Dermatology Case Challenge: An Accountant on a Weight-Loss Program Has a Rash, Poor Sleep

Melba Estrella, MD; John Plante; Andraia Li; Margaret LaPorte; Dirk M. Elston, MD


January 24, 2023

The management of textile contact dermatitis involves treatment of the acute flare and patient education. Medical management of localized acute textile contact dermatitis includes a mid-potency or high-potency topical steroid or calcineurin inhibitor.[4,5] Cool compresses may be used to reduce acute symptoms. Emollients or barrier creams may help limit allergen exposure.[5] In acute, severe, generalized cases, a short course of systemic steroids may be used.[4,5]

Locating and removing contactants from the patient's environment are critical to successful management. Part of patient education includes a discussion of compound cross-reactivity. Avoiding certain colors in clothing may not necessarily be effective because many colors are composed of a mix of dyes. Instead, wearing clothing made with nonsynthetic fibers is advised.[7] Washing new clothing twice prior to first wear is recommended.[3]

This patient in this case was prescribed triamcinolone 0.1% cream and advised to wear 100% cotton or synthetic clothing during exercise. With this treatment, his symptoms greatly improved, as described at his follow-up appointment 1 month later.


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