Group Ashley, Lea Alfred
The University of Texas Medical Branch, Galveston, Texas; Email:
Wounds. 2010 Dec;22(12):311-5.
Contact dermatitis is an inflammatory reaction in the skin that arises from exposure to an irritant or allergen. Irritant contact dermatitis is the most common form of dermatitis and occurs when any substance disrupts the epidermal skin barrier. All individuals are susceptible to this type of reaction. Allergic contact dermatitis is a delayed Type IV hypersensitivity reaction that occurs in individuals that have previously been sensitized to a particular antigen. Patients with wounds are at particular risk of developing either an allergic or irritant contact dermatitis. Various contributing factors, including an impaired skin barrier that allows for easier absorption of potential allergens and exposure to a number of wound care products and dressings, can be allergenic or irritating. Silver compounds are widely used in wound care for their antimicrobial properties. These products are generally well tolerated, but infrequently are causative agents in contact dermatitis. The following review will summarize contact dermatitis cases due to silver that have been described in the literature. Despite their widespread use in wound care, there has only been one confirmed case of contact dermatitis secondary to silver-containing wound products. It is possible that more cases have been missed simply because silver is not commonly considered to be an allergen. Routine use of patch testing for silver allergy in these patients may lead to an increased number of recognized cases. .
接触性皮炎是皮肤因接触刺激物或变应原而产生的炎症反应。刺激性接触性皮炎是最常见的皮炎形式，当任何物质破坏表皮皮肤屏障时就会发生。所有人都易患这种类型的反应。过敏性接触性皮炎是一种迟发性IV型超敏反应，发生在先前已对特定抗原致敏的个体中。伤口患者特别容易发生过敏性或刺激性接触性皮炎。各种促成因素，包括受损的皮肤屏障使潜在变应原更容易吸收，以及接触多种伤口护理产品和敷料，都可能具有变应原性或刺激性。银化合物因其抗菌特性而广泛用于伤口护理。这些产品通常耐受性良好，但很少是接触性皮炎的致病因素。以下综述将总结文献中描述的因银导致的接触性皮炎病例。尽管它们在伤口护理中广泛使用，但仅有一例确诊的因含银伤口产品继发的接触性皮炎病例。有可能更多病例被漏诊，仅仅是因为银通常不被认为是一种变应原。对这些患者常规进行银过敏斑贴试验可能会使确诊病例数量增加。
