Peter J. Frosch – författare

The sixth edition of Contact Dermatitis covers in detail every conceivable aspect of irritant and allergic contact dermatitis and its modern-day management. The 1st edition of this book was published in 1992 and has served as the main reference book of contact dermatitis. In this new edition special emphasis is given to immunological mechanisms, molecular aspects of sensitizers, atypical clinical forms, patch test methodology, reactions to medicaments, and occupational and environmental factors. In order to optimize the diagnostic approach, a wide range of information is provided, including a dictionary of contact allergens and detailed information on exposure assessment. Retained chapters from the previous edition have been thoroughly revised to reflect the latest knowledge. Furthermore, completely new chapters have been added on a variety of topics, including contact allergy to medical implants, relevant allergens in gloves and immediate reactions to occupational materials. The editors and authors are all leading practitioners in the field. The comprehensive but approachable text is supplemented by a large number of full colour illustrations and tables. Core messages highlight the most important information and will help the reader to gain a better understanding of the subject and greater competence in everyday practice.

It is an unusual event for a textbook covering such a national and international networks and the use of highly specialized field as contact dermatitis to be standardized methodology, a highly differentiated published in its fourth edition within a time period picture can now be painted; we know the major p- of 13 years. When the European and Environmental fessions at risk, as well as the influences of age and Contact Dermatitis Research Group was founded in various cofactors. This is a solid basis for preventive 1985,one of the major goals was to edit a textbook of measures. A new allergen, described in one center, high scientific standard written by renown experts can now be tested on a large scale in a short time and keep it regularly updated. The greatest danger period. If the data evaluation shows an unacceptably for a textbook is to become outdated – then it stays high rate of sensitization in the exposed population, on the bookshelf and is rarely consulted. The contin- regulatory measures will be undertaken to protect uous flow of new medicaments, the fascinating the consumer. A recent example is the “methyldib- improvements in diagnostic image analysis and ever- mo glutaronitrile story. ” changing operative procedures are the reasons for These and other issues of importance are covered considerable knowledge deficits in old textbooks, in depth in the newest edition of this textbook.

The fifth edition delivers up-to-date coverage of every conceivable aspect in modern-day management of contact dermatitis. Leading experts have thoroughly updated the previous edition, while adding new chapters on genetics, the skin barrier, respiratory symptoms to chemicals and an extensive section on prevention.Both irritant and allergic contact dermatitis are covered with special emphasis on immunological mechanisms, molecular aspects of sensitizers, atypical clinical forms, reactions to medicaments, occupational and environmental aspects.The comprehensive yet approachable text is supplemented by numerous color illustrations and tables. Core messages and case reports highlight the most important information and help in gaining better understanding of the topic and greater competence in daily practice. An extensive dictionary of allergens gives quick access to specific information.

In recent years the field of contact dermatitis has increased greatly in importance in dermatology. The variety of exogenous, environmental­ ly caused dermatoses has undoubtedly expanded over the past few de­ cades with the increasing number of potentially toxic chemicals, the changes in lifestyle, and the greater life expectancy in industrialized societies. The value of international cooperation in this field has long been realized and acted upon by the International Contact Dermatitis Re­ search Group (ICDRG). By 1975 the international journal Contact Dermatitis had been founded under the editorship of C. D. Calnan. Thanks largely to the ICDRG and Contact Dermatitis, there were, by 1986, enough additional dermatologists and scientists with a special interest in this area to form the European Environmental and Contact Dermatitis Research Group (EECDRG). Within 2 years they had in­ stituted the European Society of Contact Dermatitis (ESCD) as an in­ ternational forum for researchers in the field. The EECDRG decided to hold a symposium in Heidelberg in May 1988, an initiative supported by the ICDRG, and on this occasion the new ESCD held its inaugural session. The Society already has over 200 members and most national contact dermatitis research groups in Europe are already represented; new members are of course welcome. Subgroups and working committees have been formed to address var­ ious topics including the standardization of patch testing, photoder­ matology, and bioengineering.

In recent years the field of contact dermatitis has increased greatly in importance in dermatology. The variety of exogenous, environmental­ ly caused dermatoses has undoubtedly expanded over the past few de­ cades with the increasing number of potentially toxic chemicals, the changes in lifestyle, and the greater life expectancy in industrialized societies. The value of international cooperation in this field has long been realized and acted upon by the International Contact Dermatitis Re­ search Group (ICDRG). By 1975 the international journal Contact Dermatitis had been founded under the editorship of C. D. Calnan. Thanks largely to the ICDRG and Contact Dermatitis, there were, by 1986, enough additional dermatologists and scientists with a special interest in this area to form the European Environmental and Contact Dermatitis Research Group (EECDRG). Within 2 years they had in­ stituted the European Society of Contact Dermatitis (ESCD) as an in­ ternational forum for researchers in the field. The EECDRG decided to hold a symposium in Heidelberg in May 1988, an initiative supported by the ICDRG, and on this occasion the new ESCD held its inaugural session. The Society already has over 200 members and most national contact dermatitis research groups in Europe are already represented; new members are of course welcome. Subgroups and working committees have been formed to address var­ ious topics including the standardization of patch testing, photoder­ matology, and bioengineering.

More than 10 years ago, I had the chance to visit the university hospital in Munster, Germany. At the outpatient clinic there, I accidently met a young dermatologist who was devoted to the study of the quantification of irritated skin during his busy daily clinical work. I sensed immediately that this Dr. P. Frosch was conducting his research with the ideals and enthusiasm which were so familiar to me. Soon we found that we shared a similar past experience; we both had begun our careers in dermatological investigation with the same mentor. For me it was more than 25 years ago that I first met Dr. Kligman, Professor at the University of Pennsylvania in Philadelphia, USA. I reminisced that I had been greatly shocked by his initial question ''''As a dermatologist, do you want to study living or dead skin?" because, at that time and even today, whenever we cannot collect enough information about the skin with the naked eye, it is invasively removed is common practice to histologically examine a skin sample that from living tissue. Many dermatologists still would never think of studying the living intact skin itself noninvasively with the aid of existing advanced technologies to assess its structural and functional properties. At that time Dr. Kligman intended to build up a system of evaluating the skin from various aspects, using methods that had been unduly neglected in the past and introducing various technological instruments.

More than 10 years ago, I had the chance to visit the university hospital in Munster, Germany. At the outpatient clinic there, I accidently met a young dermatologist who was devoted to the study of the quantification of irritated skin during his busy daily clinical work. I sensed immediately that this Dr. P. Frosch was conducting his research with the ideals and enthusiasm which were so familiar to me. Soon we found that we shared a similar past experience; we both had begun our careers in dermatological investigation with the same mentor. For me it was more than 25 years ago that I first met Dr. Kligman, Professor at the University of Pennsylvania in Philadelphia, USA. I reminisced that I had been greatly shocked by his initial question ''As a dermatologist, do you want to study living or dead skin?" because, at that time and even today, whenever we cannot collect enough information about the skin with the naked eye, it is invasively removed is common practice to histologically examine a skin sample that from living tissue. Many dermatologists still would never think of studying the living intact skin itself noninvasively with the aid of existing advanced technologies to assess its structural and functional properties. At that time Dr. Kligman intended to build up a system of evaluating the skin from various aspects, using methods that had been unduly neglected in the past and introducing various technological instruments.

Aromas are an integral part of our civilised society. They are not only used in fine perfumes, but also in numerous other articles with which we have daily contact. Another new development has been the agricultural use of aromas as a "biological weapon" to combat insects and other pests. In the field of dermatology, aromas are today among the most frequent sensitizers and may trigger allergic contact eczemas. This volume presents numerous aspects of the topic for the first time in comprehensive form. In an introduction, the chemistry of frequently used aroma components is described, together with the art of perfume composition that has been refined over the centuries. In a chapter on neuropharmacology, the mechanisms of scent recognition are described in detail.

Aromas are an integral part of our civilised society. They are not only used in fine perfumes, but also in numerous other articles with which we have daily contact. Another new development has been the agricultural use of aromas as a "biological weapon" to combat insects and other pests. In the field of dermatology, aromas are today among the most frequent sensitizers and may trigger allergic contact eczemas. This volume presents numerous aspects of the topic for the first time in comprehensive form. In an introduction, the chemistry of frequently used aroma components is described, together with the art of perfume composition that has been refined over the centuries. In a chapter on neuropharmacology, the mechanisms of scent recognition are described in detail.

10. 1. 1. 1 The Purpose of Patch Testing Patch testing is a well-established method of diagnosing allergic contact dermatitis, a delayed type of hypersensitivity (type IV reaction). Patients with a history and clinical picture of contact dermatitis are reexposed to the suspected allergens under controlled conditions to verify the diagnosis. Besides testing patients with hand, arm, face or leg eczema (stasis dermatitis), testing of other types of eczema (atopic, seborrhoeic dermatitis, nummular eczema) is sometimes indicated, especially when the dermatologist suspects contact allergy to prescribed topical medicaments and their vehicles. Apart from its use to confirm a suspected allergic contact dermatitis, the patch test procedure can also be used before recommending alternative corti­ costeroids, skin care products, cosmetics, gloves, etc. in a particular patient. If the patient does not react to the alternatives tested, it is very unlikely that she or he will react to the products in ordinary use. 10. 1. 1.2 Standardization The first patch tests according to present principles were carried out in 1895 [1], but were preceded by some preliminary experiments [2] (see Chap. 1).