Allergic contact dermatitis: the future.

This article discusses the future of allergic contact dermatitis (ACD) diagnosis and management. Due to early landmark discoveries in this disorder, there is a knowledge base that can be refined. Improved patch-test technology, patch-test strategy, and patch-testing clinical relevance are emphasized. Other factors for improvement include complete ingredient identification on Material Safety Data Sheets, knowledge of the relationship of extracutaneous allergic disease to ACD, understanding of the evolutionary implications of ACD, increased chemical identification of allergens in publication, and enhanced knowledge of immunologic contact urticaria and irritant dermatitis syndrome. Further research into in vitro diagnostic methods, skin bioengineering tools, and ribonucleic acid diagnostic methods may lead to more precise and less invasive diagnosis of ACD. Development of national and international allergen banks and analytic chemistry laboratories would allow better documentation and epidemiology of allergens, as would collaboration between national and international contact dermatitis organizations via the World Wide Web. Finally, additional fellowships in contact allergy should produce more dermatologists equipped to face the complex challenges of ACD and develop solutions for ongoing questions.