Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Dermatology Department, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, PekingBeijing, 100730, China.
Clin Rev Allergy Immunol. 2021 Dec;61(3):339-350. doi: 10.1007/s12016-021-08873-2. Epub 2021 Aug 2.
Systemic contact dermatitis (SCD) is a generalized reactivation of type IV hypersensitivity skin diseases in individuals with previous sensitization after a contact allergen is administered systemically. Patients with SCD may consider their dermatitis unpredictable and recalcitrant since the causative allergens are difficult to find. If a patient has a pattern of dermatitis suggestive of SCD but fails to improve with conventional treatment, SCD should be taken into consideration. If doctors are not familiar with the presentations of SCD and the possible routes of allergen sensitization and exposure, the diagnosis of SCD may be delayed. In this work, we summarized all of the routes through which allergens can enter the body and cause SCD, including oral intake, local contact (through skin, inhalation, nasal spray and anal application), implants, and other iatrogenic or invasive routes (intravenous, intramuscular, intraarticular, and intravesicular). This will provide a comprehensive reference for the clinicians to identify the culprit of SCD.
全身性接触性皮炎（SCD）是指个体在先前致敏后，全身性给予接触变应原后，导致 IV 型超敏性皮肤病的全身性再激活。患有 SCD 的患者可能会认为其皮炎难以预测且顽固难治，因为很难找到致病变应原。如果患者的皮炎模式提示 SCD，但常规治疗无效，则应考虑 SCD。如果医生不熟悉 SCD 的表现以及可能的致敏和暴露途径，可能会延迟 SCD 的诊断。在这项工作中，我们总结了变应原进入体内引起 SCD 的所有途径，包括口服、局部接触（通过皮肤、吸入、鼻喷雾剂和肛门应用）、植入物以及其他医源性或侵袭性途径（静脉、肌肉、关节内和膀胱内）。这将为临床医生识别 SCD 的罪魁祸首提供全面的参考。
