CONTACT  DERMATITIS

 

Etiology:

  1. It is a type IV allergic reaction mediated by T-cell lymphocytes. It can be caused by deodorants, sprays, pollens, plants, detergents, jewelry,  fabrics, hairdyes.

S & S:

  1. It can be acute (erythema, +/- vesicles, exudate), subacute (erythema with some oozing/crusting) and chronic (lichenification).
     
  2. Pruritic. Fever +/- in acute form. Lesions present at exposed areas.

DX:

  1. History, History, History.
     
  2. Distribution of the lesions may be revealing ( i.e. linear due to the brush of poison ivy, clothing dermatitis is more pronounced in the axilla and groin where there is greater contact with cloth, aerosolized contactants lead to rash in exposed areas)

Treatment:

acute contact dermatitis:

  1. If severe: systemic steroid tapered over 2 weeks
     
  2. If moderate: topical steroid lotion, cream or ointment (depending on the site) bid.
     
  3. Wet compress with saline or Burow's solution will dry and cleanse the area.
     
  4. If  vesicles are large they can be drained but do not debride the epithelium.
     
  5. Antihistamines may help pruritus.

subacute or chronic dermatitis:

  1. Topical steroid lotion, cream or ointment.
     
  2. Emollients (petrolatum).
     
  3. Antihistamines may help pruritus.

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