Slodownik Dan, Lee Adriene, Nixon Rosemary
Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation, Melbourne, Victoria, Australia.
Australas J Dermatol. 2008 Feb;49(1):1-9; quiz 10-1. doi: 10.1111/j.1440-0960.2007.00409.x.
Irritant contact dermatitis is the most common form of contact dermatitis, and yet is often overlooked. Recent progress in understanding the pathogenesis has reignited the interest of clinicians in this area of dermatology. Irritant contact dermatitis is not a homogenous entity, but rather a number of subtypes contributing to different clinical presentations. The diagnosis of irritant contact dermatitis is often clinical, and may only be possible after the exclusion of allergic contact dermatitis with patch testing. There is no readily available diagnostic test. There is an incomplete understanding of the factors which lead to the development of cumulative irritant contact dermatitis and persistent postoccupational dermatitis. We have used the experience from our tertiary referral occupational dermatology clinic to illustrate various aspects of irritant contact dermatitis, and to highlight the difficulty sometimes encountered in making this diagnosis. We believe that increased awareness of the often pivotal role of irritant contact dermatitis, as well as all the other factors contributing to occupational dermatitis, will lead to improvement in outcomes for patients.
刺激性接触性皮炎是接触性皮炎最常见的形式,但常常被忽视。在理解其发病机制方面的最新进展重新点燃了临床医生对这一皮肤科领域的兴趣。刺激性接触性皮炎并非单一的实体,而是多种亚型导致了不同的临床表现。刺激性接触性皮炎的诊断通常基于临床,且可能只有在通过斑贴试验排除过敏性接触性皮炎后才能确诊。目前尚无现成的诊断测试。对于导致累积性刺激性接触性皮炎和持续性职业性皮炎发生的因素,我们的了解并不完整。我们利用三级转诊职业皮肤科诊所的经验来说明刺激性接触性皮炎的各个方面,并强调在做出这一诊断时有时会遇到的困难。我们相信,提高对刺激性接触性皮炎以及导致职业性皮炎的所有其他因素通常所起关键作用的认识,将改善患者的治疗结果。