Special Forms Of Eczema And Contact Reactions Protein Contact Dermatitis

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In 1976, a group of Danish investigators described eczematous reactions to foods in food service workers, with irregular results on patch testing but positive immediate sensitivity. Not all of these individuals were atopic according to the report. These reactions appear as early as 30 min, which is much earlier than ordinary contact dermatitis. The first report found that most reactions to food were to meats, but a few were to vegetables. The published antigens causing protein contact dermatitis have been divided into the following categories: (1) fruits, vegetables, spices, plants (including natural rubber latex); (2) animal proteins; (3) grains; and (4) enzymes. Atopic eczema patients commonly are sensitive to house dust, and some health care workers presenting with hand eczema (or contact urticaria) are sensitive to latex or glove powder. Such sensitivity is picked up with testing for immediate sensitivity. Several methods have been reported, including prick testing, ImmunoCAP or radioallergosorbent (RAST) testing, rub testing, scratch testing, and scratch chamber testing. Patch testing may or may not be positive. Persons with protein contact dermatitis may or may not have contact urticaria.

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