ALLERGIC CONTACT

DERMATITIS

PREDISPOSING FACTORS PRECIPITATING FACTORS

Occupation: Exposure to allergens

jobs with higher
Not washing the body or
risk of exposure
skin
to certain
allergens such Sensitization Phase: Haptens (low
Not wearing PPE
as metals, molecular weight antigens)
solvents, penetrate the epidermis and
cleaning activate Langhergans cells which
supplies, poison travel to regional lymph nodes and
ivy, mango, etc. activate naïve T cells.

Environmental
factors: high or
Elicitation Phase: Re-exposure to
low temperatue
offending hapten leads to Type 4
and humidity
hypersensitivity reaction.
determine the
Sensitized T-cells circulate in blood
severity
and arrive at skin sites where
antigen is present.

Increased mast cells, eosinophils, Mast cells release Fever

CD4+/CD8+ T cells, and leukotrienes
inflammatory cytokines

CD8+ T cells cause keratinocyte Dilation of Stimulation of

apoptosis (loss of intercellular microvasculature nociceptors
adhesion)

Spongiosis

LEGEND: Vesicles/
Papule Erythema Burning Pruritus
Bullae

PREDISPOSING
FACTORS
Chronic findings

PRECIPITATING
FACTORS Scaling Excoriation Lithenification

PATHOPHYSIOLOGY
Identification of culprit allergen(s) through patch testing

MECHANISM

Avoidance (education, preventive measures)

SIGNS/SYMPOTMS

Topical corticosteroids
TREATMENT/MANAG
EMENT
Topical immunomodulators: tacrolimus/pimecrolimus

COMPLICATIONS
Short term use of corticosteroids

Phototherapy: UVB/PUBA

Systemic immunomodulators: cyclosporine, methotrexate, azathioprine, mycophenolate

mofetil