Background: allergic contact dermatitis (ACD) exerts a substantial impact on both patient health and quality of life. Timely diagnosis of ACD necessitates heightened awareness among relevant healthcare professionals, meticulous history collection, access to provocation tests, and the implementation of validated questionnaires. Underdiagnosis of ACD leads to the prolonged and commonly unwarranted use of sedative and non-sedative antihistamines, as well as systemic glucocorticosteroids, which may contribute to the development of iatrogenic comorbidities. Aim: to determine the factors contributing to the underdiagnosis of ACD and to provide practical recommendations for the earlier detection of this condition. Materials and Methods: the study included 124 patients diagnosed with "ACD, chronic recurrent course of mild or moderate severity. All patients underwent standard allergological evaluation, including symptom assessment, detailed medical history, completion of the Dermatology Life Quality Index (DLQI) questionnaire, a visual analogue scale (VAS) for satisfaction with previous consultations and therapies, objective dermatological examination, patch-testing, and prick-testing with non-microbial allergens. Results: underdiagnosis of ACD in adults residing in the North Caucasian Federal District was primarily associated with management by non- specialists, the absence of patch-test preparations on the Russian pharmaceutical market, limited application of prick-testing, and steroid phobia among both patients and practitioners. Conclusion: the implementation of accessible and contemporary diagnostic approaches for ACD will enable the identification of causally significant allergens and facilitate the provision of high-quality, specialized medical care.

Sophia Krynina is a dermatovenerologist, cosmetologist. She has been working as a doctor since 2021 in a research center in Stavropol, Russia, where highly qualified care was provided to patients using modern drugs that guarantee good results in the treatment of their diseases. Site helps patients with diseases such as: atopic dermatitis, contact allergic dermatitis, HAE, psoriasis, allergies, hay fever, discoid lupus erythematosus, purulent hidradenitis.