Contact dermatitis is an inflammatory skin reaction caused by direct exposure to an external substance, presenting as erythema, itching, and sometimes vesiculation or scaling at the site of contact. It is divided into two principal forms. Irritant contact dermatitis results from non-immunologic damage to the skin ba…
Contact dermatitis is an inflammatory skin reaction caused by direct exposure to an external substance, presenting as erythema, itching, and sometimes vesiculation or scaling at the site of contact. It is divided into two principal forms. Irritant contact dermatitis results from non-immunologic damage to the skin barrier by agents such as soaps, detergents, solvents, and repeated wet work, and can occur in anyone given sufficient exposure. Allergic contact dermatitis is a delayed, type IV cell-mediated hypersensitivity response in which prior sensitization to a specific allergen, such as metals, fragrances, preservatives, plant compounds, or hair dyes, leads to a T-cell-driven reaction on re-exposure. The two types may coexist, and occupational exposures are a frequent contributor. Diagnosis combines a detailed history of exposures with patch testing, in which suspected allergens are applied to the skin under occlusion and reactions are read over several days to identify the responsible agent. Differentiating allergic from irritant disease guides management, which centers on identifying and avoiding the offending substance, restoring the skin barrier, and using topical anti-inflammatory therapy during flares. Protective measures such as appropriate gloves can reduce exposure, though their effectiveness varies. Accurate allergen identification is essential for prevention and lasting control.
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