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Allergic contact dermatitis is one of two forms of contact dermatitis, in which skin contact with a particular substance triggers an allergic skin reaction. The other form is irritant contact dermatitis (ICD), which is more common than ACD and has slightly differing clinical features. ACD presents with symptoms similar to those of eczema with skin typically becoming very dry, scaly and itchy.
The allergic reactions seen with ACD are triggered by protein molecules (allergens) present in a particular substance. Immune cells within the skin mount an immune attack that leads to symptoms of allergy. Some of the materials that commonly trigger the allergic reaction include nickel, cobalt, cosmetics, perfumes, hair dyes, medicine preservatives and latex in rubber.
In the case of ICD, substances physically break the skin and expose cutaneous skin cells to the allergen. Examples of irritants include detergents, cosmetics, soaps, perfumes, solvents, oils, chemicals, dust and plants.
Although the clinical presentation of ACD and ICD is similar, there are some small differences in symptoms which help distinguish between the two:
Diagnosis is based on a clinical history of reactions to potential allergens after exposure. For confirmation of diagnosis, a skin prick test and allergen specific IgE tests are usually used.
Avoidance of the allergen potentially leading to an allergic reaction is the most common approach to preventing ACD. In addition, the following measures may be taken: