Advancing Recognition and Treatment of Allergic Contact Dermatitis

JiaDe 'Jeff' Yu, MD, FAAD, a dermatologist at Massachusetts General Hospital in Boston, shared highlights from his presentations on the importance of recognizing and effectively managing allergic contact dermatitis at the 2025 American Academy of Dermatology (AAD) Annual Meeting.¹ Yu emphasized that allergic contact dermatitis remains largely underrecognized and undertested, leading to inadequate treatment for affected children and adults.

Recognizing Allergic Contact Dermatitis

When evaluating a patient with eczema, Yu said clinicians should investigate to determine if the presentation is solely atopic dermatitis or if allergic contact dermatitis is also present. In his experience, he has seen clinicians default to only treating atopic dermatitis, thereby missing a critical component of their condition.

Patch testing is essential for accurately diagnosing allergic contact dermatitis, he added. Although patients may inquire about alternative diagnostic methods (eg, blood tests), noted that comprehensive patch testing remains the only reliable approach.

Just as there are many potential sources for allergic contact dermatitis, there are equally a large variety of patch testing series available, each tailored to different patient populations, Yu explained. For young children, for example, there is a pediatric-specific series tests for the 40 most common allergens. Older children and adults may benefit from a more extensive series covering at least 80 allergens. Additionally, specialized patch test panels exist for individuals with specific occupational or environmental exposures, including a dental series for dentists, a health care worker series for professionals exposed to rubber gloves, and a hair care series for individuals frequently handling hair products, said Yu.

Effective Management Strategies

As in some other areas of medicine, prevention is a powerful weapon against allergic contact dermatitis, Yu explained. Thus, once an allergen is identified, the cornerstone of treatment is avoidance, and removing the offending substance from daily life can lead to significant clinical improvement. However, as a realist, he said there are options for those cases in which avoidance is not feasible—such as occupational exposure or shared living spaces. In those cases, topical therapies can be effective and include topical steroids, topical calcineurin inhibitors, and other non-steroidal topical agents, all of which Yu said can effectively manage localized allergic contact dermatitis.

New and Emerging Therapies

Yu noted he is excited to hear other lectures at the meeting, including learning about the promise of new treatments in dermatology in general as well as allergic contact dermatitis in particular. He was looking forward to hearing more about OX40 inhibition, a novel mechanism that may play a role in contact dermatitis by modulating activated T cells, at the annual meeting.

Additionally, new topical treatments for chronic hand eczema—a condition frequently seen in contact dermatitis clinics—are on the horizon, he said. Yu is optimistic that these upcoming therapies will provide much-needed relief for patients and enhance treatment options available to dermatologists.

Reference

1. Yu J. Overlap of Atopic Dermatitis and Allergic Contact Dermatitis. Presented at the 2025 American Academy of Dermatology Annual Meeting; March 7-11, 2025; Orlando, Florida.