Symptoms
The common causes of contact dermatitis
- Nickel (accessories)
- Occupational exposures
- Plants
- Cosmetic and personal care products
- Topical medications
- Dental and oral products
Causes
You may be prescribed:
- a stronger cream for short-term use for severe contact dermatitis
- a weaker cream if the eczema is mild
- a weaker cream for use on your face, genitals or in the creases of your joints (such as your elbows), as your skin is thinner in these areas
- a stronger cream to use on your palms and the soles of your feet, as the skin is thicker here
Prevention
Allergic contact dermatitis prognosis. Contact allergy often persists lifelong so it is essential to identify the allergen and avoid touching it. Dermatitis may recur on re-exposure to the allergen. Some allergens are more difficult to avoid than others, with airborne allergens being a particular problem (e.g., epoxy resin, compositae pollen).
Complications
Signs and symptoms of contact dermatitis include:
- A red rash.
- Itching, which may be severe.
- Dry, cracked, scaly skin.
- Bumps and blisters, sometimes with oozing and crusting.
- Swelling, burning or tenderness.
What are the most common causes of contact dermatitis?
How is contact dermatitis treated by doctors?
What is the prognosis of allergic contact dermatitis?
How do you describe contact dermatitis?
What is the pathophysiology of contact dermatitis?
The pathophysiology of allergic contact dermatitis starts with the contact of the allergen to the skin. This allergen penetrates that stratum corneum of the skin and is taken up by Langerhans cells. [5] [6] The antigens subsequently undergo processing by these cells and get displayed on their surface.
How does irritant contact dermatitis occur?
Irritant contact dermatitis is the most common type. This nonallergic skin reaction occurs when an irritant damages your skin's outer protective layer. Some people react to strong irritants after a single exposure. Others may develop a rash after repeated exposures to even mild irritants, such as soap and water.
What type of hypersensitivity reaction is irritant contact dermatitis?
Irritant contact dermatitis is a nonspecific response of the skin to direct chemical damage that releases mediators of inflammation predominantly from epidermal cells while allergic contact dermatitis is a delayed (type 4) hypersensitivity reaction to exogenous contact antigens.
Which immune mechanism is involved in contact dermatitis?
Allergic contact dermatitis is a classic example of a cell mediated hypersensitivity reaction in the skin. This occurs as a result of xenobiotic chemicals penetrating into the skin, chemically reacting with self proteins, eventually resulting in a hapten-specific immune response.
What is the difference between irritant contact dermatitis and allergic contact dermatitis?
Irritant contact dermatitis is caused by the non–immune-modulated irritation of the skin by a substance, leading to skin changes. Allergic contact dermatitis is a delayed hypersensitivity reaction in which a foreign substance comes into contact with the skin; skin changes occur after reexposure to the substance.
What is the most common cause of contact dermatitis?
Nickel, chrome, and mercury are the most common metals that cause contact dermatitis: Nickel is found in costume jewelry, and belt buckles. Watches, zippers, snaps, and hooks on clothing may also contain nickel. Chrome-plated items, which contain nickel.
What are the stages of contact dermatitis?
Allergic contact dermatitis has two distinct stages: the sensitization stage and the elicitation stage. The sensitization stage is when the skin first comes in contact with the offending substance. The elicitation stage is when the symptoms appear.
What is the medical term for contact dermatitis?
The term contact dermatitis sometimes is used incorrectly as a synonym for allergic contact dermatitis. Contact dermatitis is inflammation of the skin induced by chemicals that directly damage the skin (see Irritant Contact Dermatitis) and by specific sensitivity in the case of allergic contact dermatitis.
Where on the body does irritant contact dermatitis most frequently start?
The hands and feet are commonly affected but ICD can occur on the face or elsewhere on the body. If the chemical is in contact with a large area of skin the rash may be extensive.
Is contact dermatitis type 4 hypersensitivity?
Allergic contact dermatitis is a type 4 or delayed hypersensitivity reaction and occurs 48–72 hours after exposure to the allergen. The mechanism involves CD4+ T-lymphocytes, which recognise an antigen on the skin surface, releasing cytokines that activate the immune system and cause the dermatitis.
How do you fix irritant contact dermatitis?
To help reduce itching and soothe inflamed skin, try these self-care approaches:Avoid the irritant or allergen. ... Apply an anti-itch cream or ointment. ... Take an anti-itch drug. ... Apply cool, wet compresses. ... Protect your skin. ... Soak in a soothing cool bath. ... Protect your hands.
Can Irritant dermatitis spread?
Irritant Contact Dermatitis should not spread. The irritant affects the area where it came in contact with the skin. If the rash spreads to other parts of the body, you may have an Allergic Contact Dermatitis reaction. This type of contact dermatitis is immune-related and can spread away from the site of the rash.
How do you get rid of irritant dermatitis?
Remove or avoid the allergen or irritant that caused the rash. Apply hydrocortisone cream over small areas. For blisters, use a cold moist compress for 30 minutes, three times a day. Put moisturizers on damaged skin several times a day to help restore the protective layer.
What causes contact dermatitis?
Poison ivy is a top cause of allergic contact dermatitis. Other causes include:
Why does my skin itch after exposure to allergens?
Every time your skin comes into contact with an allergen that it doesn’t like, your body’s immune system responds. White blood cells are recruited into the skin, releasing chemical mediators of inflammation. This response causes the itchy rash. The rash may appear minutes, hours or several days after exposure.
What is the medical term for skin inflammation?
Dermatitis is the medical term for skin inflammation (irritation). Contact dermatitis is an allergic or irritant reaction that causes a painful or itchy skin rash. As the name suggests, you get contact dermatitis from coming into contact with an allergen (like poison ivy) or an irritant (like a chemical).
How long does it take for a red rash to develop?
It can take several days after exposure for an itchy, red rash to develop. Irritant contact dermatitis: This painful rash tends to come on quickly in response to an irritating substance. Common irritants include detergents, soap, cleaners and acid.
How long does it take for a rash to develop after exposure?
Common allergens include jewelry metals (like nickel), cosmetic products, fragrances and preservatives. It can take several days after exposure for an itchy, red rash to develop.
How long does it take for a rash to go away from contact dermatitis?
Treatment for both types of contact dermatitis is the same. Even with treatment, it can take several weeks for the rash to go away. Treatments include:
Can dermatitis cause hives?
Thus, it is possible that people with contact dermatitis can develop hives (urticaria) and swelling (an gioedema) after coming into contact with an allergen. Hives are red, raised, itchy skin welts. Angioedema is swelling deep under the skin.
What factors determine the severity of irritant contact dermatitis?
The factors which determine the severity of irritant contact dermatitis include the quantity and concentration of the irritant, duration, and frequency of exposure. It also depends on the type of skin if it is thick, thin, oily, dry, very fair, previously damaged skin, or having a pre-existing atopic tendency.
What causes irritant contact dermatitis?
The likelihood of developing irritant contact dermatitis (irritant contact dermatitis ) increases with the duration, intensity, and concentration of the substance. Chemical or physical agents and microtrauma may produce skin irritation thus causing Irritant contact dermatitis . Physical irritants like friction, abrasions, occlusion, and detergents like sodium lauryl sulfate produce more irritant contact dermatitis in combination than alone. [5][6]
What is the difference between allergic contact dermatitis and irritant contact dermatitis?
Irritant contact dermatitis is a nonspecific response of the skin to direct chemical damage that releases mediators of inflammation predominantly from epidermal cells while allergic contact dermatitis is a delayed (type 4) hypersensitivity reaction to exogenous contact antigens.
What are the environmental factors that affect allergic dermatitis?
Environmental factors like high or low temperature and humidity also determine the severity. Allergic contact dermatitis. Common etiological allergens for allergic contact dermatitis are nickel, balsam of Peru, chromium, neomycin, formaldehyde, thiomersal, fragrance mix, cobalt, and parthenium.[7] .
What is the T cell mediated inflammation of the skin caused by repeated skin exposure to haptens in a?
Allergic contact dermatitis. It is T-cell mediated inflammation of the skin caused by repeated skin exposure to haptens in a sensitized individual. Allergic contact dermatitis has two phases.
How common is allergic contact dermatitis?
Until recently it was believed that allergic contact dermatitis was rare, unfortunately, data indicate that it is very common and affects close to 20% of children.
How many morphological patterns are there in contact dermatitis?
Both irritant contact dermatitis and allergic contact dermatitis can present with three morphological patterns.
What is contact dermatitis?
Contact dermatitis is a reaction that happens after your skin comes in contact with certain substances.
Why is it important to identify the cause of your contact dermatitis?
It is important to identify the cause of your contact dermatitis so you can avoid contact with that substance.
How is contact dermatitis diagnosed?
Diagnosis is usually based on a medical history and physical exam. Patch testing can be done to identify the allergen that is causing the rash. A skin biopsy may also be performed.
How long does it take for a rash to start after exposure?
The reaction may not start until 24 to 48 hours after exposure. Contact dermatitis, caused by an irritant that is not an allergic response, happens from direct contact with the irritant. Allergic contact dermatitis most commonly affects adults, but it can affect people of all ages.
What is the best treatment for a rash?
Cortisone creams are used topically to relieve itching. Oral or injected steroids and oral antihistamines are used to control the itching and rash. Avoid scratching the rash to prevent a bacterial infection. For severe reactions, always contact your healthcare provider.
What are some things that can cause contact dermatitis?
Plants, metals, cosmetics, and medicines may also cause a contact dermatitis reaction:
What metals cause dermatitis?
Many chemical agents can cause allergic contact dermatitis. Nickel, chrome, and mercury are the most common metals that cause contact dermatitis: Nickel is found in costume jewelry, and belt buckles. Watches, zippers, snaps, and hooks on clothing may also contain nickel. Chrome-plated items, which contain nickel.
What is irritant contact dermatitis?
Irritant contact dermatitis is a form of contact dermatitis, in which the skin is injured by friction, environmental factors such as cold, over-exposure to water, or chemicals such as acids, alkalis, detergents and solvents.
How to treat irritant dermatitis?
Wear suitable gloves to protect against irritants in your home and work environment. Irritant contact dermatitis is usually treated with the following: Chemical burns are usually flushed with water followed by the use of antidote or specific remedy against the particular toxic chemical.
What are some examples of irritants?
Everyday examples of common skin irritants are water, soaps, and, in the era of COVID-19, hand sanitisers. Occupational irritants can include wet work, detergents, solvents, acids, alkalis, adhesives, and metalworking fluids. Topicalmedications 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 cumulativeimpact of multiple irritants.
What causes a blistering sensation on the skin?
Accidental exposure to a strong irritant such as a strong acid or alkali substance may cause an immediate skin reaction resulting in pain, swelling and blistering. Contact with mild irritants such as water and soap or detergent may over weeks cause dryness, itching and cracking of the skin. Eventually, sores may appear which form crusts and scales.
What causes a crusty rash on the chin?
Some typical examples of irritant contact dermatitis include: Dribble rash around the mouth or on the chin in a baby, or older children due to lip-licking; the cause is saliva, which is alkaline. Skin bacteria may contribute to the clinical appearance.
What is the term for a form of skin inflammation caused by contact with substances and/or environmental factors that injur?
Irritant contact dermatitisis a form of skin inflammationcaused by contact with substances and/or environmental factors that injure the skin, damaging the skin barrier.
Why does my face itch in winter?
Dry cold air may cause dry, irritable skin ( winter itch ). Reactions to contact with beetles, for example, paedarus, lax beetles, and caterpillars. Cosmetics may irritate sensitive facial skin (especially in rosacea) resulting in immediate stinging, burning and redness followed by itching and dryness.
What percentage of occupational skin disorders are caused by irritants?
Contact dermatitis accounts for 95% of occupational skin disorders. Irritant contact dermatitis (ICD) is often caused by cumulative exposure to weak irritants, accounting for 80% of all cases of contact dermatitis. ICD can co-exist with atopic dermatitis (AD) and allergic contact dermatitis (ACD). P …
What is the most common occupational skin disorder?
Contact dermatitis accounts for 95% of occupational skin disorders. Irritant contact dermatitis (ICD) is often caused by cumulative exposure to weak irritants, accounting for 80% of all cases of contact dermatitis. ICD can co-exist with atopic dermatitis (AD) and allergic contact dermatitis (ACD). Patients with AD and ACD may have a lower inflammatory threshold for developing ICD. Therefore, it needs to be distinguished from lesions of AD and ACD. ICD Patients report stinging and burning in excess of pruritus. Pruritus is classically reported by patients with AD and ACD. ICD lesions are typically well-demarcated unlike AD and ACD. ICD is diagnosed by exclusion. Patients undergo testing to rule out type I and type IV hypersensitivity. Negative results suggest a diagnosis of ICD. Management consists of irritant identification and avoidance with regular emollient use. Although ICD is more common in certain occupations, genetics and environment play significant roles in its development.
Can ICD be coexisting with atopic dermatitis?
ICD can co-exist with atopic dermatitis (AD) and allergic contact dermatitis (ACD). Patients with AD and ACD may have a lower inflammatory threshold for developing ICD. Therefore, it needs to be distinguished from lesions of AD and ACD. ICD Patients report stinging and burning in excess of pruritus.
What is irritant contact dermatitis?
Irritant contact dermatitis (ICD) is inflammation of the skin that arises with exposure to certain substances. It must be differentiated from allergic contact dermatitis where the skin inflammation develops due to an allergy to certain substances. Dermatitis is a term for skin inflammation that typically presents with a skin rash (redness, swelling, dryness, peeling or scaling skin). There are many different types of dermatitis. Contact dermatitis arises when certain skin irritants or allergenic substances makes contact with the skin thereby giving rise to irritant or allergic contact dermatitis respectively.
What is the redness of a rash?
Contact dermatitis, whether allergic or irritant, presents with a similar type of rash. It is typically : Red and raised over the entire affected area or there are several bumps interspersed among fairly unaffected skin. Dry, cracked and sometimes peeling patches of skin. Blisters oozing fluid sometimes with crusting.
What is the term for a rash on the face?
Dermatitis is a term for skin inflammation that typically presents with a skin rash (redness, swelling, dryness, peeling or scaling skin). There are many different types of dermatitis. Contact dermatitis arises when certain skin irritants or allergenic substances makes contact with the skin thereby giving rise to irritant or allergic contact ...
What is the term for a person's hands being in contact with a substance?
Another term that also frequently used is hand dermatitis since irritant contact dermatitis more frequently affects the skin of the hands and fingers. It is not a specific predilection for this part of the body but rather as a consequence of the hands being in touch with various substances which may be irritants.
How long does it take for a rash to appear on hands?
Other identifying features are : Itching or rash that starts shortly after exposure or even days after but usually with the first 2 weeks. Dermatitis limited to the hands since this part of the body is more often in contact with irritants.
What is the body's response to injury?
These types of injury causes the body to release certain chemicals which then triggers various reactions within the affected tissue. It presents as heat, redness, swelling and pain. With the skin there is the added feature of itching.
Is allergic contact dermatitis a separate condition?
Allergic contact dermatitis is a separate but closely related condition and it is important to differentiate between inflammation due to irritation and an allergy. Irritants in irritant contact dermatitis causes chemical or mechanical damage but the irritants in allergic contact dermatitis elicits an allergic reaction.
What is the pathophysiology of allergic contact dermatitis?
Pathophysiology of allergic contact dermatitis. Activation of innate immunity is necessary to the development of ACD. Sensitization phase. The chemicals in contact with the skin (stage 1) activate innate immunity and induce an inflammation/irritation which may be visible or not but which is necessary to the recruitment of leukocytes and ...
What is allergic contact dermatitis?
Allergic contact dermatitis is elicited upon skin contact with nonprotein chemicals, haptens, and corresponds to a cutaneous delayed type hypersensitivity reaction, mediated by hapten-specific T-cells.
What is the best test for allergic dermatitis?
Epicutaneous patch testing is still regarded as the best method of diagnosing allergic contact dermatitis. The present patch test technique is the result of a continuous process of development and improvement since its first application in the late 19th century. During the last decades of the 20th century a lot of effort was put into standardization of materials and methods used in patch testing. Patch tests can be used to confirm a suspected allergic contact dermatitis and either to recommend avoidance of particular products or to recommend alternative products in a particular patient. The true rate of clinically relevant hypersensitivity in positive patch test reactions remains to a great extent unknown. The ideal patch test should cause as few adverse reactions as possible, but a lot of adverse reactions have been described. How-ever, it has to be noted that the overall risk-benefit equation of patch testing is in favor of the benefit, if performed correctly and with the proper indications. A careful history taking and attention to the clinical picture are key actions to facilitate the interpretation of the clinical relevance of the epicutaneous patch test results.
What is the most common occupational disease?
Allergic contact dermatitis (ACD), one of the commonest occupational diseases, is a T-cell-mediated skin inflammation caused by repeated skin exposure to contact allergens, i.e. nonprotein chemicals called haptens.
What is the term for a blistered lesions?
with blisters or bullous lesions. Classically, pruritus is
What is the most common inflammatory skin disease?
Allergic contact dermatitis, also referred to as contact hypersensitivity, is one the most frequent inflammatory skin diseases, and is characterized by redness, papule and vesicles, followed by scaling and dryness.
Which stage of the lymph node is the cutaneous hapten?
Cutaneous haptens are taken up by dendritic cells which migrate to the draining lymph nodes (stage 2) where they present the antigenic peptides to specific CD8+ and CD4+ T cells which have, respectively, effector and regulatory functions (stage 3).
