Contact dermatitis
Background
- Type IV hypersensitivity reaction
- Three Types
- Allergic contact dermatitis: nickel, gold, chromium, poison ivy, poison oak, and poison sumac
- Irritant contact dermatitis: solvents, neat oils, kerosene, surfactants in cosmetics, latex, drain cleaners
- Photocontact dermatitis: interaction with UV light (lime juice and sunlight)
Dermatitis Types
- Atopic dermatitis
- Candida dermatitis
- Cercarial dermatitis
- Contact dermatitis
- Dermatitis herpetiformis
- Diaper dermatitis
- Dyshidrotic dermatitis
- Neonatal seborrhoeic dermatitis
- Nummular dermatitis
- Perianal streptococcal dermatitis
- Perioral dermatitis
- Seborrheic dermatitis
- Stasis dermatitis
Clinical Features

Contact dermatitis from poison oak exposure (Day 4).
- Inflammation of the epidermis and dermis
- Erythema may take 1-3 days to show up
- May also have blisters and wheels
- Form in linear or shaped-pattern depending on exposure
- Itchy, burning, and sometimes painful
- Can take weeks to heal
Differential Diagnosis
Vesiculobullous rashes
Febrile
- Diffuse distribution
- Varicella (chickenpox)
- Smallpox
- Monkeypox
- Disseminated gonococcal disease
- DIC
- Purpural fulminans
- Localized distribution
Afebrile
- Diffuse distribution
- Bullous pemphigoid
- Drug-Induced bullous disorders
- Pemphigus vulgaris
- Phytophotodermatitis
- Erythema multiforme major
- Bullous impetigo
- Localized distribution
- Contact dermatitis
- Herpes zoster (shingles)
- Dyshidrotic eczema
- Burn
- Dermatitis herpetiformis
- Erythema multiforme minor
- Poison Oak, Ivy, Sumac dermatitis
- Bullosis diabeticorum
- Bullous impetigo
- Folliculitis
Evaluation
- Clinical diagnosis
- Allergist or dermatologist may use patch test to determine exact cause
Management
- Supportive care
- Remove irritant
- Barrier protection
- Emollients
- Steroids
- Topical steroids may be used when <10% body surface area is involved
- Oral steroids are indicated if >10% body surface area is involved
Disposition
- Discharge
See Also
- Generalized rashes