Management of Contact Eczema

As a widespread disease, it affects all age groups with a high prevalence and incidence. In addition to impairing the quality of life, it causes considerable health and socio-economic costs. Essentially, five subtypes can be distinguished, namely irritant contact dermatitis, phototoxic contact dermatitis, allergic contact dermatitis with its two special forms of hamatogenic and aerogenic contact dermatitis, photoallergic contact dermatitis and protein contact dermatitis. The diagnosis is based on a precise medical history and clinical skin findings as well as exposure-related allergological in vivo and in vitro tests. Once the contact substance - irritant or allergen - has been identified, the key to therapeutic success lies in its strict avoidance. The symptomatic treatment of contact eczema must always be individually adapted and geared to the stage of eczema. Topical glucocorticoids are considered first-line therapy for both irritant and allergic contact dermatitis. The constant accompanying basic therapy with skin care products plays a central role in achieving lasting therapeutic success. Systemic therapy can be considered if topical therapy is not effective or cannot be carried out. The short-term use of systemic glucocorticoids should be limited to extensive or clinically severe acute contact eczema and exacerbations of chronic contact eczema. The efficacy of the use of newer biologics and Janus kinase inhibitors in contact eczema is currently being tested in several clinical studies.