Detecting Allergic Contact Dermatitis
Speaking at the American Academy of Dermatology’s 2003 Annual Meeting in San Francisco, dermatologist Joseph F. Fowler, Jr., MD, spoke about allergic contact dermatitis and the various metals that can trigger it.
"Allergic contact dermatitis accounts for a significant number of visits to a dermatologist's office and is usually caused by substances that come into contact with the skin," said Dr. Fowler. "Metal is one of the most common culprits of allergic contact dermatitis especially due to the popular trend of body piercing which can lead to irritation and rashes in not only the earlobes, but upper portions of the ears, lips, nose, tongue, navel, breasts and genitalia as well."
After poison ivy, metal allergy is the most common form of allergic contact dermatitis. In the past, women have been more susceptible to metal allergy than men due to the amount of jewelry worn, but the numbers of males wearing jewelry is increasing and so is the incidence of metal allergy in this population.
Symptoms of metal allergy usually occur between six to 24 hours following exposure and will dissipate if exposure to the allergen is eliminated. The affected skin may become red, swollen, and blisters often appear, which may break, leaving crusts and scales. Later the skin may darken and become leathery and cracked. The rash is generally confined to the site of contact, although severe cases may extend outside the contact area, especially if the allergen is on your fingers and then transmitted to the face, eyelids or genitals."It’s important to note that allergic contact dermatitis, such as metal allergy, can be difficult to distinguish from other rashes," stated Dr. Fowler. "However, dermatologists can determine clues about the nature of a rash based on its location on the body and the patient's lifestyle and work habits."
Another way dermatologists can discover the source of an allergy is through patch testing. During patch testing, small amounts of possible allergens are applied to the skin on strips of tape and then removed after two days. An allergy shows up as a small red spot at the site of the patch and a dermatologist notes what the patient is most sensitive to.
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