Irritant Contact Dermatitis is a major cause of public health concern since
it accounts for a large number of workplace related skin diseases. It has
been discussed under the following headings:
What is irritant contact dermatitis?
Irritant contact dermatitis (ICD) is an inflammatory skin disease that
is triggered by irritants agents in our surroundings and is free of
any immunological dysfunction. It is one of the two forms of contact
dermatitis, the other being allergic contact dermatitis (ACD), which
is an immunological reaction.
Irritant contact dermatitis occurs as direct skin sensitivity when
it is exposed to an irritant element and it is also generally confined
to specific body locations like the hands, neck, feet etc. In fact,
rough statistics point out that irritant contact dermatitis incurs a
yearly expenditure of up to $1 billion in the US, which includes medical
costs, employee compensation and work time loss.
Occupational irritant dermatitis (OID) became a medical concern after
the industrial revolution that led to the development of industrial
and domestic substances and chemicals. Germany and France were the first
to implement workers reimbursement for occupational skin diseases. Irritant
contact dermatitis accounts for an approximate 70% to 80% of all occupational
skin hazards. The US Bureau of Labor Statistics (BLS) says that patients
with industrial skin hazards constituted a regular 30% to 45% of all
occupational diseases though the 1970s to mid 1980s. Currently, skin
diseases constitute only 10% to 15% of all industrial hazards. Its worldwide
occurrence also shows similar statistics.
This article also includes information about its prevalence, clinical
characteristics, major irritants around us, a differential diagnosis
(with special emphasis on ACD and irritant contact dermatitis) and a
short paragraph on treatment methods.
Clinical and pathological presentation of irritant contact dermatitis
The write-up on the clinical and pathological presentation of irritant
contact dermatitis deals with its symptoms, indications and factors
that have a bearing on its form, pattern and characteristics. This apart
the common clinical features are discussed separately for irritant contact
dermatitis caused by highly potent strong or pure irritants (acids,
alkalis, oxidants) and chronic irritant contact dermatitis from frequent
contact with inferior or secondary irritants (soaps, solvents, cleansers).
Variations in clinical features have also been discussed according to
the different types of irritant contact dermatitis. The pathological
traits of irritant contact dermatitis are categorized according to the
various types of substances that cause irritant contact dermatitis.
Different types of irritant contact dermatitis
The different types of irritant contact dermatitis are further elucidated
in a separate article on the topic. The major forms discussed are include
acute irritant contact dermatitis, acute delayed irritant contact dermatitis,
irritant reaction irritant contact dermatitis, cumulative irritant contact
dermatitis, asteatotic dermatitis, traumatic irritant contact dermatitis,
pustular and acneiform irritant contact dermatitis, non-erythematous
irritant contact dermatitis and subjective or sensory irritant contact
dermatitis. For a correct prognosis, it is necessary not only to differentiate
between ACD and irritant contact dermatitis, but also to know about
the clinical features of different types of irritant contact dermatitis
in comparison to each other. Each type of irritant contact dermatitis
has been distinguished in the article on the topic according to their
specific clinical features and irritant agents.
Common causes of irritant contact dermatitis
The various substances that may trigger irritation in our skin has
been listed and detailed in this section of the website. The most common
offenders are skin-corroding acids both inorganic and organic, alkalis
or bases, metal salts, solvents, disinfectants, alcohols, plastics,
food, fabrics and plants. Workplace related causes have also been discussed
with a list of various occupations and offenders in the associated environment.
Workers who form the high-risk category are caterers, furniture makers,
hospital staff, hairdressers, chemical industry staff, dry cleaners,
metalworkers, florists and warehouse workers.
Treatment of irritant contact dermatitis
This section of the website also consists of the very important issue
of treatment of irritant contact dermatitis. The primary therapeutic
approach is the prevention and avoidance of exposure to the offending
agents. Various ways of prevention have been categorized according to
avoidance of causative substances at home and at the workplace separately.
Only when avoidance fails, the secondary line of therapy, involving
the treatment of symptoms, become an option. The secondary means of
irritant contact dermatitis cure is medication with corticosteroids
and phototherapy method including photochemotherapy (PUVA) and superficial
radiation (Grenz ray). The current trend in treatment is the use of
biologic agents with anti-inflammatory and non-steroidal action. They
have become popular due to their non-steroidal activities, which have
the effect of reducing side effects caused by steroids.