Differential Diagnosis of Irritant Versus Allergic Contact Dermatitis Based on Noninvasive Methods.

IF 2.5 4区 医学 Q2 DERMATOLOGY Dermatology practical & conceptual Pub Date : 2024-10-30 DOI:10.5826/dpc.1404a231
Panagiota Gkagkari, Anna Tagka, Alexandros Stratigos, Vangelis Karalis, Aikaterini Kyritsi, Andreas Vitsos, Michail Christou Rallis
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Abstract

Introduction: Irritant contact dermatitis (ICD) is characterized by direct injury to the epidermal cells, activating the innate immune response. Allergic contact dermatitis (ACD), in contrast, is delineated by a delayed hypersensitivity reaction of type IV. Despite the distinct etiopathogenic mechanisms under-pinning each condition, the differentiation between them presents a significant diagnostic challenge.

Objective: This study aimed to determine whether a combination of clinical evaluation and noninvasive measurements-encompassing oxidative stress, erythema, hydration, melanin content, transepidermal water loss (TEWL), hemoglobin concentration, and skin texture and volume-could distinguish ICD from ACD.

Methods: Two cohorts, each comprising 21 patients, were evaluated: one diagnosed with ICD and the other with ACD. All participants underwent biophysical and clinical assessments, along with Antera® 3D evaluations. Tape strips were utilized for skin sampling, and oxidative stress levels were measured via fluorescence assessments.

Results: ICD prompted an almost immediate inflammatory reaction (peaking at 24 hours), whereas ACD incited a delayed response (72 hours). Noninvasive evaluated parameters such as hemoglobin concentration, skin texture and volume, melanin content, erythema, and TEWL showed significant differences between the ICD and ACD cohorts (P < 0.05). The allergens amcinonide, nickel sulphate, cobalt chloride, budesonide, PPD, and thiuram mix were found to induce elevated levels of oxidative stress.

Conclusions: The evaluation of patients with noninvasive parameters, including transepidermal water loss (TEWL), hemoglobin concentration, and skin texture and volume, could markedly aid in distinguishing irritant contact dermatitis from allergic contact dermatitis (ACD). Nevertheless, the study was constrained by a limited sample size.

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基于无创方法的刺激性与过敏性接触性皮炎鉴别诊断。
简介:刺激性接触性皮炎(ICD)的特点是直接损伤表皮细胞,激活先天免疫反应。相比之下,过敏性接触性皮炎(ACD)是由IV型延迟超敏反应描述的。尽管每种疾病的发病机制不同,但它们之间的区分提出了一个重大的诊断挑战。目的:本研究旨在确定临床评估和无创测量(包括氧化应激、红斑、水合作用、黑色素含量、经皮失水(TEWL)、血红蛋白浓度、皮肤质地和体积)是否可以结合起来区分ICD和ACD。方法:对两组21例患者进行评估:一组诊断为ICD,另一组诊断为ACD。所有参与者都进行了生物物理和临床评估,以及Antera®3D评估。使用胶带条进行皮肤取样,并通过荧光评估测量氧化应激水平。结果:ICD几乎立即引起炎症反应(24小时达到峰值),而ACD则引起延迟反应(72小时)。无创评估参数如血红蛋白浓度、皮肤质地和体积、黑色素含量、红斑、TEWL在ICD组和ACD组之间差异有统计学意义(P < 0.05)。发现过敏原氨酰胺、硫酸镍、氯化钴、布地奈德、PPD和硫脲混合物可引起氧化应激水平升高。结论:评估患者的非侵入性参数,包括经皮失水(TEWL)、血红蛋白浓度、皮肤质地和体积,可以显著帮助区分刺激性接触性皮炎和过敏性接触性皮炎(ACD)。然而,该研究受到样本量有限的限制。
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