Allergic contact dermatitis (ACD) is one of the commonest
occupational diseases in industrialized countries, where it comprises 20-70% of all
occupational diseases. Recent studies found out the top ten
allergens, but there are some differences in their frequency in relation to gender and age of patients: Myroxylon pereirae and
Carba mix resulted the most prevalent
allergens in men, while in women the most common sensitizers were
nickel sulfate,
PPD, fragrance mix and
cobalt chloride. ACD is an inflammatory
skin disease caused by repeated skin exposure to contact
allergens, in which the lesions are due to T CD8+ cells in a type IV, delayed or cell-mediated, immune reaction. The typical skin lesions of ACD in general outburst in contact areas with the specific
allergens and they are erythematosus-squamous lesions with other little differences in relation to localization, for example
edema, vesicular-exuding lesions or onychodystrophy. Different treatment options exist and are applied according to the severity of the lesions. Topical treatments consist of bland
emollients,
corticosteroids ointments, topical
immunomodulators such as
tacrolimus and
pimecrolimus ointments,
coal tar and derivatives and irradiation with ultraviolet lights or X-rays; while
azathioprine,
methotrexate,
cyclosporine A, oral
retinoids or oral
corticosteroids represent systemic options of
therapy. Nevertheless, the control of chronic ACD is often difficult, overall in patients with chronic ACD.