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)

Clinical Features

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

Contact dermatitis

Differential Diagnosis

Vesiculobullous rashes

Febrile

Diffuse distribution
- Varicella
- Smallpox
- Disseminated gonococcal disease
- DIC
- Purpural fulminans
Localized distribution
- Necrotizing fasciitis
- Hand-foot-and-mouth disease

Afebrile

Diffuse distribution
- Bullous pemphigoid
- Drug-Induced bullous disorders
- Pemphigus vulgaris
- Phytophotodermatitis
- Erythema multiforme major
- Bullous impetigo
Localized distribution
- Contact dermatitis
- Herpes zoster
- 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
- Topical steroids show marginal benefit.

Disposition

Discharge

See Also

Generalized rashes

External Links

References

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