Contact dermatitis is a common skin condition characterised by inflammation of the skin as a result of exposure to irritants or allergens[1]. There are two main types of contact dermatitis: irritant contact dermatitis and allergic contact dermatitis[2]. Irritant contact dermatitis is the most common form and occurs when substances directly irritate the skin, causing redness, itching and discomfort[3]. Allergic contact dermatitis, on the other hand, occurs when the immune system reacts to a specific substance, causing an allergic reaction[4]. Understanding the distinction between these two types is crucial for accurate diagnosis and effective treatment.

Symptoms of contact dermatitis can vary depending on the type and severity of the condition[1]. Common symptoms include redness, itching, swelling and the development of a rash at the site of contact[2]. Identifying the triggers and symptoms of contact dermatitis is important for both diagnosis and treatment of the condition[5]. Contact dermatitis can be diagnosed through physical examination by the healthcare provider, where the characteristics of the clinical findings and the timing of their occurrence play a vital role[3]. In addition, allergy testing and blood tests to check IgE levels can be performed to confirm the diagnosis[6].

Treatment of contact dermatitis aims to relieve symptoms, reduce inflammation and prevent future flare-ups[6]. Depending on the type and severity of contact dermatitis, treatment options may include[5]: - Avoidance of known triggers and irritants - Topical corticosteroids to reduce inflammation - Moisturisers to soothe and moisturise the skin - Oral antihistamines to relieve itching - Immune modulating drugs in severe cases Patients with contact dermatitis should pay attention to their skin's reaction to different substances and environments to effectively manage their condition and prevent relapse[4]. By understanding the causes, symptoms and triggers of contact dermatitis, people can take proactive steps to protect their skin and maintain its health and integrity.

 

 

Diagnosis of contact dermatitis

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Diagnosis of contact dermatitis typically involves a comprehensive approach that includes performing a physical examination and taking a detailed medical history[7]. During the physical examination, dermatologists carefully examine the affected areas of the skin to observe visible signs of contact dermatitis such as redness, swelling, blisters, or dry patches[6]. In addition, a thorough medical history is important to identify potential triggers or allergens that may cause a skin reaction. Patients are often asked about their occupation, hobbies, skin care products they use, recent exposure to chemicals or plants, and any previous history of skin conditions or allergic reactions.

Patch testing plays a very important role in the diagnosis of allergic contact dermatitis because it helps to identify specific allergens that may trigger a skin reaction[1][8]. Such tests involve applying small amounts of common allergens to the skin using adhesive strips and observing the skin reaction over a period of 2-3 days[6]. The appearance of a localised rash or irritation at the site of application of the allergen indicates a positive reaction and helps to identify the substances to which the individual is allergic. Patch testing is important to differentiate allergic contact dermatitis from irritant contact dermatitis and other skin conditions with similar symptoms[3].

In addition to physical examination and patch testing, dermatologists can also perform differential diagnosis to exclude other skin conditions that may mimic the symptoms of contact dermatitis[3]. Conditions such as atopic dermatitis, psoriasis, eczema or fungal infections can present with similar skin manifestations, making it very important to differentiate contact dermatitis from these other conditions[9]. By carefully assessing the clinical signs, time of onset of symptoms and the specific characteristics of the skin reaction, healthcare providers can accurately diagnose contact dermatitis and organise appropriate treatment plans for affected individuals.

 

Treatment options for contact dermatitis

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The primary approach to managing contact dermatitis involves avoiding triggers and irritants that may worsen the condition[1]. By identifying and eliminating substances that cause an allergic reaction or irritation, individuals can prevent flare-ups and promote skin healing. Some general strategies for avoiding triggers include - Use gentle, odourless skin care products - Wear protective clothing when in contact with known irritants - Avoid prolonged exposure to water and harsh chemicals Individuals should also be careful and cautious about the products they use daily, such as soaps and detergents, to minimise exposure to potential irritants and allergens [10]. Implementation of these avoidance strategies can significantly reduce the frequency and severity of contact dermatitis episodes.

Topical corticosteroids and medications play an important role in the treatment of contact dermatitis, especially in cases of allergic contact dermatitis[3]. Creams, ointments or pills containing corticosteroids help reduce inflammation and relieve symptoms such as redness, itching and swelling. In more severe cases, healthcare providers may prescribe antihistamines to effectively manage allergic reactions[1]. Additionally, ultraviolet rays (PUVA) therapy can be used as a treatment option for certain types of contact dermatitis, further highlighting the variety of approaches available to manage this condition[3].

Emollients and moisturisers are essential components of contact dermatitis treatment and help repair and maintain the skin barrier[1]. By keeping the skin well moisturised, individuals can support the healing process and strengthen the skin's natural protective barrier. Regular use of moisturisers containing ingredients such as hydrolysed wheat protein or emollients can help soften skin, alleviate dryness and improve overall skin barrier function[11]. Incorporating these products into a skin care routine can improve skin health and reduce the risk of recurrent contact dermatitis flare-ups, emphasising the importance of maintaining skin moisture and integrity for long-term management of the condition.