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  Atopic eczema, irritant dermatitis and contact dermatitis


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.