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Contact dermatitis defines inflammation of the skin that results from direct contact of a substance with the surface of the skin, which may or may not be related to an allergy.
A person develops contact dermatitis when something that touches the skin does one of the following:
Anyone can develop contact dermatitis. Your risk factor may be increased if you are in regular contact with an irritant or allergen, or if you already have allergies to certain substances, such as plants, chemicals, or medications. People working in certain professions have a higher risk. Sometimes this is referred to as occupational dermatitis.
People who are more likely to get occupational dermatitis include:
Signs and symptoms of contact dermatitis rarely appear on contact. It may take a few hours for your skin to react. If this is your first time that your skin has an allergic reaction to that substance, weeks may pass before you notice anything. However, some people do develop a severe allergic reaction known as anaphylaxis (an-uh-fuh-lax-sis). Symptoms occur within seconds or minutes. A person may have:
The entire body reacts during these events. If you have any of these symptoms, you need immediate medical care.
During normal contact dermatitis reactions, when signs and symptoms do appear, you may have:
If exposure to the allergen continues, your skin may:
To diagnose this common skin condition, dermatologists:
If your dermatologist suspects that you have an allergy, patch testing may be recommended. This offers patients a safe and effective way to find out if your skin has developed an allergic reaction to anything. A patch test includes applying patches to your skin that contain small amounts of possible substances which may be causing the allergy for a period of time. After this time, the patches are removed to inspect the skin for reactions.
Treatment is the same for both types of contact dermatitis.
The steps involved during treatment are:
By avoiding what caused the rash, most people can avoid flare-ups.
If you work with substances that caused the rash, you can still avoid a rash. Your dermatologist can recommend ways to work and products to use. More than 80% of people diagnosed with occupational dermatitis successfully manage the condition and recover without any problems.
Contact dermatitis is a condition in which the skin becomes red, sore, or inflamed after direct contact with a substance. There are two types of contact dermatitis: irritant or allergic.
Patch testing is a diagnostic test that may determine which allergen is causing the skin to become irritated.
Occupational dermatitis is a skin disorder caused by coming into contact with certain substances in the workplace. It is therefore termed contact dermatitis. Contact dermatitis is the most common work related disease in Ireland. It can have long term consequences for workers health and in extreme cases it can hinder their ability to continue working. Research has indicated that 10 years after the condition first occurs, up to 50% of affected workers will still have some skin problems.
It has financial implications in terms of ongoing medical treatment, absence from work, social welfare compensation and possible civil claims. It brings other costs in terms of pain and suffering to affected workers. In many instances it may be totally preventable by simple inexpensive measures.
There are 2 forms of contact dermatitis, irritant and allergic.
In contact irritant dermatitis the substance that damages the skin is known as the irritant. A highly irritant substance is known as a corrosive. Irritant dermatitis makes up about 80% of contact dermatitis. The other 20% is allergic.
There are several ways that skin damage can be caused:
Irritation is analogous to a chemical burn. It acts by eroding or burning the outer protective layers of the skin. Irritant contact dermatitis usually occurs only on the parts of the body in direct contact with the irritant substance e.g. hands, forearms, face.
Common irritants are wet work, cutting oils, solvents and degreasing agents which remove the skins outer oily barrier layer and allow easy penetration of hazardous substances, alkalis and acids (see Table 1). Wet cement coming into contact with exposed feet and hands is a particular example of a skin irritant.
In this case, the substance causes the worker to become sensitized or to develop an allergic reaction some time after initial contact. The type of allergic mechanism is known as Type IV or delayed hypersensitivity. People do not become allergic to a substance immediately at first contact. The sensitization period( the time between contact and the development of an allergy) can vary from a number of days to months or even years. The risk of becoming allergic depends on several factors:
Once the individual becomes sensitized, each time he/she comes into contact with the sensitizing substance, even in very small amounts, dermatitis will develop. This is different to irritant dermatitis which is dose related. The long term health consequences and ability to remain at work can be significant. In general the majority of an exposed occupational group do NOT become sensitized. It is an idiosyncratic or individual reaction.
Sensitization is specific to one substance or to a group of substances that are chemically similar. Once sensitized a person is likely to remain so for life. In allergic dermatitis the rash can occur in areas of the skin not in direct contact with the substance - the so called “Id” reaction.
Common sensitizers are chromate's (found in cement), nickel (cheap jewellery), epoxy resins, formaldehyde, wood dust, flour, printing plates, chemicals and adhesives.