Contact dermatitis with a highlight on silver: A review

Contact dermatitis is an inflammatory reaction in the skin that arises from exposure to an irritant or allergen. Irritant contact dermatitis is the most common form of dermatitis and occurs when any substance disrupts the epidermal skin barrier. All individuals are susceptible to this type of reaction. Allergic contact dermatitis is a delayed Type IV hypersensitivity reaction that occurs in individuals that have previously been sensitized to a particular antigen. Patients with wounds are at particular risk of developing either an allergic or irritant contact dermatitis. Various contributing factors, including an impaired skin barrier that allows for easier absorption of potential allergens and exposure to a number of wound care products and dressings, can be allergenic or irritating. Silver compounds are widely used in wound care for their antimicrobial properties. These products are generally well tolerated, but infrequently are causative agents in contact dermatitis. The following review will summarize contact dermatitis cases due to silver that have been described in the literature. Despite their widespread use in wound care, there has only been one confirmed case of contact dermatitis secondary to silver-containing wound products. It is possible that more cases have been missed simply because sliver is not commonly considered to be an allergen. Routine use of patch testing for sliver allergy in these patients may lead to an increased number of recognized cases.