Contact dermatitis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Irritant contact dermatitis is caused by direct toxicity without prior sensitization, and allergic contact dermatitis is a delayed hypersensitivity reaction.
Results in localized burning, stinging, itching, blistering, redness, and swelling at the area of contact with the allergen or irritant.
Patch testing may aid identification of the causative agent. Skin biopsy may also be helpful, but may not be able to distinguish between other causes of dermatitis.
Treatment involves removal of the causative agent, future avoidance of the causative agent, topical treatments, or possibly a short course of oral corticosteroids, phototherapy, or immunosuppressants, depending on the type of contact dermatitis and severity.
Rarely, contact dermatitis can become generalized, leading to areas of dermatitis in locations distant from the site of contact with the causative agent.

Allergic contact dermatitis to nickel in watchband

From the personal collection of Dr Snehal Desai

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Allergic contact dermatitis to Toxicodendron species
Allergic contact dermatitis to nickel in watchband
Allergic contact dermatitis to nickel earring
Allergic contact dermatitis to nickel in belt buckle
Allergic contact dermatitis to nickel in earring

Citations

Key Articles

Johnston GA, Exton LS, Mohd Mustapa MF, et al. British Association of Dermatologists' guidelines for the management of contact dermatitis 2017. Br J Dermatol. 2017 Feb;176(2):317-29.[Abstract][Full Text]
Johansen JD, Aalto-Korte K, Agner T, et al. European Society of Contact Dermatitis guideline for diagnostic patch testing: recommendations on best practice. Contact Dermatitis. 2015 Oct;73(4):195-221.[Abstract][Full Text]
Fonacier L, Bernstein DI, Pacheco K, et al; American Academy of Allergy, Asthma & Immunology; American College of Allergy, Asthma & Immunology; Joint Council of Allergy, Asthma & Immunology. Contact dermatitis: a practice parameter - update 2015. J Allergy Clin Immunol Pract. 2015 May-Jun;3(3 Suppl):S1-39.[Abstract][Full Text]

Other Online Resources

American Contact Dermatitis Society

Referenced Articles

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27. Owen JL, Vakharia PP, Silverberg JI. The role and diagnosis of allergic contact dermatitis in patients with atopic dermatitis. Am J Clin Dermatol. 2018 Jun;19(3):293-302.[Abstract][Full Text]
28. Hamann CR, Hamann D, Egeberg A, et al. Association between atopic dermatitis and contact sensitization: a systematic review and meta-analysis. J Am Acad Dermatol. 2017 Jul;77(1):70-8.[Abstract]
29. Lukács J, Schliemann S, Elsner P. Occupational contact urticaria caused by food: a systematic clinical review. Contact Dermatitis. 2016 Oct;75(4):195-204.[Abstract][Full Text]
30. Villarama CD, Maibach HI. Correlations of patch test reactivity and the repeated open application test (ROAT)/provocative use test (PUT). Food Chem Toxicol. 2004 Nov;42(11):1719-25.[Abstract]
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32. Neale H, Garza-Mayers AC, Tam I, et al. Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children. J Am Acad Dermatol. 2021 Feb;84(2):235-44.[Abstract][Full Text]
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37. Bhardwaj SS, Jaimes JP, Liu A, et al. A double-blind randomized placebo-controlled pilot study comparing topical immunomodulating agents and corticosteroids for treatment of experimentally induced nickel contact dermatitis. Dermatitis. 2007 Mar;18(1):26-31.[Abstract]
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54. Johnson H, Adler BL, Yu J. Dupilumab for allergic contact dermatitis: an overview of its use and impact on patch testing. Cutis. 2022 May;109(5):265-7.[Abstract]
55. Stout M, Silverberg JI. Variable impact of dupilumab on patch testing results and allergic contact dermatitis in adults with atopic dermatitis. J Am Acad Dermatol. 2019 Jul;81(1):157-62.[Abstract]
56. Raffi J, Suresh R, Botto N, et al. The impact of dupilumab on patch testing and the prevalence of comorbid allergic contact dermatitis in recalcitrant atopic dermatitis: a retrospective chart review. J Am Acad Dermatol. 2020 Jan;82(1):132-8.[Abstract]
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