Other causative agents include chemicals found in rubber, ingredients of plastics and glues (picture 2), chromium and cobalt compounds as well as ingredients used in skin care products.
Plants may, also, cause allergic contact dermatitis (e.g. Primula obconica) (picture 10) or photodermatitis Photodermatitis (picture 11).
The definitive treatment of allergic contact dermatitis is the avoidance or removal of the allergen (personal protective equipment, changing substances or methods used at the workplace, change of employment).
Antimicrobials are very rarely needed in allergic dermatitis, and they do not replace topical treatment. If the rash is clearly infected (picture 9), an antimicrobial may be indicated (cephalexin 500 mg three times daily for 7-10 days).
Immediate contact dermatitis
Unlike allergic dermatitis (delayed allergy), this is based on an immediate, IgE-mediated allergy
Contact urticaria and protein contact dermatitis
Redness, pruritus and/or urticaria develop immediately (less than 30 minutes) at the site of the allergen contact. Allergens include natural rubber (latex), cat or dog (dander or hair), root and other vegetables.
Clearly more rare than allergic contact dermatitis, but in its chronic state its appearance may resemble that of allergic dermatitis.
Specialist consultation
Consult a dermatologist in particularly severe and extensive cases as well as chronic forms of the conditions
Patch testing and the verification of diagnosis
A suspicion of occupational allergic contact dermatitis or hand dermatitis
References
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Johansen JD, Aalto-Korte K, Agner T et al. European Society of Contact Dermatitis guideline for diagnostic patch testing - recommendations on best practice. Contact Dermatitis 2015;73(4):195-221. [PubMed]
Fonacier L, Bernstein DI, Pacheco K et al. Contact dermatitis: a practice parameter-update 2015. J Allergy Clin Immunol Pract 2015;3(3 Suppl):S1-39. [PubMed]
Boonstra MB, Christoffers WA, Coenraads PJ et al. Patch test results of hand eczema patients: relation to clinical types. J Eur Acad Dermatol Venereol 2015;29(5):940-7. [PubMed]
Johnston GA, Exton LS, Mohd Mustapa MF ym. British Association of Dermatologists' guidelines for the management of contact dermatitis 2017. Br J Dermatol 2017;176(2):317-329. [PubMed]
Bepko J, Mansalis K. Common Occupational Disorders: Asthma, COPD, Dermatitis, and Musculoskeletal Disorders. Am Fam Physician 2016;93(12):1000-6. [PubMed]