Peer-review started: October 8, 2014
First decision: November 27, 2014
Revised: December 28, 2014
Accepted: January 18, 2015
Article in press: January 20, 2015
Published online: May 2, 2015
Contact dermatitis-including allergic contact dermatitis (ACD)-n and results in over four million lost work days per year in the United States alone. ACD is a classic example of a type IV delayed hypersensitivity reaction, and represents a significant burden on the health system, economy, and patient quality of life. Thorough history taking, clinical examination, histologic evaluation, and patch testing are keys to diagnosing contact dermatitis. Patch testing, especially with comprehensive and customized panels based on the patient’s exposure history, is particularly useful in identifying potential allergens in the case of allergic contact dermatitis. ACD management requires a combination of direct medical intervention, patient education, and appropriate environmental modification to prevent exposure to offending allergens in the home or workplace. Continuing advances in the study of ACD has led to an increased understanding of the disease processes, new methods for diagnosis, and improved management. This article reviews ACD-aiming to connect recent investigational data with the current clinical understanding of disease pathophysiology, diagnostic techniques, and management strategies.
Core tip: Allergic contact dermatitis (ACD) affects approximately 20% of the adult population and results in over four million lost work days per year in the United States. Continuing advances in the study of ACD have led to an increased understanding of the disease processes, new methods for diagnosis, and improved approaches for treatment. This article discusses ACD holistically, aiming to connect recent investigational data with current clinical understanding to review disease pathophysiology, diagnostic techniques, as well as management strategies.