Erdmann S M, Werfel T
Klinik für Dermatologie und Allergologie Aachen, Universitätsklinikum Aachen, Pauwelsstrasse 30, 52074 Aachen.
Hautarzt. 2006 Feb;57(2):116-20. doi: 10.1007/s00105-005-1079-2.
Oral ingestion or parenteral administration of certain contact allergens may elicit eczematous skin reactions "from inside" in sensitized individuals; this phenomenon has been termed "systemically-induced eczema" or "hematogenous contact eczema". There is a wide range of clinical features from polyetiological dyshidrotic hand and foot eczema to baboon syndrome. The most important contact allergens known to elicit systemically-induced contact eczema are metal salts, drugs, phytoallergens and balsam of Peru. Diagnosis is based on proof of delayed type hypersensitivity by patch testing and oral challenge. Until more and better data is acquired, special diets (for instance low nickel) should be instituted only in carefully selected patients.