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Systemic Contact Dermatitis: The Routes of Allergen Entry

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Abstract

Systemic contact dermatitis (SCD) is a generalized reactivation of type IV hypersensitivity skin diseases in individuals with previous sensitization after a contact allergen is administered systemically. Patients with SCD may consider their dermatitis unpredictable and recalcitrant since the causative allergens are difficult to find. If a patient has a pattern of dermatitis suggestive of SCD but fails to improve with conventional treatment, SCD should be taken into consideration. If doctors are not familiar with the presentations of SCD and the possible routes of allergen sensitization and exposure, the diagnosis of SCD may be delayed. In this work, we summarized all of the routes through which allergens can enter the body and cause SCD, including oral intake, local contact (through skin, inhalation, nasal spray and anal application), implants, and other iatrogenic or invasive routes (intravenous, intramuscular, intraarticular, and intravesicular). This will provide a comprehensive reference for the clinicians to identify the culprit of SCD.

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Acknowledgements

The figures are created with BioRender.com.

Funding

This work was supported by the National Natural Science Foundation of China [grant number 81373175], the National Key Research and Development Program of China [grant number 2017YFA0403403], and CAMS Innovation Fund for Medical Sciences (No.2016-I2M-1003).

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Author notes

  1. Zhouxian Pan, Yongshi Yang, Lishan Zhang contributed equally to this work. Jinlyu Sun, Rui Tang and Christopher Chang contributed equally to this work.

Authors and Affiliations

  1. Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China

    Zhouxian Pan, Yongshi Yang, Lishan Zhang, Xianjie Zhou, Rui Tang & Jinlyu Sun

  2. Dermatology Department, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, PekingBeijing, 100730, China

    Yueping Zeng

  3. Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, Davis, CA, 95616, USA

    Christopher Chang

  4. Division of Pediatric Immunology and Allergy, Joe DiMaggio Children’s Hospital, Hollywood, FL, USA

    Christopher Chang

  5. Beijing Synchrotron Radiation Facility, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China

    Jing Zhang

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Pan, Z., Yang, Y., Zhang, L. et al. Systemic Contact Dermatitis: The Routes of Allergen Entry. Clinic Rev Allerg Immunol 61, 339–350 (2021). https://doi.org/10.1007/s12016-021-08873-2

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