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http://www.journal-imab-bg.org ETIOLOGY OF COMMON CONTACT DERMATITIS Department of Dermatology and Venerology,Medical University Prof. Dr. Paraskev Stoyanov – Varna, Bulgaria Journal of IMAB RESUME: Contact dermatites (allergic and non-allergic) are fre-quently observed dermatosås and they pose a serious prob-lem to the dermatologist. They are usually common derma-tites, but a considerable number of the cases are occupa-of great significance for a precise therapeutic approach andefficient prophylactics. The study aimed at etiological and pathogenetic clar-ification of common contact dermatitis in a group of 210 pa- The analysis of the received 213 positive epicutane-ous tests revealed that detergents are the most frequent al-lergens (16.43%), followed by metals (15.02%), rubber addi-tives (14.80%), parabens (10.79%), antiseptics (10,32%), The most frequent irritant etiological agents were de-tergents (28.73%), followed by soaps (27.58%), additives torubber (13.79%), acids and bases, organic solvents. lems in a dermatologist’s practice. They occur frequently; The most frequent allergens, causing ACD are: nick- ACD has undoubtedly allergic genesis (delayed al-lergic reaction), and ICD is assumed to be a non-immunologic skin irritation. The clinical occurrences, as well as the histological pictures of ACD and ICD are actuallydifferent. In ACD histologically are presented vesiculous The diagnostics of ACD and ICD is based on many There exists a complex interrelation between ACD and Skin and Venereal Diseases – Varna. MATERIALS AND METHODS: and studied for a period of five years: 123 patients with ACD th data. The differentiation of ACD and ICD was based on the http://www.journal-imab-bg.org RESULTS AND DISCUSSION: Of all the studied patients with CD in 205 patientsthe etiological cause was proven, as the followingdistribution in connection with the clinical and pathogenetic diagnosis was established (Table. 1): ACD was establishedcause was established and in 5 patients it remained unclear. Table 1. Total number of patients % Allergic 123123100 dermatitis Irritant 87 dermatitis Total210100123 Table 2. Etiology of the common allergic contact dermatitis (123 positive epicutaneous tests) AllergensPositive epicutaneous tests% 32 Rubber additives - Thiuram Mix, Phenylendiamin, Diphenyl-p-phenylendiamin, 30 Medicaments – neomycin, benzocain, 11 20 15 Scents (Parfum Mix)- cinnamat alcohol, cinnamat aldehyd,Euginol, 19 Parabens (Paraben Mix)- Nipabutyl, Nipagin A, Nipagin M, Nipazol M23 35 22 2.8 Total in patients with ACD justifies the following conclusionsabout their etiology (Table.2). Of greatest etiologicalsignificance for ACD are: detergents (16.43%), metals considerable frequency as causative agents of ACD. Of agents in the patients with ICD was the following ( Table unclear. http://www.journal-imab-bg.org Table 3. Etiology of the common irritant contact dermatitis in 87 patients Number of patients with established irritant agent% 24 Strong acids78.04 Strong bases910.34 Organic solvents33.44 Alcohol solutions22.29 25 12 Patients with unclear etiological cause55.74 Total87 local corticosteroids. Skin occlusion in such cases is dis-cussed as a predisposing factor for the exacerbation of theACD. of the ACD (16,20), as their frequency ranges between 6.8%nored. The Peruvian balsam presents 5% of the ACD cases(6). In everyday life ACD is most often caused by detergents (19), 41.4% according to the present study. The most fre- CONCLUSIONS: In the etiology of the common ACD of definite im- The clarification of the etiology and pathogenesis ofthe CD is of crucial importance for the accurate therapeuticapproach, as well as for justified and efficient prophylacticsfor each concrete case. professionally. Chromates cause ACD in 6.6% of the casesfrequently cause ACD (16,19), approximately in 14% of allrelation – atopy, spina bifida etc. (17) and p-phenylendiaminfrequent. There are reports of ACD from rubber productsand shoe industry. A number of natural dyes used in tattooscontain PPD and cause ACD (12), as does the printer toner.Widely discussed is the cross allergic reaction between PPD The etiological significance of the medicaments is abit more limited: local antibiotics (2), local anesthetics (10), http://www.journal-imab-bg.org REFERENCES: 1. Ýéñåí, Ì. À., Ñ. Ë. Êàóð, Õ. À.ðàçâèòèè êîíòàêòíîãî äåðìàòèòà, 2. Assier-Bonnet, H., J. Revuz, Top-for withdrawal, Ann. Deratol Venereol., 3. Aster, S., E. Gonzalez, A. Cheung,F. Rins-Diaz, A. Dukas , F. William , S.the Kinetics of Allergic and Irritant 4. Belsito, D., A. F. Fransway, J. F.Fowler et al., Allergic contactdermatitis to detergents: A multicenterstudy to assess prevalence, J Am.Acad 5. Brasch, J., J. Burgard, W. Sterry , 6. 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