WAO Medical Book Review
Posted: July 2014
Edited by Young Suck Ro
Online Edition Published by InTech on 16 December 2011
ISBN 978-953-307-5577-8 - online edition
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Published under the Creative Commons Attribution 3.0 Unported (CC By 3.0 License)
Retail Price: Free, Open Access for Online Edition
Available from: InTech
Freya Helena Campos Romero, MD
South Central High Specialty Hospital PEMEX Picacho
Division of Allergy and Immunology
Distrito Federal, Mexico
Contact dermatitis (CD) is an increasingly common condition, although under-diagnosed; it requires suffi-cient expertise to recognize characteristic clinical presentations, candidate causative substances, and dif-ferences from other eczematous dermatoses. This is the first edition of the book from the dermatology de-partment of the Seoul hospital written for quick recognition of contact dermatitis.
Contact allergy is an inflammatory reaction of the skin that follows percutaneous absorption of antigen from the skin surface and recruitment of previously sensitized, antigen-specific T lymphocytes, after contact with environmental substances. It occurs in up to 10 - 20 % of the adult population. The authors place special emphasis on children since most published studies have focused on adults. This is likely because when children present with pruritic eczematous dermatoses, the majority of specialists first think of atopic derma-titis, leaving aside allergic or irritant contact causes. In infants the most common allergen exposures that result in contact dermatitis contact dermatitis are nickel sulfate, ammonium per sulfate, gold sodium thiosul-fate, thimerosal, and toluene-2,5diamine.
In the last 10 years research advances have reliably defined the process of sensitizing allergens and their passage through the stratum corneum in contact dermatitis. Despite knowing this process the real clinical challenge is to identify the specific causal agent in individual patients. Currently, the gold standard remains patch testing in which the correct techniques for application, interpretation and clinical correlation are critical to accurate diagnosis.
The content is organized on 5 sections. The first part includes incidence, prevalence, and predisposing fac-tors for CD. Section 2 is a quick, intense review of innate immunity including the role of Toll-like receptors in the process to develop sensitization and production of the Th1 and Th17 cytokines. Section 3 describes the intra and extracellular movement of the stratum corneum, and the different carriers, excipients, and drugs used to modify the barrier function of the skin. Section 4 describes the significant diagnostic challenges associated with CD from dental materials, which includes a spectrum of clinical presentations. The final two chapters focus on CD risk factors in children including their association with atopic status of the child. The techniques for applying the patch tests and use of different batteries (which may not be available in clinical settings) is described.
Assessment and Audience
This treatise is a comprehensive overview of contact dermatitis. It is well written and easy to understand, but not simplistic. This provides an updated view of CD for allergists, pediatricians, resident physicians and other healthcare providers who would like to have a rapid, thoughtful, and specific approach for the evalua-tion of this malady.