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Tuesday, September 30, 2014
Skin Care and Diseases
what treatment available for severe atopic cement dermatitis ?
Contact dermatitis to cement may take several forms. First and foremost is a primary irritant that can be severe because of the lyme in the cement. This can cause ulcerations at any contact point.
In addition to primary irritant contact dermatitis, true allergic contact dermatitis may occur in any individual. The most frequent allergens are nickel and chromate salts. The precise origin of allergic contact dermatitis must be determined by your physician through various forms of patch testing.
In your question you use the term "atopic cement dermatitis" and I can only assume that the individual involved has true atopic dermatitis which is an immunologic phenomenon that is inherited and is characterized by a dermatitis usually from childhood and it may be associated with allergic rhinitis (hay fever) and/or asthma, along with skin eruption. Those individuals are known to be less resistant to primary irritant contact dermatitis than are the nonatopic population. In this case the only way to treat the process is to avoid exposure and that can be applied not only to the irritant phenomenon but to true allergic contact dermatitis.
In the case of the professional whose income depends upon using cement, the treatment is very difficult. It consists of #1 and most important avoidance of skin contact with clothing that is saturated with the fluids from the cement, as well as the cement itself. That requires various forms of occlusive clothing that has been carefully cleaned by others. The use of barrier creams is by and large ineffective. Topical and systemic steroids have been used to treat the true allergic contact dermatitis when it is severe but these must be used only intermittently and infrequently because they may produce significant skin changes themselves, as well as systemic changes that are undesirable.
If you are suffering from contact dermatitis, irritant or allergic, I would suggest that you meet with your dermatologist and/or a dermatologist with training in industrial medicine. Those individuals can be very helpful.
If you are interested in reading about contact dermatitis generally I would refer you to the textbook "Contact Dermatitis" by Fischer. The last edition was in the late 1980`s and I am sure you can find it at your local library.
Charles L Heaton, MD
College of Medicine
University of Cincinnati