Delayed Hypersensitivity Reactions Treatment & Management

Updated: May 07, 2018
  • Author: Stuart L Abramson, MD, PhD; Chief Editor: Michael A Kaliner, MD  more...
  • Print
Treatment

Medical Care

Medical treatment is specific for the disease entity. Some common examples follow.

  • Contact dermatitis: The treatment of contact dermatitis varies depending on the severity of the disease. The best advice is to avoid the offending antigen. Pharmaceutical treatment varies, including over-the-counter corticosteroid preparations, prescription corticosteroid preparations, injectable corticosteroids, oral corticosteroids, and Burow solution.

  • Tuberculin hypersensitivity skin reactions: Treatment is rarely needed because this response is usually short-lived and self-limited. Topical corticosteroid preparations can be applied as needed. On rare occasions, the reaction to a delayed hypersensitivity skin test may be extreme and result in axillary lymphadenopathy and fever. Such reactions are self-limited and may be treated with an antipyretic medication such as aspirin or ibuprofen.

  • Granulomatous diseases: Treatment varies greatly depending on the specific disease. Refer to the appropriate Medscape Reference article for a full discussion (eg, see Dermatologic Manifestations of Sarcoidosis or Crohn Disease).

Next:

Consultations

Whether or not to consult a specialist and which specialist to consult also depend on the specific disease and its severity.

  • Contact dermatitis: Most cases of contact dermatitis can be managed in an outpatient setting by a primary care physician. However, for severe cases, immediate consultation with a physician board-certified in allergy and immunology and/or dermatology is warranted.

  • Tuberculin hypersensitivity skin reactions: If the Mantoux reaction is positive, patients may require consultation with a pulmonologist or an infectious disease specialist. A primary care physician trained in assessing the significance of a positive Mantoux reaction can also effectively treat these patients.

  • Granulomatous diseases: Depending on the specific disease entity, an infectious disease specialist (eg, TB, fungal disease, schistosomiasis), pulmonologist (eg, TB, sarcoidosis), gastroenterologist (eg, granulomatous hepatitis, Crohn disease), and/or an allergist/clinical immunologist may need to be consulted.

Previous