Podstawowym objawem, który może świadczyć o kontaktowym zapaleniu skóry jest wyprysk na skórze. Najważniejszą wówczas kwestią jest unikanie kontaktu z alergenem bądź substancjami drażniącymi, a także zastosowanie leczenia objawowego. Na czym ono polega?
W celu złagodzenia objawów kontaktowego zapalenia skóry stosuje się leczenie objawowe, jednak powinno one zostać poprzedzone dokładnym spłukaniem zmienionej skóry wodą. To jakie środki zostaną zastosowane w ramach leczenia objawowego zależy od tego, czy źródłem wyprysku jest podłoże alergiczne czy podrażnienie jakąś substancją.
Niezależnie od źródła kontaktowego zapalenia skóry w leczeniu objawowym stosuje się kremy i maści. Ich celem jest zmniejszenie nasilenia stanu zapalnego skóry oraz świądu. Dodatkowo zmienioną skórę, której towarzyszą pęcherze z wysiękiem można obłożyć okładem ściągającym namoczonym wodą z 0,9 proc. roztworem soli fizjologicznej. W przypadku kontaktowego zapalenia skóry zalecane jest również stosowanie emolientów, które nawilżą skórę i odbudują jej naturalną barierę ochronną.
Jak określić przyczynę kontaktowego zapalenia skóry?
Aby potwierdzić bądź wykluczyć reakcję alergiczną, wykonuje się test paskowy, tzw. kontaktowy, naklejany na plecy pacjenta. Ten plaster z komorami, które wypełnione są alergenami w odpowiednich stężeniach pozostaje na plecach przez ok. 24-48 godzin. Jeżeli po zdjęciu plastra pojawi się reakcja zapalna, świadczy to o uczuleniu na którąś z substancji. Po dwóch, czasem trzech dniach lekarz kontroluję stan skóry pacjenta na plecach, w celu sprawdzenia ewentualnej opóźnionej reakcji zapalnej.
Jeżeli u pacjenta podejrzewa się fotoalergię, stosuje się testy płatkowe. Wówczas tylko jeden plaster jest naświetlany promieniowaniem UVA.
W badaniu źródła uczulenia stosuje się również badanie zewnątrzskórne, które polega na naniesieniu kropki z alergenem na przedramię lub plecy i nakłuciu skóry. Jeżeli 15 minut później na skórze pojawi się bąbel, będzie on potwierdzeniem składnika uczulającego. Niejednoznaczny wynik testu skórnego można potwierdzić badaniami krwi, a dokładniej oznaczeniem przeciwciał IgE.
Leczenie objawowe uczulenia
U pacjentów, których źródłem kontaktowego zapalenia skóry jest alergia na daną substancję stosuje się leki antyhistaminowe, w celu zatrzymania reakcji alergicznej. Jeżeli obszar wyprysku przekracza 1/3 powierzchni ciała, niekiedy konieczne będzie zastosowanie kortykosterydów.
Ponadto w leczeniu reakcji alergicznych stosuje się również leki immunosupresyjne, które w pewnym stopniu obniżają aktywność układu odpornościowego, jak również odczulanie. Ta forma leczenia polega natomiast na przyjmowaniu przez pacjenta alergenu w minimalnych dawkach, w celu uodpornienia na alergen.
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