Irritant Contact Dermatitis

1. Epidemiology

1.1. Contact dermatitis results from the exposure of the skin to a substance that invokes an inflammatory response: Auto sensitization occurs

2. Pathophysiology

2.1. Severity of inflammation is related to the concentration, length of exposure, and disruption of the skin barrier

3. Risk Factors

3.1. Exposure to any substance can cause a cutaneous reaction, dependent upon concentration, duration of contact and the condition of the skin contacted

4. Clinical Presentation

4.1. Acute Presentation: 80% of cases, occurs rapidly after exposure (minutes) sharp margins, fissures, chapping, occasional pustules, erythema, burns

5. Diagnosis

5.1. Careful History to include potential exposure at home, work, hobbies and the development of the rash

5.2. Physical examination

6. Adaptive Response

6.1. T-cell mediated response that is the result of chemically modified skin proteins. The irritant covalently bonds to carrier proteins

6.2. Langerhans cells process antigen and present to T-cells that release inflammatory cytokines that cause the symptoms

7. Clinical Manifestations

7.1. Erythemaotus papules, papulovesicles, vesicles, bullae, ofen in linear pattern or shape of exposed contact item. Eruption may not occur for 24 to 48 hours post-exposure