Overview
Definition
Inflammatory skin condition caused by direct contact with an irritating or allergenic substance.
Epidemiology
Very common occupational and environmental skin disease.
Etiology & Risk Factors
- Irritant (80%): Soaps, detergents, chemicals
- Allergic (20%): Poison ivy (urushiol), nickel, fragrances, preservatives (Type IV Hypersensitivity)
Clinical Symptoms
- Erythema, edema, vesicles, and intense pruritus (allergic)
- Burning, stinging, dry, fissured skin (irritant)
- Rash localized strictly to the area of contact
Clinical Approach
Diagnosis
- Clinical diagnosis
- Patch testing (to identify specific allergens)
Management
- Identify and avoid the offending agent
- Topical corticosteroids
- Oral corticosteroids (if severe/widespread)
- Emollients
Complications
- Secondary bacterial infection
- Chronic lichenification