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Protein contact dermatitisL23.6

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Eczema Instant contact dermatitis; instant type contact dermatitis; Protein contact dermatitis; Protein contact eczema

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HistoryThis section has been translated automatically.

Hjorth and Roed-Petersen, 1975

DefinitionThis section has been translated automatically.

Allergic contact dermatitis on hands and forearms, caused by repeated contact with various protein-containing products (e.g. meat, flour). S.a. flour protein dermatitis and contact urticaria. Which protein determinants are of essential importance for sensitisation has not yet been conclusively clarified (Parkinson E et al. 2017)

EtiopathogenesisThis section has been translated automatically.

  • Allergic contact dermatitis of the immediate type ( atopy patch test, type 4 reaction to type 1 allergens).
  • The causative proteins can be divided into 4 >main groups:
    • animal proteins as main group
    • Grains and flours
    • (protolytic) enzymes
    • Fruits, vegetables, spices, plants

LocalizationThis section has been translated automatically.

Hands (back of hands), forearms, face.

Clinical featuresThis section has been translated automatically.

In so-called contact reactions of the immediate type, inflammatory skin changes (sometimes also accompanying mucous membrane reactions) usually occur within a few minutes. The clinical spectrum is wide and ranges from local sensations without visible correlations, itching, redness and swelling, in extreme cases also to anaphylactic shock (see below contact urticaria). In some cases, this "non-eczematous" initial picture, which can be described as contact urticaria, changes into eczematous dermatitis within a few weeks. Protein contact dermatitis may also play a role in dermatitis caused by cosmetics (Delaunay J et al. 2018).

HistologyThis section has been translated automatically.

Spongiotic dermatitis of varying degrees of acuteity.

DiagnosisThis section has been translated automatically.

  • Epicutaneous test with the allergens in question.
  • Epicutaneous re-exposure in the area of skin lesions of the allergens known from the intradermal test.
  • Prick test
  • Friction test
  • Serological detection of specific IgE.

Differential diagnosisThis section has been translated automatically.

Important differential diagnosis in occupational dermatological questions (see below occupational dermatoses).

TherapyThis section has been translated automatically.

After exact diagnosis avoidance of the allergens in question. Stage-appropriate eczema therapy, see below Eczema, contact eczema, allergic eczema. S.a. eczema, hand eczema.

LiteratureThis section has been translated automatically.

  1. Delaunay J et al (2018) Occupational immediate contact allergy to hydrolysed wheat protein after cosmetic exposure
    . Contact dermatitis 78:291-292.
  2. Krüger U, Fuchs Th (2007) Contact urticaria and protein contact dermatitis in occupational dermatology. Derm Occupation and environment 55: 107-111
  3. Hjorth N, Roed-Petersen J (1975) Occupational eczema caused by proteins. Z Hautkr 50: 851-852
  4. Hjorth N, Roed-Petersen J (1976) Occupational protein contact dermatitis in food handlers. Contact Dermatitis 2: 28-42
  5. Laukkanen A et al (2007) Lactase-induced occupational protein contact dermatitis and allergic rhino-conjunctivits. Contact dermatitis 57: 89-93
  6. Parkinson E et al (2017) Determination of Protein Haptenation by Chemical Sensitisers within theComplexity
    of the Human Skin Proteome. Toxicol Sci doi: 10.1093/toxsci/kfx265.
  7. Vanstreels L et al (2012) Protein contact dermatitis in a butcher. Dermatologist 63: 926-928

Authors

Last updated on: 29.10.2020

Author: Prof. Dr. med. Peter Altmeyer