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# Dermatitis - Whole blood and components

## Essential information

Includes

  Ezcema

Obligatory

  Must not donate if:

  1. The venepuncture site is affected.
  2. Large areas of skin are affected.
  3. Taking steroid tablets, injections, or applying steroid, tacrolimus (Protopic??) or pimecrolimus (Elidel??) creams over large areas.
  4. The donor has needed long-term (6 months or more) steroid treatment within the last 12 months.
  5. The affected areas are infected.
  6. Less than 4 weeks from the last dose of alitretinoin (Toctino??).
Discretionary
  1. If the area affected is small, the venepuncture site is not affected and using topical treatment only, accept.
  2. If the donor:
     1. Has been established on oral treatment for their skin disease with only 1 of the following drugs:
        1. Methotrexate
        2. Sulfasalazine
        3. Hydroxychloroquine
        4. Azathioprine, and
     2. The dose of the drug has not increased in the previous 6 months, and
     3. Their skin disease is controlled by medication, and
     4. The venepuncture site is not affected, and
     5. The donor is well, accept.
  3. If there is any uncertainty about the diagnosis or the nature of treatment, refer to a Designated Clinical Support Officer.

## Supporting information

See if relevant
  - Allergy
  - Autoimmune disease
  - Infection, general
  - Monoclonal antibody therapy or other biological modalities
  - Steroid therapy
Additional information

  Dermatitis refers to a group of skin conditions characterised by epidermal change. 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 venepuncture site 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:
  A discretion to accept donors on oral medication has been added and the text has been updated to ensure consistency with other DSG references to immunosuppression.
Version details:

  WB-DSG Edition 203 Release 71 (02 May 2024)

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