Dr. Yosef Pensoff, an expert in allergology and immunology at the Lynn Consultant Medical Center of Klalit, Haifa and Western Galilee, explains about contact dermatitis (CCD). contact dermatitis,
Dermatitis is a common skin disease, but at the same time it is not always diagnosed in time or at all. As a result, there may be a continuous impairment of the quality of life of those who suffer from this disease, a lot of medication use and the need for frequent visits to different doctors. Sometimes it is not only an impairment of the quality of life but Even in the case of an occupational injury. Locating the exact cause is an essential element that has the power to solve problems that sometimes last for years. It is caused by direct contact of the skin with some allergen that triggers an inflammatory process in the area of contact and can be characterized by a combination of various skin phenomena such as redness, tiny blisters, dryness, peeling and cracks As a result, the patient will complain of a pronounced itch and sometimes of pain, especially when there are cracks in sensitive areas such as the pads of the fingers, for example.”
The allergic reaction depends on two components: one, the abnormal reaction of the immune system. The second, the allergen itself when it is known that there are substances that are more allergenic than others or are used more commonly. For example, a substance called PPD (essential for hair dyeing) is considered a potential allergen that in small exposures may cause strong reactions in a significant percentage of people.
In addition, there is a clinical difference between the reaction to substances in prolonged contact with the skin (creams, for example) versus substances in occasional and short contact (shampoo, for example): there are standards that guide manufacturers regarding what is allowed to be put on the skin for a period of time and what for a moment and at what concentration.
Many substances can cause DAM, some of them are more common, others less common and there are new allergens that are discovered all the time. The list of contact allergens is long and includes, among other things, chemicals in personal care products, creams and metal drops, adhesives, acrylic materials, dyes, materials Preservatives of various kinds, etc. There are substances that most of us are exposed to and there are substances to which the exposure is occupational, while each workplace has substances that are unique to it.
DM can appear at any age, not only in adults but also in small children. Any place in the body may react: from the scalp to the feet and along the way in the lips, eyelids and intimate places. It can appear as a skin disease by itself or as a complication of another skin disease that damages the integrity of the skin and thus Allows those allergens to penetrate and cause an allergic process that is added to the primary disease. In any prolonged or repeated dermatitis, the existence of DAM should be suspected.
“An example of a case that came to my attention is about a girl who had an innocent tattoo, a “black henna tattoo”. This is a temporary tattoo made of henna (a non-allergenic substance) together with PPD, which gives it the black shade. In these tattoos, PPD is present in a concentration much higher than what is accepted in hair dye products. The combination of A strong allergen in a high concentration causes many cases of severe reactions to these tattoos, especially at young ages.” Dr. Pensoff’s number.
Allergen detection is carried out by patch tests – stickers that are stuck on the patient’s back and have small amounts of various allergens on them. The patches are removed after 48 hours and then it is checked whether one of those substances caused a reaction in the area of its contact with the skin. After 24-48 hours the back is checked again and only then can it be known whether the test is positive (there is a reaction to a certain allergen) or negative (no reaction to any allergen). The selection of the materials to be tested is an extremely important element, therefore a negative test does not always rule out an opinion because the relevant materials may not have been tested. Sometimes several cycles of testing are required until the puzzle is solved.
“DAM is a common disease that should be suspected with any prolonged skin inflammation, especially in fixed places on the body. Years of problems may disappear after finding the cause. Therefore, it is advisable to refer suspicious cases to clinics dealing in this field.” concludes Dr. Yosef Pansoff, a specialist in allergology and immunology at the Linn Consultant Medicine Center of Klalit, Haifa District and Western Galilee