Anti-Irritants Agents for the Treatment of Irritant Contact Dermatitis: Clinical and Patent Perspective

Department of Dermatology, University of California, School of Medicine, Box 0989, Surge 110, 90 Medical Center Way, San Francisco, CA 94143-0989, USA. .
Recent Patents on Inflammation & Allergy Drug Discovery 07/2012; 6(3):169-85. DOI: 10.2174/187221312802652857
Source: PubMed


This overview defines whether anti-irritant agents, in fact, inhibit, prevent or treat irritant contact dermatitis (ICD) in man. We performed a literature search using PubMed, EMBASE, and Scopus via the library at University of California San Francisco, and a hand search of relevant text books to investigate chemicals that can be considered anti-irritants in either prevention or treatment. Emphasis was placed on data that included quantitative and qualitative results and that followed evidence-based dermatological guidelines. Related patents were summarized. Conflicting observations summarized here suggest well controlled, but often arduous, field type studies are required for confirmation.

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    01/2014; 5(6). DOI:10.4172/2155-9554.1000246
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    ABSTRACT: Irritant contact dermatitis (ICD) is a commonly occurring non-specific cutaneous inflammatory response to topical chemical, physiologic, and biologic toxins. Direct damage to the skin induces barrier dysfunction, epidermal cell stimulation, and pro-inflammatory mediator release leading to a visibly variable, itchy cutaneous reaction. Workplace exposure of the hands to water, cleansers, and solvents remains the most common source of ICD. There is no diagnostic test for ICD, as such a diagnosis is based on history and clinical findings. Exclusion of allergic contact dermatitis, atopic dermatitis, and other xerotic conditions is a key part of the work-up. Prevention and treatment of ICD lies in the utilization of barrier protectants, incorporation of hydrating cleansers to decrease disruption of the barrier, and avoidance protocols and protective gear (fabrics, gloves, etc.). Therapeutic tools to treat ICD include acute anti-pruritic and antibacterial soaks, cutaneous barrier protectants such as petrolatum, paraffin, and dimethicone; lipid-laden moisturizers rich in wool wax alcohols, ceramides, and cholesterol esters and colloidal oatmeal based creams; and, when there is an eczematous component, the restrained use of anti-inflammatory agents such as topical corticosteroids may be warranted. Future research in ICD pathophysiology will yield more precise treatment options for future patients and clinicians.
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    ABSTRACT: Contact dermatitis (CD) is an inflammatory skin condition induced by direct contact with a specific chemical. Irritant CD (ICD) is a nonspecific inflammatory cutaneous reaction to an irritating agent. Allergic CD (ACD) is an immune-mediated antigen-specific skin reaction to an allergenic chemical. The biomedical literature (human, basic science, veterinary) was reviewed to evaluate the current state of knowledge regarding CD. The incidence of human CD remains unclear, but represents up to 90-95% of all occupational skin diseases. The prevalence of CD has not been established in veterinary medicine. The pathogenesis of CD is not fully understood, but involves a complex cascade of events between resident skin cells, relocated immune cells, pro-inflammatory cytokines and chemokines. The main difference between ICD and ACD is that ACD is an antigen-specific reaction to an allergenic irritating agent whereas ICD is not antigen-specific. To date, there is no fully validated diagnostic test available for CD. Thus, its clinical diagnosis relies on the patient's history, clinical examination, dermatological tests and, in some cases, research-based assays. The most important factor in CD management is the identification and avoidance of the culprit irritant or allergen. In addition, various topical and systemic therapies can be considered. CD is a relatively common occupational skin disease in human beings, but the prevalence in veterinary medicine is undefined. It can lead to debilitating clinical signs. Further research in human medicine and even more so in veterinary patients, will be required in order to allow for an evidence-based approach in its diagnosis and management. © 2015 ESVD and ACVD.
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