The document discusses the history and pathogenesis of contact dermatitis. It notes that contact dermatitis can be either allergic or irritant-induced. Allergic contact dermatitis is a type IV hypersensitivity reaction resulting from skin exposure to contact allergens. It affects 15-20% of the population and has a latency period of 2-3 days. Nickel, fragrances and balsam of Peru are common allergens identified on patch testing. Irritant contact dermatitis does not involve sensitization and has a shorter latency period of less than 48 hours.

1. Dr. Héctor Cuevas Castillejos

2. Respuesta inflamatoria cutánea
Eczema Eritema
 Prurito
 Pápulas
 Vesículas
 Excoriaciones
 Costras
 Descamación
Dermatitis
World Allergy Organization. Disease Summaries: Contact Dermatitis.
http://www.worldallergy.org/public/allergic_diseases_center/contactdermatitis/ (accessed 24 August 2013)
Contacto de la piel con alguna
sustancia
de contacto
X
alérgica
Hipersensibilidad tipo IV

3. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of
Dermatology, 1979;18: 665–668
Antecedentes históricos
Papiro de Ebers
(1500 A.C)
“En el primer día la cabeza es pintada con una
loción de frutas de palma y es envuelta, en el
segundo día la cabeza se pinta con aceite de
pescado…”

4. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of
Dermatology, 1979;18: 665–668
Antecedentes históricos
Papiro de Ebers
(1500 A.C)
Antiguo Testamento
(900 A.C.)
“No haréis sajaduras en vuestro cuerpo por un
muerto, ni os haréis tatuajes; yo soy el Señor”
Levítico 19:28

5. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of
Dermatology, 1979;18: 665–668
Antecedentes históricos
Papiro de Ebers
(1500 A.C)
Antiguo Testamento
(900 A.C.)
Celso
(45 D.C.)
“Úlceras producidas por cáusticos”

6. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of
Dermatology, 1979;18: 665–668
Antecedentes históricos
Papiro de Ebers
(1500 A.C)
Antiguo Testamento
(900 A.C.)
Celso
(45 D.C.)
Paracelso
(1491)
“…efectos perniciosos que ejercen algunas
profesiones sobre la piel…”
De Morbis Metalicis

7. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of
Dermatology, 1979;18: 665–668
Antecedentes históricos
Papiro de Ebers
(1500 A.C)
Antiguo Testamento
(900 A.C.)
Celso
(45 D.C.)
Georgius
Agricola
(1556 D.C.)
Paracelso
(1491)
“…úlceras que sufren los mineros”
De Re Metallica

8. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of
Dermatology, 1979;18: 665–668
Antecedentes históricos
Papiro de Ebers
(1500 A.C)
Antiguo Testamento
(900 A.C.)
Celso
(45 D.C.)
Georgius
Agricola
(1556 D.C.)
Paracelso
(1491)
Bernardino
Ramazzini
(1713)
“…enfermedades que aquejan a los
artesanos…”
De Morbis Artificum

9. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of
Dermatology, 1979;18: 665–668
Antecedentes históricos
Revolución Industrial
(1750)

10. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of
Dermatology, 1979;18: 665–668
Antecedentes históricos
Description and treatment of cutaneous
diseases
• Psoriasis palmar de los zapateros
• Psoriasis difusa de los panaderos
• Eczema de las lavanderas
Revolución Industrial
(1750)
Willan
(1798 D.C.)

11. Wright RC, Goldman, L. Contact Dermatitis: A historical perspective. International Journal of
Dermatology, 1979;18: 665–668
Antecedentes históricos
Leçons théoriques et cliniques sur les
affections cutanées parasitaires
Características cutáneas de 40
profesiones
Revolución Industrial
(1750)
Willan
(1798 D.C.)
Bazin
(1862 D.C.)

12. Rycroft RJG. Textbook of Contact Dermatitis. Springer, Jan 1, 2001 - 1114 pages
Antecedentes históricos
Funktionelle Hautprüfung
Describe el proceso de hipersensibilidad
retardada ante químicos simples
Revolución Industrial
(1750)
Willan
(1798 D.C.)
Bazin
(1862 D.C.)
Jadassohn
(1895 D.C.)

13. Nater JP. Oscar Wilde's skin disease: allergic contact dermatitis? Contact Dermatitis. 1992 Jul;27(1):47-9.
Antecedentes históricos
Dermatitis en cara, brazos, pecho, espalda
Revolución Industrial
(1750)
Willan
(1798 D.C.)
Bazin
(1862 D.C.)
Jadassohn
(1895 D.C.)
Oscar Wilde
(1900)

14. Antecedentes históricos
Grupo Internacional de Investigación para
la Dermatitis de Contacto
Revolución Industrial
(1750)
Willan
(1798 D.C.)
Bazin
(1862 D.C.)
Jadassohn
(1895 D.C.)
Oscar Wilde
(1900)
ICDRG
(1966)
International Contact Dermatitis Research Group. http://www.icdrg.org/ (accessed 24 August 2013)

15. Epidemiología
Peiser M et al. Allergic contact dermatitis: epidemiology, molecular mechanisms, in vitro methods and
regulatory aspects. Current knowledge assembled at an international workshop at BfR, Germany. Cell Mol
Life Sci [Internet]. 2012 [cited 2012 Mar];69(5):763-81. In: Ovid MEDLINE(R) [Internet].
 15 – 20 % de la
población mundial

16. Epidemiología
 Profesionistas más
afectados
• Industria metalúrgica
• Estilistas
• Trabajadores de la
Salud
• Industria alimentaria
• Trabajadores de la
Construcción
• Pintores
Peiser M et al. Allergic contact dermatitis: epidemiology, molecular mechanisms, in vitro methods and
regulatory aspects. Current knowledge assembled at an international workshop at BfR, Germany. Cell Mol
Life Sci [Internet]. 2012 [cited 2012 Mar];69(5):763-81. In: Ovid MEDLINE(R) [Internet].

17. Epidemiología
Thyssen JP. The epidemiology of contact allergy in the general population--prevalence and main findings.
Contact Dermatitis. 2007 Nov;57(5):287-99.
 Sensibilización:
(12.5 – 40.6 %)
21 %

18. Epidemiología
Thyssen JP. The epidemiology of contact allergy in the general population--prevalence and main findings.
Contact Dermatitis. 2007 Nov;57(5):287-99.
 Sensibilización:
• Níquel
• Timerosal
• Fragancias

19. Pratt MD et al. North American Contact Dermatitis Group patch-test results, 2001–2002 study periods.
Dermatitis. 2004;15:176-83.
Níquel, Neomicina, Bálsamo de Perú

20. Britton et al. The British standard series of contact dermatitis allergens: Validation in clinical practice and value
for clinical governance. Br J Dermatol. 2003;148:259-64.
Níquel, Fragancias, Bálsamo de Perú

21. García-Bravo B et al. Estudio epidemiológico de la dermatitis alérgica de contacto en España (2001). Actas
Dermosifiliogr. 2004;95:14-24.
Níquel, Cobalto, Dicromato Potásico

22. Lazarov A. European standard series patch test results from a contact dermatitis clinic in Israel during the 7
year period from 1998 to 2004. Contact Dermatitis. 2006;55:73-6.
Níquel, Fragancias, Dicromato Potásico

23. Pratt MD et al. North American Contact Dermatitis Group patch-test results, 2001–2002 study periods.
Dermatitis. 2004;15:176-83.
Níquel, Fragancias, Cobalto

24. Olumide Y M. Contact dermatitis in Nigeria. Contact Dermatitis 1985: 12: 241–246.
Factores ambientales

25. Barros M A, Baptista A, Correia T M, Azevedo F. Patch testing in children: a study of 562 schoolchildren.
Contact Dermatitis 1991: 25: 156–159.
Factores culturales

26. Menne T, Rasmussen K. Regulation of nickel exposure in Denmark. Contact Dermatitis 1990: 23: 57–58.
Factores culturales

27. Menne T et al. Regulation of nickel exposure in Denmark. Contact Dermatitis 1990: 23: 57–58.
Factores político-sociales

28. Dermatitis de contacto
Alérgica Irritativa
World Allergy Organization. Disease Summaries: Contact Dermatitis.
http://www.worldallergy.org/public/allergic_diseases_center/contactdermatitis/ (accessed 24 August 2013)
80%20%

29. Tipo I
(Anticuerpos IgE)
Tipo II
(Anticuerpos
IgG/IgM)
Tipo III
(Anticuerpos
IgG/IgM)
Tipo IV (Linfocitos T)
Tipo IVa
Th1
Tipo IVb
Th2
Tipo IVc
LTc
Tipo IVd
LTh17
Antígeno Antígeno soluble
(alergeno)
Antígeno celular o
asociado a la matriz
Antígenos
solubles
Antígenos
solubles
Antígenos
solubles
Antígeno
asociado a
células
Antígeno asociado
a células
Mecanismos
efectores
FCɛRI o FCɤRIII
activación
dependiente de
células cebadas, con
liberación de
mediadores/citocinas
Células FCɤR+
(fagocitos, células
NK), complemento
Células FCɤR+,
complemento
Activación de
macrófagos
Activación de
eosinófilos
Activación de
linfocitos Tc
Activación de
neutrófilos
Ejemplos • Anafilaxia
sistémica
• Asma
• Rinitis alérgica
• Urticaria
• Angioedema
IIa:
o Ciertas
reacciones a
fármacos
o Reacciones a
incompatibilidad
sanguínea
IIb:
o Enfermedad de
Graves
o Urticaria
idiopática
crónica
• Reacción de
Arthus
• Otras
reacciones
mediadas por
complejos
inmunes
o Enfermedad
del suero
o Endocarditis
bacteriana
subaguda
• Dermatitis de
contacto
• Diabetes tipo
I
• Reacción
tuberculínica
• Inflamación
alérgica
crónica
o Asma
crónica
o Rinitis
alérgica
crónica
• Sindrome de
Stevens-
Johnson
• Epidermolisis
epidérmica
tóxica
• Pustulosis
exantemática
• Psoriasis
pustular
• Enfermedad de
Behcet
Uzzaman A and Cho S. Chapter 28: Classification of hypersensitivity reactions. Allergy Asthma Proc 2012; 33: S96 -9

30. Dermatitis de contacto
Alérgica Irritativa
Frecuencia
Etiología
Antígeno
Sensibilización
Concentración
Diagnóstico
Apariencia
Demarcación
Síntomas
Latencia
Resolución
20% 80%
Hipersensibilidad tipo IV No inmunológico
Haptenos No
Sí No
Independiente Dependiente
Pruebas de Parche Historia clínica / Examen físico
Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy
Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM
(accessed 24 August 2013)
Eritema
macular, pápulas, vesículas, bulas,
y/o excoriaciones
Descamación, eritema difuso,
pápulas, excoriaciones.
No Sí
Prurito Dolor urente
72 – 120 horas 48 horas
1 -2 semanas 90 horas

31. Werfel T, Kapp A. Atopic dermatitis and allergic contact dermatitis. In: Holgate ST, Church MK, Broide DH, Martinez FD (eds.)
Allergy. 4th edition. Edinburgh, SCT: Elsevier; 2012. p263-276
24 – 48 horas > 48 horas

32. Werfel T, Kapp A. Atopic dermatitis and allergic contact dermatitis. In: Holgate ST, Church MK, Broide DH, Martinez FD (eds.)
Allergy. 4th edition. Edinburgh, SCT: Elsevier; 2012. p263-276
24 – 48 horas > 48 horas
 Infiltrado inflamatorio linfocitario
en dermis y epidermis
 Eosinófilos en dermis y epidermis
 Basófilos y células cebadas
 Espongiosis importante
 Infiltrado inflamatorio linfocitario
menos prominente
 Infiltrado de macrófagos
 Espongiosis leve y microvesículas
 Diagnóstico diferencial
 Enfermedades vesiculares
 Impétigo buloso
 Herpes simplex
 Diagnóstico diferencial
 Eczema numular
 Procesos infiltrativos
 Rosácea
 Sarcoidosis
 Linfoma cutáneo de células T
 Eritrodermia
 Psoriasis
 Reacción a fármacos
 Síndrome de Sézary

33. Fisiopatología

34. Kaplan DH et als. Early immune events in the induction of allergic contact dermatitis. Nature Reviews Immunology 12, 114-
124 (February 2012)
Pre-haptenos Pro-haptenos Haptenos
Célula cutánea
• Especies
reactivas de
oxígeno (ERO)
• ATP
• Otros DAMPs
Ácido hialurónico de
bajo peso molecular
P2X7
Inflamosoma
Activación
caspasa 1
Pro-IL-1β
Pro-IL-18
TLR-2 TLR-4
MYD
88
TRIF
NFKB
IL-1β
IL-18
IFN-ɑ
IFN- β
IRF3
IL-1β
IL-18
IFN-ɑ
IFN- β
Níquel

35. Alergenos del Año
2013 Metilisotiazolinona Castanedo-Tardana
2012 Acrilatos Sasseville
2011 Dimetil Fumarato Bruze et al.
2010 Neomicina Sasseville
2009 Dialquil Tioureas Anderson
2008 Níquel Komik
2007 Fragancias Storrs
2006 Fenil E Diaminas (PPD) DeLeo
2005 Corticoesteroides Isaksson
2004 Cocoamidopropil Betaína Fowler J
2003 Bacitracina Sood
2002 Timerosal Belsito
2001 Oro Fowler
2000 Tintes azules dispersables Storrs
Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy
Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM
(accessed 24 August 2013)

36. Manifestaciones clínicas

106. Lacey A. BBC News Health. http://www.bbc.co.uk/news/health-22956874 (accesed 24 September 2013)

112. Bercovitch L , and Luo J CMAJ 2008;178:23-24

115. Hillen, U., Haude, M., Erbel, R. and Goos, M. (2002), Evaluation of metal allergies in patients
with coronary stents. Contact Dermatitis, 47: 353–356.

117. L. Host: A case of severe metal hypersensitivity post tibial plating. The Internet Journal of Orthopedic Surgery.
2009 Volume 11 Number 2.

118. Diagnóstico

119. Abordaje del paciente
Antecedente de
exposición
Localización: Pistas
geográficas
Prueba de Parche
• Agente identificado
• Entorno ambiental
• Párpados:
fragancias, níquel, formaldehíd
o
• Mano: Quarternio 15, CAPB
• Selección adecuada de
los antígenos

120. Es el único método práctico, científico y objetivo para el
diagnóstico
Prueba de Parche
Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy
Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM
(accessed 24 August 2013)

121. Escribir Desprender Aplicación Colocación
Retiro Lectura temprana Clasificación Lectura tardía

122. Stefan Wöhrl et al. Copper allergy revisited. Journal of the American Academy of Dermatology Volume
45, Issue 6, Pages 863-870, December 2001

123. Stefan Wöhrl et al. Copper allergy revisited. Journal of the American Academy of Dermatology Volume
45, Issue 6, Pages 863-870, December 2001

125. Pruebas de Parche
Estandarizados No estandarizados
Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy
Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM
(accessed 24 August 2013)

126. T.R.U.E.
Test
AllergEAZE
Trolab -
Hermal
Dormer
36 520 380 548
Estandarizados

127. T.R.U.E. Test®
Panel 1.2
1. Nickel sulfate
2. Wool alcohols
3. Neomycin sulfate
4. Potassium dichromate
5. Caine mix
6. Fragrance mix
7. Colophony
8. Paraben mix
9. Negative control
10. Balsam of Peru
11. Ethylenediamine
dihydrochloride
12. Cobalt Dichloride
Panel 2.2
13. p-tert-Butylphenol
formaldehyde resin
14. Epoxy resin
15. Carba mix
16. Black rubber mix
17. Cl+ Me- isothiazolinone
(MCI/MI)
18. Quaternium-15
19. Methyldibromo
glutaronitrile
20. p-Phenylenediamine
21. Formaldehyde
22. Mercapto mix
23. Thimerosal
24. Thiuram mix
Panel 3.2
25. Diazolidinyl urea
26. Quinoline mix
27. Tixocortol-21-pivalate
28. Gold sodium thiosulfate
29. Imidazolidinyl urea
30. Budesonide
31. Hydrocortizone-17-butyrate
32. Mercaptobenzothiazole
33. Bacitracin
34. Parthenolide
35. Disperse blue 106
36. 2-Bromo-2-nitropropane-1,3-
diol (Bronopol)

128. Seleccionar Desprender Aplicación Escribir

129. T.R.U.E.
Test
AllergEAZE
Trolab -
Hermal
Dormer
36 520 380 550
Estandarizados

130. Dormer®
1. European Baseline Series
2. International Comprehensive Baseline Series
3. Bakery Series
4. Corticoesteroids Series
5. Cosmetic Series
6. Cutaneous Adverse Drug Reaction Series
7. Dental Screening
8. Dental Materials Patients
9. Dental Materials Staff
10. Epoxy Series
11. European Photopatch Baseline Series
12. European Photopatch Extended Series
13. Fragrance Series
14. Hairdressing Series
15. International Standard Series
16. Isocyanate Series
17. Leg Ulcer Series
18. Medicament Series
19. Metal Series
20. (Meth) Acrylate Series [Adhesives Dental &
Other]
21. (Meth) Acrylate Series [Nails – Artificial]
22. (Meth) Acrylate Series [Printing]
23. Oil & Cooling Fluid Series
24. Photographic Chemicals Series
25. Plant Series
26. Plastics & Glues Series
27. Rubber Additives Series
28. Scandinavian Photo Patch
29. Shoe Series
30. Sunscreen Series
31. Textile Colours & Finish
32. Various Haptens
28
80
19
9
56
29
31
24
10
14
19
33
42
28
21
7
27
14
43
15
13
24
35
16
14
25
26
20
23
20
33
65
Trolab – Hermal®
1. Baseline Series (European)
2. Irritant control
3. Antioxidants
4. Bakery Allergens
5. Cosmetics
6. Cutting Oils I (current)
7. Cutting Oils II (historical)
8. Dental Materials
9. Disinfectants
10. Epoxy Resin Systems
11. Hairdressing
12. Industrial Biocides
13. Medicaments I - Antibiotics
14. Medicaments II - Antiseptics,
Antimycotics
15. Medicaments III - Miscellaneous
16. Medicaments IV - Local Anaesthetics
17. Medicaments V - Corticosteroids
18. Medicaments VI - Ophthalmics
19. Metal Compounds
20. Methacrylates
21. Perfumes, Flavours
22. Photoallergens
23. Photographic Chemicals
24. Plants
25. Plastic Materials
26. Preservatives
27. Rubber Chemicals
28. Shoe Allergens
29. Sunscreen Agents
30. Textile and Leather Dyes
31. Vehicles, Emulsifiers
32. Miscellaneous
28
1
6
14
14
27
11
20
6
12
9
15
9
5
5
5
7
5
7
9
45
16
14
2
12
22
18
8
9
13
9
5
AllergEAZE®
1. Antibiotics / Antimycotics
2. Corticosteroids
3. Eye Medicaments
4. Local Anesthetics
5. Medicinal Substances (various)
6. Antimicrobials / Preservatives
7. Dye Colorants
8. External Agents / Emulsifiers
9. Food Aditives
10. Metal Compounds
11. Natural Origin & Plants
12. Perfumes & Flavors
13. Plastics / Glues
14. Rubber Chemicals
15. Supplemental Allergens
16. Core Allergen Series
17. Supplement Core Allergen Series
18. Australian Baseline Series
19. British Baseline Series
20. European Baseline Series
21. Japanese Standard Series
22. Minimum International Baseline Series
23. North American Standard Series
24. Supplement North American Standard Series
25. Bakery
26. Cosmetics
27. Cooling Lubricants (Metalworking)
28. Dental Screening Patients
29. Dental Screening Technicians / HCPs
30. Eyelid Dermatitis
31. Footwear
32. Hairdressing
33. Leg Ulcer
34. Metal Implants
35. Photoallergens
36. Photochemicals
37. Sunscreens
24
21
25
11
31
74
26
34
22
53
21
57
55
36
3
80
50
60
41
28
24
32
70
42
20
64
40
29
25
30
30
33
34
29
26
19
10

131. Dormer®
1. European Baseline Series
2. International Comprehensive Baseline Series
3. Bakery Series
4. Corticoesteroids Series
5. Cosmetic Series
6. Cutaneous Adverse Drug Reaction Series
7. Dental Screening
8. Dental Materials Patients
9. Dental Materials Staff
10. Epoxy Series
11. European Photopatch Baseline Series
12. European Photopatch Extended Series
13. Fragrance Series
14. Hairdressing Series
15. International Standard Series
16. Isocyanate Series
17. Leg Ulcer Series
18. Medicament Series
19. Metal Series
20. (Meth) Acrylate Series [Adhesives Dental &
Other]
21. (Meth) Acrylate Series [Nails – Artificial]
22. (Meth) Acrylate Series [Printing]
23. Oil & Cooling Fluid Series
24. Photographic Chemicals Series
25. Plant Series
26. Plastics & Glues Series
27. Rubber Additives Series
28. Scandinavian Photo Patch
29. Shoe Series
30. Sunscreen Series
31. Textile Colours & Finish
32. Various Haptens
28
80
19
9
56
29
31
24
10
14
19
33
42
28
21
7
27
14
43
15
13
24
35
16
14
25
26
20
23
20
33
65
Trolab – Hermal®
1. Baseline Series (European)
2. Irritant control
3. Antioxidants
4. Bakery Allergens
5. Cosmetics
6. Cutting Oils I (current)
7. Cutting Oils II (historical)
8. Dental Materials
9. Disinfectants
10. Epoxy Resin Systems
11. Hairdressing
12. Industrial Biocides
13. Medicaments I - Antibiotics
14. Medicaments II - Antiseptics,
Antimycotics
15. Medicaments III - Miscellaneous
16. Medicaments IV - Local Anaesthetics
17. Medicaments V - Corticosteroids
18. Medicaments VI - Ophthalmics
19. Metal Compounds
20. Methacrylates
21. Perfumes, Flavours
22. Photoallergens
23. Photographic Chemicals
24. Plants
25. Plastic Materials
26. Preservatives
27. Rubber Chemicals
28. Shoe Allergens
29. Sunscreen Agents
30. Textile and Leather Dyes
31. Vehicles, Emulsifiers
32. Miscellaneous
28
1
6
14
14
27
11
20
6
12
9
15
9
5
5
5
7
5
7
9
45
16
14
2
12
22
18
8
9
13
9
5
AllergEAZE®
1. Antibiotics / Antimycotics
2. Corticosteroids
3. Eye Medicaments
4. Local Anesthetics
5. Medicinal Substances (various)
6. Antimicrobials / Preservatives
7. Dye Colorants
8. External Agents / Emulsifiers
9. Food Aditives
10. Metal Compounds
11. Natural Origin & Plants
12. Perfumes & Flavors
13. Plastics / Glues
14. Rubber Chemicals
15. Supplemental Allergens
16. Core Allergen Series
17. Supplement Core Allergen Series
18. Australian Baseline Series
19. British Baseline Series
20. European Baseline Series
21. Japanese Standard Series
22. Minimum International Baseline Series
23. North American Standard Series
24. Supplement North American Standard Series
25. Bakery
26. Cosmetics
27. Cooling Lubricants (Metalworking)
28. Dental Screening Patients
29. Dental Screening Technicians / HCPs
30. Eyelid Dermatitis
31. Footwear
32. Hairdressing
33. Leg Ulcer
34. Metal Implants
35. Photoallergens
36. Photochemicals
37. Sunscreens
24
21
25
11
31
74
26
34
22
53
21
57
55
36
3
80
50
60
41
28
24
32
70
42
20
64
40
29
25
30
30
33
34
29
26
19
10

132. Dormer®
1. European Baseline Series
2. International Comprehensive Baseline Series
3. Bakery Series
4. Corticoesteroids Series
5. Cosmetic Series
6. Cutaneous Adverse Drug Reaction Series
7. Dental Screening
8. Dental Materials Patients
9. Dental Materials Staff
10. Epoxy Series
11. European Photopatch Baseline Series
12. European Photopatch Extended Series
13. Fragrance Series
14. Hairdressing Series
15. International Standard Series
16. Isocyanate Series
17. Leg Ulcer Series
18. Medicament Series
19. Metal Series
20. (Meth) Acrylate Series [Adhesives Dental &
Other]
21. (Meth) Acrylate Series [Nails – Artificial]
22. (Meth) Acrylate Series [Printing]
23. Oil & Cooling Fluid Series
24. Photographic Chemicals Series
25. Plant Series
26. Plastics & Glues Series
27. Rubber Additives Series
28. Scandinavian Photo Patch
29. Shoe Series
30. Sunscreen Series
31. Textile Colours & Finish
32. Various Haptens
28
80
19
9
56
29
31
24
10
14
19
33
42
28
21
7
27
14
43
15
13
24
35
16
14
25
26
20
23
20
33
65
Trolab – Hermal®
1. Baseline Series (European)
2. Irritant control
3. Antioxidants
4. Bakery Allergens
5. Cosmetics
6. Cutting Oils I (current)
7. Cutting Oils II (historical)
8. Dental Materials
9. Disinfectants
10. Epoxy Resin Systems
11. Hairdressing
12. Industrial Biocides
13. Medicaments I - Antibiotics
14. Medicaments II - Antiseptics,
Antimycotics
15. Medicaments III - Miscellaneous
16. Medicaments IV - Local Anaesthetics
17. Medicaments V - Corticosteroids
18. Medicaments VI - Ophthalmics
19. Metal Compounds
20. Methacrylates
21. Perfumes, Flavours
22. Photoallergens
23. Photographic Chemicals
24. Plants
25. Plastic Materials
26. Preservatives
27. Rubber Chemicals
28. Shoe Allergens
29. Sunscreen Agents
30. Textile and Leather Dyes
31. Vehicles, Emulsifiers
32. Miscellaneous
28
1
6
14
14
27
11
20
6
12
9
15
9
5
5
5
7
5
7
9
45
16
14
2
12
22
18
8
9
13
9
5
AllergEAZE®
1. Antibiotics / Antimycotics
2. Corticosteroids
3. Eye Medicaments
4. Local Anesthetics
5. Medicinal Substances (various)
6. Antimicrobials / Preservatives
7. Dye Colorants
8. External Agents / Emulsifiers
9. Food Aditives
10. Metal Compounds
11. Natural Origin & Plants
12. Perfumes & Flavors
13. Plastics / Glues
14. Rubber Chemicals
15. Supplemental Allergens
16. Core Allergen Series
17. Supplement Core Allergen Series
18. Australian Baseline Series
19. British Baseline Series
20. European Baseline Series
21. Japanese Standard Series
22. Minimum International Baseline Series
23. North American Standard Series
24. Supplement North American Standard Series
25. Bakery
26. Cosmetics
27. Cooling Lubricants (Metalworking)
28. Dental Screening Patients
29. Dental Screening Technicians / HCPs
30. Eyelid Dermatitis
31. Footwear
32. Hairdressing
33. Leg Ulcer
34. Metal Implants
35. Photoallergens
36. Photochemicals
37. Sunscreens
24
21
25
11
31
74
26
34
22
53
21
57
55
36
3
80
50
60
41
28
24
32
70
42
20
64
40
29
25
30
30
33
34
29
26
19
10

133. Internacional Grupo Internacional de Investigación para la
Dermatitis de Contacto
ICDRG
Europeo Sociedad Europea de Dermatitis de Contacto ESCD

134. ICDRG Trolab - Hermal®
Budesonide 0.01% Budesonide 0.1%
Formaldehyde 2% Formaldehyde 1%
Mercapto Mix 2% Mercapto Mix 1%
Methylisothiazolinone 0.01% Methylisothiazolinone 0.05%
Quaternium 15 2% Quaternium 15 1%
Tixocortol-21-pivalate 0.1% Tixocortol-21-pivalate 1%
Patch Test Allergens and Devices. TROLAB®. http://www.almirall.de/al/dermatologie/dermatologische-
produkte/epicutantest/TROLAB-brochure.pdf (accessed 24 September 2013)

135. Dormer® Concentración % Vehículo
Adeps lanae
Ácido Abiético
Dibutyl phthalate
Ammonium Persulphate
Acid Yellow 36
Arnica Montana Extract
Amcinonide
Alantolactona
30
10
5
2.5
1
0.5
0.1
0.033
Petrolato
Propylene Glycol
Dimethylol dihydroxy ethylene urea
Cocamidopropyl betaine
Amidoamine
Methylisothiazolinone
30
4.5
1
0.1
0.01
Agua
Shellac 20 Alcohol
Benzyl alcohol 10 Soft drink
(benzoato de sodio)
Patch Test Products & Reference Manual 2013. Dormer®. http://www.dormer.ca/pdf/che-webcat.pdf (accessed 24 September
2013)

136. Nomenclatura Internacional de
Ingredientes Cosméticos
Ingredientes Cosméticos
Trolab-Hermal®
Hydroabietyl Alcohol Abitol
Lanolin Adeps lanae
Amyl Cinnamal alpha-Amyl-Cinnamaldehyde
Amylcinnamyl alcohol alpha-Amylcinnamyl Alcohol
Lanolin alcohol (and) Parafinum
Liquidum
Amerchol® L 101
PABA 4-Aminobenzoic Acid
M-Aminophenol 3-Aminophenol
P-Aminophenol 4-Aminophenol
Ammonium Persulfate Ammonium Persulphate
Anise alcohol Ansyl Alcohol
Patch Test Allergens and Devices. TROLAB®. http://www.almirall.de/al/dermatologie/dermatologische-
produkte/epicutantest/TROLAB-brochure.pdf (accessed 24 September 2013)

138. No Estandarizados

139. Concentraciones para Pruebas de Parche no
estandarizadas
Agente Concentración
Cosméticos
(Maquillaje, Perfume, humectante, barniz de uña)
Igual
Cosméticos transitorios
(Jabones, Shampoo)
1:10 – 1:100
Productos de limpieza
(detergentes, limpiadores, solventes)
1:100 – 1:1000
Medicamentos tópicos
- Antibacterianos, Esteroides
- Tretinoína, peróxido de benzoílo
-Igual
- 1:10 – 1:1000
Ropa, zapatos, guantes - Igual
- Humedecer en solución salina
Plantas y alimentos - Igual
- Cebolla y ajo diluidos al 50%
Productos industriales Precaución
Fonacier L. Contact Dermatitis. Presented at the Conferences On-Line Allergy of the Children’s Mercy
Hospitals & Clinicis. Kansas city, Missouri, USA. 2012 http://www.youtube.com/watch?v=gJoROhyjBTM
(accessed 12 September 2013)

140. Jacob S. Contact Dermatitis. Presented at the Conferences On-Line Allergy of the Children’s Mercy Hospitals
& Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=HDosxIkw-ag (accessed 12
September 2013)

141. Indicaciones para Pruebas de Parche
 Confirmar el diagnóstico de DCA
 Identificar a los alérgenos
 Determinar la causa de una dermatitis ocupacional
 Demostrar la ausencia de sensibilización a una sustancia
específica
 Incluir o excluir el diagnóstico de DCA para aspectos
médico-legales
 Identificar problemas de salud potenciales
Fonacier L. Contact Dermatitis. Presented at the Conferences On-Line Allergy of the Children’s Mercy
Hospitals & Clinicis. Kansas city, Missouri, USA. 2012 http://www.youtube.com/watch?v=gJoROhyjBTM
(accessed 12 September 2013)

142. Contraindicaciones para Pruebas de Parche
 Dermatitis aguda generalizada y severa
 Utilización oral de corticoesteroides
 Utilización de esteroides tópicos en el área donde se
aplicarán los parches
 Descontinuar esteroides tópicos 5 – 7 días previos
 Paciente inmunocomprometido – Quimioterapia
 Los pacientes con VIH frecuentemente presentan
positividad ante los alergenos de contacto
 Quemaduras solares
Fonacier L. Contact Dermatitis. Presented at the Conferences On-Line Allergy of the Children’s Mercy
Hospitals & Clinicis. Kansas city, Missouri, USA. 2012 http://www.youtube.com/watch?v=gJoROhyjBTM
(accessed 12 September 2013)

143. Tratamiento
 Preventivo
 Farmacológico

144. Contact Allergen Replacement Databse. Preventice. http://www.preventice.com/card/(accessed 24 September 2013)

145. Tratamiento Farmacológico
 Tópico
 Sistémico

146. Tratamiento Tópico
 Shampús
 Lociones / Suspensiones
 Geles
 Tinturas
 Emulsiones
 Cremas
Emolientes
Pomadas
Ungüentos
 Pastas
 Polvos
 Baños coloides

147. Tratamiento Tópico
 Antimicrobianos
 Antihistamínicos
 Inmunomoduladores
 Glucocorticoides
 Inhibidores de la
calcineurina
 Otros

148. Alergenos del Año
2013 Metilisotiazolinona Castanedo-Tardana
2012 Acrilatos Sasseville
2011 Dimetil Fumarato Bruze et al.
2010 Neomicina Sasseville
2009 Dialquil Tioureas Anderson
2008 Níquel Komik
2007 Fragancias Storrs
2006 Fenil E Diaminas (PPD) DeLeo
2005 Corticoesteroides Isaksson
2004 Cocoamidopropil Betaína Fowler J
2003 Bacitracina Sood
2002 Timerosal Belsito
2001 Oro Fowler
2000 Tintes azules dispersables Storrs
Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy
Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM
(accessed 24 August 2013)

162. Alergenos del Año
2013 Metilisotiazolinona Castanedo-Tardana
2012 Acrilatos Sasseville
2011 Dimetil Fumarato Bruze et al.
2010 Neomicina Sasseville
2009 Dialquil Tioureas Anderson
2008 Níquel Komik
2007 Fragancias Storrs
2006 Fenil E Diaminas (PPD) DeLeo
2005 Corticoesteroides Isaksson
2004 Cocoamidopropil Betaína Fowler J
2003 Bacitracina Sood
2002 Timerosal Belsito
2001 Oro Fowler
2000 Tintes azules dispersables Storrs
Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy
Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM
(accessed 24 August 2013)

163. Producto Parabenos Aceite Fragancia Acrilatos Esteroide Propilengli
col
Planta Otros
Cremas Cetaphil
Crema
Metilparabe
no
No No
letiAT4 Metilparabe
no
Propilparabe
no
-Omega 6
- Acidos
grasos
esenciales
- Ceramidas
- Maíz
Sí Sí - Linum
usitassimum
- Manteca de
Karité
Fisiogel Vegetal No - Coco
- Manteca
de Karite
Fisiogel A.I. Vegetal No - Oliva
- Palma
Trixera No - Semilla de
cártamo
- Aceite de
coco
- Oenothera
biennis
- Semilla de
glicina
- Soya
Nutratopic
Rx
- Aceite de
semilla de
girasol
- Cera de
abeja
Algunos ejemplos de productos disponibles en México…

164. Producto Parabenos Aceite Fragancia Acrilatos Esteroide Propilengli
col
Planta Otros
Cetaphil
loción
humectante
- Butilpara
beno
- Metilpara
beno
No No Sí
Cetaphil
loción
ultrahumect
ante
No No Sí - Semilla
Macadamia
Lociones Ureadin Rx
30
Sí Sí Sí Salicilatos
Geles letiAT4 (gel
de baño)
- Metilpara
beno
- Propilpar
abeno
Sí
Fisiogel - Acido
caprilico
-
Triglicéridos
- Ceramidas
- Goma
Xantano
- Coco
- Manteca de
Carité
Trixera gel - Coco
- Ricino
- Oenother
a biennis
- Soya
Nutratopic Sí - Aceite
Rosa
Damasce
na
Barras Cetaphil
barra
Metilparabe
no
Sí - Almendra
de Palma
Emulsión Aqua Soap +

166. Alergenos del Año
2013 Metilisotiazolinona Castanedo-Tardana
2012 Acrilatos Sasseville
2011 Dimetil Fumarato Bruze et al.
2010 Neomicina Sasseville
2009 Dialquil Tioureas Anderson
2008 Níquel Komik
2007 Fragancias Storrs
2006 Fenil E Diaminas (PPD) DeLeo
2005 Corticoesteroides Isaksson
2004 Cocoamidopropil Betaína Fowler J
2003 Bacitracina Sood
2002 Timerosal Belsito
2001 Oro Fowler
2000 Tintes azules dispersables Storrs
Herro E. Contact Dermatitis: Part I. Presented at the Conferences On-Line Allergy of the Children’s Mercy
Hospitals & Clinicis. Kansas city, Missouri, USA. 2011 http://www.youtube.com/watch?v=6ICTSX-xqSM
(accessed 24 August 2013)

170. ¡Gracias!
drcuevashector@hotmail.com