Allergic contact dermatitis
Allergic contact dermatitis
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DOI：
10.1111/ddg.12143
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发表时间：
2013-07-01
影响因子：
3.6
通讯作者：
Becker, Detlef
中科院分区：
文献类型：
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作者：
Becker, Detlef
过敏性接触性皮炎是一种常见的炎症性皮肤病。疑似诊断基于临床症状、合理的过敏原接触史和合适的皮炎病史。只有在仔细排除任何因果接触过敏之后，才应考虑鉴别诊断。因此，斑贴试验的仔细诊断具有重要意义。对标准化试验程序的修改是纸条斑贴试验和重复开放应用试验。对SLS(十二烷基硫酸钠)斑贴试验的解释以及对患者自己的产品和工作材料的测试是潜在的误差来源。准确的斑贴测试读数尤其受考官的经验和个人因素的影响。因此，高度的标准化和持续的质量控制是必要的，并可以通过使用德国接触性皮炎研究小组提供的在线斑贴测试阅读课程来支持。对过敏斑贴试验反应的关键相关性评估有助于避免复发和考虑鉴别诊断。如果合适的话，任何过敏测试反应都应该记录在过敏身份证上，包括INCI的名字。变态反应性接触性皮炎的诊断因德国法定医疗保险对贴片测试的资金严重减少而受到威胁。德国药品法的限制性规定阻止了对用于常规斑贴测试的新接触性过敏原的批准。除了持续避免接触变应原外，暂时使用全身和局部皮质类固醇是首选治疗方法。
Allergic contact dermatitis is a frequent inflammatory skin disease. The suspected diagnosis is based on clinical symptoms, a plausible contact to allergens and a suitable history of dermatitis. Differential diagnoses should be considered only after careful exclusion of any causal contact sensitization. Hence, careful diagnosis by patch testing is of great importance. Modifications of the standardized test procedure are the strip patch test and the repeated open application test. The interpretation of the SLS (sodium lauryl sulfate) patch test as well as testing with the patients' own products and working materials are potential sources of error. Accurate patch test reading is affected in particular by the experience and individual factors of the examiner. Therefore, a high degree of standardization and continuous quality control is necessary and may be supported by use of an online patch test reading course made available by the German Contact Dermatitis Research Group. A critical relevance assessment of allergic patch test reactions helps to avoid relapses and the consideration of differential diagnoses. Any allergic test reaction should be documented in an allergy ID card including the INCI name, if appropriate. The diagnostics of allergic contact dermatitis is endangered by a seriously reduced financing of patch testing by the German statutory health insurances. Restrictive regulations by the German Drug Law block the approval of new contact allergens for routine patch testing. Beside the consistent avoidance of allergen contact, temporary use of systemic and topical corticosteroids is the therapy of first choice.