Protein contact dermatitis is a cutaneous condition, and was a term originally used to describe an eczematous reaction to protein-containing material in food handlers.[1] Usually affecting the hands or forearms, it manifests clinically as a subacute or chronic dermatitis that recurs frequently over time.[2] Niels Hjorth and Jytte Roed-Petersen coined the phrase "protein contact dermatitis" in 1976.[3]
| Protein contact dermatitis | |
|---|---|
| Specialty | Dermatology |
Signs and symptoms
editProtein contact dermatitis appears as urticarial or vesicular skin reaction within minutes of contact with the causative protein on previously afflicted skin; nonetheless, chronic or recurring eczema is the most frequently reported clinical picture. The most common affected areas are the hands (fingers, wrists, and forearms), although dermatitis can also occur on the face and neck (caused by airborne particles) in certain cases.[4]
Certain foods have been linked to a few occurrences of chronic paronychia, which is accompanied by erythema and edema of the proximal nail folds.[5]
Causes
editProtein contact dermatitis is typically caused by food-related, proteinaceous etiologic agents, such as cereal grains, flours, enzymes, and proteins from vegetables and animals.[6]
Mechanism
editSimilar to immunologic contact urticaria, the pathophysiology is a type I hypersensitivity reaction mediated by allergen-specific IgE within a previously sensitized individual.[4] Although the precise mechanism underlying protein contact dermatitis is yet unknown, it may resemble that of atopic dermatitis, especially given that a delayed IgE-mediated reaction may be caused by IgE receptors on epidermal Langerhans cells.[7]
Diagnosis
editPatch tests are typically negative, so the diagnosis is made using the results of a prick test with the allergen, which is thought to be the gold standard. Certain antibodies may occasionally be found in the patient's serum.[4]
Treatment
editUsually, the eruption heals quickly when the causative material is avoided. Corticosteroid ointments or lotions expedite the healing process in extreme situations.[8]
See also
editReferences
edit- ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
- ^ Barata, Ana Rita Rodrigues; Conde-Salazar, Luis (2013). "Protein contact dermatitis — case report". Anais Brasileiros de Dermatologia. 88 (4). FapUNIFESP (SciELO): 611–613. doi:10.1590/abd1806-4841.20132023. ISSN 0365-0596. PMC 3760939. PMID 24068135.
- ^ Hjorth, Niels; Roed-Petersen, Jytte (1976). "Occupational protein contact dermatitis in food handlers". Contact Dermatitis. 2 (1). Wiley: 28–42. doi:10.1111/j.1600-0536.1976.tb02975.x. ISSN 0105-1873. PMID 145923.
- ^ a b c Goossens, An (2021). "Protein Contact Dermatitis". Clinical Contact Dermatitis. Cham: Springer International Publishing. pp. 423–426. doi:10.1007/978-3-030-49332-5_20. ISBN 978-3-030-49331-8.
- ^ Tosti, Antonella; Guerra, Liliana; Morelli, Rossella; Bardazzi, Federico; Fanti, Pier Alessandro (1992). "Role of foods in the pathogenesis of chronic paronychia". Journal of the American Academy of Dermatology. 27 (5): 706–710. doi:10.1016/0190-9622(92)70242-8. PMID 1430392.
- ^ JANSSENS, V.; MORREN, M.; DOOMS-GOOSSENS, A.; DEGREEF, H. (1995). "Protein contact dermatitis: myth or reality?". British Journal of Dermatology. 132 (1). Oxford University Press (OUP): 1–6. doi:10.1111/j.1365-2133.1995.tb08616.x. ISSN 0007-0963. PMID 7756118.
- ^ Vester, Lotte; Thyssen, Jacob P.; Menné, Torkil; Johansen, Jeanne Duus (2012-04-06). "Occupational food-related hand dermatoses seen over a 10-year period". Contact Dermatitis. 66 (5). Wiley: 264–270. doi:10.1111/j.1600-0536.2011.02048.x. ISSN 0105-1873. PMID 22486568.
- ^ Hannuksela, Matti (2006). "Protein Contact Dermatitis". Contact Dermatitis. Berlin, Heidelberg: Springer Berlin Heidelberg. pp. 345–348. doi:10.1007/3-540-31301-x_20. ISBN 978-3-540-24471-4.
Further reading
edit- Barbaud, Annick (2020). "Mechanism and diagnosis of protein contact dermatitis". Current Opinion in Allergy & Clinical Immunology. 20 (2). Ovid Technologies (Wolters Kluwer Health): 117–121. doi:10.1097/aci.0000000000000621. ISSN 1528-4050. PMID 31972603.
- Hernández-Bel, P.; De La Cuadra, J.; García, R.; Alegre, V. (2011). "Protein Contact Dermatitis: Review of 27 Cases". Actas Dermo-Sifiliográficas (English Edition). 102 (5). Elsevier BV: 336–343. doi:10.1016/s1578-2190(11)70816-2. ISSN 1578-2190. PMID 21497331.