William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine
William D James, MD is a member of the following medical societies: American Academy of Dermatology , Society for Investigative Dermatology
Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Naked Biome<br/>Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>StatPearls; Editor.
Secondary prevention involves established latex allergic patients. These patients should carry nonlatex products at all times, particularly if they are involved in the healthcare field. In addition, these patients should have a list of latex-safe products, cross reacting foods and other less common sources of latex exposure with them at all times. Medical alert bracelets and epinephrine syringes are also vital for emergency situations. It is also essential for employers to get involved to periodically screen workers with educational programs and to accommodate patients with latex allergies.
Patch testing is the key to the diagnosis of contact cheilitis. Testing should include the baseline series of patch test allergens as well as cosmetic and toothpaste series, and others suggested by the history. It is most important to also test the patient's own products and musical instruments if possibly relevant. Cosmetics are often applied ‘as is’, but sawdust from wooden instruments should be applied diluted to 10% in petrolatum. A significant number of patients react only to their own products. The relevance of positive results must be assessed, based on careful history taking and clinical examination. Multiple positive reactions are common.