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德国 S1 指南:接触性皮炎。

German S1 guideline: Contact dermatitis.

机构信息

Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center of the Ruhr University Bochum, Bochum, Germany.

Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.

出版信息

J Dtsch Dermatol Ges. 2022 May;20(5):712-734. doi: 10.1111/ddg.14734. Epub 2022 May 8.

Abstract

Contact dermatitis is an inflammation of the epidermis and dermis at the site of exposure triggered by external agents. The two main forms are irritant and allergic contact dermatitis, which cause significant health and socioeconomic costs in addition to a marked reduction in quality of life. The anamnesis and the clinical picture are decisive for the necessary diagnostic measures. The most accurate possible diagnostic classification of contact dermatitis by means of allergological testing is important for disease management, since not only classical eczema therapy but also avoidance of the exogenous triggering factors are of great importance here. The choice of therapy should be based on the acuity, clinical severity, morphology of the lesions and localization of the contact dermatitis. A combination of basic therapy, topical, physical, and systemic therapy adapted to the patient's needs is required, whereby not all forms of therapy must be carried out simultaneously but can be used in a varying manner. Primary, secondary, and tertiary prevention strategies aim at the recognition of the triggering noxae or allergens with subsequent contact avoidance or minimization. The present S1-guideline on contact dermatitis is primarily intended to provide dermatologists, allergologists and physicians working in allergology and occupational dermatology with a decision-making aid for the selection and implementation of suitable and sufficient diagnostics, therapy, and prevention.

摘要

接触性皮炎是一种表皮和真皮在暴露于外部物质的部位发生的炎症。主要有两种形式,即刺激性和过敏性接触性皮炎,除了显著降低生活质量外,还会导致巨大的健康和社会经济成本。病史和临床表现对于必要的诊断措施至关重要。通过过敏测试对接触性皮炎进行尽可能准确的诊断分类对于疾病管理很重要,因为这里不仅需要经典的湿疹治疗,还需要避免外源性触发因素。治疗方案的选择应基于疾病的严重程度、临床严重程度、病变形态和接触性皮炎的定位。需要结合基础治疗、局部治疗、物理治疗和全身治疗,以适应患者的需求,其中并非所有形式的治疗都必须同时进行,而是可以以不同的方式使用。一级、二级和三级预防策略旨在识别触发因素或过敏原,随后避免或最小化接触。本接触性皮炎 S1 指南主要旨在为皮肤科医生、过敏学家和从事过敏学和职业性皮肤病学的医生提供决策辅助,以选择和实施合适且充分的诊断、治疗和预防措施。

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