接触性皮炎:临床分型概览!

文摘   2024-12-14 21:32   河南  

接触性皮炎(contact dermatitis)是皮肤科常见炎症性皮肤病,其临床亚型多样且复杂,亚型分类不同与潜在发病机制相关,而发病机制决定其治疗用药差异。为增进认知,现对接触性皮炎临床亚型简述如下。

1变应性接触性皮炎(allergic contact dermatitis)

核心特征:致敏个体反复接触已致敏变应原所致;常见于接触部位。

(急性变应性接触性皮炎)

2刺激性接触性皮炎(Irritant contact dermatitis)

进一步分类:

(1)化学烧伤(chemical burns);

(2)刺激性反应(irritant reactions);

(3)急性刺激性皮炎(acute irritant dermatitis);

(4)晚发型急性刺激性皮炎(late-onset acute irritant dermatitis);

(急性刺激性接触性皮炎伴脓疱疮化)

(5)主观反应(subjective reaction);

(6)累积性刺激性接触性皮炎(cumulative irritant contact dermatitis);

(7)创伤性刺激性皮炎(traumatic irritant dermatitis);

(8)脓肿及痤疮样皮炎(abscess and acne-like dermatitis);

(9)摩擦性皮炎(frictional dermatitis);

(慢性刺激性接触性皮炎)

3即刻皮肤反应(immediate skin reaction)

进一步分类:

(1)接触性荨麻疹(contact urticaria):包括免疫性接触性荨麻疹(immunological contact urticaria)及非免疫性接触性荨麻疹(non-immunological contact urticaria);

(2)蛋白质接触性皮炎(protein contact dermatitis);

(接触性荨麻疹)

4光接触性皮炎(photocontact dermatitis)

进一步分类:

(1)光毒性接触性皮炎(phototoxic contact dermatitis,PTCD);

  1. 光变应性接触性皮炎(photoallergic contact dermatitis,PACD);

5系统性接触性皮炎(systemic contact dermatitis)

核心特征:既往皮炎复发;既往斑贴部位阳性反应;水疱性掌部/跖部皮炎、屈侧皮炎(flexural dermatitis)、狒狒综合征(Baboon syndrome)、对称性药物相关间擦及屈侧疹(symmetrical drug-related intertriginous and flexural exanthema);

6非湿疹性接触性皮炎(non-eczematous contact dermatitis)

进一步分类:

(1)多形红斑样(Erythema multiforme-like eruption);

(2)色素性紫癜样(Pigmented purpuric eruption);

(3)扁平苔藓样(Lichen planus-like eruption);

(4)大疱性(Bullous eruption);

(5)丘疹-结节性(Papular and nodular eruption);

(6)肉芽肿性(Granulomatous eruption);

(7)脓疱性(Pustular eruption);

(8)硬皮病样(Scleroderma-like eruption);

(9)色素性接触性皮炎(Pigmented contact dermatitis);

(10)淋巴瘤样接触性皮炎(Lymphomatoid contact dermatitis);

  1. 血管闭塞性接触性皮炎(Vascular-occlusive contact dermatitis)

7特殊类型接触性皮炎

(1)血源性接触性皮炎(hematogenous contact dermatitis);

(2)空气源性接触性皮炎(airborne contact dermatitis);

参考文献

[1] H Dickel, A Bauer, R Brehler, et al. German S1 guideline: Contact dermatitis. J Dtsch Dermatol Ges 2022; 20: 712-734.

[2] Y Li,L Li. Contact Dermatitis: Classifications and Management. Clin Rev Allergy Immunol 2021; 61: 245-281.

[3] G Novak-Bilić, M Vučić, I Japundžić, et al. IRRITANT AND ALLERGIC CONTACT DERMATITIS - SKIN LESION CHARACTERISTICS. Acta Clin Croat 2018; 57: 713-720.

[4] M Seki, T Okusa, H Takei, et al. Contact urticaria syndrome from copper. Contact Dermatitis 2021; 85: 375-376.

(本文仅作为科普与学术交流,增进了解,引起重视,有相关临床症状者,建议及时就医!!!)

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