Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • occupational hx of exposure
  • hx of atopic dermatitis
  • previous episodes of similar dermatitis
  • acute onset
  • affecting hands and face
  • affecting sun-exposed skin
  • sparing of non-exposed areas of skin
  • pruritus
  • burning
  • erythema
  • vesicles and bullae
  • urticaria
  • lichenoid lesions
  • corrosion or ulceration
  • pustules and acneiform lesions

Other diagnostic factors

  • social hx of exposure
  • persistence of symptoms
  • scaling
  • lichenification
  • crusting
  • erythema multiforme
  • cellulitic lesions
  • leukoderma
  • hypopigmentation
  • hyperpigmentation
  • purpura
  • miliaria
  • alopecia
  • granulomatous lesions

Risk factors

  • occupation with frequent exposure to water or caustic material
  • atopic dermatitis

Diagnostic investigations

1st investigations to order

  • patch testing
  • repeated open application test (ROAT) or provocative use test (PUT)
Full details

Emerging tests

  • reflectance confocal microscopy (RCM)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Dermatology

Department of Dermatology and Allergology

University Hospital Poitiers

Poitiers

France

Disclosures

GG declares that he has no competing interests.

Dr Gerard Guillet would like to gratefully acknowledge Dr David M. Ozog and Dr Snehal Desai, previous contributors to this topic. DMO and SD declare that they have no competing interests.

Peer reviewers VIEW ALL

Assistant Professor

Department of Dermatology

Geisinger Medical Center

Danville

PA

Disclosures

CM declares that he has no competing interests.

Consultant Dermatologist

Department of Dermatology

Queen's Medical Centre

Nottingham University Hospitals

Nottingham

UK

Disclosures

JE declares that he has no competing interests.

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