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General Medicine

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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Related Images
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1.8. Contact dermatitis is a delayed hypersensitivity reaction to topical ophthalmic medication causing a periocular eczematoid reaction.
1.8. Contact dermatitis is a delayed hypersensitivity reaction to topical ophthalmic medication causing a periocular eczematoid reaction.
FIG. 6.4. Contact dermatitis may be quite localized as in this patient with facial involvement (A) or more diffuse, as in this child with a rash on the extremities (B, C).
FIG. 6.4. Contact dermatitis may be quite localized as in this patient with facial involvement (A) or more diffuse, as in this child with a...
FIG. 6.4. Contact dermatitis may be quite localized as in this patient with facial involvement (A) or more diffuse, as in this child with a rash on the extremities (B, C).
FIG. 6.4. Contact dermatitis may be quite localized as in this patient with facial involvement (A) or more diffuse, as in this child with a...
Figure 52-1 Contact dermatitis. Erythematous diaper dermatitisdistributed primarily on convex surfaces with sparing of the intert-riginous folds in an infant.
Figure 52-1 Contact dermatitis. Erythematous diaper dermatitisdistributed primarily on convex surfaces with sparing of the intert-riginous ...
Irritant contact dermatitis: hands, health-care worker
Irritant contact dermatitis: hands, health-care worker
Rhus dermatitis (poison ivy) in a child
Rhus dermatitis (poison ivy) in a child
Facial dermatitis after exposure to poison ivy leaves
Facial dermatitis after exposure to poison ivy leaves
Facial dermatitis after exposure to poison ivy leaves. Same pt as in previous photo
Facial dermatitis after exposure to poison ivy leaves. Same pt as in previous photo
Rhus dermatitis (poison ivy) after clearing brush in the springtime
Rhus dermatitis (poison ivy) after clearing brush in the springtime
Interdigital poison ivy eruption acquired in December by pulling up 'dead' vines
Interdigital poison ivy eruption acquired in December by pulling up 'dead' vines
Figure 24-18 Eczema of allergic contact dermatitis. Contact with poison ivy has produced a weeping, crusted, erythematous collection of vesicles and papules.
Figure 24-18 Eczema of allergic contact dermatitis. Contact with poison ivy has produced a weeping, crusted, erythematous collection of ves...
Rhus (poison ivy) dermatitis. Close-up of previous.
Rhus (poison ivy) dermatitis. Close-up of previous.
Rhus (poison ivy) dermatitis. Acute eczema with vesicles, weeping and crusting
Rhus (poison ivy) dermatitis. Acute eczema with vesicles, weeping and crusting
Acute allergic eczematous eruption of poison ivy. The red color and linear blistered appearance suggest an acute “boiling,” bubbling, second-degree burn. From Goodheart HP. Goodheart's Photoguide to Common Skin Disorders: Diagnosis and Management, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2009.
Acute allergic eczematous eruption of poison ivy. The red color and linear blistered appearance suggest an acute “boiling,” bubbling, secon...
Irritant contact dermatitis. The localized erythema on this boy's face was caused by irritation from benzoyl peroxide in an acne preparation. From Goodheart HP. Goodheart's Photoguide to Common Skin Disorders: Diagnosis and Management, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2009.
Irritant contact dermatitis. The localized erythema on this boy's face was caused by irritation from benzoyl peroxide in an acne preparatio...
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