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Irritant Contact Dermatitis

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Images of Dermatitis, Irritant Contact

Overview

Irritant contact dermatitis is an inflammatory rash caused by direct chemical injury to the skin. Unlike allergic contact dermatitis, which appears 48–72 hours after exposure to an allergen, the symptoms of irritant contact dermatitis can result within a few hours if the exposure is a strong irritant.

  • Patients typically present complaining of a burning or stinging early in the course of irritant contact dermatitis.
  • As the irritation becomes chronic and the skin becomes continually inflamed, itching can become a predominant symptom.

Who's at risk?

Irritant contact dermatitis can occur at any age.

  • Patients with a history of eczema (atopic dermatitis) are particularly predisposed.
  • Environmental factors include frequent hand washing and repeated exposure to water, solvents, fiberglass, mild acids, and alkalis.
  • Dry air can predispose to irritant contact dermatitis.

Signs and Symptoms

The most common location for irritant contact dermatitis is the hands, though any body surface can be involved, including the genitals.

  • Lesions can appear pink to red.
  • In chronic cases, affected areas may develop scale and cracks.
  • In acute cases, areas may have a sharp border corresponding to the areas of chemical exposure.
  • On the fingertips, peeling of the skin, cracks, and scaling may be noted.

Self-Care Guidelines

  • Remove the offending exposure and protect the skin from re-exposure.
  • For irritated skin in body folds, consider a barrier cream with zinc oxide paste, such as Desitin®.

When to Seek Medical Care

Seek medical evaluation for a rash that does not resolve with self-care measures.

Treatments Your Physician May Prescribe

  • Your physician may recommend that you use petroleum jelly or a thick moisturizing cream applied directly to wet skin after bathing. Apply frequently (at least twice daily) to moisturize and protect the skin.
  • Mild- to mid-potency topical steroids may be prescribed if inflammation is pronounced.

Trusted Links

MedlinePlus: RashesClinical Information and Differential Diagnosis of Dermatitis, Irritant Contact

References

Bolognia, Jean L., ed. Dermatology, pp, New York: Mosby,

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp, New York: McGraw-Hill,

Sours: https://www.skinsight.com/skin-conditions/adult/irritant-contact-dermatitis

The Signs and Symptoms of Contact Dermatitis

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What is allergic contact dermatitis?

If you experience itchy, red skin after coming into contact with an irritating substance, chances are you have contact dermatitis.

The two most common types of contact dermatitis occur when your skin is exposed to something that you’re especially sensitive to or that you’re allergic to. This first type is known as irritant contact dermatitis. The second is known as allergic contact dermatitis.

What causes allergic contact dermatitis?

If you have allergic contact dermatitis, then your body will trigger an immune system response that makes the skin itchy and irritated.

Examples of substances that cause allergic contact dermatitis include:

Irritant contact dermatitis is mostly caused by toxins, such as detergents and chemicals in cleaning products. It can also result from repeated exposure to nontoxic substances.

Soap is an example of a substance that can cause either allergic contact dermatitis or irritant contact dermatitis.

What are the symptoms of allergic contact dermatitis?

Allergic contact dermatitis doesn’t always cause a skin reaction right away. Instead, you may notice symptoms that take place anywhere from 12 to 72 hours after exposure.

Symptoms associated with allergic contact dermatitis include:

These symptoms can last anywhere from two to four weeks after exposure.

There’s a difference between an allergic reaction that could affect your breathing — known as an anaphylactic reaction — and an allergic contact dermatitis one.

Serious allergic reactions involve the body releasing an antibody known as IgE. This antibody isn’t released in allergic contact dermatitis reactions.

When should you see a doctor?

If you have a skin rash that just won’t go away or have skin that feels chronically irritated, make an appointment to see your healthcare provider.

If these other symptoms apply, you may also need to see your doctor:

  • You have a fever or your skin’s showing signs of infection, such as being warm to the touch or oozing with fluid that isn’t clear.
  • The rash distracts you from your daily activities.
  • The rash is becoming more and more widespread.
  • The reaction is on your face or genitalia.
  • Your symptoms aren’t improving.

If your doctor thinks allergic contact dermatitis may be to blame, they can refer you to an allergy specialist.

How is allergic contact dermatitis diagnosed?

An allergy specialist can perform patch testing, which involves exposing your skin to small amounts of substances that commonly cause allergies.

You’ll wear the skin patch for about 48 hours, keeping it as dry as possible. After a day, you’ll return to your doctor’s office so they can look at the skin exposed to the patch. You’ll also come back about a week later to further inspect the skin.

If you experience a rash within a week of exposure, you likely have an allergy. Some people may experience an immediate skin reaction, however.

Even if your skin doesn’t react to a substance, you can be on the lookout for substances that commonly cause your skin to be irritated. Some people keep a journal of their skin symptoms and determine what they were around when the reaction occurred.

What are the treatments for allergic contact dermatitis?

Your doctor can recommend allergic contact dermatitis treatments based on what’s causing your reaction and its severity. The following are some examples of common treatments.

For mild reactions:

For severe reactions causing facial swelling, or if the rash covers your mouth:

For an infection, antibiotics are recommended.

Avoid scratching your rash because scratching can cause infection.

How can you prevent allergic contact dermatitis?

Once you determine what’s causing your allergic contact dermatitis, you should avoid that substance. This will often mean you must take care when reading labels for skin care products, household cleaners, jewelry, and more.

If you suspect that you’ve come into contact with any substances you may be allergic to, wash the area with soap and lukewarm water as quickly as possible. Applying cool, wet compresses may also help soothe itching and irritation.

Sours: https://www.healthline.com/health/allergies/contact-dermatitis
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Irritant contact dermatitis

HomeTopics A–ZIrritant contact dermatitis

Authors: Vanessa Ngan, Staff Writer, ; Updated: Dr Kajal Patel, Research Fellow, Occupational Dermatology Research and Education Centre, Carlton, Australia; A/Prof Rosemary Nixon AM, Dermatologist and Occupational Physician, Occupational Dermatology Research and Education Centre, Carlton, Australia. Copy edited by Gus Mitchell. July


Irritant contact dermatitis — codes and concepts

What is irritant contact dermatitis?

Irritant contact dermatitis is a form of skin inflammation caused by contact with substances and/or environmental factors that injure the skin, damaging the skin barrier.

Irritant contact dermatitis of the hand
Irritant contact dermatitis
Irritant dermatitis
Irritant dermatitis

Who gets irritant contact dermatitis?

Irritant contact dermatitis will affect anyone with sufficient exposure to irritants, but those with atopic dermatitis are particularly susceptible. Occupational hand dermatitis is due to irritants in 80% of cases, most often affecting those who involved in wet work such as cleaners, hairdressers, food handlers, and healthcare personnel. Irritant contact dermatitis can affect all age groups, both sexes, and any race.

What causes irritant contact dermatitis?

Irritant contact dermatitis develops when chemical or physical agents damage the skin surface faster than the skin can repair. Irritants remove oils and natural moisturising factor from the outer layer of the skin, allowing chemical irritants to penetrate the skin barrier and trigger inflammation.

Factors influencing the development and severity of the dermatitis include:

  • Concentration, amount, and properties of the irritant
  • Duration and frequency of exposure, for example short concentrated or repeated prolonged low exposure
  • Skin susceptibility such as pre-existing skin damage or atopic tendency
  • Mechanical trauma including hand scrubbing
  • Environmental factors such as temperature extremes or humidity.

Everyday examples of common skin irritants are water, soaps, and, in the era of COVID, hand sanitisers. Occupational irritants can include wet work, detergents, solvents, acids, alkalis, adhesives, and metalworking fluids. Topical medications such as retinoids and benzoyl peroxide, may cause irritant contact dermatitis with long-term use. Friction, sweating, and heat are examples of environmental factors. Irritant dermatitis is often the result of the cumulative impact of multiple irritants.

Irritant contact dermatitis

What are the clinical features of irritant contact dermatitis?

Irritant contact dermatitis:

  • Resembles dermatitis of any cause
  • Usually is confined to the site of contact with the irritant
  • Is the commonest cause of hand dermatitis in occupational and non-occupational settings
  • Burning and pain more common symptoms than itch
  • Acute due to a single severe exposure
    • Localisedwell-defined, redness, papules, swelling, blistering (vesicles/bullae)
    • Example: kneeling in wet cement, which is very alkaline, causing severe dermatitis of the knees
  • Chronic due to mild irritants or repetitive cumulative exposure
    • Initial dryness and cracking of the skin
    • Evolves to include inflammatory changes with redness and itch
    • May develop tolerance or hardening with time
    • Examples include dribble rash, napkin dermatitis, housewife’s eczema, ring dermatitis

Interdigital dermatitis, also called the ‘sentinel sign’, is regarded as an early stage of irritant contact dermatitis affecting the hands. It is commonly seen in occupations involving wet work.

Irritant contact dermatitis

How do clinical features vary in differing types of skin?

Erythema of dermatitis may be more difficult to observe in darker skin types, and postinflammatoryhyperpigmentation is more common after resolution of the dermatitis.

Irritant hand dermatitis in skin of colour

What are the complications of irritant contact dermatitis?

How is irritant contact dermatitis diagnosed?

Irritant contact dermatitis may be diagnosed on detailed medical history, including occupational exposures, and clinical examination. There is no test for irritant contact dermatitis. Patch testing may be necessary to distinguish it from allergic contact dermatitis. Irritant and allergic contact dermatitis can co-exist.

What is the differential diagnosis for irritant contact dermatitis?

What is the treatment for irritant contact dermatitis?

General measures

Specific measures

What is the outcome for irritant contact dermatitis?

Chronic irritant contact dermatitis can be slow to improve or resolve, especially of the hands, without obsessive care.

See smartphone apps to check your skin.
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Related information

 

Bibliography

  • Bains SN, Nash P, Fonacier L. Irritant contact dermatitis. Clin Rev Allergy Immunol. ;56(1)– doi/s PubMed
  • Brans R, Skudlik C, Weisshaar E, et al. Multicentre cohort study 'Rehabilitation of Occupational Skin Diseases - Optimization and Quality Assurance of Inpatient Management (ROQ)': results from a 3-year follow-up. Contact Dermatitis. ;75(4)– doi/cod PubMed
  • Johnston GA, Exton LS, Mohd Mustapa MF, et al. British Association of Dermatologists' guidelines for the management of contact dermatitis  Br J Dermatol. ;(2)– doi/bjd Journal
  • Li Y, Li L. Contact dermatitis: classifications and management. Clin Rev Allergy Immunol. ;/s doi/s PubMed
  • Modi GM, Doherty CB, Katta R, Orengo IF. Irritant contact dermatitis from plants. Dermatitis. ;20(2)– PubMed
  • Patel V, Atwater AR, Reeder M. Contact dermatitis of the hands: is it irritant or allergic?. Cutis. ;(3) doi/cutis Journal
  • Slodownik D, Lee A, Nixon R. Irritant contact dermatitis: a review. Australas J Dermatol. ;49(1) doi/jx. PubMed

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How to Heal Skin After Contact Dermatitis

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Dermatitis pictures of irritant contact

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What is contact dermatitis?

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