Allergic Contact Dermatitis: Rubber Allergies

Abstract

Latex (rubber) allergy is a growing health concern among medical and nonmedical fields. Common occupational exposures include, health care and food industry workers using disposable gloves, latex industry employees, and car ­factory workers assembling rubber details. Additionally, high-risk groups include children with spina bifida or spinal dysraphism. Risk factors for latex allergic ­contact dermatitis (ACD) include skin damage allowing increased invasion of chemical residues into the skin dermis and atopy inducing an increased prevalence of latex immunologic contact urticaria (ICU). The pathophysiology of latex (rubber) allergy is IgE-mediated (ICU) and type IV ACD related. The IgE-mediated allergy is ­protein related, while ACD typically results from exposure to chemical accelerators and antioxidants produced during the vulcanization process. The clinical manifestations of latex ACD generally include an erythematous, papular eczema at the site of rubber contact, although distal site involvement is possible. Patch testing is the diagnostic test of choice for type IV latex ACD; however, a thorough history and physical examination are the cornerstone of latex ACD diagnosis. The primary mode of treatment for latex ACD is prevention; however, topical corticosteroids and other medicaments may be used for symptomatic relief.