Summary
Definition
History and exam
Key diagnostic factors
- occupational history of exposure
- history 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 history 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)
Investigations to consider
- skin biopsy
Emerging tests
- reflectance confocal microscopy (RCM)
Treatment algorithm
irritant contact dermatitis
allergic contact dermatitis (ACD)
contact dermatitis
Contributors
Authors
Gerard Guillet, MD
Professor of Dermatology
Department of Dermatology and Allergology
University Hospital Poitiers
Poitiers
France
Disclosures
GG declares that he has no competing interests.
Acknowledgements
Dr Gerard Guillet would like to gratefully acknowledge Dr David M. Ozog and Dr Snehal Desai, previous contributors to this topic.
Disclosures
DMO and SD declare that they have no competing interests.
Peer reviewers
Christen Mowad, MD
Assistant Professor
Department of Dermatology
Geisinger Medical Center
Danville
PA
Disclosures
CM declares that he has no competing interests.
John English, MBBS, FRCP
Consultant Dermatologist
Department of Dermatology
Queen's Medical Centre
Nottingham University Hospitals
Nottingham
UK
Disclosures
JE declares that he has no competing interests.
Differentials
- Atopic dermatitis
- Nummular eczema
- Dyshidrotic eczema
More DifferentialsGuidelines
- British Association of Dermatologists' guidelines for the management of contact dermatitis 2017
- European Society of Contact Dermatitis guideline for diagnostic patch testing – recommendations on best practice
More GuidelinesPatient leaflets
Dermatitis
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