Clinical Question: What modalities are effective in the prevention and treatment of contact dermatitis?

Setting: Various (meta-analysis)

Study Design: Systematic review

Synopsis: Contact dermatitis is a common primary care disease. The investigators searched multiple databases including MEDLINE, EMBASE, the Cochrane Registry of Clinical Trials, and references of relevant articles and reviews. Two authors independently reviewed the studies for eligibility and methodologic quality. A third author arbitrated disagreements. Only controlled trials in English were included. From 413 initial articles, 49 met eligibility criteria. Of these, 12 were rated as good quality, 16 were rated as fair, and 21 were rated as poor and were not included in the final analysis. Barrier creams (e.g., Dermashield, Uniderm [not available in the United States], Dermofilm); high-lipid content moisturizing creams (e.g., Keri brand lotion, Petrolatum [Lipkote], coconut oil); fabric softeners; and cotton glove liners are effective for preventing irritative contact dermatitis. Rhus dermatitis can be reduced or prevented with quaternium 18 bentonite lotion (Ivy Block) and a topical skin protectant. The chelator diethylenetriamine pentaacetic acid is effective in preventing dermatitis from nickel, chrome, and copper (common components of jewelry). Steroid preparations are effective in the treatment of irritative and contact dermatitis. The authors did not mention an evaluation for publication bias.

Bottom Line: Barrier creams, high-lipid content moisturizing creams, fabric softeners, and cotton glove liners are effective for preventing irritative contact dermatitis. Rhus dermatitis can be reduced or prevented with quaternium 18 bentonite lotion and a topical skin protectant. Steroid preparations are effective in the treatment of irritative and contact dermatitis. (Level of Evidence: 1a–)