Protein contact dermatitis: Difference between revisions
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'''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.<ref name="Bolognia">{{cite book |author=Rapini, Ronald P. |author2=Bolognia, Jean L. |author3=Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |isbn=1-4160-2999-0 }}</ref> |
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'''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.<ref name="Bolognia">{{cite book |author=Rapini, Ronald P. |author2=Bolognia, Jean L. |author3=Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |isbn=1-4160-2999-0 }}</ref> Usually affecting the hands or forearms, it manifests clinically as a subacute or chronic [[dermatitis]] that recurs frequently over time.<ref name="case report">{{cite journal | last=Barata | first=Ana Rita Rodrigues | last2=Conde-Salazar | first2=Luis | title=Protein contact dermatitis — case report | journal=Anais Brasileiros de Dermatologia | publisher=FapUNIFESP (SciELO) | volume=88 | issue=4 | year=2013 | issn=0365-0596 | doi=10.1590/abd1806-4841.20132023 | pages=611–613}}</ref> Niels Hjorth and Jytte Roed-Petersen coined the phrase "protein contact dermatitis" in 1976.<ref name="Hjorth Roed‐Petersen 1976">{{cite journal | last=Hjorth | first=Niels | last2=Roed‐Petersen | first2=Jytte | title=Occupational protein contact dermatitis in food handlers | journal=Contact Dermatitis | publisher=Wiley | volume=2 | issue=1 | year=1976 | issn=0105-1873 | doi=10.1111/j.1600-0536.1976.tb02975.x | pages=28–42}}</ref> |
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== Signs and symptoms == |
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Protein 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.<ref name="Goossens 2021">{{cite book | last=Goossens | first=An | title=Clinical Contact Dermatitis | chapter=Protein Contact Dermatitis | publisher=Springer International Publishing | publication-place=Cham | date=2021 | isbn=978-3-030-49331-8 | doi=10.1007/978-3-030-49332-5_20 | page=423–426}}</ref> |
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Certain foods have been linked to a few occurrences of chronic [[paronychia]], which is accompanied by [[erythema]] and [[edema]] of the proximal nail folds.<ref name="Role of foods">{{cite journal | last=Tosti | first=Antonella | last2=Guerra | first2=Liliana | last3=Morelli | first3=Rossella | last4=Bardazzi | first4=Federico | last5=Fanti | first5=Pier Alessandro | title=Role of foods in the pathogenesis of chronic paronychia | journal=Journal of the American Academy of Dermatology | volume=27 | issue=5 | date=1992 | doi=10.1016/0190-9622(92)70242-8 | pages=706–710}}</ref> |
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== Causes == |
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Protein contact dermatitis is typically caused by food-related, proteinaceous etiologic agents, such as cereal grains, flours, enzymes, and proteins from vegetables and animals.<ref name="JANSSENS MORREN DOOMS-GOOSSENS DEGREEF 1995 pp. 1–6">{{cite journal | last=JANSSENS | first=V. | last2=MORREN | first2=M. | last3=DOOMS-GOOSSENS | first3=A. | last4=DEGREEF | first4=H. | title=Protein contact dermatitis: myth or reality? | journal=British Journal of Dermatology | publisher=Oxford University Press (OUP) | volume=132 | issue=1 | year=1995 | issn=0007-0963 | doi=10.1111/j.1365-2133.1995.tb08616.x | pages=1–6}}</ref> |
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== Mechanism == |
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Similar to immunologic contact urticaria, the pathophysiology is a [[type I hypersensitivity]] reaction mediated by allergen-specific [[Immunoglobulin E|IgE]] within a previously sensitized individual.<ref name="Goossens 2021"/> Although the precise mechanism underlying protein contact dermatitis is yet unknown, it may resemble that of [[atopic dermatitis]], especially given that a delayed [[Immunoglobulin E|IgE]]-mediated reaction may be caused by [[Immunoglobulin E|IgE]] receptors on epidermal [[Langerhans cell]]s.<ref name="10‐year period">{{cite journal | last=Vester | first=Lotte | last2=Thyssen | first2=Jacob P. | last3=Menné | first3=Torkil | last4=Johansen | first4=Jeanne Duus | title=Occupational food‐related hand dermatoses seen over a 10‐year period | journal=Contact Dermatitis | publisher=Wiley | volume=66 | issue=5 | date=2012-04-06 | issn=0105-1873 | doi=10.1111/j.1600-0536.2011.02048.x | pages=264–270}}</ref> |
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== Diagnosis == |
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[[Patch test]]s are typically negative, so the diagnosis is made using the results of a [[Skin allergy test|prick test]] with the allergen, which is thought to be the gold standard. Certain [[Antibody|antibodies]] may occasionally be found in the patient's serum.<ref name="Goossens 2021"/> |
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== Treatment == |
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Usually, the eruption heals quickly when the causative material is avoided. [[Corticosteroid]] ointments or lotions expedite the healing process in extreme situations.<ref name="Hannuksela 2006 pp. 345–348">{{cite book | last=Hannuksela | first=Matti | title=Contact Dermatitis | chapter=Protein Contact Dermatitis | publisher=Springer Berlin Heidelberg | publication-place=Berlin, Heidelberg | date=2006 | isbn=978-3-540-24471-4 | doi=10.1007/3-540-31301-x_20 | page=345–348}}</ref> |
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== See also == |
== See also == |
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== Further reading == |
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* {{cite journal | last=Barbaud | first=Annick | title=Mechanism and diagnosis of protein contact dermatitis | journal=Current Opinion in Allergy & Clinical Immunology | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=20 | issue=2 | year=2020 | issn=1528-4050 | doi=10.1097/aci.0000000000000621 | pages=117–121 | ref=none}} |
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* {{cite journal | last=Hernández-Bel | first=P. | last2=De La Cuadra | first2=J. | last3=García | first3=R. | last4=Alegre | first4=V. | title=Protein Contact Dermatitis: Review of 27 Cases | journal=Actas Dermo-Sifiliográficas (English Edition) | publisher=Elsevier BV | volume=102 | issue=5 | year=2011 | issn=1578-2190 | doi=10.1016/s1578-2190(11)70816-2 | pages=336–343 | ref=none}} |
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== External links == |
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| ICD11 = {{ICD11|EK11}} |
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| ICD10 = {{ICD10|L25.4}} |
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| SNOMED CT = 1172686000 |
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{{Dermatitis and eczema}} |
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Revision as of 04:13, 5 March 2024
| Protein contact dermatitis | |
|---|---|
| Specialty | Dermatology |
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]
Signs and symptoms
Protein 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
Protein 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
Similar 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
Patch 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
Usually, the eruption heals quickly when the causative material is avoided. Corticosteroid ointments or lotions expedite the healing process in extreme situations.[8]
See also
References
- ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
- ^ 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.
- ^ 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.
- ^ a b c Goossens, An (2021). "Protein Contact Dermatitis". Clinical Contact Dermatitis. Cham: Springer International Publishing. p. 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.
- ^ 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.
- ^ 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.
- ^ Hannuksela, Matti (2006). "Protein Contact Dermatitis". Contact Dermatitis. Berlin, Heidelberg: Springer Berlin Heidelberg. p. 345–348. doi:10.1007/3-540-31301-x_20. ISBN 978-3-540-24471-4.
Further reading
- 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.
- 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.