University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Lakeside Suite 6223, Cleveland, OH 44106, USA.
Dermatol Clin. 2020 Jul;38(3):301-308. doi: 10.1016/j.det.2020.02.006. Epub 2020 Apr 17.
The duration of cutaneous inflammation preceding sensitization influences the resulting allergic response; the innate immune system instructs the adaptive immune response. Potent allergens that function as their own irritant cause classic T helper cell type 1 skewed dermatitis. Examples include poison ivy, epoxy resin, and methylchloroisothiazolinone. Less potent allergens, such as food proteins and propylene glycol, sensitize skin affected by chronic dermatitis resulting in a T helper cell type 2 skewed response, sometimes with associated systemic contact dermatitis. Systemic contact dermatitis should therefore be suspected in patients with positive patch tests to ingested allergens in the setting of chronic dermatitis.
致敏前皮肤炎症的持续时间会影响过敏反应的结果；先天免疫系统会指导适应性免疫反应。具有自身刺激性的强效变应原会导致经典的 T 辅助细胞 1 型偏倚性皮炎。例如，毒葛、环氧树脂和甲基氯异噻唑啉酮。较弱效的变应原，如食物蛋白和丙二醇，会致敏受慢性皮炎影响的皮肤，导致 T 辅助细胞 2 型偏倚反应，有时还伴有相关的全身性接触性皮炎。因此，对于慢性皮炎患者，若摄入性变应原斑贴试验阳性，应怀疑全身性接触性皮炎。
