Contact eczema

Diagnosis

The effects of any damage to the skin or allergy can only be avoided if their trigger is known and avoided in future. The clarification by the dermatologist is thus of decisive importance.

In particular with an allergic contact dermatitis, it is important to identify the triggering factor. The large number of potential allergens means that this is sometimes time-consuming and not always successful. Good monitoring and the collaboration of the patient is decisive here. The more information is available about the possible source of the disease, the more targeted, time-saving and possibly lower-cost the clarification of the cause. Various test methods help to provide evidence of the allergy-triggering substances (allergens), although the well-known and frequent allergens are today part of routine diagnostics.

Recognised test procedures

There is a reliable test procedure (so-called 'patch test' or 'epicutaneous test') to distinguish an irritative-toxic contact eczema from an allergic one and to identify the allergen. For this purpose, small quantities of the substances to be tested are brought into contact with the skin using special test plasters. After 1 or 2 days (24 or 48 hours), the test plasters are removed. After removal of the test plaster (usually on the 2nd day [48 hours]), the occurrence of skin appearances (redness, swellling, papules, blisters) on the test areas is documented for the first time. At the further reading points on the 3rd day (72 hours) and, if necessary, on other days, the dermatologist will clearly determine whether it is an allergic reaction or an irritation of the skin: It is seldom that a skin reaction does not occur until after more than a week.

Treatment

• Avoid triggers: All substances that can lead to the eczema flaring up again should be avoided. However, this is particularly difficult if you have to deal with them on an everyday basis, e.g. at your place of work. Consequently, strategies for avoiding contact should be developed with the dermatologist. These include e.g. the use of skin protection creams (e.g. Aqua non Hermal^®), the regular care of the skin with creams and ointments (for the protection and reconstruction of the skin protection barrier), the wearing of gloves and the correspondig 'glove hygiene'.
• Anti-inflammatory therapy: External glucocorticoid creams or calcineurin inhibitors can help to combat skin inflammation and so-called anti-histamines the itching. In severe cases, a light therapy may be carried out or some medications might be given systematically.
• Antibiotics are prescribed with an infection of the eczema with bacteria.