Nar Farsi (Eczema) is a group of diseases that results in inflammation of the skin and characterized by itchiness, red skin, and a rash. There are various forms of Nar Farsi (Eczema). Nar Farsi T’alluqi (Contact Eczema) is an inflammatory skin process caused by an exogenous agent or agents that directly or indirectly injure the skin. Contact eczema results from a complex interaction between external substances or contactant and skin. It accounts for 4% to 7% of all patients presenting to the dermatology clinics. It is classified as irritant or allergic. In irritant contact dermatitis (ICD), this injury is caused by an inherent characteristic of a compound –for example, a concentrated acid or base. Agents that cause Allergic contact dermatitis (ACD) induce an antigen-specific immune response. The clinical lesion of contact Eczema may be acute (wet and edematous) or chronic   (dry, thickened, and scaly), depending on the persistence of the insult.

    Irritant contact dermatitis (ICD) is defined as a non immunological inflammatory reaction of the skin to external agents which cause direct toxic injury. It is caused by substances like alkalis, acids, organic solvents oxidants and reducing agent. Acute ICD is painful, associated with burning, stinging or itching. Mild irritants cause erythema, dryness and fissuring while strong irritants often cause oedema, blistering and ulceration.

     Allergic contact dermatitis (ACD) occurs due to a delayed type 4 cell-mediated immunity. A minimum of 8 days to 10 days are needed after sensitization for clinical allergy to manifest. Once sensitisation to an allergen occurs, it tends to persist throughout life. However, the degree of sensitivity wanes with time unless repeated exposures occurs.

     Allergic contact dermatitis may clinically present acute after allergen exposure and initial sensitization or after elicitation in a previously sensitized individual. Erythema, oedema, papules, vesicles and oozing are the cardinal signs of acute onset of eczematous ACD. In India the common sensitisers are plants specially parthenium hysterophorus, nickel, chromium and paraphenylene diamine. Parthenium allergy manifests as air born contact dermatitis affecting the face, including the eyelids neck and flexures.

     An enormous number of substances are capable of causing allergic contect dermatitis. Nickel dermatitis is one of the commonest examples-some 5 percent of women in the UK are said to be nickel sensitive. Affected individuals cannot wear stainless-steel jewellery because of the nickel in the steel and develop a rash beneath steel studs, clips and buckles. Patients who are nickel sensitive may also react to dichromate and other chromate salts.

     The pathogenesis of Contact Eczema is complex and still incompletely understood. In management of Contact Eczema, topical steroids, immunosuppressant and bland emollients are in use but they only suppress the symptoms and relapse is always there. The specific measures include emollients as well as steroids. The topical and systemic steroid can cause several side effects.    

Due to the high prevalence and non availability of safe and effective treatment, present study is being designed to Evaluate the Efficacy and Safety of Marham-e-Safeda Kafoori in the Management of Nar Farsi T’alluqi (Contact Eczema).