{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:46:36Z","timestamp":1782312396085,"version":"3.54.5"},"reference-count":15,"publisher":"Mattioli1885","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,24]]},"abstract":"<jats:p>The current limited availability of patch tests for diagnosing Allergic contact dermatitis (ACD) and occupational or non-professional diseases, in accordance with AIFA regulations, has significantly affected the diagnostic approach for patients and affected workers. The issue is even more severe for haptens of occupational origin. In occupational medicine, the patch test is crucial for establishing the causal link between the skin disease and the patient's work activities. Accurate diagnosis is essential for occupational physicians both to determine the need for a job change and to assess workers' compensation. Due to limited diagnostics and regulatory restrictions, it remains impossible to diagnose occupational ACD. In this context, occupational doctors will focus on primary prevention by avoiding risk products and replacing them with non-sensitizing or non-cross-reactive alternatives. This paper addresses the challenges posed by the new AIFA (Italian Medicines Agency) diagnostic restrictions and explores potential solutions and future perspectives.\u00a0<\/jats:p>","DOI":"10.23749\/mdl.2026.18631","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T13:53:30Z","timestamp":1782309210000},"page":"18631","source":"Crossref","is-referenced-by-count":0,"title":["The Evolving Landscape of Contact Dermatitis Diagnosis: A Critical Appraisal of Recent Regulatory Constraints"],"prefix":"10.23749","volume":"117","author":[{"given":"Marco","family":"Polonioli","sequence":"first","affiliation":[{"name":"Post Graduation School of Occupational Medicine, Universit\u00e0 degli Studi di Milano, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Dubini","sequence":"first","affiliation":[{"name":"General Medicine, Immunology, and Allergology Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia Mariel","family":"Ferrucci","sequence":"first","affiliation":[{"name":"Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Marraccini","sequence":"first","affiliation":[{"name":"General Medicine, Immunology, and Allergology Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27750","reference":[{"key":"10.23749\/mdl.2026.18631_ref1","doi-asserted-by":"crossref","unstructured":"1. Nassau S, Fonacier L. Allergic Contact Dermatitis. Med Clin North Am. 2020;104(1):61\u201376.","DOI":"10.1016\/j.mcna.2019.08.012"},{"key":"10.23749\/mdl.2026.18631_ref2","doi-asserted-by":"crossref","unstructured":"2. Luckhaupt SE, Dahlhamer JM, Ward BW, et al. Prevalence of dermatitis in the working population, United States, 2010 National Health Interview Survey. Am J Ind Med. 2010;56(6):625\u2013634.","DOI":"10.1002\/ajim.22080"},{"key":"10.23749\/mdl.2026.18631_ref3","doi-asserted-by":"crossref","unstructured":"3. Mostosi C, Simonart T. Effectiveness of barrier creams against irritant contact dermatitis. Dermatology. 2016;232(3):353-62.","DOI":"10.1159\/000444219"},{"key":"10.23749\/mdl.2026.18631_ref4","doi-asserted-by":"crossref","unstructured":"4. Diepgen TL, Coenraads PJ. The epidemiology of occupational contact dermatitis. Int Arch Occup Environ Health. 1999;72(8):496\u2013506.","DOI":"10.1007\/s004200050407"},{"key":"10.23749\/mdl.2026.18631_ref5","unstructured":"5. Marraccini P. Occupational Allergy. In: Oddone E, editor. Occupational Exposure and Health Risks. New York: Nova Science Publishers; 2016. p. 147\u2013164."},{"key":"10.23749\/mdl.2026.18631_ref6","doi-asserted-by":"crossref","unstructured":"6. American Accademy of Allergy. Asthma and Immunology: American College of Allergy, Asthma and Immunology. Contact dermatitis: a practice parameter. Ann Allergy Asthma Immunol. 2006;7(3 Suppl.2):S1-38.","DOI":"10.1016\/S1081-1206(10)60811-3"},{"key":"10.23749\/mdl.2026.18631_ref7","unstructured":"7. D.Lgs 178\/1991: recepimento delle direttive della Comunit\u00e0 economica europea in materia di specialit\u00e0 me-dicinali. (GU Serie Generale n.139 del 15-06-1991)"},{"key":"10.23749\/mdl.2026.18631_ref8","unstructured":"8. D.Lgs 219\/2006: attuazione della direttiva 2001\/83\/CE (e successive direttive di modifica) relativa ad un co-dice comunitario concernente i medicinali per uso umano, nonch\u00e9 della direttiva 2003\/94\/CE. (GU Serie Gen-erale n.142 del 21-06-2006 \u2013 Suppl. Ordinario n. 153)"},{"key":"10.23749\/mdl.2026.18631_ref9","unstructured":"9. AIFA. Available online: www.aifa.gov.it"},{"key":"10.23749\/mdl.2026.18631_ref10","unstructured":"10. Regulation and clinical use of haptens for patch test rev. 1. Rome: Italian Medicines Agency, 2024. ISBN 979-12-80335-33-3. Available online: www.aifa.gov.it"},{"key":"10.23749\/mdl.2026.18631_ref11","unstructured":"11. Regolamentazione e uso clinico degli apteni per patch test. Roma: Agenzia Italiana del Farmaco, 2023. Available on: www.aifa.gov.it"},{"key":"10.23749\/mdl.2026.18631_ref12","unstructured":"12. Relazione annuale dell\u2019Area Autorizzazioni Medicinali. Anno 2022. Avaible on: www.aifa.gov.it"},{"key":"10.23749\/mdl.2026.18631_ref13","doi-asserted-by":"crossref","unstructured":"13. Uter W, Schwitulla J, Thyssen JP, et al. The 'overall yield' with the baseline series \u2013 a useful addition to the array of MOAHLFA factors describing departmental characteristics of patch tested patients. Contact Dermati-tis.2011;65(6):322-8.","DOI":"10.1111\/j.1600-0536.2011.01964.x"},{"key":"10.23749\/mdl.2026.18631_ref14","doi-asserted-by":"crossref","unstructured":"14. Uter W, Bauer A, Belloni Fortina A, et al. Patch test results with the European baseline series and additions there-of in the ESSCA network, 2015-2018. Contact Dermatitis. 2021;84(2):109-120.","DOI":"10.1111\/cod.13704"},{"key":"10.23749\/mdl.2026.18631_ref15","doi-asserted-by":"crossref","unstructured":"15. Brans R, Skudlik C. Patch testing in occupational dermatology: practical aspects in relation to the conditions in Germany. 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