William Pinette 30 July, 2010 Toxicodendron diversilobum, Poison-oak

 Contact Dermatitis: “Contact dermatitis is an eczematous skin reaction caused by direct and usually repeated exposure to harmful objects or chemicals … It is typically characterized by itching papules... but may vary from slight hyperkeratosis... and small fissures to extensive redness, swelling and oozing. A histopathological examination of a biopsy shows an acute inflammation in the epidermis.” – European Society for Contact Dermatitis  Allergic Contact Dermatitis  Irritant Contact Dermatitis

 Immune response  Delayed Type Hypersensitivity  T lymphocytes  Allergens  Toxicodendron  Urushiol  Nickel and other metals  Latex  Chemicals  Formaldehyde  Perfume

 No direct immune response  Exposure to irritants that compromise the epithelium in various ways  Industrial Solvents  Oil products  Hair products  Dimethyl Fumarate (DMF)

 ACD  Cannot “cure” the immune system.  Avoid exposure to allergen  Wash affected area with soap and cool water  Corticosteroids and antihistamine for more severe cases  ICD  Avoid prolonged exposure to irritants  Personal protective equipment  Barrier creams

 What is contact dermatitis? European Society of Contact Dermatitis.  Kalish RS, Johnson KL. Enrichment and function of urushiol (poison-ivy)- specific T Lymphocytes in lesions of allergic contact dermatitis to urushiol. J Immunol.(1990) 145:  Niyama et. al. Th2 Immune Response Plays a Critical Role in the Development of Nickel-Induced Allergic Contact Dermatitis. Int Arch Allergy Immunol (2010). 153: 303–314  Gimenez-Arnaui et al. Shoe contact dermatitis from dimethyl fumarate: clinical manifestations, patch test results, chemical analysis, and source of exposure. Contact Dermatitis (2009) 61: 249–260  Chew IL, Maibach HI. Occupational issues of irritant contact dermatitis. Int Arch Occup Environ Health (2003) 76: 339–346