POINTS À RETENIR

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De nombreux médicaments et intermédiaires de synthèse ont été rapportés comme sensibilisants, le plus souvent dans des cas isolés. La sensibilisation peut apparaître après un contact accidentel.

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Les personnels de nettoyage et de maintenance sont aussi à risque de sensibilisation.

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Les principaux allergènes sont les additifs de vulcanisation des équipements de protection individuelle, les médicaments et leurs intermédiaires de fabrication et les animaux de laboratoire.

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La sensibilisation se développe pour des allergènes bien connus mais aussi pour des sensibilisants rares ou des nouvelles substances.

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Le diagnostic étiologique peut être difficile parce que de nombreuses substances sont utilisées, notamment des intermédiaires de synthèse inconnus.

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La dermatite aéroportée, avec atteinte du visage et des zones découvertes, est fréquente.

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Après sensibilisation par voie cutanée, l’exposition par voie générale au médicament peut provoquer une dermatite de contact systémique.

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Il est impératif d’avertir le patient allergique à un médicament d’origine professionnelle de ne pas l’utiliser à usage médical.

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Des cas de brûlure après contact accidentel ont également été décrits.

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Les deux facteurs essentiels de prévention sont la réduction maximale du contact cutané avec les irritants et l’éviction complète des allergènes auxquels le salarié est sensibilisé.

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132 | B^ARBAUD A - Prise en charge globale des toxidermies. Ann Dermatol Vénéréol. 2007 ; 134 (4 Pt 1) : 391-401.

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