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Contact dermatitis is a non-infectious inflammatory skin disease caused by an offending substance localized at the site of contact. The prevalence and incidence are increasing throughout the world, especially in Europe and North America. There are two main groups – irritant contact dermatitis and allergic contact dermatitis – with the former being more frequent. However, more than 4,000 contact allergens are known to cause allergic contact dermatitis in populations, of which nickel is the most common. Allergic contact dermatitis is a delayed IV type hypersensitivity resulting from cutaneous contact with a specific allergen. In pathogenesis, there is a significant difference between irritant and allergic dermatitis. Irritant contact dermatitis is a nonimmunologic, nonspecific inflammatory reaction to a wide range of chemical, physical or mechanical hazardous causes involving the innate immune system without prior sensitization. Topical corticosteroids are the mainstay therapy. Calcineurin inhibitors are employed in dermatology as an alternative therapy to topical corticosteroids with a better safety profile. Systemic treatments are used in severe cases and may provide temporary remission, but are not always suitable for prolonged use due to adverse effects. Alitretinoin is used to treat severe and refractory chronic hand dermatitis. After clinical clearance of contact dermatitis, the skin barrier requires restoration therapy provided by a moisturizing agent, which should be used for a prolonged period. The application of a moisturizing agent promotes epidermal barrier healing, prolongs the time to flare and reduces the number of flares. Most frequently, absolute avoidance of the triggering offending contact is very difficult, or even impossible. Therefore, protective measures to prevent renewed skin contact are indicated. Any type of symptomatic treatment cannot substitute this approach. (Nova Biomedical)
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