CONTACT DERMATITIS / FOOD

ALLERGIES / LATEX ALLERGY

CONTACT DERMATITIS
• Dermatitis Venenata
• Type IV delayed hypersensitivity reaction response
• Often eczematous condition caused by skin reaction to variety of irritating or allergenic materials
• Poison Ivy is the most common cause
• Frequent Offenders: Cosmetics, Soaps, Detergents, and industrial chemicals
• Skin sensitivity may develop after brief or prolonged exposure
• Clinical picture may appear hours or weeks after sensitized skin has been exposed

CLINICAL MANIFESTATIONS
• Symptoms
o Itching, Burning, erythema, Skin lesions (vesicles) and Edema
• Followed by
o Weeping, Crusting then Drying and peeling of skin
• Repeated Reaction
o Thickening of skin and Pigmentary changes
• Severe Responses
o Hemorrhagic Bullae
• Secondary Invasion By
o Bacteria may develop with abraded by rubbing or scratching

4 BASIC TYPES
• Allergic
o Results from contact of skin and allergenic substance has sensitization period of 10-14
days
 Clinical Presentation:
• Vasodilation and perivascular infiltrates on dermis
• Intracellular edema
• Usually seen dorsal aspect of hand
• Irritant
o Results from contact with a substance that chemically or physically damages the skin on
nonimmunologic basis; occurs after first exposure to irritant or repeated exposures to
milder irritants over an extended time.
 Clinical Presentation:
• Dryness lasting days to months
• Vesiculation, fissures, cracks on hands and lower arms most common
areas
• Phototoxic
o Resembles irritant type but requires sun and chemical in combination to damage
epidermis
 Clinical Presentation:
• Similar to irritant dermatitis
• Photallergic
o Resembles allergic dermatitis but requires light exposure in addition to allergen contact to
produce immunologireactivity
 Clinical Presentation
 • Similar to allergic dermatitis

FOOD ALLERGY
• Almost any food can cause Type 1 Hypersensitivity

MOST COMMON OFFENDERS

• Nuts – Especially peanuts

• Eggs
• Milk
• Soy
• Wheat
• Chocolate

CLINICAL MANIFESTATIONS

• Urticaria
• Atopic dermatitis
• Wheezing
• Cough
• Laryngeal edema
• Angioedema

GI Symptoms
• Itching
• Swelling of lips, tongue, palate
• Abdominal Pain
• Nausea
• Cramps
• Vomiting
• Diarrhea
LATEX ALLERGY
POPULATION MOST AT RISK
• Health care workers
• People with atopic allergies
• Multiple surgeries
• People working factories manufacturing latex products
• Females
• Person with Spina Bifida

CROSS RX REPORTED IN PEOPLE WHO ARE ALLERGIC TO CERTAIN FOODS

• Kiwis
• Bananas
• Pineapples
• Passion Fruit
• Avocados
• Chestnuts

CLINICAL MANIFESTATIONS
• Range from mild contact dermatitis  moderately severe symptoms or rhinitis,
conjunctivitis, urticaria, bronchospasm  severe life threatening anaphylaxis

• Delayed Type - Type IV

o Symptoms contact dermatitis
 Pruritus
 Edema
 Erythema
 Vesicles
 Papules
 Crusting and thickening of skin

• Anaphylactic – Type I
o Rapid onset
 Urticaria
 Wheezing
 Dyspnea
 Laryngeal edema
 Bronchospasm
 Tachycardia
 Angioedema
 Hypertension
 Cardiac arrest

MEDICAL MANAGEMENT
• Only treatment is avoidance of latex products
• Anaphylactic reaction must be counseled to wear medical identification and carry supply
nonlatex gloves; antihistamines and emergency kit containing Epinephrine provided along
with instructions about emergency management.