Dermatite allergica da contatto
Che cos’è la dermatite allergica da contatto?
La dermatite allergica da contatto è una comune affezione cutanea caratterizzata dalla presenza di lesioni eritemato maculo- vescicolo- crostose e da prurito, causati dal contatto con un allergene. Il processo immunologico alla base della dermatite allergica da contatto è una reazione di ipersensibilità ritardata e le sostanze di questa risposta sono numerosissime. Vista la prevalenza di molecole utilizzate in diverse attività professionali, la dermatite allergica da contatto si presenta talora come una malattia professionale che può colpire diverse categorie di lavoratori quali parrucchieri, muratori, lavoratori dell’industria farmaceutica e cosmetica ecc..
Quali sono le cause della dermatite allergica da contatto?
L’allergia ai metalli, e in particolare al nichel, rappresenta la causa più comune di dermatite allergica da contatto. I metalli(nichel,cromo,cobalto) non sono allergeni completi ma apteni, ovvero piccole molecole che diventano antigeni completi grazie al legame con con proteine “carrier”; possono avere un effetto irritante e, penetrando attraverso l’epidermide raggiungono facilmente le APC inducendo la risposta T cellulare specifica.
Quali sono i sintomi della dermatite allergica da contatto?
La prima manifestazione della dermatite da contatto è l’arrossamento cutaneo accompagnato da prurito intenso localizzato nella sede di contatto con l’allergene; successivamente compaiono delle vescicole che tendono a rompersi (fase essudativa) e a formare delle croste. Nei casi in cui il contatto con l’allergene continui, la cute diviene spessa e iperpigmentata (lichenificazione), con fissurazioni e desquamazione costantemente accompagnata da prurito di notevole intensità. Se l’allergene viene assorbita ed entra in circolo, le lesioni possono estendersi a distanza dal punto di primo contatto. La fase di sensibilizzazione può durare da 10 a 15 giorni di solito è asintomatica.
Diagnosi
La sede iniziale della comparsa delle manifestazioni cutanee può aiutare nel risalire all’allergene implicato. I test epicutanei o patch test sono considerate l’indagine più appropriata per la diagnosi delle dermatiti allergiche da contatto.
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