Clinical Aspects of Irritant Contact Dermatitis

Abstract

Irritant contact dermatitis (ICD) is more common than allergic contact dermatitis (ACD). It ranges from acute irritant reactions to chronic forms, often morphologically indistinguishable from ACD. Numerous exogenous and endogenous factors are involved in the pathogenesis of ICD. Major irritants are water, detergents, and acidic and alkaline substances of various natures. Mechanical, thermal, and climatic influences are important contributory or sometimes even causative factors. In particular chronic ICD is a diagnostic challenge and may be complicated by secondary sensitization to environmental allergens. Therapy and prevention require identification of irritants followed by elimination or reduction of skin contact, e.g., by personal protective equipment, organizational, or technical measures. Some topical medications and skin care products may cause subjective discomfort (“stinging”) without clinical signs of irritation. This is considered to be a special form of neurosensory irritation.