Contact dermatitis: etiopathogenetic aspects of the formation of the clinical picture and the rational choice of external therapy

Abstract

Contact dermatitis is one of the most common skin diseases in many countries, especially among occupational dermatoses. This pathology is considered as an inflammatory skin disease caused by direct exposure to environmental factors. Obligate irritants have a direct damaging effect on the cells of the epidermis and, due to the activation of the predominantly innate immune system, lead to the development of dermatitis in any person. The action of facultative irritants is associated with a delayed type IV cell-mediated allergic reaction, which causes the development of the disease when exposed to substances with sensitizing properties in predisposed individuals. The severity and nature of the symptoms of contact dermatitis depend both on the type of irritant and on the individual characteristics of the organism. A necessary condition for the effectiveness of the treatment of contact dermatitis is the elimination of the allergen. To suppress the inflammatory response, topical glucocorticosteroids are the first-line drugs. The ease of use and the speed of relief of the symptoms of the disease can lead to the uncontrolled use of this group of drugs, in this regard, the article provides an analysis of the necessary conditions and rules for the use of topical glucocorticosteroids. Attention is focused on the risk of developing skin xerosis when they are prescribed. A modern method for the prevention of epidermal barrier dysfunction based on the use of preparations containing topical glucocorticosteroid in combination with ceramides is described. We present our own clinical observations of patients with contact dermatitis treated with this drug, while demonstrating a pronounced positive dynamics of the skin pathological process and regression of subjective symptoms without the development of side effects.