Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran.
Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
J Trace Elem Med Biol. 2023 Sep;79:127240. doi: 10.1016/j.jtemb.2023.127240. Epub 2023 Jun 8.
Contact dermatitis is an inflammatory skin reaction caused by direct contact with chemical substances in the environment and can either be irritant or allergic in nature. The clinical symptoms of contact dermatitis, include local skin rash, itching, redness, swelling, and lesions. Nowadays, 15-20% of people have some degree of contact dermatitis, which can be more or less severe. Immune responses in allergic contact dermatitis (ACD) are due to the effects of cytokines and allergen-specific CD4 and CD8 T cells on the skin. Acids and alkalis such as drain cleaners, plants such as poinsettias, hair colors, and nail polish remover, are all prominent causes of irritant contact dermatitis (ICDs). Heavy metals are metallic elements with a high atomic weight that are hazardous in low quantities and are known to cause dermatitis after systemic or local exposure. Nickel (Ni), chromium (Cr), lead (Pb), and copper (Cu) are among the most common heavy metals used in various industries. Metal allergies may cause ACD and also systemic contact dermatitis (SCD). Contact dermatitis is detected by laboratory tests such as patch testing, lymphocyte stimulation test (LST), and evaluation of cytokine production by primary cultures of peripheral blood mononuclear cells. This article presents an update on the epidemiological and clinical characteristics of ACD and SCD caused by three heavy metals (Cr, Cu, and Pb). Ni is not discussed due to recent coverage. Furthermore, the effects of contact sensitivity to some other heavy metals, such as gold (Au), cobalt (Co), palladium (Pd), and mercury (Hg) are discussed.
接触性皮炎是一种由环境中的化学物质直接接触引起的炎症性皮肤反应，其性质既可以是刺激性的，也可以是过敏性的。接触性皮炎的临床症状包括局部皮疹、瘙痒、发红、肿胀和病变。如今，15-20%的人患有某种程度的接触性皮炎，其严重程度可能有所不同。过敏性接触性皮炎（ACD）中的免疫反应是由于细胞因子和过敏原特异性 CD4 和 CD8 T 细胞对皮肤的影响。酸和碱，如排水管清洁剂，植物，如一品红，染发剂和指甲油去除剂，都是刺激性接触性皮炎（ICD）的显著原因。重金属是原子量较高的金属元素，在低剂量下具有危害性，已知会在全身或局部暴露后引起皮炎。镍（Ni）、铬（Cr）、铅（Pb）和铜（Cu）是各种工业中最常见的重金属元素。金属过敏可能导致 ACD 和全身性接触性皮炎（SCD）。接触性皮炎通过实验室检测进行诊断，如斑贴试验、淋巴细胞刺激试验（LST）和外周血单个核细胞原代培养物中细胞因子产生的评估。本文介绍了三种重金属（Cr、Cu 和 Pb）引起的 ACD 和 SCD 的流行病学和临床特征的最新进展。由于最近已经有报道，因此未讨论 Ni。此外，还讨论了接触敏感性对其他一些重金属（如金（Au）、钴（Co）、钯（Pd）和汞（Hg））的影响。
