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Dermatitis, Contact

Anne Walsh, ANP-BC and Konstantinos E. Deligiannidis, MD, MPH, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • A cutaneous reaction to an external substance

  • Each type has a different mechanism, whereas the clinical presentation is the same (1).

  • Primary irritant dermatitis (ID) is a result of di...

DIAGNOSIS

HISTORY

  • Itchy rash

  • Assess for prior exposure to irritating substance.

PHYSICAL EXAM

  • Acute

    • Papules, vesicles, bullae with surrounding erythema

    • Crusting and oozing

    • Pruritus

  • Chronic

    • Erythematous base

    • Thi...

TREATMENT

GENERAL MEASURES

  • Remove offending agent:

    • Avoidance

    • Work modification

    • Protective clothing

    • Barrier creams, especially high-lipid content moisturizing creams (e.g., Keri lotion, petrolatum, coconut ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Stay active, but avoid overheating. 

Patient Monitoring

  • As necessary for recurrence

  • Patch testing for etiology after resolved

DIET

No special diet 

PATIENT EDUCATION

  • Avo...

REFERENCES

1
Sultan TA, Hatem AMA. Management of contact dermatitis. J Dermatol Dermatol Surg.  2015;19(2):86–91. [View Abstract on OvidMedline]
2
Tan CH, Rasool S, Johnston GA. Contact dermatitis: ...

ADDITIONAL READING

Pelletier JL, Perez C, Jacob SE. Contact dermatitis in pediatrics. Pediatr Ann.  2016;45(8):e287–e292. [View Abstract on OvidMedline] 

SEE ALSO

Algorithm: Rash 

CODES

ICD10

  • L25.9 Unspecified contact dermatitis, unspecified cause

  • L23.9 Allergic contact dermatitis, unspecified cause

  • L25.5 Unspecified contact dermatitis due to plants, except food

  • L25.3 Unsp contact ...

CLINICAL PEARLS

  • Commonly occurs on hands and face

  • Anyone exposed to irritants or allergic substances is predisposed to contact dermatitis, especially in occupations that have high exposure to chemicals...

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