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变应性接触性皮炎:从发病机制到新的预防策略的发展。

Allergic contact dermatitis: From pathophysiology to development of new preventive strategies.

机构信息

Faculty of Pharmacy, University of Coimbra, Coimbra, 3000-548, Portugal; Center for Neuroscience and Cell Biology - CNC, University of Coimbra, Coimbra, 3004-504, Portugal.

Faculty of Pharmacy, University of Coimbra, Coimbra, 3000-548, Portugal.

出版信息

Pharmacol Res. 2020 Dec;162:105282. doi: 10.1016/j.phrs.2020.105282. Epub 2020 Nov 5.

Abstract

As the body's first line of defense, the skin is the organ most frequently exposed to chemicals present in personal hygiene products, household products, or materials used in the work environment. In this context, skin disorders account for more than 40 % of all occupational and work-related diseases, constituting a significant public health burden. Among skin disorders, allergic contact dermatitis (ACD) is the most prevalent occupational disease and the most common form of immunotoxicity in humans. ACD is a T-cell-mediated skin inflammation resulting from the priming and expansion of allergen-specific CD4 and CD8 T cells. The clinical condition is characterized by local skin rash, itchiness, redness, swelling, and lesions, being mainly diagnosed by the patch test. Upon ACD diagnosis, avoiding the exposure to the triggering allergen is the mainstay of treatment to prevent future flares. In cases where avoidance is not possible, the use of a standard of care interim treatments such as steroid creams or ointments, barrier creams, and moisturizers are strongly recommended to alleviate symptoms. In this review, we sought to provide the reader with an overview of the pathophysiology of ACD as well as the currently available pharmacological treatment options. Furthermore, a comprehensive outline of several preventive strategies is also provided.

摘要

作为人体的第一道防线,皮肤是最常接触个人卫生用品、家用产品或工作环境中使用的材料中所含化学物质的器官。在这种情况下,皮肤疾病占所有职业性和与工作相关疾病的 40%以上,是一个重大的公共卫生负担。在皮肤疾病中,过敏性接触性皮炎 (ACD) 是最常见的职业病,也是人类最常见的免疫毒性形式。ACD 是一种由过敏原特异性 CD4 和 CD8 T 细胞的致敏和扩增引起的 T 细胞介导的皮肤炎症。其临床特征为局部皮疹、瘙痒、发红、肿胀和损伤,主要通过斑贴试验进行诊断。在诊断出 ACD 后,避免接触引发过敏的物质是预防未来发作的主要治疗方法。在无法避免接触的情况下,强烈建议使用标准护理临时治疗方法,如类固醇乳膏或软膏、屏障乳膏和保湿剂,以缓解症状。在这篇综述中,我们试图为读者提供 ACD 的病理生理学以及目前可用的药理学治疗选择的概述。此外,还提供了几种预防策略的综合概述。

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