Contact dermatitis is a skin reaction to irritants (irritant contact dermatitis) or allergens (allergic contact dermatitis) that are applied directly to the skin.
1. Irritant contact dermatitis is an epidermal non-immune response.
2. Allergic contact dermatitis is an immune reaction to a specific agent that occurs after one or more exposures.
Incidence
It happens to people of all ages. Irritant dermatitis is more common in people who deal with chemicals on a regular basis and wash their hands often.
Because of their dry skin, the elderly are more likely to develop irritant contact dermatitis
Pathogenesis
Chemicals, lotions, cold, dry air, soaps, detergents, or organic solvents cause an alteration of the outer layer of the dermis, resulting in irritant contact dermatitis.
Allergic contact dermatitis is caused by a change in the epidermis that occurs when the immune system reacts to an allergen by inflaming the cutaneous tissue. Poison ivy, poison oak, sumac, nickel jewellery, hair dye, rubber and leather chemicals (latex gloves), cleaning products, harsh soaps and detergents, and topical antibiotics are also common allergens.
Factors that Predispose
A. Profession (hairdresser, nurse, house cleaner, etc.)
B. Jewelry C. Yard or woods activities
Typical Complaints
A. Skin irritation ranging from redness to pruritic inflammation, with blisters developing as a result.
1. Poison oak, ivy, and sumac cause classic lesions (vesicles) and papules with sharp margins on an erythemic base.
2. When oleoresin is contacted from pets or smoke from a burning fire, a diffuse pattern of erythema can appear.
B. Exposure to an irritant that the patient is aware of. An internal cause, such as a drug reaction, may be the cause of round or annular lesions.
Some Symptoms and Signs
A. Serious
1. Erythema with thickening Erythema with thickening Erythema with thicken
2. Sizing up
3. Ruptures
4. Inflammation; lichenification with scales and fissures may occur with chronic dermatitis.
B. Diaper dermatitis: A swollen, shiny rash on the buttocks and genitalia.
C. Candidiasis 1. Bright red rash with satellite lesions at the margins
2. Inflammation and excoriations present
3. Creases may be involved
Diagnostic Procedures
A. If the source is known, consider none.
B. If candida is suspected, wet mount (potassium hydroxide [KOH], saline) to rule out fungal infection.
C. Pustule sensitivity and culture
D. To rule out allergic contact dermatitis, perform a patch examination.
Distinctive Diagnosis
Irritant contact dermatitis, allergic contact dermatitis, and diaper dermatitis are the three forms of contact dermatitis.
Candida
Tinea pedis, corporis, cruris
Treatment
Topical soaks with saline or Burow’s solution
lukewarm baths (not hot)
For dry erythematous skin, use recommend Eucerin or Aquaphor
ointments to rehydrate skin
use of mild soaps and cleansers
apply calamine lotion after baths
Diaper dermatitis:change the patient’s diaper frequently
Pharmaceutical therapy
1)Irritant contact dermatitis: Hydrocortisone 2.5% ointment
Tags:
Comments