Contact dermatitis, also known as contact eczema, is an adverse skin reaction after contact exposure to a foreign agent, caused either by its irritant (irritant contact dermatitis, ICD) or its allergenic property (allergic contact dermatitis, ACD). The clinical appearance of the lesions depends on the skin region involved and the duration of the exposure; it may be papular, urticaria-like, vesicular, or bullous, presented on an erythematous background. In dark pigmented or black skin, erythema is less recognizable, and the lesions are often hypo- or hyperpigmented; after repeated or persisting exposure, eczematization occurs, and chronic pruritus often results in lichenification. In specific areas of the body such as the eyelids, penis, and scrotum, contact dermatitis can be presented as erythematous edema rather than papules or vesicles. Lesions can be provoked or aggravated by exposure to sun or UV light, resulting in a phototoxic or photoallergic reaction. The skin response also depends on the particular properties of the agent, the nature and duration of the contact, and the individual susceptibility of the patient.
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Zaidi Z. Skin of colour: characteristics and diseases. J Pak Med Assoc. 2017;67:292–9.
Berardesca E, Maibach H. Racial differences in skin pathophysiology. J Am Acad Dermatol. 1996;34:667–72.
Kompaore F, Marty JP, Dupont C. In vivo evaluation of the stratum corneum barrier function in blacks, Caucasians and Asians with two noninvasive methods. Skin Pharmacol. 1993;6:200–7.
Reed JT, Ghadially R, Elias PM. Skin type, but neither race of gender, influence epidermal permeability barrier function. Arch Dermatol. 1995;131:1134–8.
Hicks SP, Swindells KJ, Middelkamp-Hup MA, et al. Confocal histopathology of irritant contact dermatitis in vivo and the impact of skin color (black vs white). J Am Acad Dermatol. 2003;48:727–34.
Berardesca E, Maibach HI. Racial differences in sodium-lauryl-sulphate induced cutaneous irritation: black and white. Contact Dermatitis. 1988;18:65–70.
Berardesca E, Maibach HI. Sodium-lauryl-sulphate-induced cutaneous irritation. Comparison of white and Hispanic subjects. Contact Dermatitis. 1988;19:136–40.
Kligman AM, Epstein W. Updating the maximization test for identifying contact allergens. Contact Dermatitis. 1975;1:231–9.
Dickel H, Taylor JS, Evey P, et al. Comparison of patch test results with a standard series among white and black racial groups. Am J Contact Dermat. 2001;12:77–82.
Deleo VA, Alexis A, Warshaw EM, et al. The Association of Race/Ethnicity and patch test results: North American Contact Dermatitis Group, 1998-2006. Dermatitis. 2016;27:288–92.
Berardesca E, Maibach H. Ethnic skin: overview of structure and function. J Am Acad Dermatol. 2003;48(S1):39–42.
National Health Services (NHS) Choices. Contact dermatitis. 2014. www.nhs.us/conditions/eczema-(contact-Dermatitis)/pages/introductionn.aspx.
Taylor JS, Amado A. Contact dermatitis and related conditions; August 2010 www.clevelandclinicmed.com/medicalpubs/diseasemanagement/dermatology/contact-dermatitis-and-related-conditions.
Pratt MD, Belsito DV, DeLeo DA, et al. North American contact dermatitis group patch test results, 2001-2002 study period. Dermatitis. 2004;15:176–83.
Schäfer T, Böhler E, Ruhdorfer S, et al. Epidemiology of contact allergy in adults. Allergy. 2001;56:1192–6.
Kot M, Bogaczewicz J, Kręcisz B, et al. Contact hypersensitivity to European baseline series and corticosteroid series haptens in a population of adult patients with contact eczema. Acta Dermatovenerol Croat. 2016;24:29–36.
Schnuch A, Uter W, Geier J, et al. Epidemiology of contact allergy: an estimation of morbidity employing the clinical epidemiology and drug-utilization research (CE-DUR) approach. Contact Dermatitis. 2002;47:32–9.
Spiewak R. Pesticides as a cause of occupational skin diseases in farmers. Ann Agric Environ Med. 2001;8:1–5.
Mark KA, Brancaccio RR, Soter NA, et al. Allergic contact and photoallergic contact dermatitis to plant and pesticide allergens. Arch Dermatol. 1999;135:67–70.
Trehan A, Singh K, Kanodia S, et al. Contact hypersensitivity and hand eczema–a study with Indian standard series of allergens. MedPulse. 2014;1:304–9.
Sharma VK, Bhari N, Wadhwani AR, et al. Photo-patch and patch tests in patients with dermatitis over the photo-exposed areas: a study of 101 cases from a tertiary care centre in India. Australas J Dermatol. 2016. https://doi.org/10.1111/ajd.12504.
Douglas KE, Ofure Agbi J, Akpovienehe O, et al. Occupational hand dermatitis among hair dressers in a semi-urban community in Rivers State, South-South Nigeria. Nigerian Health J. 2013;13:125–30.
Paulsen E, Hyldgaard MG, Andersen KE, et al. Allergenic sesquiterpene lactones from cushion bush (Leucophyta brownii): new and old sensitizers in a shrub-turned-a-pot plant. Contact Dermatitis. 2017. https://doi.org/10.1111/cod.12757.
Shahzad M, Alzolibani AA, Al Robaee AA, et al. Patients seen at the Dermatology ambulatory office in a tertiary care center in Qassim region, Saudi Arabia. Int J Health Sci. 2013;7:130–5.
Lachapelle JM. The spectrum of diseases for which patch testing is recommended. In: Lachapelle JM, Maibach HI, editors. Patch testing and prick testing. Berlin: Springer; 2009. p. 7–32.
Tan Q, Yang H, Liu E, et al. Establishing a role for interleukin-17 in atopic dermatitis-related skin inflammation. J Cutan Med Surg. 2017;21(4):308–15. https://doi.org/10.1177/1203475417697651.
Halder RM, Nootheti PK. Ethnic skin disorders overview. J Am Acad Dermatol. 2003;48:143–8.
Turner RN, Low RH. The principles and practice of moxibustion. Wellingborough: Thorsons Publishers; 1992.
Look KM, Look RM. Skin scarping, cupping, and moxibustion that may mimic physical abuse. J Forensic Sci. 1997;42:103–5.
Nguyen T, Saleh MA. Exposure of women to trace elements through the skin by direct contact with underwear clothing. J Environ Health Sci. 2016;52:1–6. https://doi.org/10.1080/10934529.2016.1221212
Berih A, Berhanu A. Allergic dermatitis – black henna (para-phenylenediamine) use among the East African patient population in a general practice setting. Aust Fam Physician. 2014;43:383–5.
Mukkanna KS, Stone NM, Ingram JR. Para-phenylenediamine allergy: current perspectives on diagnosis and management. J Asthma Allergy. 2017;10:9–15.
Khumalo NP, Jessop S, Ehrlich R. Prevalence of cutaneous adverse effects of hairdressing: a systematic review. Arch Dermatol. 2006;142:377–83.
Stallings A, Sood A. Hair-care practices in African American women: potential for allergic contact dermatitis. Semin Cutan Med Surg. 2016;35:207–10.
Plombom GY, Oliveira MS, Tabushi FL, et al. Epidemiological analysis of occupational dermatitis notified in Brazil in the period 2007 to 2012. An Bras Dermatol. 2016;91:732–73.
Vejanurug P, Tresukosol P, Sajjachareonpong P, et al. Fragrance allergy could be missed without patch testing with 26 individual fragrance allergens. Contact Dermatitis. 2016;74:230–5.
Goh CL. Patch tests in the tropics. Berlin: Springer; 2014. p. 143–7.
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Ruszczak, Z., Abdelhadi, S. (2018). Contact Dermatitis in Skin of Color. In: Orfanos, C., Zouboulis, C., Assaf, C. (eds) Pigmented Ethnic Skin and Imported Dermatoses. Springer, Cham. https://doi.org/10.1007/978-3-319-69422-1_2
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