Systematic review of treatment and prevention of contact dermatitis

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Title Systematic review of treatment and prevention of contact dermatitis
Year 2003
Investigators Joan Saary, Roohi Qureshi, Val Palda, Joel DeKoven, Melanie Pratt, Sandy Skotnicki-Grant, Linn Holness
CREOD Research Program Occupational Skin Disease
Research Theme Prevention, Treatment
Funder WSIB
Product Type Systematic Review
Background Work-related contact dermatitis (WRCD) is common, accounting for a significant portion of all occupational disease. Medical management has had little impact on clinical outcomes. Work outcomes have also been poor. There have been no systematic reviews of contact dermatitis treatment or prevention.
Study Focus (Research Question/Goals/
Methods)
As background for the Dermatitis Program of Care, we conducted a systematic review of the literature on contact dermatitis to aid in the provision of evidence-based recommendations. Forty nine studies met inclusion criteria.
Key Findings Interventions that effectively prevent irritant contact dermatitis (ICD), Rhus dermatitis (RD), and nickel, chrome, and copper dermatitis (NCCD) include:

  • Barrier creams containing dimethicone or perfluoropolyethers (ICD)
  • Cotton liners in gloves (ICD)
  • Fabrics treated with fabric softener (ICD)
  • Lipid-rich moisturizers (ICD)
  • Topical skin protectant (RD)
  • Quaternium 18 bentonite (organoclay) (RD)
  • Diethylene triaminepenta-acetic acid (chelator) cream (NCCD)

Interventions that effectively treat allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) include:

  • Potent or moderately potent steroids (ACD)
  • Lipid-rich moisturizers (ICD)

Interventions that do not effectively treat or prevent WRCD:

  • Barrier cream containing aluminum chlorohydrate (ICD)
  • Pentoxifylline (NCCD)
Implications for Health/Labour Policy and Practice The right interventions can prevent WRCD. For example, programs that encourage the use of lipid-rich moisturizers during and after work are likely to improve prevention as well as treatment outcomes in workplaces with high frequencies of WRCD.
Publication & Presentation Information Publications

  • Saary MJ, Qureshi R, Palda V, DeKoven J, Pratt M, Skotnicki-Grant S, Holness DL. A systematic review of treatments for contact dermatitis. Report to the Workplace Safety and Insurance Board, August 2003.
  • Saary J, Qureshi R, DeKoven J, Skotnicki-Grant S, Holness DL. A systematic review of treatments for contact dermatitis, Dermatitis 2004;15:100.
  • Saary J, Qureshi R, Palda V, DeKoven J, Pratt M, Skotnicki-Grant S, Holness L. A systematic review of contact dermatitis treatment and prevention. ┬áJ Amer Acad Derm 2005;53:845-855.

Presentations

  • Saary MJ, Qureshi R, Palda V, DeKoven J, Pratt M, Skotnicki-Grant S, Holness DL. A systematic review of treatment for contact dermatitis. American Contact Dermatitis Society Annual Meeting, Washington, February 2004.