A 30-year-old man was presented with reddish maculopapular rash on his face, neck, chest and back. There was no history of atopia or family history of asthma recorded. He had neither medical history nor drug allergies. For his condition, He was given 25 mg of antihistamine (Atarax) twice daily and steroid (1% hydrocortisone) to be applied daily by a family doctor. The itch and rash did not subside after two weeks of antihistamine. Aware of the side effects of steroids, he did not apply it. He went to a dermatologist and received a diagnosis of allergic contact dermatitis ACD. However, a skin prick test was performed on him and there were no positive findings.
After a few round of various antihistamine, the rash and itch were still persistant, which severely affect his daily life and even his ability to work. He came to us for an alternative solution, TCM herbal medicaiton was given and applied to him twice daily. The lesions were resolved with herbal formulation therapy.
A skin prick test, also called a puncture or scratch test, checks for immediate allergic reactions to only 50 different substances, such as pollen, mold, pet dander, dust mites and various foods. Thousands of products (substances) contact the skin throughout the day, making it nearly impossible to pinpoint the cause of ACD through prick test. Allergic contact dermatitis is complicated by common misconceptions. New and old products can be responsible, and an allergy can develop after using the same product for years. Furthermore, ingredients may be changed by manufacturers over time. The responsible product, contacted as little as once weekly, can cause a constant rash. Additionally, allergies can develop due to expensive and natural/organic products. Finally, switching products does not often clear the rash, because similar ingredients may be contained in multiple products. After becoming allergic to a substance, further contact causes itchy, red, and flaky rashes, sometimes with blisters or oozing.