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Dermatitides
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Allison Perz, Tara Jennings, Robert Duffy, Warren Heymann
Clinical presentation: Primary irritant contact dermatitis results from the direct toxic effect of an irritant substance coming in contact with the skin. Trichloracetic acid would be an example of an agent that causes an irritant contact dermatitis. Patients with primary irritant contact dermatitis typically present with cracked, fissured skin accompanied by erythema and pain.
Patient assessment
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
The core of managing irritant contact dermatitis is to avoid the irritant as best as possible. For some individuals, this is not possible due to the nature of their work, and subsequently, the next best approach is to limit exposure as much as possible through the use of personal protective equipment. Should a patient be symptomatic with pruritus and tenderness, then topical corticosteroids are frequently used in conjunction with a thick emollient to both act as a barrier and moisturise the traumatised skin. Finally, irritant contact dermatitis confers similar risks to superadded infection as atopic eczema and therefore it is a pertinent differential diagnosis in a person who continues to be symptomatic despite appropriate preventative and conservative management.
Test of time and test of treatment
Published in Caroline J Rodgers, Richard Harrington, Helping Hands: An Introduction to Diagnostic Strategy and Clinical Reasoning, 2019
Caroline J Rodgers, Richard Harrington
In the above case, the history and clinical features suggest a diagnosis of irritant contact dermatitis. We can employ the ‘test of treatment’ strategy by advising the following: Avoid using soaps and use a non-soap alternative for handwashing – this includes at work.Avoid the use of alcohol gel altogether if possible.Use emollient regularly, especially after handwashing – again this includes at work.To treat the very itchy areas, she could apply a moderately potent steroid such as betamethasone 0.1% ointment for 2 weeks and then use it occasionally for flare-ups.In order to facilitate the new routine at work, she should speak to her occupational health department about the provision of emollients and non-soap cleansers at work.
COVID-19 and dermatological personal protective equipment considerations
Published in Baylor University Medical Center Proceedings, 2021
Travis S. Dowdle, Mallory Thompson, Mahmud Alkul, Jeannie M. Nguyen, Ashley L. E. Sturgeon
Closely associated is the relationship between handwashing/disinfecting and hand eczema. Even before COVID-19, this relationship was studied and established, but it is now more prevalent among HCWs due to higher rates of handwashing and sanitization.16 In a study of >12,000 HCWs, 21% reported hand eczema; 30% were washing their hands with soap >20 times per day and 45% were using alcohol disinfectants >50 times per day.17 The mechanism of increased hand eczema in HCWs involves the interplay between water and surfactants. Consistent exposure to water and humidity causes swelling of the stratum corneum and increased permeability of the skin, thereby increasing skin’s sensitivity to irritants.18 Repeated use of soaps and surfactants, which normally have only a weak irritant effect, can have a cumulative effect leading to irritant contact dermatitis. Specifically, surfactants have the ability to disrupt our natural cutaneous barrier by removing skin surface lipids, denaturing epidermal keratin, and altering the cell membrane of keratinocytes.
Cutaneous irritancy of an ibuprofen medicated plaster in healthy volunteers
Published in Postgraduate Medicine, 2018
Manisha Maganji, Mark P. Connolly, Aomesh Bhatt
The skin reactions observed in this study are consistent with those observed for other transdermal therapeutic systems [17]. Prior studies have observed that irritant contact dermatitis is the most common type of application-site reaction and often consists of erythema with itching of burning, and sometimes accompanied by edema [24]. Consistent with the currents study results, these skin reactions typically are mild to moderate in severity, transient in nature, and occur in 20–50% of patients [24]. Signs and symptoms of irritant contact dermatitis may be minimized through rotation of the application site, careful removal of the plaster, the use of moisturizers, and topical corticosteroids if necessary [24,25]. Allergic contact dermatitis can also occur, but is relatively rare [17].
Breast implant causes allergic contact dermatitis or foreign body reaction?
Published in Case Reports in Plastic Surgery and Hand Surgery, 2020
Hilde M. Bosker, Jorrit B. Terra, Martin M. Stenekes
The expander was filled periodically by injecting saline solution and methylene blue through the distant fill port. After seven months the exact location of the fill port could not be determined anymore, and several attempts were made before succeeding. The next day the patient developed an itching, erythematous plaque on the lateral side of the right breast, caudally to the injection site. There were no systemic symptoms. The patient had no prior history of atopic dermatitis or contact allergies. The diagnosis irritant contact dermatitis was determined and treatment with medium potency topical steroids was initiated.