The diagnostic evaluation, treatment. and prevention of allergic contact dermatitis in the new millennium

Identifying the etiology of allergic contact dermatitis is a rewarding yet challenging endeavor. Not all allergic contact reactions are eczematous in appearance. The most reliable clinical clue to the allergic nature of the d ermatitis is its geographic distribution. Once a list of culprit allergens has been identified by patch testing, the practitioner must identify the re levant allergen(s) and counsel the patient in avoidance. For most individua ls, allergen avoidance results in resolution of the dermatitis; however, so me patients will require continuing symptomatic therapy despite avoidance. For those patients unable to avoid known allergens, immunosuppressant thera pies (including phototherapy) or barriers ran be beneficial. Currently, hyp osensitization is not a viable alternative for the treatment of allergic co ntact dermatitis.