Published online Aug 2, 2014. doi: 10.5314/wjd.v3.i3.45
Revised: April 3, 2014
Accepted: July 12, 2014
Published online: August 2, 2014
Contact dermatitis (CD) is the most common professional skin disease, with frequencies ranging from 24 to 170 every 100000 individuals. Approximately 20% of the United States population suffers from CD. CD can be classified according to its origin and severity. ICD stands for irritant CD, whereas ACD means allergic CD. Their clinical presentation includes acute, sub-acute and chronic eczema. Despite their different origin, ICD and ACD often present similar clinical and histologic findings. The current gold standard for diagnosis is patch-testing. However, patch-testing is being questioned in terms of validity and reproducibility, as it relies heavily on the skill of the observer. Real-time reflectance confocal microscopy is a non-invasive imaging technique that bears strong promise for the study of CD, and it enables the evaluation of cellular and subcellular changes over time with similar resolution compared to that of conventional histology.
Core tip: Contact dermatitis (CD) is the most common professional skin disease. CD is classified into irritant (ICD) and allergic (ACD), with both subtypes displaying sub-acute, acute and/or chronic eczema. The gold standard in CD diagnosis is patch-testing, although its validity and reproducibility are under question. Real-time reflectance confocal microscopy is a very promising tool for the diagnosis and management of ACD and ICD, providing significant advantage over conventional histology (due to the possibility to manage the disease through repetitive assessment) and patch-testing, due to increased sensitivity and specificity.