New Ohio State Clinic Gets Under the Surface of Skin Rashes
A new clinic at Ohio State University Medical Center is combining medical knowledge with investigative techniques to track down causes of the most persistent skin rashes that appear to have no clear origin.
The Contact and Occupational Dermatitis Center focuses on patients who require intensive testing from a bank of up to 300 substances that might be triggering a severe immune response that results in unrelenting itching, redness and scaling of the skin.
"There's a significant amount of detective work," says Dr. Matthew Zirwas, a dermatologist specializing in these difficult cases at Ohio State's Medical Center. "There are often very hidden exposures, and we take considerable time with patients to figure those out."
Patients must be referred to the center by allergists or other dermatologists, who typically work with a standard pool of 24 substances to test sources of skin irritation and refer patients on when that testing doesn't solve the mystery behind a rash.
Patients at the center complete a questionnaire seeking details about medical history and rash characteristics as well as employment, hobbies, family life, clothing, shoes, personal care products, diet and travel history. Based on the answers and what they indicate about likely exposure to preservatives, fragrances, materials or chemicals, Zirwas typically tests between 100 to 140 substances on a single patient to rule out and rule in the likely culprits.
"The primary problem we see is reactions to chemicals used in processing materials, such as dyes in synthetics or natural products, chemicals to make clothes wrinkle- and shrink-resistant, or glues and dyes in shoes," Zirwas said. "In the workplace, the most common allergy is to the soap in the restroom