JPAC Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee

Dermatitis

Includes

Eczema.

Obligatory

Must not donate if:
a) The venepuncture site is affected.

b) Large areas of skin are affected.

c) Taking steroid tablets, injections, or applying steroid, tacrolimus (Protopic®) or pimecrolimus (Elidel®) creams over large areas.

d) The donor has needed long term (six months or more) steroid treatment within the last 12 months.

e) Within 12 months of using systemic therapies affecting immune function.

f) The affected areas are infected.

g) Less than four weeks from the last dose of Alitretinoin (Toctino®)

Discretionary

If the area affected is small, the venepuncture site (where the needle is put in) is not affected and using topical treatment only, accept.

See if Relevant

Allergy
Autoimmune Disease
Infection - General
Steroid Therapy

Additional Information

Eczema (also known as contact dermatitis) is a skin reaction due to sensitivity to substances that come into contact with the skin. It may involve both allergic and non-allergic processes. Because of damage to the skin, local infection is a common problem. For this reason the place where the needle goes in must not be affected.

Steroid therapy in high doses causes immunosuppression. This may mask infective and inflammatory conditions that would otherwise prevent donation. Long term steroid therapy may also cause temporary adrenal dysfunction. A waiting period of 12 months from the last dose allows time for the adrenal glands to recover.

Some of the treatments used to treat eczema can affect the immune system (e.g. azathioprine (Imuran®), ciclosporin, hydroxycarbamide (hydroxyurea, Hydrea®), mycophenolate (CellCept®)) and so can mask signs of infection. This is why systemic treatments (taken by mouth or injection and so affecting the whole body) requires a 12 month deferral period from the time the treatment stops. Under normal circumstances the use of topical treatment with steroid, tacrolimus (Protopic®) or pimecrolimus (Elide® ) will not result in blood levels which cause systemic suppression of the immune response. Systemic suppression is more likely if there is a skin barrier defect or high doses are used over large areas for extended periods. A large area of skin is defined as >9% (Wallace Rule of Nines). 1% is equal to the area of the closed digits and palm of the donor's hand.

 

Reason for change

To improve clarity and include information on Alitretinoin (Toctino®).

Donor Information

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Update Information

This entry was last updated in:
DSG-WB Edition 203, Release 20.