Irritant Contact Dermatitis

Irritant Contact Dermatitis
Medical Subjects: Skin

What Is Irritant Contact Dermatitis

What is irritant contact dermatitis?

Irritant contact dermatitis is a localized inflammatory reaction of the skin induced by a variety of chemical or physical substances. Mostly caused by the direct cytotoxic effect of irritants; Unlike allergic contact dermatitis, (irritant contact dermatitis, ICD) is not immune-mediated.

Is irritant contact dermatitis common?

Irritant contact dermatitis (ICD) is the most common type of contact dermatitis. About 80% of occupational contact dermatitis is an ICD, and the ICD is the most common cause of hand eczema. The prevalence of hand eczema in the general population is estimated to be about 4%, with women more frequently affected.

People who "worked in a wet process" had the highest risk of developing occupational ICDs, including food processor, medical worker, mechanical worker, cleaner and homemaker.


What Is The Cause Of Irritant Contact Dermatitis

What are the common irritants of irritant contact dermatitis?

  • Common chemical irritants include water and wet processes, detergents and surfactants, solvents, oxidants, acids and bases.

  • Physical irritants include metal tools, wood, glass fibers, plants, paper, dust, or soil.


What Symptom Does Irritant Contact Dermatitis Have

What expression can irritant contact dermatitis have?

Clinical manifestations of irritant contact dermatitis (ICD) vary from mild dry and red skin to acute or chronic eczema dermatitis and even skin necrosis (chemical burn).

  • Acute ICD are often caused by a single exposure to a stimulant or corrosive chemical. Clinical features included erythema, edema, blisters, bullae, and exudation. Reaction is generally localized to the area of contact with a burning, tingling, or aching sensation. Patients with milder conditions may have only transient erythema.

  • Chronic or cumulative ICDs are caused by repeated exposure to slight irritants or strong irritants at low concentrations. Clinically, chronic ICD presents with skin erythema, desquamation, lichenoid change, hyperkeratosis and rhagadia. Often involving the back of hand, fingertips and web. The face of patients exposed to volatile irritants or cosmetics may be affected.


How To Check For Irritant Contact Dermatitis

When irritant contact dermatitis is diagnosed, what medical history to need to ask emphatically?

Important aspects of history collection in patients with suspected irritant contact dermatitis (ICD) include:

  • Daily activities, including occupations and interests;
  • The type of substance or device used in the workplace; The type of substance or device used in the workplace;
  • Working environment (temperature, humidity, dust);
  • Use of protective gloves or devices;
  • Wet work (including use of closed gloves);
  • Wash your hands;
  • Use of detergents and skin care creams;
  • Accidental exposure;
  • Previous atopic dermatitis, atopic respiratory disease or other inflammatory skin conditions.

How is irritant contact dermatitis diagnosed?

Understand past medical history, life contact history, especially occupation, hobby, habit, etc., and make a diagnosis based on skin symptom characteristics. Skin patch test (investigation of allergic contact dermatitis) was performed when necessary.

What is the diagnostic standard of irritant contact dermatitis?

Other clinical criteria supporting the diagnosis of irritant contact dermatitis (ICD) include:

  • Onset of symptoms within minutes to hours after exposure to irritants;
  • Pain, burning sensation, tingling sensation or discomfort in excess of pruritus;
  • The epidermis shows shiny, scorched or scalded appearance;
  • It is mainly caused by desquamation, hyperkeratosis or rhagadia of the skin, rather than vesicular changes.

Irritant contact dermatitis needs to distinguish with which disease?

  • Allergic contact dermatitis (ACD): The two presenting with similar findings are difficult to identify and a positive patch test for the corresponding exposure usually leads to a diagnosis of ACD. But that possibility of a false positive or false negative is also exclude.

  • Atopic dermatitis: A history of atopic dermatitis and/or involvement of the intercostal area suggested this condition.

  • Hand eczema: Acute and chronic hand eczema (poor sweating or psoriasis) may be difficult to distinguish from ICD. However, acute sweatless eczema is characterized by blisters and bullae on the palms and soles of the feet that can spread between the fingers but do not involve the back of the hand and foot. It is more common in adolescents and young adults, and aggravates in spring and summer, with spontaneous remission in autumn and winter. Chronic hand eczema may be induced by a certain irritant while the patient is susceptible to "endogenous" or idiopathic eczema.

  • Other: Irritant contact dermatitis should also be distinguished from psoriasis, fungal infection, scabies, etc.


How To Prevent Irritant Contact Dermatitis

How does irritant contact dermatitis prevent effectively?

Precautions include wearing suitable gloves and using barrier creams and emollients.


How To Treat Irritant Contact Dermatitis

How should irritant contact dermatitis treat?

Treatment principles of irritant contact dermatitis (ICD) are as follows:

  • Identify and avoid exposure to pathogenic irritants;
  • Treating skin inflammation;
  • Restore epidermal barrier function;
  • Prevent further exposure.

Avoid contact: When treating an ICD, it is essential to avoid exposure to pathogenic irritants and to take protective measures. For hand dermatitis, general measures include:

  • Try to avoid contact with detergents or other detergents, polishing agents or solvents;

  • If wet work is unavoidable, wear cotton lined plastic gloves (plastic gloves are less likely to cause ACD than rubber gloves);

  • Wear gloves when the weather is cold;

  • Wash hands with warm water and a small amount of mild skin cleanser;

  • Wash and dry gently and thoroughly after washing your hands;

  • Use moisturizer more than once a day.

Treatment of inflammation: Active treatment of an ICD is aimed at alleviating inflammatory symptoms and signs and rebuilding the epidermal barrier.

  • Topical corticosteroid and emollients may be administer empirically. Calcineurin inhibitors are not used to treat ICD.

  • The specific treatment of ICD with topical corticosteroids depends on the severity and location of the skin lesions. Generally speaking, ointment is superior to cream.

Emollients or moisturizers:

  • It is beneficial for all patients with ICD and should be applied more than once a day without restriction, especially after hand washing and work.

  • Closure emollients: Vaseline (video), lanolin, mineral oil, vegetable oil, beeswax, ceramide, and silicone oil;

  • Humectant: glycerol, sorbitol, propylene glycol or topical urea.


What Should Irritant Contact Dermatitis Patient Notice In Life

What should irritant contact dermatitis notice on life?

There are no special precautions in life, just keep a healthy lifestyle.

Do not smoke; Insist on exercise, don't sit for a long time, avoid overweight and obesity, exercise 3 ~ 5 times a week, 30 minutes each time, the combination of aerobic exercise and strength exercise, moderate intensity is not excessive; • Get plenty of sleep every day, whether you go to bed early or late; When mental stress, emotional tension, learn to self-regulation.

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