Management of Contact dermatitis
Acute contact (exogenous) dermatitis can be either irritant or allergic.
Features:
• itchy, infl amed skin
• red and swollen
• papulovesicular
Causes Irritant contact dermatitis: caused by primary irritants (e.g. acids,
alkalis, detergents, soaps).
Allergic contact dermatitis (~80%): caused by allergens that provoke
an allergic reaction in some individuals only, most people can handle the
chemicals without undue effect. This allergic group also includes photocontact
allergens. 4–5% of population is allergic to nickel.
Common allergens
• Ingredients (fragrances) in cosmetics (e.g. perfumes, preservatives)
• Topical antibiotics (e.g. neomycin)
• Topical anaesthetics (e.g. benzocaine)
• Topical antihistamines
• Plants (skin of mango cross-reacts with these): rhus, grevillea,
primula, poison ivy
• Metal salts (e.g. nickel sulphate, chromate)
• Dyes esp. clothing dyes
• Hairdressing chemicals
• Glutaraldehyde (e.g. sterilising agent)
• Rubber/latex
• Resins
• Toluene sulfonamide compound resin (e.g. nail polish)
• Coral
Management
• Determine cause with vigour and remove it
• If acute with blistering, apply Burow’s compresses
• Wash with water (only) and pat dry (avoid soap)
• Oral prednisolone for severe cases: 25–50 mg/d for 1–2 wks, then
reduce gradually over 1–2 wks
• Topical corticosteroid cream
• Oral antihistamines
For chronic phase use fragrance-free moisturisers regularly, e.g. glycerol
10% in sorbolene cream.
Acute contact (exogenous) dermatitis can be either irritant or allergic.
Features:
• itchy, infl amed skin
• red and swollen
• papulovesicular
Causes Irritant contact dermatitis: caused by primary irritants (e.g. acids,
alkalis, detergents, soaps).
Allergic contact dermatitis (~80%): caused by allergens that provoke
an allergic reaction in some individuals only, most people can handle the
chemicals without undue effect. This allergic group also includes photocontact
allergens. 4–5% of population is allergic to nickel.
Common allergens
• Ingredients (fragrances) in cosmetics (e.g. perfumes, preservatives)
• Topical antibiotics (e.g. neomycin)
• Topical anaesthetics (e.g. benzocaine)
• Topical antihistamines
• Plants (skin of mango cross-reacts with these): rhus, grevillea,
primula, poison ivy
• Metal salts (e.g. nickel sulphate, chromate)
• Dyes esp. clothing dyes
• Hairdressing chemicals
• Glutaraldehyde (e.g. sterilising agent)
• Rubber/latex
• Resins
• Toluene sulfonamide compound resin (e.g. nail polish)
• Coral
Management
• Determine cause with vigour and remove it
• If acute with blistering, apply Burow’s compresses
• Wash with water (only) and pat dry (avoid soap)
• Oral prednisolone for severe cases: 25–50 mg/d for 1–2 wks, then
reduce gradually over 1–2 wks
• Topical corticosteroid cream
• Oral antihistamines
For chronic phase use fragrance-free moisturisers regularly, e.g. glycerol
10% in sorbolene cream.