Saary Joan, Qureshi Roohi, Palda Valerie, DeKoven Joel, Pratt Melanie, Skotnicki-Grant Sandy, Holness Linn
Department of Occupational and Environmental Health, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
J Am Acad Dermatol. 2005 Nov;53(5):845. doi: 10.1016/j.jaad.2005.04.075.
Contact dermatitis (CD) is a common occupational disease. There have been no systematic reviews of CD treatment or prevention.
Multiple databases were systematically searched. Using independent double review and published quality review criteria, articles were rated as good, fair, or poor. Treatment benefit data were tabulated and conclusions were based on the rated strength of published evidence.
In all, 49 studies met inclusion criteria. Barrier creams containing dimethicone or perfluoropolyethers, cotton liners, and softened fabrics prevent irritant CD. Lipid-rich moisturizers both prevent and treat irritant CD. Topical skin protectant and quaternium 18 bentonite (organoclay) prevent rhus dermatitis. Diethylenetriamine pentaacetic acid (chelator) cream prevents nickel, chrome, and copper dermatitis. Potent or moderately potent steroids effectively treat allergic CD. There were no macrolide immunomodulator trials that met inclusion criteria. This review did not include studies of children, animals, or non-English language publications.
A limited number of interventions effectively prevent or treat irritant and allergic CD, but well-controlled, outcome-blinded studies, particularly in the area of allergic CD prevention are needed.
接触性皮炎（CD）是一种常见的职业病。目前尚无关于CD治疗或预防的系统评价。
系统检索多个数据库。采用独立双审和已发表的质量评价标准，将文章评为优、良或差。整理治疗获益数据，并根据已发表证据的评定强度得出结论。
共有49项研究符合纳入标准。含二甲硅油或全氟聚醚的屏障乳膏、棉质衬里和柔软织物可预防刺激性CD。富含脂质的保湿剂既能预防也能治疗刺激性CD。局部皮肤保护剂和季铵盐-18膨润土（有机粘土）可预防漆树皮炎。二乙烯三胺五乙酸（螯合剂）乳膏可预防镍、铬和铜皮炎。强效或中效类固醇可有效治疗过敏性CD。没有符合纳入标准的大环内酯类免疫调节剂试验。本评价未纳入儿童、动物或非英文出版物的研究。
有限的一些干预措施可有效预防或治疗刺激性和过敏性CD，但仍需要开展严格对照、结果设盲的研究，尤其是在过敏性CD预防领域。
