scholar 

  40. Halkier-Sorensen L, Thestrup-Pedersen K (1993) The efficacy of a moisturizer (Locobase) among cleaners and kitchen assistants during everyday exposure to water and detergents. Contact Dermatitis 29:266–271

    Article  PubMed  CAS  Google Scholar 

  41. Hannuksela A (1996) Moisturizers in the prevention of contact dermatitis. In: Eisner P, Lachapeíle JM, Wahlberg JE, Maibach HI (eds) Prevention of contact dermatitis. (Curr Probl Dermatol) Karger, Basel, pp 214–220

    Google Scholar 

  42. Hannuksela A, Kinnunen T (1992) Moisturizers prevent irritant dermatitis Acta Derm Venereol 72:42–44

    PubMed  CAS  Google Scholar 

  43. Haynes RC, Muraud F (1985) Adrenocorticotropic hormone; adrenocortical steroids and their synthetic analogs; inhibitors of adrenocortical steroid biosynthesis. In: Gilman AG, Goodman LS, Rail TW, Murad F (eds) The pharmacological basics of therapeutics. Macmillan Publishing company, New York, pp 1459–1489

    Google Scholar 

  44. Held E, Sveinsdóttir S, Agner T (1999) Effect of long-term use of moisturizer on skin hydration, barrier function and susceptibility to irritants. Acta Derm Venereol 79:49–51

    Article  PubMed  CAS  Google Scholar 

  45. Hirata F, Schiffmann E, Venkatasubamanian K, Salomon D, Axelrod J (1980) A phospholipase A2 inhibitory protein in rabbit neutrophils induced by glucocorticoids. Proc Natl Acad Sei USA 77:2533–2536

    Article  CAS  Google Scholar 

  46. Juhlin L, Michaelsson G (1969) Cutaneous vascular reactions to prostaglandins in healthy subjects and in patients with urticaria and atopic dermatitis. Acta Derm Venereol 49: 251–261

    PubMed  CAS  Google Scholar 

  47. Lachapelle JM (1996) Efficacy of protective creams and/or gels. In: Eisner P, Lachapelle JM, Wahlberg JE, Maibach HI (eds) Prevention of contact dermatitis. (Curr Probl Dermatol) Karger, Basel, pp 182–192

    Google Scholar 

  48. Lachapelle JM, Nouaigui H, Marot L (1990) Experimental study of the effects of a new protective cream against skin irritation provoked by the organic solvents n-hexane, trichlorethylene and toluene. Dermatosen 38:19–23

    CAS  Google Scholar 

  49. Lagos BR, Maibach HI (1998) Frequency of application of topical corticosteroids: an overview. Br J Dermatol 139: 763–766

    Article  PubMed  CAS  Google Scholar 

  50. Lavker R, Scheckter N (1985) Cutaneous mast cell depletion results from topical corticosteroid usgae. J Immunol 135:2368–2373

    PubMed  CAS  Google Scholar 

  51. Lindelöf B (1994) X-ray treatment of hand eczema. In: Menné T, Maibach HI (eds) Hand eczema. CRC Press, Boca Raton, PP 303–309

    Google Scholar 

  52. Loden M (1995) Biophysical properties of dry atopic and normal skin with special reference to effects of skin care products. Acta Derm Venereol Suppl (Stockh) 192:1–48

    CAS  Google Scholar 

  53. Loden M (1996) Urea-containing moisturizers influence barrier properties of normal skin. Arch Dermatol Res 288:103–107

    Article  PubMed  CAS  Google Scholar 

  54. Loden M (1997) Barrier recovery and influence of irritant stimuli in skin treated with a moisturizing cream. Contact Dermatitis 36:256–260

    Article  PubMed  CAS  Google Scholar 

  55. Loden M, Lindberg M (1991) The influence of a single application of different moisturizers on the skin capacitance. Acta Derm Venereol 71:79–82

    PubMed  CAS  Google Scholar 

  56. Loden M, Maibach HI (1999) Skin moisturizers: development and clinical use. CRC Press, Boca Raton (in press)

    Google Scholar 

  57. Maibach HI, Körting HC (1993) Topical glucocorticoids with increased benefit/risk ratio. Karger, Basel

    Google Scholar 

  58. Maibach HI, Surber C (1992) Topical corticorsteroids. Karger, Basel

    Google Scholar 

  59. Malkinson FD, Ferguson EH (1955) Percutaneous absorption of hydrocortisone-1-C14 in two human subjects. J Invest Dermatol 25:281–283

    Article  PubMed  CAS  Google Scholar 

  60. Marks JG Jr, Fowler JF Jr, Sherertz EF, Rietschel RL (1995) Prevention of poison ivy and poison oak allergic contact dermatitis by quaternium-18 bentonite. J Am Acad Dermatol 33:212–216

    Article  PubMed  Google Scholar 

  61. Mathias CGT (1990) Prevention of occupational contact dermatitis. J Am Acad Dermatol 23:742–748

    Article  PubMed  CAS  Google Scholar 

  62. McClain DC, Storrs F (1992) Protective effect of both a barrier cream and a polyethylene laminate glove against epoxy resin, glyceryl monothioglycolate, frullania, and tansy. Am J Contact Dermat 13:201–205

    Google Scholar 

  63. Mckenzie AW, Stoughton RB (1962) Method for comparing percutaneous absorption of steroids. Arch Dermatol 86:603–610

    Google Scholar 

  64. Mellström GA, Wahlberg JM, Maibach HI (1994) Protective gloves for occupational use. CRC Press, Boca Raton

    Google Scholar 

  65. Mellström GA, Johansson S, Nyhammar E (1996) Barrier effect of gloves against cytostatic drugs. In: Eisner P, Lachapelle JM, Wahlberg JE, Maibach HI (eds) Prevention of contact dermatitis. (Curr Probl Dermatol) Karger, Basel, pp 163–169

    Google Scholar 

  66. Menné T, Maibach HI (1999) Hand eczema, 2nd edn, CRC Press, Boca Raton

    Google Scholar 

  67. Miller JA, Munro DD (1980) Topical corticosteroids: clinical pharmacology and therapeutic use. Drugs 19:119–134

    Article  PubMed  CAS  Google Scholar 

  68. Munro DD (1976) The effect of percutaneously absorbed steroids on hypothalamic-pituitary-adrenal function after intensive use in patients. Br J Dermatol 94[Suppl 12]:67–76

    Article  PubMed  Google Scholar 

  69. Olivarius FDF, Hansen AB, Karlsmark T, Wulf HC (1996) Water protective effect of barrier creams and moisturizing creams: a new in vivo test method. Contact Dermatitis 35:219–225

    Article  Google Scholar 

  70. Orchard S (1984) Barrier creams. Dermatol Clin 2:619–629

    Google Scholar 

  71. Packham CL (1994) Evaluation of barrier creams: an in vitro technique on human skin (letter). Acta Derm Venereol 74:405

    PubMed  CAS  Google Scholar 

  72. Parrillo JE, Fauci AS (1979) Mechanisms of glucocorticoid action on immune processes. Ann Rev Pharmacol Toxicol 19:179–201

    Article  CAS  Google Scholar 

  73. Ramsing DW, Agner T (1995) Efficacy of topical corticosteroids on irritant skin reactions. Contact Dermatitis 32:293–297

    Article  PubMed  CAS  Google Scholar 

  74. Reiner R, Roßmann K, Hooidonk CV, Ceulen BI, Bock J (1982) Ointments for the protection against organophos-phate poisoning. Arzneimittelforschung 32:630–633

    PubMed  CAS  Google Scholar 

  75. Schlâter-Wigger W, Eisner P (1996) Efficacy of 4 commercially available protective creams in the repetitive irritation test (RIT), Contact Dermatitis 34:278–283

    Article  Google Scholar 

  76. Scoggins RB, Kliman B (1965) Relative potency of percutaneously absorbed corticosteroids in the suppression of pituitary-adrenal function. J Invest Dermatol 45:347–355

    PubMed  CAS  Google Scholar 

  77. Serup J (1992) A double-blind comparison of two creams containing urea as the active ingredient, Assessment of efficacy and side-effects by non-invasive techniques and a clinical scoring scheme. Acta Derm Venereol Suppl (Stockh) 177:34–43

    CAS  Google Scholar 

  78. Serup J (1992) A three-hour test for rapid comparison of effects of moisturizers and active constituents (urea), measurement of hydration, scaling and skin surface lipid-ization by noninvasive techniques. Acta Derm Venereol Suppl (Stockh) 177:29–33

    CAS  Google Scholar 

  79. Serup J, Winther A, Blichmann CW (1989) Effects of repeated application of a moisturizer. Acta Derm Venereol 69:457–459

    PubMed  CAS  Google Scholar 

  80. Singh G, Singh P (1986) Tachyphylaxis to topical steroid measured by histamine-induced wheal response. Int J Dermatol 25:324–326

    Article  PubMed  CAS  Google Scholar 

  81. Solomon LM, Wentzel HE, Greenberg MS (1965) Studies in the mechanism of steroid vasoconstriction. J Invest Dermatol 44:129–131

    PubMed  CAS  Google Scholar 

  82. Stoughton RB (1972) Bioassay systems for topically applied glucocorticoids. Arch Dermatol 106:825–827

    Article  PubMed  CAS  Google Scholar 

  83. Sulzberger MB, Witten VH (1957) The effect of topically applied compound F in selected dermatoses. J Invest Dermatol 19:101–102

    Google Scholar 

  84. Swanbeck G (1992) Urea in the treatment of dry skin. Acta Derm Venereol Suppl (Stockh) 177:7–8

    CAS  Google Scholar 

  85. Thompson J, van Fürth R (1970) The effect of glucocortic-oidsteroids on the kinetics of mononuclear phagocytes. J Exp Med 131:429–442

    Article  PubMed  CAS  Google Scholar 

  86. Treffel P, Gabard B (1996) Bioengineering measurements of barrier creams efficacy against toluene and NaOH in an in vivo single irritation test. Skin Res Technol 2:83–87

    Article  Google Scholar 

  87. Treffel P, Gabard B, Juch R (1994) Evaluation of barrier creams: an in vitro technique on human skin. Acta Derm Venereol 74:7–11

    PubMed  CAS  Google Scholar 

  88. Van der Valk PGM, Maibach HI (1996) The irritant contact dermatitis syndrome. CRC Press, Boca Raton

    Google Scholar 

  89. Vermeer BJ, Heremans GFP (1974) A case of growth retardation and Cushing’s syndrome due to excessive application of betamethasone-17-valerate ointment. Dermatológica 149:299–304

    Article  PubMed  CAS  Google Scholar 

  90. Vernon-Roberts B (1969) The effects of steroid hormones on macrophage activity. Int Rev Cytol 25:131–159

    Article  PubMed  CAS  Google Scholar 

  91. Vickers CFH (1963) Existence of reservoir in the stratum corneum. Arch Dermatol 88:20–23

    Article  PubMed  CAS  Google Scholar 

  92. Wertz PW, Downing DT (1990) Metabolism of topically applied fatty acid methyl esters in BALB/C mouse epidermis. J Dermatol Sei 1:33–37

    Article  CAS  Google Scholar 

  93. Weston WL, Sams WM, Morris HG (1980) Morning plasma Cortisol levels in infants treated with topical fluorinated glucocorticosteroids. Paediatrics 65:103–106

    CAS  Google Scholar 

  94. Wigger-Alberti W, Eisner P (1998) Do barrier creams and gloves prevent or provoke contact dermatitis? Am J Contact Dermat 9:100–106

    Article  PubMed  CAS  Google Scholar 

  95. Wigger-Alberti W, Maraffio B, Wernli M, Eisner P (1997) Self-application of a protective cream. Pitfalls of occupational skin protection. Arch Dermatol 133:861–864

    Article  PubMed  CAS  Google Scholar 

  96. Wohlrab W (1990) Effect of urea on penetration kinetics of vitamin A acid in human skin. Z Hautkr 65:803–805

    PubMed  CAS  Google Scholar 

  97. Wormser U, Brodsky B, Green BS, Arad-Yellin R, Nyska A (1997) Protective effect of povidone-iodine ointment against skin lesions induced by sulphur and nitrogen mustards and by non-mustard vesicants. Arch Toxicol 71:165–170

    Article  PubMed  CAS  Google Scholar 

  98. Zhai H, Maibach HI (1996) Effect of barrier creams: human skin in vivo. Contact Dermatitis 35:92–96

    Article  PubMed  CAS  Google Scholar 

  99. Zhai H, Maibach HI (1996) Percutaneous penetration (Dermatopharmacokinetics) in evaluating barrier creams. In: Eisner P, Lachapelle JM, Wahlberg JE, Maibach HI (eds) Prevention of contact dermatitis. (Curr Probl Dermatol) Karger, Basel, pp 193–205

    Google Scholar 

  100. Zhai H, Maibach HI (1998) Moisturizers in preventing irritant contact dermatitis: an overview. Contact Dermatitis 38:241–244

    Article  PubMed  CAS  Google Scholar 

  101. Zhai H, Willard P, Maibach HI (1998) Evaluating skin-protective materials against contact irritants and allergens: an in vivo screening human model. Contact Dermatitis 38:155–158

    Article  PubMed  CAS  Google Scholar 

  102. Zhai H, Buddrus DJ, Schulz AA, Wester RC, Hartway T, Serranzana S, Maibach HI (1999) In vitro percutaneous absorption of sodium lauryl sulfate (SLS) in human skin decreased by quaternium-18 bentonite gels. In Vitro Mol Toxicol (in press)

    Google Scholar 

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Zhai, H., Anigbogu, A., Maibach, H.I. (2000). Treatment of Irritant and Allergic Contact Dermatitis. In: Kanerva, L., Wahlberg, J.E., Elsner, P., Maibach, H.I. (eds) Handbook of Occupational Dermatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-07677-4_51

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