Last reviewed: 8 Feb 2021
Last updated: 14 May 2019
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)
Treatment algorithm
Contributors
Authors
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.
Disclosures
DMO and SD declare that they have no competing interests.
Peer reviewers
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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