Contact Dermatitis Flashcards
What is CD?
Inflammatory skin condition that results from contact with external substances
What are the 2 subcategories & describe?
- Irritant Contact Dermatitis (ICD) - occurs when skin undergoes mechanical or chemical trauma on exposure to an irritating substance ( ~ 80% of Contact Dermatitis cases)
- Allergic Contact Dermatitis (ACD) – occurs when skin is exposed to an allergen
What is CD characterized by?
inflammation, redness, itching, burning, stinging, scaling and vesicle and pustule formation on skin areas exposed
What is the difference b/t an acute and a chronic rxn?
- Acute reactions:
– “Red, edematous papules in early phase, which become vesicles and bullae that ooze if the reaction is severe enough” - Chronic reactions:
– “Primary lesions are minimal, and secondary changes such as dryness, lichenification, pigment changes, hyperkeratosis or thickening, excoriation and fissuring predominate.” - Itching primary symptom in both acute and chronic
What are the signs/sx’s of ICD?
Mild irritants produce irritation, redness, vesiculation and oozing while strong irritants produce blistering, erosions and ulcers
What are the signs/sx’s of ACD?
Mild form similar to irritant exposure. A typical allergic reaction consists of grouped or linear tense vesicles and blisters. Severe = edema, especially in face and periorbital and genital areas.
What are ex’s of Contact Allergens?
- Plants such as: poison ivy
- Latex
- Metals
- TopicalAntibiotics
- TopicalAntihistamines
- Preservatives such as parabens, methylisothiazolinone
- Lanolin
- Topical anesthetics
Poison Ivy
- Perennial
- Consists of 3 leaflets
- Edges may be smooth or toothed
- Leaves vary in size (8-55mm long)
- Reddish in spring
- Green in summer
- Orange/red in autumn
- Allergen = urushiol
What are risk factors?
- Gender
– Women more frequently exposed - Area on the body
– Different types of irritants – Metals and elastics - Seasonal
– More likely to occur in winter - Occupational
– Irritation through contact with chemicals – Exposure to foods and plants - UVlight
– Phototoxic reactions when taking medications
When to refer?
- Dermatitis spreads to distant sites or becomes generalized to more than 30% of BSA
- Acute and nonresponsive with a few days
- Edema persists or increases within a few days
- Chronic and nonresponsive within 7 to 10 days
- Interferes with quality of life
- Skin infection present
What is the non-pharm tx?
- Immediately wash with soap and water
- Avoid or remove the allergen (tips on reducing exposure)
- Take cold or tepid soapless showers and wash hands with cool water
- Avoid scrubbing affected area
- Remove and wash all clothing exposed to irritant/allergen
- Use wet compresses for acute weeping or oozing lesions
What is the tx?
- Identify and avoid irritant
- Wet compresses for 1 minute on, 1 minute off for 20 minutes 4 to 6 times per day
- Topical steroid may be used to treat symptoms on a short term basis (max 2 weeks). Acute symptoms should be improved within 7 to 10 days.
- Avoid topical anesthetics and topical antihistamines
What is the tx of Poison Ivy?
- Shower after exposure
- Wash all items that have been exposed to the oil-shoes jewelry, tools and clothing
- Wash clothing as soon as possible using oil free soap. (Sunlight is a good example)
- The initial rash can appear 7 to 10 days after exposure but with previous exposure may appear within 1 or 2 days
- To treat the itch and rash
– Application of a topical corticosteroid
What is the prevention of Poison Ivy?
- Total avoidance to plant – easier said than done
- Wear protective clothing that can be removed if
exposed to the oil/plant - Wash objects that have come into contact with
the plant
– Use gloves to handle exposed objects - Wash skin within 2 hours of exposure (the sooner the better)
- Do not burn the plant!
