Contact dermatitis due to irritation

Abstract

Irritant contact dermatitis (ICD) denotes inflammation of the skin which results from a contact with external agent and does not require prior sensitization of the immune system. Irritant contact dermatitis is the most frequent cause for occupational contact dermatitis. The clinical features are quite diverse and there are ten clinical types described: acute; acute delayed; irritant reaction; cumulative; traumiterative; exsiccation eczematid; traumatic; pustular and acneiform; nonerythematous; subjective. Distinction from allergic contact dermatitis (ACD) usually relies on time course (quicker onset in irritation), subjective symptoms (itch in ACD vs burning or pain in ICD), and morphology (spread outside the contact area, more infiltration and vesiculation in ACD). However, distinction may be clinically very difficult or impossible; histology, pathogenesis, and therapy are also very similar. Atopic skin predisposition is the best established risk factor for irritant contact dermatitis; respiratory manifestations of atopy are less predictive than skin manifestations. Prevention, early recognition, and therapy are decisive in averting chronic and persistent forms.