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Got a Rash? We’ve Got Answers!

by Dr. Abner Bagenstose

Contact dermatitis is one of the most common causes of inflammatory skin diseases, accounting for 10% of all dermatology visits. However, not all of these skin ailments are easily treated, and many are allergic reactions. Read on to learn how our in-house allergy practice might help get you answers quickly and save you time and money!

What is Irritant Contact Dermatitis?

Contact dermatitis has two main groups of causes with the most common being irritant contact dermatitis. Irritant contact dermatitis occurs when the skin comes into direct contact with irritating chemicals that are toxic and injure the top layer of skin. Examples include acids, alkalis, oxidants, harsh soaps, and exposure to water. The rash often appears within minutes although it may develop after several days. Treatments include avoiding the irritant, using mild soaps, moisturizers, and topical corticosteroids. If the reaction is severe, oral corticosteroids (i.e. prednisone) may be necessary.

What is Allergic Contact Dermatitis?

The second group of causes for contact dermatitis is allergic contact dermatitis and makes up an estimated 20-50% of contact dermatitis patients. This type of contact dermatitis is caused by an immune response to an allergen that has come into direct contact with the skin. The rash usually presents within 12-72 hours and can last 2 weeks or more after exposure to the allergen. Allergic contact dermatitis should be suspected when dermatitis does not improve as expected with therapy, if the dermatitis reoccurs, suddenly appears, or if it appears in certain areas such as the face, hands, feet or perineal area. The best course of action for suspected allergic contact dermatitis is patch testing in order to find the causative allergen and implement avoidance therapy. History is unreliable and 50% of allergic contact dermatitis cases are missed by experienced specialists.

The North American Core Series Test vs. the True Test

Most dermatologists use a product called the True Test, which is a patch test consisting of 35 contact allergens and a negative control. These are some of the most common allergens, however, approximately 33% of allergic contact dermatitis causes are missed using the True Test due to the limited number of allergens tested. This is why we have adopted the North American Core Series of 87 allergens. We are one of only a few practices in central Ohio that offer this standard.

By doing the more extensive series, we have had a higher percentage of relevant contact allergens positively identified making avoidance therapy possible and reducing the time the patient spends in discomfort. This definitive identification of allergens by patch testing is also cost effective for the patient since it is reducing the expense in doctor visits, additional testing, prescriptions, and time off of work. Northeast Dermatology has been utilizing the North American Core series for several months and have already picked up many causative allergens not included in the True Test series, positively affecting our patients’ lives.

If you have symptoms that suggest allergic contact dermatitis and would like to have them tested using the North American Core Series, we are accepting new patients and can typically schedule you within 2-3 weeks. Call us today to learn more!

#allergy #dermatitis #rash