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Allergic contact dermatitis
Irritant contact dermatitis
photoallergic contact dermatitis
photoxic contact dermatitis
Atopic dermatitis
Seborrhoeic dermatitis
Nummular eczema
Asteatotic eczema
stasis dermatitis
Dyshidrotic eczema
Hyperkeratotic fissured hand and foot eczema
Overlapping dermatoses


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Irritant contact dermatitis

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The term “contact dermatitis” describes an inflammation of the skin caused by contact with external agents. Irritant contact dermatitis develops when the skin comes in contact with irritant chemical or physical agents. Acute irritant contact dermatitis is caused by exposure to strong irritants such as acids and alkalis. It is often seen with occupational accidents. Cumulative irritant dermatitis results from multiple sub-threshold insults to the skin, with clinical symptoms developping only after the cumulative damage exceeds an individually determined manifestation threshold. Detergents and cleaners, alcohols, disinfectants, solvents, water, food, heat, cold and friction may contribute to cumulative irritant dermatitis.

Clinical picture:

An acute irritant contact dermatitis may present with erythema, oedema, bullae and necrosis, leading to a burning and stinging senzation. The reaction reaches its peak within minutes to hours after exposure, then healing starts. In cumulative irritant dermatitis hyperkeratosis, lichenification and fissures predominate, leading to pain and itching, but erythema and vesicles may also be present.

Distribution:

The lesions are restricted to the area of contact with the causative chemical or physical agent. Often the hands are involved.

Diagnosis:

The diagnosis is based on a history of exposure to the suspected irritant(s) and clinical examination. Patch testing is performed to exclude an allergic contact dermatitis.

Differential diagnoses:

Other forms of dermatitis such as allergic contact dermatitis, atopic dermatitis and idiopathic dyshidrotic eczema have to be taken into account. Non-eczematous dermatoses such as palmar psoriasis including acrodermatitis continua of Hallopeau, dyshidrotic tinea manuum and erythema multiforme are possible differential diagnoses too.



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