From the Guidelines
Treatment for full body contact dermatitis involves a multi-faceted approach, prioritizing removal of the triggering substance, use of topical corticosteroids, and moisturization with fragrance-free emollients, as recommended by the British Association of Dermatologists' guidelines for the management of contact dermatitis 2017 1. The first step in managing full body contact dermatitis is to identify and remove the triggering substance to prevent further exposure. This may involve substituting soaps and detergents with emollients, as they can compound the situation by being irritants 1. Some key considerations for treatment include:
- Applying topical corticosteroids such as triamcinolone 0.1% or hydrocortisone 1% to affected areas twice daily for 1-2 weeks, as supported by studies on the efficacy of topical steroids in the treatment of contact dermatitis 1
- Using fragrance-free emollients like CeraVe or Vanicream after bathing to repair the skin barrier, and considering the use of thiuram-free gloves or isothiazolinone-free creams/cleansers in patients with identified contact allergy to these allergens 1
- Considering second-line treatments such as phototherapy and systemic immunomodulators like methotrexate and mycophenolate mofetil for persistent cases, as outlined in the British Association of Dermatologists' guidelines 1
- Evaluating severe or persistent cases with a dermatologist, as they may require prescription-strength medications or specialized therapies like psoralen plus UVA or azathioprine 1.
From the FDA Drug Label
CLINICAL STUDIES Three randomized, double-blind, vehicle-controlled, multi-center, Phase 3 studies were conducted in 589 pediatric patients ages 3 months-17 years old to evaluate ELIDEL ® (pimecrolimus) Cream 1% for the treatment of mild to moderate atopic dermatitis The treatment for full body contact dermatitis is not directly addressed in the provided drug label. The label discusses the treatment of atopic dermatitis with pimecrolimus (TOP) cream, but does not provide information on contact dermatitis.
- The studies mentioned in the label were conducted on patients with atopic dermatitis, not contact dermatitis.
- The label does not provide guidance on the treatment of full body contact dermatitis. 2
From the Research
Treatment for Full Body Contact Dermatitis
- The treatment for full body contact dermatitis involves avoiding the causative substance and using topical or systemic corticosteroids to reduce inflammation and itching 3, 4.
- For extensive areas of skin involvement (greater than 20 percent), systemic steroid therapy is often required and offers relief within 12 to 24 hours 3.
- In patients with severe rhus dermatitis, oral prednisone should be tapered over two to three weeks because rapid discontinuation of steroids can cause rebound dermatitis 3.
- Emollients, topical corticosteroids, and antihistamines can also be used to restore the skin barrier and reduce skin inflammation 4.
- In some cases, advanced therapies such as immunosuppressants may be necessary, especially when trigger avoidance is not feasible 5.
Topical Treatments
- Topical pimecrolimus has been studied as a treatment for allergic contact dermatitis, but its effectiveness in established human allergic contact dermatitis is limited 6.
- Topical corticosteroids, such as triamcinolone 0.1% or clobetasol 0.05%, are commonly used to treat localized acute allergic contact dermatitis lesions 3.
Diagnostic Tests
- Patch testing is the gold standard for diagnosing allergic contact dermatitis and can help identify the causative allergen 3, 4, 7.
- Other diagnostic tests, such as photopatch test, skin tests for detecting immediate contact reactions, and serum allergen-specific IgE test, can also be used to help diagnose contact dermatitis 4.