During a multi-speaker session at the 2022 AAD annual meeting, Peter Lio, MD, FAAD, Peggy Wu, MD, MPH, FAAD, April Armstrong, MD, MPH, FAAD, Adam Friedman, MD, FAAD, and Amy McMichael, MD, FAAD, all came together to discuss dietary triggers and modifications among patients with common dermatologic conditions.

Dr Vivian Shi kicked off the session and said to the audience, “[T]his session isn’t to tell our patients to go vegan, it’s to modify treatment plans to each patient.”

The session speakers discussed how diets impact the following:

• atopic dermatitis/urticaria;
• contact dermatitis;
• psoriasis;
• acne; and
• hair.

Dr Wu kicked off her session on contact dermatitis and said, “This is a scenario where we can have dietary interventions for our patients.”

Dr Wu started her session by defining systemic contact dermatitis (SCD). She said that it is a “skin condition that occurs in contact-sensitized persons when they are systemically exposed orally, transcutaneous, and intravenously.”

According to Dr Wu, the following substances cause SCD:

• medications;
• plants;
• metals;
• fragrances;
• benzoates;
• gallates;
• propylene glycol;
• aspartame; and
• sorbic acid.

Dr Wu highlighted how dermatologists should approach SCD. She explained that dermatologists should ask their patients to avoid topical contact with allergens, and after at least 2 months without significant improvement, try an elimination diet if the patient reacted to a potential systems allergen. Further, she said diet avoidance for at least one month is important.

Overall, Dr Wu said that dermatologists should “think about diet and contact dermatitis when a patient has a vesicular hand presentation, symmetrical intertriginous presentation, generalized dermatitis and a positive patch test.”

“If a person has a very strong reaction to an allergen, which is a potential culprit for systemic contact dermatitis, have the conversation about diet early,” she stressed.

Finally, Dr Wu said that if a rash “does not improve with topical avoidance, there may be a significant component of systemic contact dermatitis. Start with a one month trial.”

She told the audience there are several tools, papers, and websites that can guide both a dermatologist and their patients, and she stressed to keep ither common allergies in mind, including latex, poison ivy/oak/sumac, and associated foods.

Reference:

Wu P. Diet and Contact Dermatitis. Presented at: AAD Annual Meeting; March 25-28, 2022; Boston, MA.