Contact dermatitis

Background

Normal dermal anatomy.
  • 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

Clinical Features

Contact dermatitis
Contact dermatitis at the application site of a transdermal patch.
Contact dermatitis from poison oak exposure (Day 4).
Contact dermatitis.
  • 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

Afebrile

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

External Links

References