What Is Allergic Contact Eczema

The allergic contact eczema is a medical condition wherein due to contact with an allergen, the skin develops rashes right from the point of contact to the surrounding skin. Allergen is an invading substance or organism to which the skin is sensitive. Allergic contact eczema is also known as delayed hypersensitivity, as contrast to the immediate hypersensitivity. In this medical condition and other skin diseases, the cells of the immune system play an important role. Let’s see how!

When you are hurt by nettles, the skin develops rashes within a few minutes of contact. The scientific reason behind this is that the immunity cells secrete certain chemicals such as histamine in the layers of the skin. Such a condition is termed as immediate hypersensitivity.

On the other hand, sometimes these rashes develop gradually, rather than instantly. This is due to slow response of the immune system. This happens because the quantity of cells that are required to fight or react against the allergen is yet to be developed from a small amount of memory cells that sense or identify the allergen. Between two or three days of time, these cells produce other cells that finally activate the other defense mechanisms. This mechanism includes the secretion of chemicals that pull the scavenger cells of the immune system.

Due to the time interval between the initial contact of the allergen and its consequent reaction, such a state is known as delayed hypersensitivity.

Characteristics

In allergic contact eczema, the rash is first developed at the point of contact between the skin and allergen. But gradually, this rash spreads to such an extent such that it reaches the skin that is far away from the contact spot. This happens because the immune cells are switched on that travel to other areas through the blood flow. So, if you suspect allergic contact eczema, it is important for you to keep a note of initial spot. This information needs to be given your doctor when he/she asks the history of the rash development.

In many cases, the cause and effect of allergic eczema is clear, for instance, a red scaly rash surrounding an earring (of nickel) or under the strip of the watch (nickel). But sometimes, it is tough to detect whether the skin reaction is contact allergic eczema or some other eczema when too much time is passed since the original reaction. Listed below are a few types of eczema.

• Atopic eczema
• Discoid eczema
• Irritant contact eczema
• Seborrhoeic eczema

Sometimes, it is also difficult to find a line of demarcation between allergic contact eczema (an immune response) and irritant eczema (a direct skin reaction against a nuisance material). However, this hardly matters for the patient and the doctor, as both require common treatment.

Allergens that Cause Allergic Contact Eczema

Until today, medical experts are unable to find the exact reason as to why certain substances cause skin allergies. Listed below are these allergens.

• Nickel
  A white metal and a common cause of allergic eczema. It is found in jewellery, watch strips made up of metal, belt buckles, and jean hoops. Apart from nickel, there are more metals that can cause skin rashes.
• Perfumes
  Balsam of Peru is related to fragrance that can result in contact allergy.
• Rubber and Related Chemicals
  In shoes, tyres, and clothing.
• Potassium Dichromate
  In cement, leather, and matches.
• Hairdressing Chemicals
  Example includes paraphenylenediamine.
• Medications
  Lanolin, neomycin (antibiotic), cetearyl alcohol (in emollient creams), steroid creams, and fusidic acid (antibiotic).
• Epoxy Resins
  In glues, woodworking, and development of glass fibers.
• Colophony
  Resin from spruce trees used in sticking plaster glue.
• Plants
  By direct contact and due to the particles in the air.

Considering the diet, there are wide varieties of food items that can potentially lead to contact allergy. Listed below are these food items.

• Sugar
• Flour or dough
• Citrus fruits and their peel
• Spices, herbs, and seasonings (for example, horseradish and garlic)
• Fish and sea foods
• Meat and poultry

A complete list of allergens that can cause contact eczema is not available. It is advisable to try and determine all possible allergens. To do so, the most common technique is to test a person’s skin against a set of standard sample substances that have the potential to lead to allergic contact eczema. This technique is known as patch testing.

Kindly note that some of the substances that can result in skin reactions are actually a part of standard treatments for allergic eczema, for instance, lanolin in moisturizers and hydrocortisone in steroid creams. This means the treatment itself can be potentially be the cause of worsening the condition of eczema. If this is true, then the treatment needs to be revised by the concerned doctor.

Allergic Contact Eczema Treatment

Upon examining the allergy, if the cause that is detected can be removed, there are more changes that the problem can be solved. However, this is not applicable to all individuals, for example, patients having hand eczema. There is no clarity as to what is the reason behind this. Listed below are the treatments suggested for contact allergic eczema.

• Moisturizers and Steroid Creams
  Are effective but it is dependent on the extent of sensitization and the frequency of exposure.
• Cytokine Inhibitor
  Includes pimecrolimus and tacrolimus and are likely to be as useful as steroids.

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