Dermatitis diagnosis

Nitrofurazone (Furacin) has over the years been used in solution or powder for leg ulcers and varicose eczema. Many cases of contact allergy occurred and subsequently descreased the dermatologic use of this drug topically (Braun and ScHUTZ 1968). Each individual case tends to be dramatic, i.e., the extent and severity of the dermatitis is clinically striking, so that, unlike neomycin dermatitis, diagnosis presents no problem. The frequency of the dermatitis has probably been exaggerated, and may be less than that due to neomycin. 

The clinical features of a compound allergy are those of allergic contact dermatitis. Diagnosis of a compound allergy requires the fulfillment of certain criteria ... 

If conventional treatment fails, unresolved diaper rash can also lead to secondary bacterial infections. Staphylococcus aureus and streptococci are the most likely pathogens responsible for these infections and require treatment with systemic antibiotics.3 37 While topical protectants may be used as an adjunct in treatment, suspected bacterial infections should always be referred to a physician for accurate diagnosis and the selection of an appropriate antibacterial regimen.34 Figure 62-7 shows a useful algorithm for the effective treatment of diaper dermatitis. 

Suggested Alternatives for Differential Diagnosis Hog cholera, salmonellosis, erysipelas, Glasser s disease, erysipelas, septicemic salmonellosis, pasteurellosis, Haemophilus suis infection, Streptococcus suis infection, eperythrozoonosis, porcine dermatitis and nephropathy syndrome, porcine reproductive and respiratory syndrome, pseudorabies, coumarin poisoning, and salt poisoning. 

Suggested Alternatives for Differential Diagnosis Contagious ecthyma, contagious pustular dermatitis, bluetongue, mycotic dermatitis, sheep scab, mange, insect bites, parasitic pneumonia, and photosensitization. 

Suggested Alternatives for Differential Diagnosis Bovine viral diarrhea/mucosal disease, rinderpest, bluetongue, foot and mouth disease, vesicular stomatitis, pneumonic pas-teurellosis, photosensitive dermatitis, infectious bovine rhinotracheitis, theileriosis, rabies, and the tick-borne encephalitides. 

The recent Burden of Skin Disease study, a joint project of the American Academy of Dermatology Association and the Society of Investigative Dermatology, found that the third most common skin ailment was contact dermatitis. According to this study, 72 million Americans had contact dermatitis in 2004 which resulted in 1.4 billion in direct costs and almost 500 million in indirect costs due to lost productivity.83 A review of 1993 BLS data showed that of 60,200 cases of occupational skin diseases, 12,613 (21%) resulted in one or more days away from work.70 The mean time away from work was 3 days, but 17% lost workday cases had over 11 days away from work. Of those with days away from work, 70% had a diagnosis of dermatitis. In 2001, of the 38,900 skin disease cases, 6,051 (16%) resulted in days away from work, with a median of 3 days lost.68 Of these, 78% had dermatitis. A study of 235 Canadian workers with oc-... 

Spiewak, R. and Dutkiewicz, J., A farmer s occupational airborne contact dermatitis masqueraded by coexisting rosacea delayed diagnosis and legal acknowledgement, Ann. Agric. Environ. Med, 11, 329, 2004. 

Abs, Antibodies CD, celiac disease DH, dermatitis herpetiformis Dx, Diagnosis EM, endomysial antibodies GI, gastrointestinal GFD, gluten-free diet IELs, intraepithelial lymphocytes IFN, interferon Lab, laboratory tTG, tissue transglutaminase antibodies Ret, reticulin IH, immunohistochemistry. 

Bennett, E.O., Dermatitis in Machinists Causes and Solutions, Biotech Publishing, Angleton, TX, 1993. Cros, D., Ed., Peripheral Neuropathy a Practical Approach to Diagnosis and Management, Lippincott Williams Wilkins, Philadelphia, 2001. 

Before confirming a diagnosis of subjective irritation, patients must be patch tested and open tested to exclude allergic contact dermatitis and contact urticaria, respectively. Subclinical contact urticaria, in particular, mimics sensory irritation. 

Contin-Bordes, C., Petersen, A., Chahine, I., Boralevi, F., Chahine, H., Taieb, A., Sarrat, A., Moreau, J.F., and Taupin, J.L. 2007. Comparison of ADVIA Centaur and Pharmacia UniCAP tests in the diagnosis of food allergy in children with atopic dermatitis. Pediatr Allergy Immunol 18(7) 614—620. 

Sicherer, S.H. and Sampson, H.A. 1999. Food hypersensitivity and atopic dermatitis pathophysiology, epidemiology, diagnosis and management. J Allergy Clin Immunol 104 114-122. 

In a study of 1,752 patients considered to have occupational dermatoses, contact dermatitis was the main diagnosis in 1,496 patients (92% women, 83% men). The allergic type, as opposed to the irritant type, was more prevalent in men (73%) than in women (51%). Positive patch tests to chromium (not otherwise specified) occurred in 8% of the women and 29% of the men. Among 280 chromium-sensitized men, 50% were employed in building and concrete work, 17% in metal work, and 12% in tanneries. In the 42 chromium-sensitized women, 20% were in cement work, 19% in metal work, 28% in cleaning, and 15% in laboratory work (Fregert 1975). 

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