Allergic contact dermatitis: Description, Causes and Risk Factors:Abbreviation: ACD.A delayed type IV allergic reaction of the skin with varying degrees of erythema, edema, and vesiculation resulting from cutaneous contact with a specific allergen.The skin is the largest organ of the body. Its top layer is the epidermis, which provides protection against the environment. The second layer of the skin is the dermis, which supplies blood, oxygen, strength and support. Underneath the dermis is the hypodermis, or subcutaneous fat layer, which provides an ongoing blood supply to the dermis.Contact dermatitis occurs when the skin reacts to direct contact with a triggering substance. There are two main types of contact dermatitis: allergic and irritant.Allergic contact dermatitis indicates an overreaction of the body's immune system to a normally harmless substance.Common causes of allergic contact dermatitis may include:Plants such as poison ivy, poison oak, ragweed and primrose.
Metals such as nickel, which is used in many items including jewelry, belt buckles and kitchen utensils.
Fragrances and preservatives found in cosmetics, soap, lotions, perfumes, deodorants, scented tissues and hair dyes, straighteners and removers.
Nail polish, nail polish remover and other nail care products.
Latex rubber, which is used in many items including waistbands, bras, sneakers and shoe soles, rubber gloves, bandages, balloons and hot water bottles.
Tanning agents used for leather products.
Certain medications such as antihistamine and antibiotic skin creams.
Common causes of irritant contact dermatitis may include:Detergents (washing-up liquid, soaps, bleach, etc). People who do a lot of cleaning are prone to irritant contact dermatitis.
Solvents such as petrol.
Oils and other chemicals used in various places of work.
Acids and alkalis, including cement.
Powders, dust, and soil.
Certain plants (for example, ranunculus, anemone, clematis, helleborus, mustards).
Certain workers are at greater risk of developing dermatitis. They include healthcare workers, hairdressers, beauticians, printers, those in cleaning, catering and construction and workers using metalworking fluids. But remember, dermatitis can occur in just about any workplace.Symptoms:The primary symptom of contact dermatitis isitching. Other signs and symptoms usually includesome combination of cracking and dryness of theskin, redness, inflammation, swelling, and blisterformation with weeping.Diagnosis:Physical examination and history-taking frequentlysuggest aetiological factor(s), although patch orepicutaneous testing is the universally acceptedmethod for the detection of causative agents.Patch testing: Patch testing helps to find the cause of allergic contact dermatitis. You need to be referred to a dermatologist. They will place on your skin a small amount of various substances that may be causing the rash. This is usually done on the skin on your back in sets of 10 with an adhesive dressing.After two days the dressing is removed and the skin is examined to see if there is a reaction to any of the tested substances. The skin is also usually examined again after a further two days in case you have a delayed reaction to any substance.If no skin reaction occurs on patch testing then this can also be helpful to rule out allergic contact dermatitis as a cause of your skin problem.Other tests may be used to rule out other possible causes, including skin lesion biopsy or culture of the skin lesionTreatment:Contact dermatitis can be treated in a variety of ways, but treatment is generally not effective until there is no further contact with the triggering substance. Then it may take up to 4 weeks for the irritated area to return to normal.The following treatment options may include:Soothing Therapies - Cool cloth or gauze compresses soaked in water or aluminum acetate (Burow's solution) can be applied for up to an hour several times a day to help ease the symptoms of contact dermatitis. Other soothing therapy choices include calamine lotion (not containing diphenhydramine) and cool tub baths with added bath oil or colloidal oatmeal.Oral Antihistamines - Over-the-counter (OTC) or prescription oral antihistamines may be recommended to help relieve itching. Antihistamine creams, however, are not recommended for treating contact dermatitis.Corticosteroids - An OTC hydrocortisone or prescription-strength corticosteroid cream may be used to treat contact dermatitis. For severe cases, an oral corticosteroid pill or corticosteroid injection may be prescribed.Antibiotics - When an infection develops at the site of contact dermatitis, antibiotics may be prescribed to treat the infection. In addition, the liberal use of emollient moisturizers is recommended to protect the skin as it recovers from a bout of contact dermatitis.Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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