|Skin in Health and Disease|
Contact dermatitis is a common occupational disease and occurs at home to cosmetics, skin care products and to other chemicals. Outdoors plants are common causes of contact dermatitis poison ivy is prototype of a skin irritant that produces dramatic inflammation on contact. Textile dyes in clothing are a common source of skin problems.
Our strategy of managing skin diseases is to treat them as ecological problems. You get better results if you assume that several factors interact to produce skin disease than if you assume that each disease has a single cause and single cure. The skin is a meeting place for disease- causing agents coming from the outside and the inside at the same time. Skin irritants and allergens combine forces to produce skin chronic skin disease. Food allergy and contact allergy may be two expressions of the same or similar antigens. Food allergy may start eczema, and the inflamed skin, in turn, becomes more vulnerable to irritants, allergens and infections.
Contact dermatitis has been divided into two categories:
1. allergic contact dermatitis 2. and irritant contact dermatitis
Both allergic contact dermatitis and irritant contact dermatitis have similar presentations. Acute skin lesions may be red, swollen and weeping crusting lesions may appear after a few days. In chronic cases skin reddening, scaling and fissuring are common. The distribution of the lesions may provide clues to the irritant or allergen trigger. Identifying and removing the contact solves the problem.
Allergic Contact Dermatitis
Allergic contact dermatitis is a delayed, type IV allergic reaction. Latex rubber is a well recognized source of contact reactions. Healthcare personnel. now wear latex gloves routinely in all patient encounters and sensitization estimates go as high as 40%. Patients who have been sensitized to skin-contact allergens may develop generalized eczematous inflammation if these allergens or chemically related substances are ingested. For example, a patient with a history of nickel allergy may get a widespread involvement after eating foods rich in nickel. Patients sensitized to latex may cross-react to bananas and kiwifruit. Patients sensitized to topical ethylenediamine may develop generalized inflammation following treatment with aminophylline.
Contact urticaria is a local immediate or delayed hive-like reaction reaction at the site of contact . The skin contact may also cause a generalized allergic reaction with rhinitis, asthma, or anaphylaxis. Natural rubber latex, for example can cause contact urticaria. Symptoms vary from mild itching to asthma and anaphylaxis. Ethylene oxide, isocyanates, chloramine-T, epoxy resins and nickel sulphate have caused IgE-mediated skin reactions.
Ahmed and Richardson described patients with hand dermatitis their occupations were in healthcare, followed by laborers, service workers, and machinists/mechanics. The most commonly positive patch tests were: formaldehyde & releasers, other preservatives, fragrances, rubber, nickel, and neomycin/bacitracin. Bacitracin is an antibiotic that is used in several types of consumer products, including cosmetics and ophthalmic and skin ointments. Bacitracin is often combined with two other antibiotics, polymyxin and neomycin, in first aid antibiotic products (Polysporin). Increasing reports of allergic contact dermatitis reactions and near fatal anaphylaxis concerns the North American Contact Dermatitis Group.
Allergic contact dermatitis of the feet may be caused by rubber and leather
components of shoes substances identified by patch testing included
chromated leather, p-tert butylphenol formaldehyde resin,
dithiodimorpholine, 2- mercaptobenthiazole, thiurams and isocyanates.
Textile contact dermatitis often presents itching and red patches with or
without fine skin peeling. Huntley suggests: “Usually these lesions develop at
sites where the garments fit tightly, such as inner and posterior thighs, back
of knees, buttocks, waistband area, and anterior and posterior axillary folds.”
Treating Contact Dermatitis
Recall our strategy of managing skin diseases as ecological problems. You get better results if you assume that several factors interact to produce skin disease than if you assume that each disease has a single cause and single cure. The skin is a meeting place for disease- causing agents coming from the outside and the inside at the same time.
Skin irritants and allergens combine forces to produce skin chronic skin disease. Food allergy and contact allergy may be two expressions of the same or similar antigens.
Food allergy may start eczema, and the inflamed skin, in turn, becomes more vulnerable to irritants, allergens and infections. Agner et al reported that the combined effect of an irritant and an allergen was substantially greater than the effect produced by either of the substances alone. They studied 20 nickel-sensitized subjects were exposed to patch testing with nickel chloride and sodium lauryl sulphate (the detergent in most shampoos) alone and in combination. [i] Elsner reported that skin exposure to a variety of irritants such as surfactants and solvents is common and the irritant effects may combine. They showed that a tandem application of 0.5% sodium lauryl sulfate, an anionic detergent and undiluted toluene, applied twice daily for 30 minutes to the forearms of 20 volunteers, induced stronger irritant reactions than those caused by application of the single irritants. [ii]
[i] Tove Agner, Jeanne Duus Johansen, Lene Overgaard, Aage Vølund, David Basketter, Torkil Menné. Combined effects of irritants and allergens. Presented at the annual meeting of the Contact Dermatitis Society. 2002 http://www.contactderm.org/acds_mtginfo.pdf
[ii] P. Elsner, W. Wigger-Alberti, A. Krebs, N. Goeritz, J. Spoo, U. Kappes, Interactions Of Irritants - A New Approach To Irritant Contact Dermatitis
Skin in Health and Disease
is a book about skin health and skin care that offers solutions to specific skin disorders. The good news for many suffers some chronic skin disorders is that complete diet revision will often improve and sometimes resolve skin symptoms. This book focuses on the most common skin disorders that can be controlled by changes in skin care, diet and the environment. Eczema, for example, is sometimes an expression of food allergy, or allergy to contact materials. Dermatologist may deny the food allergy causes, so that their patients often have to make independent decisions. In all aspects of medicine, we advocate responsible self-management and offer this book as primer and reference for self-managers with skin problems.
The book, Skin in Heath and Disease is intended to be used with the Alpha Nutrition Program. This text provides background knowledge, helpful in understanding skin disorders and the relevance of diet revision. Often a food holiday on Alpha ENF is the best way to begin recovery and the Alpha Nutrition program is an ideal way to design a safer, healthier long-term diet. If diet revision is appropriate to solve your Skin Disorders, you can order the the Starter Pack Option.
We recommend diet revision to people with
Starter Packs bundle the Alpha Nutrition Program, with other books and formulas to help you get started solving your health problems. The starter packs are sold at discounts to make it easier and affordable for you to learn more and try our nutrient formulas.
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Alpha Online is a hub for twenty five Medical Information Centers. Each center acts as its own web site with a home page and a list of links to relevant topics. Take advantage of 800 pages of text which describe common medical problems and introduce you to innovative solutions such as Alpha ENF and the Alpha Nutrition Program.
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