MacNeal Hospital, Berwyn, IL, USA.
Dermatitis. 2009 Nov-Dec;20(6):327-33.
This article discusses the future of allergic contact dermatitis (ACD) diagnosis and management. Due to early landmark discoveries in this disorder, there is a knowledge base that can be refined. Improved patch-test technology, patch-test strategy, and patch-testing clinical relevance are emphasized. Other factors for improvement include complete ingredient identification on Material Safety Data Sheets, knowledge of the relationship of extracutaneous allergic disease to ACD, understanding of the evolutionary implications of ACD, increased chemical identification of allergens in publication, and enhanced knowledge of immunologic contact urticaria and irritant dermatitis syndrome. Further research into in vitro diagnostic methods, skin bioengineering tools, and ribonucleic acid diagnostic methods may lead to more precise and less invasive diagnosis of ACD. Development of national and international allergen banks and analytic chemistry laboratories would allow better documentation and epidemiology of allergens, as would collaboration between national and international contact dermatitis organizations via the World Wide Web. Finally, additional fellowships in contact allergy should produce more dermatologists equipped to face the complex challenges of ACD and develop solutions for ongoing questions.
本文讨论了变应性接触性皮炎（ACD）诊断和管理的未来。由于该疾病的早期开创性发现，已经有了一个可以完善的知识库。本文强调了改进斑贴试验技术、斑贴试验策略和斑贴试验临床相关性的重要性。其他改进因素包括在材料安全数据表上完整识别成分、了解与 ACD 相关的非皮肤过敏性疾病、了解 ACD 的进化意义、在出版物中增加对过敏原的化学鉴定，以及增强对免疫性接触性荨麻疹和刺激性皮炎综合征的认识。进一步研究体外诊断方法、皮肤生物工程工具和核糖核酸诊断方法可能会导致更精确、侵入性更小的 ACD 诊断。建立国家和国际过敏原库和分析化学实验室，以及通过万维网进行国家和国际接触性皮炎组织之间的合作，将有助于更好地记录和研究过敏原的流行病学。最后，增加接触过敏方面的奖学金将培养更多能够应对 ACD 复杂挑战并为持续存在的问题提供解决方案的皮肤科医生。
