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Abstract: The management of patients who have developed a contact dermatitis due to topical drugs requires to stop the suspected drug application, to declare, if severe, the adverse drug reaction to a center for drug safety, to treat the patient with corticosteroid ointments, to perform dermatoallergological investigations e.g. drug patch tests in case of contact eczema and diluted prick tests in case of contact urticaria in order to determine whether the adverse drug reaction was due to excipients or to the drug itself. It is also absolutely necessary to advise the patient concerning the avoidance of topical but also systemic readministration of the responsible molecule. An excipient responsible in inducing a contact sensitization to a topical drug can also be found in cosmetics, the name of the responsible excipient has to be given to the patient under the common name but also under the INCI and/or CFTA name. When the drug itself is responsible in inducing a contact allergy it is necessary to determine if cross reactions with other drugs can occur and if the responsible molecule can induce systemic cutaneous adverse drug reactions if the drug is systemically readministred. Among NSAID there is no cross reactions between bufexamac and diclofenac, between salicylamide, glycol salicylate, salicylic acid and acetylsalicylic acid. In case of photosensitization 1) to ketoprofen or 2) piroxicam the topical and/or systemic administration of the following molecules are contraindicated with respectively 1) ketoprofen, tiaprofenic acid, fenofibrate, oxybenzone or 2) piroxicam, thimerosal. A patient sensitized to corticosteroid ointment has to be tested in order to determine which corticosteroid classes are sensitizing. The topical and systemic administrations of molecules belonging to the sensitizing classes (A, B, C, D1 or D2) have to be forbidden. In general, a contact dermatitis due to an antimicrobial drug induces a contraindication in further topical or systemic uses of the drug and to all the molecules belonging to the same class. In most of the cases there is no risk in systemically administering iodine, sulfites or excipients in a sensitized patient who had developed a contact dermatitis to topical medications. [Copyright &y& Elsevier]

Abstract: Occupational dermatitis (irritant dermatitis, contact urticaria and contact eczema) is frequent among healthcare workers. Irritant hand dermatitis, the most common occupational dermatitis, occurs often in individual who work in a humid environment, who handle disinfectants, and who are required to wash their hands frequently; atopic dermatitis is a risk factor for this condition. Natural rubber latex present in rubber gloves is the most common cause of contact urticaria. Contact eczema can be induced by rubber accelerators (for example, thiurams) present in gloves, and also by disinfectants (glutaraldehyde, dodecyldimethylammonium), disinfectants and detergents, hand creams, acrylates (in dentists), and echography gels. Nurses sometimes develop contact dermatitis to drugs they handle; these allergies should be diagnosed by appropriate skin testing because sensitized individuals may develop a severe, generalized cutaneous adverse reaction if they are subsequently exposed systemically to the sensitizing drug. [Copyright &y& Elsevier]